- 临床护理实用医学英语：评估、分析、计划、实施与评价
- 万艳 姜立
- 2985字
- 2020-12-01 14:39:47
Unit One
Directions: In this unit, there are ten pieces of information about different patients. This “situation” or “case study” is found between two lines. Several questions will be asked about the patient information given to you in the situation. After each question, you will be given four possible answers.Only ONE answer is right. Choose the ONE answer you think is right.
Margaret Dunneden is a 40-year-old businesswoman who was admitted to the psychiatric unit 2 days ago with severe depression.
Words and Expressions
psychiatric adj. 精神病学的
therapeutic adl. 治疗的；治疗学的
depression n. 抑郁
1．Mrs. Dunneden says to the nurse, “I'm terrible. I don't deserve to live.” Which of the following responses by the nurse would be the most appropriate？
A. “Yes, it has occurred to us that you have that opinion of yourself.”
B. “If you continue to talk this way, I can't listen to you any more.”
C. “What has led you to think that you don't deserve to live?”
D. “I don't think you're terrible. Don't you think you're liked here?”
2．When the nurse tells Mrs. Dunneden that he will be meeting with her for regular interviews, she says, “Why would you want to do that?” What would be the therapeutic response？
A. “I think you're worth the time and effort.”
B. “I have been assigned as your therapist.”
C. “You need to talk about your feelings.”
D. “You can't get better without help.”
3．One day, the nurse notices Mrs. Dunneden sitting alone in the television lounge; and although the TV is on, she is not watching it. Which of the following would be the most therapeutic way to open a conversation with her？
A. “How are you feeling?”
B. “Do you like TV?”
C. “Tell me how you are doing today.”
D. “You're not watching TV.”
4．Which of the following statements about suicide is accurate？
A. Suicide is the leading cause of death in this country among all age groups and among adolescents.
B. Depressed persons attempt suicide as an expression of anger.
C. Hospitalized persons rarely attempt suicide.
D. A person who talks about suicide will not attempt it.
Alda Clark is a 75-year-old widow, who maintains her own residence. While cleaning the snow off her walk, she slipped and fell.
Words and Expressions
widow n. 寡妇
fracture n. 骨折
manifestation n. 表示，显示
osteoarthritis n. 骨关节炎
urinary retention n. 尿潴留
diplopia n. 复视
tinnitus n. 耳鸣
5．The nurse notices Mrs. Clark is unable to move her left leg. The nurse's first priority is to________ .
A. extend her leg into a normal position
B. try and reduce the fracture
C. elevate the extremity
D. treat her as if a fracture had occurred
6．The nurse suspects that Mrs. Clark fractured her left hip because of which of the following manifestations？
A. Edema around the site.
B. Internal rotation of the left hip.
C. Abduction of the left hip.
D. Shortened right leg.
7．Mrs. Clark has bad osteoarthritis for years. She takes aspirin 600mg q4h to relieve the pain. Which of the following signs indicates side effects of aspirin？
A. Urinary retention.
B. Bradycardia.
C. Tinnitus.
D. Diplopia.
Thirteen-year-old Darren has hemophilia, and has recently been diagnosed with acquired immune deficiency syndrome（AIDS）resulting from contaminated blood products. Darren is currently free from infectious disease.
Words and Expressions
hemophilia n．血友病
contaminate vt．污染，弄脏
hemarthrosis n．关节积血；关节血肿
immobilize vt．使固定，使不动
8．Darren has been hospitalized for hemarthrosis of his left elbow. He is complaining of severe elbow pain. In addition to placing Darren on bedrest, the nurse should________.
A. apply a heating pad to Darren's left elbow
B. give Darren aspirin po
C. gently perform passive range-of-motion exercises to Darren's left elbow
D. elevate and immobilize Darren's left elbow in a flexed position
9．The nurse plans to obtain a nursing history from Darren and his mother. No direct body contact with Darren will be necessary during this time. Since Darren has AIDS, which precautions should the nurse take？
A. Wear a mask only.
B. Put on a mask and gown.
C. Wear a mask, gown, and gloves.
D. No special precautions are needed.
Two-month-old Evan Martin was born with a unilateral complete cleft lip, and is 12 hours post-op surgical repair of the lip. His mother is staying in his hospital room.
