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Subject 1. ISSUES OF GENERAL MEDICAL CARE. Each of the question or incomplete statement below is followed by suggested answers or completions. Select the one which is the best in each case. 001. What are the responsibilities of junior medical personnel? a) damp cleaning b) dispensation of food c) injections d) intubation and enemas 002. What are the responsibilities of medical nurses? a) damp cleaning b) feeding and care for the severely ill patients c) accompanying the patients to be investigated 003. What is ethics? a) theory of debt of honour b) theory of medical workers duty c) theory of moral principles d) theory of morality 004. What is medical deontology? a) theory of duty b) theory of necessity c) theory of proper behavior of medical nurses d) theory of medical nurses’ duty 005. What are the cases of disclosing the medical confidentiality? a) should this data inflict harm on the medical worker b) with a view to exercise a morale effect on the patient c) availability of socially dangerous diseases: HIV infection, gonorrhea, syphilis d) to improve the quality of patients’ treatment 006. What is required to do in case of incurable disease? a) the patient to be told the truth b) the patient to be “white lied” c) to tell the truth to an immediate relative (wife, children) d) to clarify relatives’ motivation, to tell them the truth in case they are capable to adequately take it 007. Main types of patient care institutions, except: a) hospitals b) in-patient departments c) polyclinics d) specialized clinics e) pharmacies 008. What is medical station? a) an institution of urgent medical aid b) an institution of undergoing prophylactic medical examination c) an institution for curing the women 1 d) a medical institution at work 009. In Russia there exist all the dispensaries, except for: a) TB b) dermatovenerological c) oncological d) cardiological e) obstetrical-gynecological f) psychoneurological g) of medical exercises 010. Major documents kept at a nurse’s station: a) log of blood and blood substitutes transfusion b) log of medical assignments c) narcotic drugs log d) procedural log 011. A relationship between “care” and “treatment”: a) “care” and “treatment” are different notions: treatment is performed by doctors; care is performed by junior medical personnel and medical nurses b) “care” and “treatment” are identical notions, since the purpose of both care and treatment is to make the patient healthy c) care is an integral part of treatment 012. What does “special care” mean? a) care to be performed particularly careful b) care to be performed under special conditions c) care to be performed with targeted specialists being available d) care which needs additional measures because of specific character of disease 013. Who should care for patients? a) patient’s relatives b) junior medical personnel and medical nurses c) all medical workers jointly with patient’s relatives, each one having specific range of tasks to have the care organized properly 014. What does the medical deontology study, except? a) relationships between the doctor and the patient b) a wide range of the issues of duty, morality and professional ethics of medical workers c) iatrogenic diseases d) prophylaxis doctrine 015. Patient’s illness was diagnosed as malignant tumor of stomach at the stage when it can be removed drastically by surgical procedure. The patient strongly objects to be subject to surgery. Your tactics: a) to tell the patient his/her actual diagnosis b) to discharge the patient concealing the actual diagnosis from him/her c) to tell the patient that his/her illness is diagnosed as gastric ulcer / polypus, which is nevertheless to be subject to surgery; do your best to persuade the patient to be operated. 2 016. The patient is suffering severe epigastric pains, sickness, vomiting. Medical workers evaluated status of the patient as food poisoning and directed the patient to an infectious diseases hospital, where being more carefully investigated he was diagnosed as abdominal (gastric) myocardial infarction. How can you evaluate the initial actions of medical workers? a) the only true way b) as a medical mistake c) negligent, careless 017. Medical nurse mixed up bottles looking very much alike and injected to the patient a high dose of insulin instead of heparin decreasing by this the level of blood sugar; this resulted in deterioration of the patient’s state (hypoglycemic coma). How can you evaluate the actions of the medical nurse? a) legally wrong from the medical point of view (negligence, carelessness) b) medical mistake c) wrongdoing occurring by chance 018. Several months ago young woman’s father died of myocardial infarction. She experienced bitter grief because of his death. While reading a special literature, she came to the conclusion that there can be genetic predisposition to myocardial infarction. Then, she started to feel a sense of discomfort in left breast; fear hung upon her to die. She asked the doctor to consult her. What disease is the patient supposed to have? a) iatrogenic illness b) most probably, iatrogenic illness is accompanied by elements of neurosis (cardiophobia), nevertheless the patient needs to be given an additional examination. c) acute cardial disease 019. Maintaining of medical confidentiality is a principle of: a) medical ethics b) medical deontology c) legal medicine 020. Moral principles of medicine are the subject of studying: a) medical ethics b) medical deontology c) legal medicine 3 Subject 2. HOSPITAL RECEPTION ROOM. DOCUMENTATION. Each of the question or incomplete statement below is followed by suggested answers or completions. Select the one which is the best in each case. 001. How are the medications of groups A and B kept?: a) on an open shelf in the cabinet b) in a locked away compartment in the cabinet c) in the fridge 002. How are serum and vaccines kept?: a) on an open shelf in the cabinet b) in a locked away compartment in the cabinet c) in the fridge 003. Who is responsible for thermometry? : a) medical nurse at a nurse’s station: b) procedural medical nurse c) reception medical nurse d) medical nurse of functional diagnostics department 004. Which of medical nurses samples blood? a) medical nurse at a nurse’s station: b) procedural medical nurse c) reception medical nurse d) medical nurse of functional diagnostics department 005. Which of medical nurses perform injections? a) medical nurse at a nurse’s station: b) procedural medical nurse c) reception medical nurse d) medical nurse of functional diagnostics department 006. Which of medical nurses supervises observance of personal hygiene by patients? a) medical nurse at a nurse’s station: b) procedural medical nurse c) reception medical nurse