内外科护理：心血管与呼吸练习卷（附答案）

Where is the apex beat normally felt in an adult?

1. AThe second intercostal space to the right of the sternum
2. BOver the middle of the breastbone
3. CJust below the right nipple
4. DThe fifth intercostal space in the left mid-clavicular line

What does the term "preload" describe?

1. AThe stretch of the ventricle at the end of filling
2. BThe amount of blood left in the atria after systole
3. CThe force of contraction regardless of filling
4. DThe resistance the ventricle pumps against

What is the main cause of varicose veins?

1. AA clot blocking a deep vein in the calf
2. BNarrowing of the leg arteries by plaque
3. CInflammation of the lymph nodes in the groin
4. DFaulty valves in the superficial leg veins

The telemetry monitor suddenly shows a chaotic waveform resembling ventricular fibrillation, but the patient is talking and brushing their teeth. What should the nurse do first?

1. AStart chest compressions straight away and call the arrest team
2. BGive IV amiodarone as a bolus
3. CCheck the patient and the electrodes, as this is likely artefact
4. DDeliver an immediate defibrillation shock before checking anything

A patient with chest pain has a first troponin result within the normal range one hour after the pain started. Why is a repeat test arranged?

1. AThe repeat test is only needed for patients over 80
2. BThe first sample is always contaminated
3. CTroponin may take a few hours to rise after muscle damage
4. DTroponin falls during an MI, so a lower value confirms it

A patient taking simvastatin drinks a large glass of grapefruit juice every morning. Why is this a concern?

1. AIt turns the statin into a blood thinner
2. BIt causes the cholesterol level to rise sharply
3. CIt stops the statin from being absorbed from the gut at all
4. DIt raises statin levels and the risk of muscle damage

A patient with life-threatening asthma has not responded to repeated nebulised salbutamol (albuterol), ipratropium and steroids. Which drug is commonly given intravenously next?

1. AMagnesium sulfate
2. BIntravenous furosemide
3. CMetoprolol
4. DMorphine

On day 2 after a surgical tracheostomy, the tube falls out. The patient is breathing but distressed. What should the nurse do first?

1. ACover the stoma completely with a sealed dressing and wait for help
2. BCall for expert help and give oxygen to both the face and the stoma
3. CForce the tube back through the stoma immediately with firm pressure
4. DLeave the patient alone while fetching a new tube