Words and Expressions
nasogastric gavage n. 鼻饲法
diphenhydramine n. 盐酸苯海拉明
elixir n. 万应灵药
syringe n. 注射器
unilateral adj. 单边的
10．Evan is acting fussy and starts to cry softly. The nurse should________ .
A. encourage Evan's mother to hold and rock him
B. give Evan his pacifier and rub his back
C. sedate Evan with diphenhydramine hydrochloride（Benadry I）elixir 2.5mg
D. allow Evan to cry to facilitate lung inflation
11．Evan's oral feedings of 4 to 6 ounces of infant every 4 to 5 hour are to be resumed. What method should the nurse teach Mrs. Martin to feed Evan？
A. A bottle with a soft nipple.
B. A small paper cup.
C. A syringe with catheter tubing.
D. Nasogastric gavage.
12．While feeding Evan, Mrs. Martin asks the nurse, “Why do you think this happened to Evan?” The nurse should reply________
A. “Cleft lip probably occurrences in your family.”
B. “Sometimes it's hard to know why these things happen.”
C. “Did you have any infections or take any drugs while you were pregnant?”
D. “What thoughts do you have about why it happened?”
Oscar Brown, age 37, has had a cough and fatigue for several weeks. A sputum culture is positive for Mycobacterium tuberculosis.
Words and Expressions
mycobacterium tuberculosis n. 结核杆菌
pulmonary adj. 肺的
tertiary adj. 第三期的；处于第三阶段的
tuberculin n. 结核菌素
13．Which of the following best prevents the transfer of the tuberculosis organism？
A. Having Mr. Brown cover his nose and mouth with double-ply tissue when he coughs or sneeze.
B. Instructing Mr. Brown's family in effective hand washing.
C. Having Mr. Brown's laundry disinfected after use.
D. Having Mr. Brown's dishes sterilized after use.
14．Mr. Brown and his family ask many questions when first told about his diagnosis, e.g., “How did this happen?” “What can we do? What will happen?” Which of the following might be the best response of the nurse？
A. “Mr. Brown probably contracted tuberculosis from another person with tuberculosis.”
B. “Mr. Brown will be given medication and treated at home.”
C. “You need not be concerned; tuberculosis is curable.”
D. “You seem very worried about the tuberculosis. What concerns you most?”
15．The definitive test for the diagnosis of tuberculosis is________ .
A. A positive PPD skin
B. A positive sputum culture
C. Abnormal finding's on chest x-ray
D. Abnormal results of a pulmonary function test
16．Screening a population for tuberculosis with tuberculin skin testing is an example of________.
A. Primary health promotion
B. Secondary health promotion
C. Tertiary health promotion
D. Primary prevention
Three-year-old Nicole Lyon's mother brings her to the emergency room because Nicole ate “half a bottle of my acetaminophen tablets 15 minutes ago.”
Words and Expressions
antidote n. 解毒剂，解药
syrup of ipecac n. 吐根糖浆
charcoal n. 活性炭
pediatric adj. 小儿科的
hemoglobin and hematocrit 血红蛋白和红细胞压积
serum transaminase n. 血清转氨酶
N-acetylcysteine n. N-乙酰半胱氨酸
acetaminophen n. 对乙酰氨基酚
17．The nurse ascertains that the bottle originally contained 100 tablets. What should be the first action of the nurse？
A. Have Nicole drink an 8-oz glass of milk.
B. Give Nicole 30ml of syrup of Ipecac followed by a glass of water.
C. Insert a nasogastric tube and administer activated charcoal.
D. Obtain a brief history of events leading up to the ingestion from Mrs. Lyon.
18．Nicole is admitted to the pediatric unit for observation. Which laboratory findings should the nurse monitor most closely for changes in Nicole's health status？
A. Hemoglobin and hematocrit.
B. White blood cell count and differential.
C. Blood gases（PO2·PCO2, and pH）.
D. Serum transaminase levels（SGOT and SGPT）.
19．Nicole is receiving N-acetylcysteine（Mucomyst） as an antidote to the acetaminophen. To make the drug more palatable for Nicole to drink, what fluid should the nurse mix the drug with？
A. Water.
B. Orange juice.
C. Milk.
D. Flavored milkshake.
Josephine Harrod has been admitted to the hospital with hepatitis Type A.
