急救護(hù)理學(xué)A卷

1、Final Examination OfEmergency Nursing Grade 2003 Nursing department Nanchang University Medical College (A)南昌大學(xué)醫(yī)學(xué)院護(hù)理學(xué)系2003級(jí)急救護(hù)理學(xué)試卷（A卷）Part : Term Definition ( 5 points each, 15 points totally ) 1.shock2. heat stroke 3. hypertensive emergenciesPart : True or False ( 2 points each, 10 points totally )

2、1. W e can use iodine tincture (碘酊) to degerm (消毒) the primary wound. ( )2. Blood pressure starts decreasing since the early stage of shock. ( )3.Terminal stage of liver cancer is a kind of disease that can be hospitalized in ICU. ( )4. Hypertensive emergencies patients BP should be decreased to nor

3、mal level at once. ( )5. Any chemical that may burn skin is indication for use dermal decontamination ( )Part : Single Choice ( 2 points each, 20 points totally )1. Which is not included in the emergency nursing? ( )A. prehospital first-aid B. critical care C. disaster preparedness and management D.

4、 rehabilitation service2. The normal value of shock index(指數(shù)) is . ( )A. 1 B. 2 C. 3 D. 0.53. When disturbance of acid - base balance happened, which is the PH value limits for salvage. ( ) 4. Whats the common characteristic of all kind of shock? ( ) A. blood pressure decrease B. narrowed BPC. sharp

5、 decreasing of circulating volume D. decreased CVP5. which Trauma Scores (TS) is best for salvage. ( ) A.13B.413C.1416D.16206. Which will not induce diabetic ketoacidosis(酮癥酸中毒)? ( ) A. infection B. discontinue insulin C. dewatering treatmentD. stress to operating 7. The adults airway pressure is (

6、) A. 812mmH2OB. 1016 mmH2O C. 1220 mmH2O D. 1624 mmH2O8. Barbiturate(巴比妥酸鹽) poisoning mechanism is ( ) A. hypoxia B. anesthetic(麻醉) actionC. inhibit enzymic(酶的) vigor D. receptor competition9. ECG shows ventricular fibrillation. The nurse decides to perform external defibrillation on patients. First

7、 you select energy _ in adult. ( )A.50J B.100J C.200J D.300J10. Which is not the nursing interventions of coma ( ) A. Provide oxygen B. Gastric lavage(灌洗)C. Suction if necessary D. Establish IV accessPart : Brief Answers ( 10 points each, 40 points totally )1. What are the manifestations for cardiac

8、 arrest? (10 points) （Please answer in English, or you will lose the half score請(qǐng)用英文回答，否則扣一半分）2. What are the first aid care points of a hyperthermic(體溫過(guò)高) crisis patient? (10 points)3. Please describe the WHO analgesic ladder for pain management ? (10 points)4.Write down the indications(適應(yīng)證) of vent

9、ilator application(呼吸機(jī)應(yīng)用). (10 points)Part : Case Analysis ( 15 points )A male patient，23 years old, lower limbs crush(壓傷) trauma, still conscious, apathia(淡漠), thirsty, pale, moist and cold skin, Pulse 112 times/minute， BP 90/60mmHg，CVP 4cmH2O，capillary refill time longer than normal, blood gas ana

10、lysis, PH 7.30, HCO3一 15mmol/L, BE 9mmol/L.(1 )Whats the matter with this patient?(5 points)(2) Whats the nursing point of this patients?(10 points)Final Examination OfEmergency Nursing Grade 2003 Nursing department Nanchang University Medical College (A)南昌大學(xué)醫(yī)學(xué)院護(hù)理學(xué)系2003級(jí)急救護(hù)理學(xué)試卷（A卷）STANDARD ANSWER (標(biāo)

11、準(zhǔn)答案)Part : Term Definition ( 5 points each, 15 points totally ) 1 Shock: 是由多種原因引起的以循環(huán)障礙為主要特征的急性循環(huán)功能衰竭.(3分)由于微循環(huán)障礙,導(dǎo)致維持生命的主要器官、組織的血液灌注不足，從而在臨床上出現(xiàn)一系列的癥狀和體征（2分）。2. heat stroke: 熱射病是一種嚴(yán)重的熱相關(guān)疾?。?分），通常是在烈日底下勞動(dòng)時(shí)間過(guò)長(zhǎng)，又沒(méi)有防護(hù)措施而發(fā)生的（1分）。其臨床特征是中心溫度大于40度，并伴有中樞神經(jīng)系統(tǒng)異常的癥狀，如譫妄、驚厥，昏迷等（2分）。3. hypertensive emergencies：是發(fā)

12、生在高血壓病或癥狀性高血壓過(guò)程中的一種特殊臨床危象（2分），是指在高血壓病程中，由于某些誘因，外周小動(dòng)脈發(fā)生暫時(shí)性強(qiáng)烈收縮（1分），血壓急劇升高，伴有重要器官的功能障礙或不可逆的損害（2分）。Part : True or False ( 2 points each, 10 points totally )1.False 2.False 3. False 4. False 5.TruePart : Single Choice ( 2 points each, 20 points totally )1.D 2. D 3. B 4. C 5. B 6. C 7. C 8. A 9. C 10. BP

13、art : Brief Answers ( 10 points each, 40 points totally )1. 每小點(diǎn)2分，答全得10分。臨床表現(xiàn)：意識(shí)喪失；脈搏捫不到；呼吸斷斷續(xù)續(xù)，后停止；心音消失；瞳孔散大；面色蒼白兼青紫。 Patient is unresponsive； The femoral pulses are not palpable; Respiratory motion of the chest wall cannot be detected.; No audible heart sound can be discerned; Patient has a blue,

14、pale, or deathlike appearance; Dilated pupils and no response to light.2. 每小點(diǎn)2分，答全得10分。 1)嚴(yán)密觀察病情;2)一般處理;3)降溫：迅速而有效地將體溫降至38.5左右是治療高熱危象的關(guān)鍵;4)病因治療;5)基礎(chǔ)護(hù)理和對(duì)癥護(hù)理。3. 答全得10分第一階梯輕度疼痛給予非阿片類(非甾類抗炎藥)加減輔助止痛藥。如阿司匹林。（3分）第二階梯中度疼痛給予弱阿片類加減非甾類抗炎藥和輔助止痛藥。常用藥物有可待因等。（3分）第三階梯重度疼痛給予阿片類加減非甾類抗炎藥和輔助止痛藥。（3分）4. Indications(適應(yīng)證) of ventilator application(呼吸機(jī)應(yīng)用). 每小點(diǎn)1分，答全得10分。1)急、慢性呼吸衰竭 2)心源性或非心源性肺水腫 3)ARDS 4)胸部創(chuàng)傷、多發(fā)性肋骨骨折、連枷胸 5)呼吸中樞控制失調(diào)、神經(jīng)肌肉疾患 6)呼吸性