d) medical nurse of functional diagnostics department 007. Who keeps a log to accept-&-handover the shifts? a) medical nurse at a nurse’s station: b) procedural medical nurse c) reception medical nurse d) medical nurse of functional diagnostics department 008. Which of medical nurses distributes drugs for patients? a) medical nurse at a nurse’s station: b) procedural medical nurse c) reception medical nurse d) medical nurse of functional diagnostics department 4 009. Who assembles and installs the intravenous drip-feed systems? a) medical nurse at a nurse’s station: b) procedural medical nurse c) reception medical nurse d) medical nurse of functional diagnostics department 010. Procedural medical nurse carries out all medical manipulations except for: a) injections b) pleurocentesis c) blood grouping d) measurement of blood pressure 011. Which of medical nurses keeps a log of medical assignments? a) medical nurse at a nurse’s station: b) procedural medical nurse c) reception medical nurse d) medical nurse of functional diagnostics department 012. What is a preventive medical examination? a) investigation and treatment of patients in dispensaries b) recording the patients suffering some particular diseases c) close supervision over the patients suffering some particular diseases, alongside over the health of particular population group 013. A patient applied to a hospital reception room without any medical application documents; he suddenly felt queer. What are you expected to do? a) to survey the patient rendering him a required medical aid to solve the issue of further treatment b) to call an ambulance c) to ask the patient to bring appropriate medical documents 014. At arrival of the patient in reception, lousiness was revealed. What shall you do? a) to refuse the patient to be hospitalized b) the patient to be re-washed with soap in a tub, his clothes being forwarded to a disinfection room c) to undertake cleansing, including hair cut (if possible), greasing the hair with a mixture of kerosene and sunflower oil, then the hair to be washed again + hot 10% vinegar 015. In a hospital reception room is a patient complaining of abdominal pains. General condition is satisfactory. Can he take a hygienic bath? a) yes, he can b) no, he can’t c) he cannot unless serious surgical indications are excluded 016. In a hospital reception room is a patient on suspicion of gastrointestinal bleeding. (3 hours ago he vomited, vomit mass looked like “coffee grounds”). He feels satisfactory, capable of moving. How should he be transported to an in-patient department? a) on foot escorted by a nurse b) by the seat-wheelchair c) by the stretcher-wheelchair 5 017. What are responsibilities of a head medical nurse? a) carrying out the most critical medical manipulations b) supervising the activity of a charge nurse, writing out the requirements for medicines c) supervising over the provision of the department with hard and soft equipment, 018. What contributes to spreading the nosocomial infections? a) violation of the rules of aseptics and antiseptics in the hospital b) appearance of bedbugs and roaches at the departments c) revealing lousiness at the departments 019. What disinfectant solutions are used for damp cleaning? a) 10% solution of chloric lime b) 1% solution of chloramine c) 3% solution of hydric dioxide d) solution of potassium hypermanganate 020. How often should the wards be subject to damp cleaning? a) every day b) as required c) as required, two times a day at least 6 Subject 3. PERSONAL HYGIENE OF THE PATIENT Each of the question or incomplete statement below is followed by suggested answers or completions. Select the one which is the best in each case. 001. What is the mouth cavity of severely ill patients washed with? a) 3% solution of hydric dioxide b) 0,5% solution of sodium hydrocarbonate c) solution of furacilinum d) spiritus 002. In what position should be the patient so that the liquid would no penetrate into a respiratory tract? a) vertical b) semisedentary position with the head bent forward c) sedentary position d) edgewise 003. When are the eyes washed with 2% solution of boric acid and 0,9% solution of sodium chloride? a) all bed patients b) patients hands and legs c) conjunctivitis 004. What vessel should be used to wash the conjunctival cavity? a) eyedropper b) bottle c) undine d) drinking bowl 005. What should be the temperature of eye drops? a) body tº (37 degrees) b) indoor tº (about 20 degrees) c) warm tº (above 40 degrees) d) chilled tº (18-20 degrees) 006. What is used to make cerumen soft? a) vegetable oil b) eau de cologne c) 3% solution of hydric dioxide d) chlorhexidine 007. To what depth is the tip of Janet's syringe introduced to delete cerumen? a) 3 mm b) 1 cm, no more c) 2 cm, no more 008. How to soften nasal crusts? a) with water b) 0,9% solution of sodium chloride c) vaseline oil 7 009. How to apply cold on an area of the nose bridge? a) unless the bleeding stops b) 10-15 min, no more c) up to 1 hour with some breaks d) 3-4 min with some breaks 010. What one should do with the patient’s face before shaving: a) to wash the patient b) to wash the skin with a soap c) to treat the face with cold water d) to treat the face with hot water 011. Why are the patients suffering the cardiovascular system disease, shortbreathing are recommended to be in a semisedentary position in bed? a) it’s more convenient to feed the patient b) to decrease congesion of blood in pulmonary circulation c) to lessen the danger of bed sores 012. What is the main purpose of a functional bed? a) to create a convenient position to the patient b) it can be easily and quickly transported c) it can fixed the patient 013. How often is the change of underwear and linen carried out? a) every 10 days b) every week, after a bath or shower c) as soon as it becomes dirty, at least every 10 days 014. Can the decubitus ulcers appear with those patients who had to be in a sitting position? a) no, they can’t, since decubitus ulcers can only be generated with the patients lying on down on his/her back , pronate or edgewise b) yes, they can, in the are of ishial tuberosity c) no, they can’t since in a sitting position there is a thick layer of subcutaneous fat and muscular tissue between bony prominences and mattress 015. Why can’t a rubber ring be inflated intensively? a) it shall fail to work rather soon b) it shall be difficult to stably position it c) it should change its shape with the patient moving 016. What should be undertaken in the initial stage of decubitus ulcers? a) to reinforce the preventive control (keeping the patient’s bed clean and neat, changing the position of the patient, careful skin care) b) surgical treatment c) to assign physiotherapeutic procedures to the affected region (UHF, UVL) d) to