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国际护士模拟试题及答案
1. A patient is receiving Total Parenteral Nuttion(TPN)secondary to acute pancreatitis. The nurse is about to administer insulin when the patient states. "Why am I getting insulin? I'm not diabetic.”Which of the following responses would be the most appropriate?
A.The infection in your pancreas is causing too much insulin to be produced.”
B. "This type of infection stops the production of insulin.”
C.The TPN solution contains a high amount of glucose.”
D. "The TPN solution interferes with the production of insulin.”
2. When developing a teaching plan for a patient who is prescribed a sulfonylurea, the nurse should instruct the patient to avoid which of the following substances?
A. Green vegetables.
B. Alcohol.
C. Beef products.
D. Caffeine.
3. Which of the following nursing diagnoses should the mental health nurse address first in a patient with major depression?
A. Severe anxiety.
B. Risk for self-directed violence.
C. Self-care deficit.
D. Ineffective coping.
4. Which of the following laboratory values would the nurse expect to be elevated in a patient with parasitic infection who recently immigrate to the United States?
A. White blood cell count.
B. Reticulocyte count.
C. Eosinophils count.
D. Sedimentation rate.
5. The charge nurse on a unit should be aware that which of the following patients may not legally sign an informed consent?
A. A 55-year-old patient who is crying about the surgery she will be undergoing.
B. A 16-year-old married patient.
C. A 45-year-old patient who has been sedated.
D. An 80-year-old patient.
【参考答案及解析】
1. Key: C
Client Need: Pharmacological and Parenteral Therapies
C. TPN is used to maintain nutritional status and prevent malnutrition when the patient is unable to be fed orally or by tube feeding. Glucose is used to supply energy and caloric needs and usually accounts for 50% to 70% of the nutrient prescription.
A. In pancreatitis. 50% of the patients have a transient hyperglycemia due to damage to the beta cells.If the pancreas were producing too much insulin, the patient would experience hypoglycemia. Giving additional insulin would not be the correct intervention.
B. Fifty percent of patients with pancreatitis have interference with insulin release from the beta cells,which may cause hyperglycemia. Not all patients exhibit hyperglycemia.
D. TPN does not interfere with the production of insulin. The goal of therapy is to reduce the secretion of pancreatic enzymes, which stops the inflammatory process. The use of TPN meets the patient's nutritional needs while the patient is taking nothing by mouth (NPO).
2. Key: B
Client Need, Pharmacological and Parenteral Therapies
B. Sutfonylurea medications are oral anti-diabetic agents used to control blood sugar in type 2 diabetes mellitus. The ingestion of alcohol when these medications are used may result in a disulfiram-like(Antabase-like) reaction (abdominal cramps, nausea, flushing, headaches and hyperglycemia).
A. Dietary management is an essential part of diabetes management. Dietary guidelines suggest a daily intake of three to five servings of fruits and vegetables, including green vegetables.
C. Diabetics have the same protein requirements as non-diabetic individuals. Approximately 10-20% of total daily calories should be from protein.
D. Caffeine is not contraindicated with sulfonylurea medications.
3. Key: B
Client Need: Management of Care
B. During the initial assessment, the highest priority is to identify the presence of suicidal risk. Patients with major depression often experience persistent thoughts of death or suicide; therefore, potential for self-harm is a priority concern and protecting the patient from self-directed violence is the most important nursing action.
A. Anxiety is a common symptom of depression and can range from mild to severe. Tension-relieving activities such as pacing,nail biting and finger tapping convey psychomotor agitation or severe anxiety in the patient with a major depression. Treating anxiety is important but not the most important priority on admission.
C. Grooming and hygiene are usually neglected by the depressed patient and may necessitate nursing action. Promoting self-activities is important but is not a priority initially.
D. Teaching adaptive coping methods is a nursing action that is implemented during the course of treatment but cannot be initiated until the patient's readiness to learn has been determined.
4. Key:C
Client Need, Reduction of Risk Potential
C. Eosinophils are a type of white blood cell that is involved in allergic reactions. They do not respond to bacterial and viral infections. Parasitic infections can stimulate the production of these cells.
A. This test would not be specific for a parasitic infection. An increase in the total white blood count(WBC) count is usually seen in infection. inflammation. tissue necrosis or leukemic neoplasm.
B. An increase in the reticulocyte count is an indication of the bone marrow's ability to respond to anemia.
D. The sedimentation rate is a non-specific test used to detect inflammation associated with acute and chronic infection. inflammation, advanced neoplasm, tissue necrosis and infarction.
5. Key: C
Client Need: Management of Care
C. This patient may not sign his consent at this lime. Adults may sign their own operative permits unless they are unconscious or mentally incompetent. The consent must be signed before the patient receives any medication that may alter consciousness.
A. Crying behavior does not make the patient unconscious or mentally incompetent. The patient may sign the consent. The nurse. however. should explore the patient's feelings and offer emotional support.
B. Emancipated minors may legally sign their own consent forms. Emancipated minors are considered to be under the legal age (18) of emancipation but, because of marriage or other circumstances, are independent of parents.
D. An 80-year-old may sign a consent form. The age of 80 does not make a person incompetent.
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