A patient with anorexia nervosa is admitted. Which finding is the priority?
AHas fine, downy hair on her arms
BHeart rate 38/min and potassium 2.8 mEq/L
CRefuses to eat in front of other people
DSays she feels fat although she is very thin
15.感染控制与患者安全中等
A patient is on suicide precautions. Which room safety measure is appropriate?
ARemove items that could be used for self-harm, such as belts and cords
BLet the patient keep a personal razor for shaving, as long as staff are told
CKeep the door closed at all times so the patient has privacy
DAllow glass bottles if the patient seems calm
16.感染控制与患者安全困难
A patient on airborne precautions for tuberculosis wants to walk in the hallway. What is the best response?
AAllow it, if they avoid the nurses’ station
BExplain that they must stay in the room, and offer ways to stay active inside it
CAllow it, as long as the patient wears an N95 respirator in the corridor
DAllow it, as long as they walk quickly
17.实验室检查值与电解质中等
Why must a blue-top (citrate) coagulation tube be filled to the correct level?
AThe laboratory charges extra when a tube is not filled correctly
BThe blood-to-anticoagulant ratio must be right for accurate clotting times
CUnderfilled tubes always give a falsely low hemoglobin and hematocrit
DAn overfull tube is needed to measure the potassium level
18.实验室检查值与电解质困难
A patient has a positive hepatitis C antibody (anti-HCV) test. What is the most appropriate next step?
AGive hepatitis C vaccine to prevent further infection
BRepeat the antibody test, as a positive test is always false
CTest for HCV RNA to find out whether infection is current
DTell the patient they definitely have chronic hepatitis C
3溶液
1.护理学基础
答案: C · Hold their breath for about 10 seconds
为什么是这个答案
The patient breathes out, seals the lips round the mouthpiece, presses as they start a slow deep breath in, then holds the breath for about 10 seconds or as long as is comfortable.
答案
C · Hold their breath for about 10 seconds
2.护理学基础
答案: B · Not start CPR, note the time, inform the team and support the family
为什么是这个答案
CPR is not attempted when a valid DNACPR decision applies. The nurse notes the time, follows local policy for verifying death, informs the medical team and supports the family.
答案
B · Not start CPR, note the time, inform the team and support the family
3.临床护理
答案: B · 急性肺水肿
为什么是这个答案
急性肺水肿引起严重气短、湿啰音和泡沫痰。让患者坐起,给氧,并紧急呼叫医生;通常会使用利尿剂。
答案
B · 急性肺水肿
4.临床护理
答案: C · Diabetes insipidus
为什么是这个答案
Cranial diabetes insipidus is a lack of ADH, so the kidneys cannot concentrate urine. Water loss raises sodium; strict fluid balance and replacement are needed.
QT 与 QTc:QT 间期从 QRS 波群起点到 T 波终点。它随心率加快而缩短,因此要用以秒为单位的 R–R 间期按心率校正:Bazett QTc = QT/√RR,Fridericia QTc = QT/∛RR。多数教科书使用 Bazett 公式;它在心率快时校正过度,此时宜用 Fridericia。各参考标准的界限不同:QTc 男性高于约 0.45 s、女性高于约 0.46 s 通常称为延长,高于 0.50 s 称为明显延长。
测量
从 QRS 起点到 T 波终点共 8.5 个小格
转换
QT = 8.5 × 0.04 s = 0.34 s
答案
QT = 0.34 s
粗略的规则:在正常心率下,QT 应小于 R–R 间期的一半(此处 R–R = 0.84 s)。
12.心电图节律条带解读
答案: 心室率 = 48 bpm
房室传导阻滞:逐个标出 P 波,检查哪些 P 波后面跟着 QRS。一度:每个 P 波都下传,PR 恒定且大于 0.20 s。二度 I 型(Mobitz I,文氏现象):PR 逐搏延长,直到一个 P 波未下传,然后周期重新开始(成组搏动)。二度 II 型(Mobitz II):下传搏动的 PR 保持恒定,P 波突然不下传;QRS 常增宽。三度(完全性)阻滞:P 波和 QRS 波群各自规则但互相独立,PR 随机变化,心房率快于逸搏率(交界性逸搏 40–60 次/分,QRS 窄;室性逸搏 20–40 次/分,QRS 宽)。2:1 阻滞仅凭一份条带无法判断是 I 型还是 II 型。
D · 一名 COPD 患者,吸氧 1 L/min,SpO₂ 90%(目标 88–92%),能说完整的句子
14.优先排序与委派
答案: B · Heart rate 38/min and potassium 2.8 mEq/L
为什么是这个答案
Severe bradycardia and low potassium can cause fatal arrhythmias. The body-image beliefs and eating behaviors matter, but physiological safety comes first.
答案
B · Heart rate 38/min and potassium 2.8 mEq/L
15.感染控制与患者安全
答案: A · Remove items that could be used for self-harm, such as belts and cords
为什么是这个答案
Patients at risk of suicide need a safe environment, with belts, cords, sharp objects and glass removed, and observation at the level ordered. Privacy is secondary to safety in this situation.
答案
A · Remove items that could be used for self-harm, such as belts and cords
16.感染控制与患者安全
答案: B · Explain that they must stay in the room, and offer ways to stay active inside it
为什么是这个答案
Patients on airborne precautions stay in the negative-pressure room with the door closed, leaving only for essential tests while wearing a surgical mask. The nurse explains why and helps the patient cope with confinement.
答案
B · Explain that they must stay in the room, and offer ways to stay active inside it
17.实验室检查值与电解质
答案: B · The blood-to-anticoagulant ratio must be right for accurate clotting times
为什么是这个答案
Citrate tubes contain a set volume of anticoagulant. If the tube is underfilled, the extra citrate falsely prolongs the PT and aPTT, so the laboratory may reject the sample.
答案
B · The blood-to-anticoagulant ratio must be right for accurate clotting times
18.实验室检查值与电解质
答案: C · Test for HCV RNA to find out whether infection is current
为什么是这个答案
Anti-HCV shows exposure, but some people clear the virus and keep antibodies. An HCV RNA test shows whether the infection is current. There is no vaccine for hepatitis C, but antiviral treatment can cure most infections.核对依据:Hepatitis C · MedlinePlus (NIH) (2025)
答案
C · Test for HCV RNA to find out whether infection is current