process the affected regions with a 1% solution of brilliant green, strong solution of potassium permanganate, 5-10% solution of iodine 8 017. A seriously ill patient is subject to fragility of hair and slight hair fall. Does he/she need combing and brushing? a) by all means and as often as possible b) try no to comb and brush the hair at all c) to comb and brush in a usual way using a large-toothed comb 018. The patient suffering from pneumonia was assigned penicillin, which brought to white fur plastering his/her mouth. What will you do? a) to improve the mouth care b) to take a swab from oral mucosa for bacteriological test c) to recommend the patient to clean the teeth more often d) to recommend the patient to remove dental prosthesis e) to administrate antifungal agents (nystatin, for example) 019. Why is it not viable to drop into the eyes more that 1-2 drops of medicine solutions? a) eye drops contain superpotent drugs b) conjunctival cavity does not keep more than 1 drop of solution c) large quantity of conjunctiva is not good for the condition of conjunctiva 020. Is the patient with nasal bleeding recommended to throw back his/her head? a) yes, in doing so, the bleeding shall stop sooner b) this position is only recommended with more voluminous bleeding c) no, he/she doesn’t need to do so because the blood will be flowing down along rear wall of nasopharynx, which prevents from the right assessment of the bleeding dynamics 9 № 6. Medical diets. Each of the question or incomplete statement below is followed by suggested answers or completions. Select the one which is the best in each case. 001. One of the main principles of medical diet is: a) the balance of main components b) to increase caloric value and vitamins contents c) to limit caloric value through reduced animal fat and refined carbohydrates 002. The ration of a healthy man should include: a) 80 – 100 g of proteins, 80 – 100 g of fats, 400 – 500 g of carbohydrates b) 150 – 250 g of proteins, 150 – 250 g of fats, 150 – 250 g of carbohydrates c) 400 – 500 g of proteins, 80 – 100 g of fats, 80 – 100 g of carbohydrates 003. The ration of a healthy man should include: a) 2500 – 3000 g of water b) 1700 – 2000 g of water c) 3000 – 3500 g of water 004. How many are there main diets now? a) 10 b) 12 c) 15 005. In what diets are reduced a salt content (sodium chloride)? a) 7, 10 b) 8, 9 c) 1, 2 006. In what diets are reduced an animal fat and refined carbohydrates content? a) 7, 10 b) 8, 9 c) 1, 2 007. What should be a correlation between proteins, fats and carbohydrates in rational diet of the patients? a) 1:1:4 b) 4:1:1 c) the correlation between proteins, fats and carbohydrates depends on the character of the disease 008. Who prescribes the diet to the patients? a) a doctor b) a buffet nurse c) a head medical nurse d) a charge nurses 009. Who registers the diet for every patient? a) a doctor b) a buffet nurse c) a head medical nurse 10 d) a charge nurses 010. Can buffet nurse change a diet number by the patient`s request? a) yes b) no c) it depends on the situation 011. Who is carried out the total daily register of diets and responsible for correct planning and application of medical diets? a) a doctor-dietologist b) a head physician c) a head medical nurse 012. What diet`s number is prescribed for patients with stomach and duodenum ulcers diseases? a) № 7 b) № 1 c) № 5 013. What diet`s number is prescribed for patients with liver and gall bladder diseases? a) № 7 b) № 1 c) № 5 014. What diet`s number is prescribed for patients with kidney diseases? a) № 7 b) № 1 c) № 5 015. What diet`s number is prescribed for patients with obesity? a) № 7 b) № 8 c) № 9 016. What diet`s number is prescribed for patients with diabetes mellitus? a) № 7 b) № 8 c) № 9 017. What diet`s number is prescribed for patients with heart diseases? a) № 10 b) № 11 c) № 15 018. The artificial feeding is used: a) when the patients can not take food by himself b) when the oral intake of food appears insufficient c) all above 019. There are all the following ways of artificial feeding, except: a) through the probe introduced into the stomach b) through the rectum 11 c) by stomas d) peripheral parenteral nutrition 020. Probes for artificial feeding are as follows, except: a) a soft plastic tubes 3 – 5 mm in diameter b) a silicone tubes 3 – 5 mm in diameter c) a rubber tubes 3 – 5 mm in diameter d) a metal tubes 3 – 5 mm in diameter 021. Is it possible to use a mixtures containing a milk, eggs, broth for enteral feeding by stomas or through the probe? a) yes b) no 022. How often should be given various mixtures for enteral feeding during the day? a) 2 - 3 times a day with a large portions b) 5 – 6 times a day with a small portions c) 10 - 12 times a day with a small portions 023. Preparation for parenteral feeding more frequently are introduced: a) intramuscularly b) intravenously c) subcutaneously 024. For parenteral feeding are used: a) protein hydrolyzates, fatty emulsions b) glucose solutions, vitamins c) donor blood, plasma d) all above 025. Correct application of parenteral preparation make it possible: a) to decrease intoxication of an organism b) to correct metabolic disturbances c) to normalize functions of various organs and systems d) all above 12 № 7. Measurement of body temperature, registration of a temperature chart. Each of the question or incomplete statement below is followed by suggested answers or completions. Select the one which is the best in each case. 001. The scale of the medical thermometer includes a range of temperature from: a) 34 up to 42 b) 32 up to 40 c) 35 up to 43 002. The scale interval of the medical thermometer there is (graded in): a) 0,1 oC b) 0,2 oC c) 0,3o C 003. Body temperature may be taken: a) in the axillary region b) in the inguinal region c) sublingually d) rectally e) all above 004. When temperature is measured in the mouth cavity, the thermometer is located: a) under the tongue b) above the tongue 005. Duration of body temperature measurement is: a) 3-5 minutes b) 7-10 minutes c) 10-15 minutes 006. Rectal temperature is higher than in the armpit on: a) 0,1 - 0,5o b) 1,0 - 1,5o c) 0,5 - 1,0o 007. Elevated temperatures from 37o to 38o C are called: a) moderately high b) subfebrile c) high 008. Elevated temperatures from 38o to 39o C are called: a) moderately high b) subfebrile c) high 009. Elevated temperatures from 39o to 40o C are called: a) moderately high b) subfefrile c) high 010. Elevated temperature over 41o and 42o C are called: a) high b) very high 13 c) hyperpyretic 011. What type of fever is characterized by rises temperature sharply (by 2o – 4o C) and drops to normal and subnormal level: a) remittent fever b) hectic fever c) continued fever d) inverse fever 012. A sudden temperature drop (to normal within 24 