Words and Expressions
hepatitis n. 肝炎
cholecystitis n. 胆囊炎
cholelithiasis n. 胆石症
jaundice n. 黄疸
prothrombin n. 凝血素
gallbladder n. 胆囊
atelectasis n. 肺不张
pneumonia n. 肺炎
thrombophlebitis n. 血栓性静脉炎
hemorrhage n. 出血
20．Which of the following precaution is inappropriate to include in Mrs. Harrod's care？
A. Stool and needle isolation.
B. Special care of linens and food.
C. Use of a gown and gloves during client contact.
D. Reverse isolation.
21．Several months following her hospitalization for hepatitis, Mrs. Harrod reentered the hospital with complains indicative of cholecystitis and cholelithiasis. Because she has an existing jaundice, which of the following tests should be performed prior to surgery？
A. Lee-White clotting time.
B. Bleeding time.
C. Prothrombin time.
D. Circulation time.
22．For which post-op complication is Mrs. Harrod at risk after gallbladder surgery？
A. Atelectasis.
B. Pneumonia.
C. Hemorrhage.
D. Thrombophlebitis.
23．Following surgery, Mrs. Harrod has a nasogastric tube in place with an order to irrigate it prn. What is the rationale for irrigating a post-op client's nasogastric tube？
A. To remove secretions from the stomach.
B. To decrease abdominal distension.
C. To minimize bleeding.
D. To maintain patency of the tube.
Allen Spinet,23 years old, was injured in an automobile accident.
Words and Expressions
vertebrae n. 椎骨；脊椎
intracranial adj. 颅内的
capillary permeability n. 毛细血管通透性
cardiopulmonary resuscitation n. 心肺复苏术
carotid adj. 颈动脉的
dilate vt. 使扩大；使膨胀
vascular tone n. 血管紧张度
hemorrhage n. 出血
24．Of the following sequences, which would be the most appropriate in the immediate post-trauma minutes？
A. Control the hemorrhage; establish an open airway; stabilize the fractured vertebrae; splint the fractured leg.
B. Establish an open airway; control the hemorrhage; stabilize the fractured vertebrae; splint the fractured leg.
C. Establish an open airway; stabilize the fractured vertebrae; control the hemorrhage; splint the fractured leg.
D. Establish an open airway; control the hemorrhage; splint the fractured leg;stabilize the fractured vertebrae.
25．Which is the most important intervention in treating hemorrhage？
A. Allay apprehension.
B. Give oral fluids.
C. Prevent chilling, but don't overheat.
D. Restore blood volume.
26．Which of the following is caused by shock？
A. A pO2greater than 80mmHg.
B. A pH less than 7.34.
C. A pCO2 less than 45mmHg.
D. A decrease in capillary permeability.
27．If cardiopulmonary resuscitation were performed on Mr. Spinet by 2 persons, which of the following rations of cardiac compression to pulmonary ventilation would be used？
A. 1∶1.
B. 5∶1.
C. 15∶2.
D. 20∶2.
28．Which sign would best indicate effective cardiopulmonary resuscitation？
A. Palpable carotid pulse.
B. Dilated pupils.
C. Easily blanched nail beds.
D. Normal skin color.
29．What is the primary objective of therapy for Mr. Spinet's shock？
A. Maintain adequate blood pressure.
B. Improve tissue perfusion.
C. Maintain adequate vascular tone.
D. Improve kidney function.
30．Mr. Spinet's injuries include a skull fracture.One of the goals of care for him is to 12 observe for increasing intracranial pressure. Which sign would indicate increased intracranial pressure？
A. Increased pulse rate and increased blood pressure.
B. Increased pulse rate and decreased blood pressure.
C. Decreased pulse rate and increased blood pressure.
D. Decreased pulse rate and decreased blood pressure.
31．In addition, which of the following would best indicate increased intracranial pressure？
A. BP change from 110/80mmHg to 140/50mmHg.
B. Pulse change from 78/minute to 92/minute.
C. Respirations change from 16/minute to 26/minute.
D. Change in level of consciousness from stupor to drowsy and restless.
Janice Carter is in the 37 thweek of pregnancy. Her husband calls the physician to report that his wife awakened in the middle of the night, lying in a pool of bright red blood.