hours) is called: a) lysis b) crisis 013. The course of fever is characterized by: a) period of elevation of temperature b) period of high temperature c) period of decreasing temperature d) all above 014. What conditions can provoke the physiological rises of the body temperature? a) physical strain, emotional stress, meals b) infection disease c) malignant tumours d) tissues necrosis 015. What purpose does wipe (dry) the armpit before measurement temperature? a) hygienic procedure b) to prevent a mistake (more lower result) of measurement temperature c) to have a stable position of the thermometer in the armpit 016. The difference between the morning and evening temperature in normal persons does not exceed: a) 0,6o C b) 0,9o C c) 0,1o C 017. Vertical axis of temperature chart consists of the temperature grid with: a) 0,2o C interval b) 0,1o C interval c) 0,5o C interval 018. Temperature chart is used to: a) graphic records of temperature curve b) reflect dynamics of blood pressure, breath and pulse rate c) reflect dynamics of body weight, daily amount of urine d) all above 019. A patient has a fever during 2 weeks, morning temperature varies in the range of 36,0o – 36,5o C and evening temperature is 37,5o – 38,0o C. What type of fever has the patient? a) remittent fever b) hectic fever c) inverse fever 14 d) intermittent fever 020. What type of fever is characterized by the morning temperature is higher than in the evening? a) remittent fever b) hectic fever c) inverse fever d) intermittent fever 021. The first stage of elevation temperature is accompanied by: a) the skin blood vessels contraction b) the skin blood vessels expansion (widening) c) heavy perspiration 022. The stage of decreasing temperature is accompanied by: a) chills b) the skin blood vessels contraction c) the skin blood vessels expansion 023. What nursing care should be done during the stage of elevation temperature? a) put a cold compress on a forehead of patient b) cover up warm, give to drink a hot tea, fruit juices c) prevent a decubitus ulcers (bedsores) 024. The nursing care during the period of high temperature includes all these manipulations, except? a) put a cold compress on a forehead b) observe the dynamics of blood pressure, pulse rate, diuresis c) cover up warm d) fluid intake 025. The nursing care during crisis decreasing temperature includes all these manipulations, except? a) put a cold compress on a forehead b) observe the dynamics of blood pressure, pulse rate, dieresis c) change a linen, bed-clothes d) fluid intake 15 № 8. Measures of effect on an organism of the patient: cups, mustard plasters (sinapisms), compresses. Balneotherapeutics. Each of the question or incomplete statement below is followed by suggested answers or completions. Select the one which is the best in each case. 001. Segmental-reflex therapy is accompanied by the following effects: a) functional changes in organs and tissues (changes of vascular tension, secretory and motor activity, cellular metabolism) b) an improvement of appetite, mood and sleep c) all above 002. All the following are the methods of segmental-reflex therapy, except: a) the application of compresses, cups, sinapisms b) hydrotherapy c) injections 003. The wet cold compress may be effective in the treatment of various bruises: a) in the first hours b) in the first days c) are not used in the treatment 004. How often should be change a cold compress? a) in 2 – 3 minutes b) in 10 – 15 minutes c) when compress gets a dry 005. The application of cold compresses are used for various purposes, except: a) constricts blood vessels b) inhibits local circulation, suppuration and tissue metabolism c) as a temporary anesthetic d) vasodilation and increases local circulation 006. The wet warming compress is prepared of: a) four layers b) three layers c) two layers 007. The duration of wet warming compress application should not exceed: a) 10 hours b) 15 hours c) 12 hours d) 6 hours 008. A half-spirituous warming compress is applied: a) to accelerate resolution of inflammatory infiltrates b) to inhibit local circulation c) to inhibit tissue metabolism 009. Contra-indications for application of warming compresses are as follows, except: a) the various skin diseases (dermatitis) b) violations of skin cover integrity c) local infiltrates 16 010. An ice-bag is used: a) for durable local cooling b) for accelerate resolution of inflammatory infiltrates c) for increase local circulation 011. Sinapisms are used for treatment all the following, except: a) bronchitis b) neurologic diseases c) angina pectoris d) skin diseases 012. The cups are used for treatment all the following, except: a) skin disease b) bronchitis c) myositises d) pneumonia 013. The application of the cups is contra-indicated for all the following, except: a) malignant neoplasms b) active tuberculosis c) pulmonary bleeding d) myositises e) skin diseases 014. The duration of the cups application is usually: a) 5 – 10 minutes b) 10 – 15 minutes c) when the colour of skin changes under the cups 015. The cups are a glass jar with a volume: a) 100 – 150 ml b) 150 – 200 ml c) 30 – 70 ml 016. To avoid burns, before applying the cups, it is necessary: a) to grease the skin with mineral jelly b) to moist the skin with warm water c) to moist the skin with camphoric spirit 017. Each layer of wet warming compress should be of larger size than the previous one, that to: a) avoid fast drying b) avoid burns c) avoid hyperemia of the skin 018. Leeches are contra-indicated at: a) anemia b) hemorrhoid c) essential hypertension 019. Leeches can be applied on the following parts of the body, except: a) right hypochondrium b) behind the ears 17 c) left part of the chest d) face 020. How much blood are usually removed (sucked out) by the each leeches during 0,5 – 1 hours: a) 40 – 50 ml b) 10 – 15 ml c) 60 – 70 ml 021. You can remove the leeches from the patient`s skin by application: a) a cotton wool moistened with salt water or spirit solution (alcohol) b) a cotton wool moistened with sweet water c) a dry cotton wool 022. What effect can cause a cold bath (hydrotherapy) on the patient`s body? a) spasm of smooth muscular of inner organs, blood pressure increase b) relax influence on the central nervous system c) dilation of smooth muscular of inner organs, blood pressure decrease 023. Hydrotherapy is contra-indicated at: a) heavy atherosclerosis b) pronounced stage of circulatory insufficiency and essential hypertension c) active tuberculosis d) malignant neoplasms e) all above 024. Duration of hydrotherapeutic procedures (a baths) varies usually at a range: a) 10 – 15 minutes b) 20 - 25 minutes c) 25 – 30 minutes 025. For hydrotherapeutic procedures can be used: a) a cold water (about 20o ) b) indifferent water (34o – 36o ) c) warm water (37o – 39o ) d) hot water (high 40o ) e) all above 18 Tests for the lesson № 9. Drug administration. Intradermal, subcutaneous, intramuscular injection. 001. The following types of injections are performed by the nurse except a) subcutaneous injection; b) intramuscular injection; c) intraarterial injection; d) intravenous injection. 002. What site is commonly used for intradermal injection? a) ventral forearm; b) fat pads on the abdomen; c) upper hips; d) ventrogluteal areas. 003. The following volume of medical solution is commonly administered intradermaly a) 0.5 ml or less; b) 1-2 ml of fluid; c) 3-5 ml of fluid; d) 10-20 ml of fluid. 004. The following type of injection is used in allergy and tuberculin testing a) intradermal injection; b) subcutaneous injection; c) intramuscular injection; d) intravenous injection. 005. The following is right position of the syringe for intradermal injection a) at a 90-degree angle to the skin surface; b) at a 10-to-15- degree angle to the skin surface; c) at a 30-to-45- degree angle to the skin surface; d) at a 45-to-60- degree angle to the skin surface. 006. The following are subcutaneous injection sites except a) loose tissue of the lower abdomen; b) upper hips; c) ventral forearm; d) lateral upper arms. 007. What is the route of insulin administration? a) intradermal injection; b) subcutaneous injection; c) intramuscular injection; d) intravenous injection. 008. The following volume of medical solution is commonly administered subcutaneously a) 0.5 ml or less; b) 1-2 ml of fluid; c) 3-5 ml of fluid; d) 10-20 ml of fluid. 19 009.The following are skin contradications to perform subcutaneous injection except a) pallid skin; b) inflamed skin; c) edematous skin; d) scarred skin. 010. Is it necessary to aspirate for blood return when giving insulin or heparin? a) yes; b) no. 011. The following is right position of the syringe for subcutaneous injection a) at a 90-degree angle to the skin surface; b) at a 10-to-15- degree angle to the skin surface; c) at a 30-to-45- degree angle to the skin surface; d) at a 45-to-60- degree angle to the skin surface. 012. What type of injection is needed forming a fat fold? intradermal injection; subcutaneous injection; intramuscular injection; intravenous injection 013. a) b) c) d) The following site is commonly used for intramuscular injection ventrogluteal and dorsogluteal areas; loose tissue of lower abdomen; dorsum of the hands; lateral upper arms. 014. What complication can appear after all types of injections? a) allergic reaction; b) hematoma; c) nerve or ligament damage; d) air embolism. 015. The following volume of medical solution is commonly administered intramuscularly a) 0.5 ml or less; b) 1-2 ml of fluid; c) 3-5 ml of fluid; d) 10-20 ml of fluid. 016. The following are systemic contradications for intramuscular injection except a) impaired coagulation mechanisms; b) acute myocardial infarction; c) shock; d) anemia. 017. Why is it necessary to check for blood return giving intramuscular injection? a) it indicates that the needle isn’t in the vein; 20 b) it minimizes vascular irritation; c) it prevents an immediate effect of drug; d) it prevents contamination with bacteria. 018. After intramuscular injection withdraw the needle a) gently but quickly at a 90-degree angle; b) slowly and smoothly, keeping it parallel to the skin; c) gently but quickly at a 45-degree angle; d) slowly at a 30-degree angle. 019. The following complication can appear after intramuscular injection except a) nerve or ligament damage; b) hematoma; c) broken needle; d) air embolism. 020. The following are typical features of the allergic reaction except a) itching; b) thrombosis; c) bronchospasm; d) urticarial rash. 21 Tests for lesson № 10. Peripheral intravascular therapy. 001. The following types of injections are performed by the doctor except a) intraarterial injection; b) intramuscular injection; c) intrapleural injection; d) intraarticular injection. 002. The best route of drug administration in emergency is a) intradermal injection; b) subcutaneous injection; c) intramuscular injection; d) intravenous injection. 003. The following are preferred venipuncture sites except a) cephalic and basilic veins in the lower arm; b) veins in the dorsum of the hand; c) antecubital veins; d) leg and foot veins. 004. The air vent clamp is needed a) to control speed of infusion; b) to provide administration of solution in the vein; c) to administer the air in the bottle; d) to prevent the passage of air in the vein. 005. The following are contradications to administer the solution intravenously except a) abnormal discoloration; b) cloudiness; c) particles; d) large volume of the solution. 006. Membrane-filter set at the bottom of the fluid chamber is needed a) to control speed of infusion; b) to provide administration of solution in the vein; c) to administer the air in the bottle; d) to prevent the passage of air in the vein. 007. The following are contradications to perform intravenous injection except a) sclerotic vein; b) burns; c) pallid skin; d) edematous skin. 008. The following can cause a vasomotor response resulting in venous constriction except a) patient’s anxiety; b) cold room; c) lower temperature of the solution; d) massage of the arm. 22 009. What type of injection is needed the application of a tourniquet? a) intradermal injection; b) subcutaneous injection; c) intramuscular injection; d) intravenous injection. 010. Applying the tourniquet is necessary a) to control bleeding; b) to dilate the vein; c) to prevent hematoma; d) to determine the place of venipuncture. 011. What is the best place applying the tourniquet in peripheral intravascular therapy? a) 5 cm above intended puncture site; b) 15cm above intended puncture site; c) 30 cm above intended puncture site; d) 15 cm below intended puncture site. 012. To perform venipuncture hold the needle a) at a 15-to-25-degree angle over the vein; b) at a 30-to-45- degree angle over the vein; c) at a 45-to-60- degree angle over the vein; d) at a 90- degree angle over the vein. 013. Why is it necessary to check for blood return giving intravenous injection? a) it indicates that the needle is in the vein; b) it minimizes vascular irritation; c) it prevents an immediate effect of drug; d) it prevents contamination with bacteria. 014. After intravenous injection withdraw the needle a) gently but quickly at a 90-degree angle; b) slowly and smoothly, keeping it parallel to the skin; c) gently but quickly at a 45-degree angle; d) slowly at a 30-degree angle. 015. The following complication can appear after intravenous injection except a) allergic reaction; b) broken needle; c) thombophlebitis; d) air embolism. 016. The following are systemic complications of intravascular therapy except a) septicemia or bacteremia; b) hematoma; c) allergic reaction; d) air embolism. 