Words and Expressions
pitocin n. 催产素
placenta n. 胎盘
ectopic pregnancy n．宫外孕
pelvimetry n. 骨盆测量
crossmatch n. 交叉配血；器官移植前交叉配型
perineal adj. 会阴的
cervical adj. 颈的；子宫颈的
cesarean n. 剖腹产
enema n．灌肠剂
lochia rubra n．血性恶露
dextrose n. 葡萄糖
32．The onset of third-trimester painless bleeding is usually a sign of potential________ .
A. abruption placentae
B. placenta previa
C. incomplete abortion
D. ectopic pregnancy
33．Mrs. Carter is admitted to the labor room. Which of the following is contraindicated during the admission assessment？
A. Vaginal examination.
B. X-ray pelvimetry.
C. Type and crossmatch.
D. Perineal prep.
34．Mrs. Carter is worried about her condition, and about her 2-year-old twins at home. Mr. Carter asks you if he should remain with Mrs. Carter or return home to check on the children and their teenaged sitter. Which response indicates an understanding of their feelings at this time？
A. “You would feel more secure if you checked on your family.”
B. “Your wife is well cared for here, you may go home for a while.”
C. “You really belong here, now. Call home and check on the children.”
D. “Why not ask your wife what she feels would be best for her?”
35．An ultrasound confirms that the placenta totally covers the cervical os. Mrs. Carter is prepared for a cesarean birth. In addition to providing emotional support, preparation for the client includes all except________ .
A. type and crossmatch
B. insertion of catheter
C. skin prep and shave
D. tap-water enema
36．Mrs. Carter will receive a spinal anesthetic. As she signs the consent forms, she asks about the possibility of postanesthetic headaches. An appropriate response is________
A. “Headaches rarely occur, and are usually mild.”
B. “Medication is available to counteract headaches, and is given as needed.”
C. “If there is an allergy to the agent used, headaches may occur.”
D. “This problem may be prevented by keeping the bed flat.”
37．Baby Carter,6Ib4 oz, is delivered by cesarean section, and appears to be in stable condition. Mrs. Carter's blood loss during delivery was 1,200ml. She receives 2 units of whole blood. While she is in the recovery room, several changes of her condition are noted. Which assessment should be reported to the physician immediately？
A. Pulse changes from 88 to 120; she is restless.
B. Blood pressure is stable at 100/80; she appears pale
C. Temperature rises to 100.2℉; her mouth is dry.
D. Lochia rubra noted; she seems to be in pain.
38．An IV of 1,000ml of 5% dextrose in saline with 10 units of pitocin is ordered. The solution is to infuse in 6 hours. Drop factor is 10. At what rate should the IV infuse？
A. 2.7 drops per minute.
B. 3.7 drops per minute.
C. 27 drops per minute.
D. 37 drops per minute.
Three-month-old Pedro Cruz is seen in the pediatric clinic for well baby care. During this visit, the physician diagnoses congenital hypothyroidism.
Words and Expressions
congenital hypothyroidism n. 先天性甲状腺功能低下
hyperirritability n. 应激性亢进
tachycardia n. 心动过速
levothyroxine n. 左甲状腺素
constipation n. 便秘
toxicity n. 毒性
39．When explaining the diagnosis to Mr. and Mrs. Cruz, which findings should the nurse describe as characteristic of congenital hypothyroidism？
A. Hyperirritability, prominent nasal bridge.
B. Tachycardia, small oral cavity.
C. Constant hunger, runny stools.
D. Inactivity, mottled skin.
40．Pedro is placed on levothyroxine（synthroid）25mg per day. Which instruction should the nurse provide to Pedro's parents？
A. The medication should be given until symptoms subside, then gradually discontinued.
B. Pedro can be expected to lose some weight as he adjusts to the medication.
C. The medication should be administered as a single morning does.
D. Constipation may develop and indicates toxicity.