017. The following are local complications of intravascular therapy except a) phlebitis; b) cannula dislodgment; 23 c) allergic reaction; d) hematoma; 018. The following are the symptoms of air embolism except a) alteration or loss of consciousness; b) respiratory distress; c) decreased blood pressure; d) erythema at a puncture site. 019. The following are the symptoms of thrombosis except a) alteration or loss of consciousness; b) edema and erythema at a puncture site; c) pain along the vein; d) ipsilateral swelling of arm. 020. The following are the symptoms of phlebitis except a) redness at tip of cannula and along vein; b) puffy area over vein; c) vein hard on palpation; d) decreased skin temperature around site of injection; 24 Tests for lesson № 12 001. a) b) c) d) Arterial hypertension is characteristic for all, except some renal diseases pathology of large blood vessels diseases of endocrine system gastritis and peptic ulcer 002. a) b) c) In case of arterial hypertension all the following are true except: free salt diet rest and psychological comfort negative emotional factors 003. a) b) c) d) All the following signs are suggestive of hypertonic attack except: sever headache dizziness nausea and vomiting abdominal distention 004. a) b) c) d) The patient's treatment in case of hypertonic attack all the following are except: ranitidine 20 mg bendazole solution 0.5% 10 ml magnesium sulfate 10% 10 ml clonidin hydrochloride 0.03% 0.5-1 ml 005. a) b) c) Hypotension may be occurs in all following except: thyrotoxicosis myocardial infarction bleeding 006. a) b) c) d) Chest pain may be in all following except: Plevritis or pleurisy Intercostals neuralgia Myositis Colitis 007. a) b) c) In typical cases of the anginal attacks all are true except: pain in the right hypochondrium retrosternal pain left side of the chest 008. a) b) c) d) In case of typical angina pectoris pain radiates to all parts except: left shoulder right shoulder intrascapula region left part of neck 009. a) b) c) d) Typical angina pectoris is characterized by all symptoms, except: duration of pain more 30 minutes pain is relieved by nitroglycerin pain isn't relieved by nitroglycerin duration of pain no more 30 minutes 25 e) f) true a) and c) true b) and d) 010. a) b) c) d) e) f) g) In case of myocardial infarction all symptoms are true except: pain duration is less than 30 minutes pain is accompanied by acute general weakness fear of death pain is relieved by nitroglycerin true a) and d) true b) and c) all true 011. a) b) c) d) e) Symptoms of myocardial infarction all are true except: diarrhea asthma sever pain e in epigastria area arrhythmia disorders of brain circulation 012. a) b) c) What staff of intensive therapy departments should be 2 doctors and 2 nurses for 6 patients 1 doctor and 2 nurses for 6 patients 1 doctor and 1 nurse for 6 patients 013. a) b) c) d) Intensive therapy departments are supplied with all the following, except: monitor observation of cardiovascular and respiratory functions endoscopy defibrillators cardiac stimulators 014. Stabilization of the course of acute myocardial infarction includes all the following, except: a) estimation of pain b) decrease of blood coagulation c) normalization of stool and urination d) normalization of the heart rhythm and level of blood pressure 015. a) b) c) How many days the patient usually stay in CCU: 1-3 days 2-4 days 5-7 days 016. The medical care of the patient with myocardial infarction during the first days includes of the following except: a) strict bed rest b) free bed rest c) control of bedclothes state d) regular change of bedding clothes 017. The medical care of the patient with myocardial infarction during the first few days includes all the following except: a) free bed rest 26 b) c) d) feeding of the patients skin care provision of bedpan and urinal 018. a) b) c) d) Vital signs are called all the following except: breath and pulse rate count measurement of blood pressure measurement of temperature measurement of daily urine amount 019. The causes of the heart failure are all the following, except: a) myocarditis b) ischemic heart disease c) defects of heart d) hypertension e) peptic ulcer 020. The cause of cardiac asthma is a) stagnation of blood in lesser circulation b) bronchitis c) spasm of bronchi and trachea d) tumor of larynx 021. Signs of cardiac asthma are all the following, except: a) sever dyspnea b) rapid shallow breath c) cyanosis d) abdominal pain 022. Irregular pulse occurs in all situations, except: a) ectopic beats b) atrial fibrillation c) sinuse tachycardia d) sinuse bradicardia e) true a) and b) f) true c) and d) 023. Pulse is changed in next situation a) stress b) during work c) fever d) physical exercises e) all is true 024. What properties of pulse should be estimated: a) rate b) rhythm c) pressure d) volume e) all is true 025. Heart beat rate more 90 per minute is called 27 a) tachycardia b) bradicardia 026. Heart beat rate lesser 60 per minute is called a) tachycardia b) bradicardia Tests for lesson №13 001. Complication of cardiac asthma is a) pneumonia b) bronchitis c) pulmonary edema d) myocardial infarction 002. Signs and symptoms of chronic heart failure include all the following except: a) dyspnea b) cyanosis c) tachycardia d) bradycardia 003. Signs of chronic heart failure include all the following except: a) dyspnea b) peripheral edemas c) enlargement of liver d) enlargement of spleen 004.Most dangerous complication of myocardial infarction is a) myocarditis b) endocarditis c) pericarditis d) cardiogenic shock 005. Signs of cardiogenic shock are all the following, except a) pale skin b) hyperemia c) cold sweating d) dyspnea e) thready pulse 006. a) b) c) First aid in cardiogenic shock is all the following, except: removing painful sensation elevation of blood pressure decreasing blood pressure 007. a) b) c) d) First aid in cardiogenic shock is all the following except: increasing circulating blood volume decreasing circulating blood volume increasing myocardium contractility decreasing myocardium contractility 28 e) f) g) true a),b) true c), d) true a), c) 008. a) b) c) d) First aid in chronic heart failure is all the following, except: keeping bed rest raising bed head inhalation of oxygen mixture flat position of patient 009. a) b) c) Regular control for dynamics of edemas is necessary as daily liquid balance daily ECG daily blood analysis 010. a) b) c) positive diuresis means next: predominance of amount of discharged liquid above intake predominance of intake liquid above of amount of discharged liquid amount of discharged liquid same with intake liquid 011. a) b) c) Negative diuresis means next: predominance of amount of discharged liquid above intake predominance of intake liquid above amount of discharged liquid amount of discharged liquid same with intake liquid 012. a) b) Retention of liquid in the organism is characterized by? positive diuresis negative diuresis 013. a) b) c) Regular control for dynamics of edemas is all the following, except: daily liquid balance control daily blood analysis control regular weighing of the patient 014. a) b) c) Treatment of edema is all the following, except: Limit the amount of liquid intake Administration of cardiac glycosides Administration of diuretics promoting elimination of potassium from the organism 015. a) b) c) Syncope is characterized by falling of vascular tone falling of vascular tone and decreasing circulation of blood volume increasing circulation of blood volume 016. a) b) c) Collapse is characterized by falling of vascular tone falling of vascular tone and decreasing circulation of blood volume increasing circulation of blood volume 017. a) b) Cause of syncope is all the following, except: sever pain negative emotions 29 c) d) e) long standing fast transition from a horizontal position to vertical sever bleeding 018. a) b) c) d) e) f) Cause of collapse is all the following, except: long standing thromboembolisim of pulmonary artery acute pancreatitis sever arrhythmias blood loss poisoning 019. a) b) c) d) e) f) g) Signs of syncope are next hypertension hypotension short-term loss of consciences long-term loss of consciences true a), c) true b), d) true b), c) 020. a) b) c) d) Treatment of syncope includes all the following, except: horizontal position with the lowered head and raised legs horizontal position with the lowered legs and raised head fresh air providing releasing patient from constraining clothes 021. a) b) c) d) Treatment of syncope includes all the following, except: sprinkling cold water on the face of the patient clapping on the cheeks fresh air providing providing horizontal position with the lowered legs and raised head 022. a) b) c) d) Collapse is characterized by all the following, except: unconscious pallor of the skin redness of the skin decreased body temperature 023. a) b) c) d) Collapse is characterized by all the following, except: pallor of the skin increased body temperature surface and rapid breath low blood pressure 024. a) b) c) d) Treatment of collapse includes all the following, except: elevation of circulating blood volume warming of the patient elimination of collapse cause administration of hypotensive drugs 025. Usually pulse is checked on 30 a) b) ulnari artery radial artery 026. Pulse can be changed in all the following, except: a) age b) sex c) climate d) fever e) all true Tests for lesson № 14 001. Pains due to impairment of the organ’s motor function are named а - visceral pains b – peritoneal pains c – motor pains d – boring pains 002. Pains due to perforation of stomach ulcer and inflammation of peritoneal layer are named а - visceral pains b – peritoneal pains c – motor pains d – boring pains 003. Peritoneal pains are characterized by а - precisely localization b – no precisely localization 004. What is necessary to prescribe by nurse if the nature of abdominal pains isn’t clear? а - analgesics b – laxative c - hot water bottle d - enema c - bed regimen 005. Dyspeptic disorder isn’t а - nausea b – vomiting c - diarrhea d - abdominal pain e - heartburn 006. Vomiting occurs at all diseases besides а - peptic ulcer b – tumor of stomach c - renal colic d - bile colic e - phlebitis 007. Profuse vomiting can lead to 31 а - dehydration or disorders of cardiac activity b – constipation or diarrhea c - pyuria or haematouria 008. First medical care by nurse during vomiting is а - estimation of volume of emetic masses, smell, color, consistence, pH, character of food remnants b – put or laid patient on the side, incline patient’s head downwards, put basin on the floor, collect emetic contents c - rinse the mouth of the patient with warm water d – gastric aspiration 009. Hematomesis means а - admixture of blood in emetic masses b – admixture of blood in feces c - admixture of blood in sputum 010. Flatulence can be seen after next meals а - cabbage, black bread, haricot b – meat, butter, fish c - buckwheat, millet, oats 011. Medical care in flatulence includes the prescription of а - of activated charcoal or carbolen b – laxative c - spasmolytics 012. Length of colonic tube is а - 10-20 cm b – 30-50cm c - 60-70 cm d – 70-90 cm 013. Diameter of colonic tube is а - 1-2 mm b – 3-5 mm c - 2-4 mm d – 5-10 mm 014. Colonic tube is usually introduced through the rectum for а - 10-20 cm b – 30-40cm c - 60-70 cm d – 20-30 cm 015. Gastrointestinal bleeding can arise in patients with а - peptic ulcer, liver cirrhosis, hemorrhoids, tumor of stomach b – neurosis, atherosclerosis, hives c - pulmonary edema, cardiac asthma, myocardium infarction 016. Gastrointestinal bleeding appears as а - heamatemesis or melena 32 b – hemoptysis or melena c - black tarry stool or flatulence d - black tarry stool or constipation 017. Emetic masses contain scarlet blood in case of а - gastric bleeding with high acidity or esophageal bleeding b – gastric bleeding with low acidity or intestinal bleeding c - gastric bleeding with low acidity or esophageal bleeding or gastric bleeding with very significant amount of blood loss 018. Emetic masses alike “coffee-ground” occur in case of а - gastric bleeding with high acidity b – gastric bleeding with low acidity c - esophageal bleeding 019. Brownish color of emetic mass in gastric bleeding are result from а - chemical reaction of blood with pepsin b – chemical reaction of blood with hydrochloric acid c - chemical reaction of blood with pentagastrin d - chemical reaction of blood with gastrin 020. Melena is caused by а - impurity of sulfides b – impurity of chlorides c - impurity of phosphates 021. Gastrointestinal bleeding is accompanied by а - low blood pressure, bradycardia or tachycardia, pallor of skin b – high blood pressure, bradycardia or tachycardia, pallor of skin c - high blood pressure, bradycardia or tachycardia, tachypnea or bradypnea d - low blood pressure, tachycardia, pallor of skin 022. After profuse gastrointestinal bleeding the level of blood hemoglobin а - increases b – decreases c - no changes 023. Patient with gastrointestinal bleeding needs а - strict bed regimen b – Trendelenburg’s position c - half-sedentary position 024. Patient with gastrointestinal bleeding needs a medical care as а - applying hot water bottle b – applying ice-bag c - applying caps d – applying enema 025. Patient with gastrointestinal bleeding needs a medical care as а - injection of vicasol b – injection of libexin c - injection of diuretic 33 026. Patient with gastrointestinal bleeding needs a medical care as а - injection of 1% calcium chloride solution b – injection of 10% calcium chloride solution c - injection of 0.1% calcium chloride solution 027. Melena is a sign of а - pulmonary bleeding b – intestinal bleeding c - gastrointestinal bleeding d – rectal bleeding 028. Heamatemesis is a sign of а - pulmonary bleeding b – intestinal bleeding c - gastrointestinal bleeding d – rectal bleeding 029. Gastroenterological diseases aren’t а - gastritis and duodenitis b – enteritis and colitis c - peptic ulcer and tumor of stomach d – heamatomesis and melena 030. Gastroenterological diseases are а - eructation and regurgitation b – diarrhea and constipation c - peptic ulcer and tumor of stomach d – nausea and vomiting Tests for lesson № 15 001. Gastric aspiration is used for а - treatment of gastric bleeding b – fractional investigation of gastric juice c – treatment of vomiting d – treatment of poisoning 002. Gastric aspiration helps to make diagnosis of а - peptic ulcer and gastritis b – peptic ulcer and colecystitis c – peptic ulcer and colitis 003. For gastric aspiration a nurse uses а - gastric probe 6-7 mm in diameter b – gastric probe 4-5 mm in diameter c – gastric probe 1-2 mm in diameter 004. For gastric aspiration a nurse usually uses а - 20-g syringe 34 b – 10-g syringe c – 5-g syringe d - 2-g syringe 005. Dyspeptic disorder isn’t а - nausea b – vomiting c - diarrhea d - abdominal pain c - heartburn 006. First portion of gastric aspiration characterizes а - gastric secretion at morning b – gastric secretion at night c - gastric secretion at day and night d - gastric secretion at night and morning 007. Pentagastrin for gastric aspiration is used in dose а - 6 mkg per 1 kg of body weight b – 5 mkg per 1 kg of body weight c - 0.04 mkg per 1 kg of body weight d - 0.04 mg per 1 kg of body weight 008. Histamine for gastric aspiration is used in dose а - 6 mkg per 1 kg of body weight b – 5 mkg per 1 kg of body weight c - 0.04 mkg per 1 kg of body weight d - 0.04 mg per 1 kg of body weight 009. Basal secretion means а - gastric juice before stimulation b – all gastric juice c - portion at fasting d - hydrochloric acid production before stimulation e - hydrochloric acid production after stimulation f - all amount hydrochloric acid production during aspiration 010. Acidity is determine by titration of gastric juice with а - 0.01N sodium hydroxide solution b – 1N sodium hydroxide solution c - 0.1N sodium hydroxide solution 011. To stop bleeding the gastric lavage is used а - with iced water b – with hot water c - with room temperature water 012. Normal intragastric pH is а - 1.0-1.3 b – 1.3-1.7 c - 1.2-1.3 d – 1.5-1.7 35 013. Duodenal aspiration is used for diagnostics а - gastritis b – cholecystitis c - colitis 014. Duodenal probe is rubber probe а - 4-5 mm in diameter b – 5-6 mm in diameter with metal tip c - 4-5 mm in diameter with metal tip d – 5-6 mm in diameter 015. There are three marks on duodenal probe as а - 45 cm, 70 cm, 80 cm b – 40 cm, 70 cm, 80 cm c - 50 cm, 70 cm, 80 cm 016. Duodenal probe mark 70 cm means а - distance to subcardial stomach area b – distance to pyloris c - distance to duodenum 017. Duodenal probe mark 80 cm means а - distance to subcardial stomach area b – distance to pyloris c - distance to duodenum 018. When the probe of duodenal aspiration reaches the stomach, the patient should have the position а - of Trendelenburg b – on right side c - on left side d - of sitting 019. Duodenal probe mark 45 cm means а - distance to subcardial stomach area b – distance to pyloris c - distance to duodenum 020. Common duration of gastric aspiration is а - 40-60 minutes b – 20-30 minutes c - 60-150 minutes d - 120-150 minutes 021. The stimulant of gall bladder contraction for duodenal aspiration is а - 25-33% solution of magnesium sulfate b – 25-33% solution of calcium sulfate c - 25-33% solution of calcium chloride 022. Portion A of duodenal aspiration is а - gastric contents b – duodenal contents 36 c - gall bladder contents d – contents of intra liver bile ducts 023. Portion B of duodenal aspiration is а - gastric contents b – duodenal contents c - gall bladder contents d – contents of intra liver bile ducts 024. Portion C of duodenal aspiration is а - gastric contents b – duodenal contents c - gall bladder contents d – contents of intra liver bile ducts 025. Normal portion B has а - brown or olive color b – white color c - yellow color 026. Histamine for sub maximal gastric secretory stimulation is used in dose а - 0.01 mkg per 1 kg of body weight b – 0.01 mg per 1 kg of body weight c - 0.04 mkg per 1 kg of body weight d - 0.04 mg per 1 kg of body weight 027. Histamine for maximal gastric secretory stimulation is used in dose а - 0.01 mkg per 1 kg of body weight b – 0.01 mg per 1 kg of body weight c - 0.04 mkg per 1 kg of body weight d - 0.04 mg per 1 kg of body weight 028. Stimulators of gastric secretory are а - histamine and pentagastrin b – histamine and charcoal c - histamine and magnesium sulfates 029. Basal secretion includes а - all gastric aspiration portions before stimulation b – all gastric aspiration portions c - four gastric aspiration portions before stimulation d - gastric aspiration portions after stimulation e – last four gastric aspiration portions 030. Stimulated secretion includes а - all gastric aspiration portions before stimulation b – all gastric aspiration portions c - four gastric aspiration portions before stimulation d - gastric aspiration portions after stimulation e – last four gastric aspiration portions 37 Tests for lesson №16 001. In retention enema the patient holds the solution within the rectum for а - 10-15 minutes b – 20-40 minutes c – 30-40 minutes d – 30-60 minutes 002. In irrigating enema the patient holds the solution within the rectum for а - 15 minutes b – 40 minutes c – 30 minutes d – 60 minutes 003. Diagnostic enema is applied for diagnostics of а - flatulence b – ileus c – duodenitis 004. Vegetable oil for oil enema is usually used in dose а - 200-400 g b – 200-300 g c – 200-400 g d - 100-200 g 005. Vegetable oil for oil enema is usually heated to a temperature а - 37-38 o C b – 38-39 o C c – 36-37 o C d - 36-38 o C 006. The oil enemas provide а - relaxation of intestinal wall b – increased tonus of intestinal wall c - general relaxation d - decreased blood pressure 007. Hypertonic enema is used in patient with а - spasmodic constipation b – atonic constipation c - diarrhea d - ileus 008. Janet syringe is used for applying а - flash enema b – irrigating enema c - oil enema d - retention enema 009. Sodium chloride solution for hypertonic enema is usually used in concentration а - 20 % b – 10 % 38 c - 30 % d – 40% 010. Sodium chloride solution for hypertonic enema is usually used in volume а - 40-50 ml b – 50-60 ml c - 60-80 ml d – 80-100 ml e - 50-100 ml 011. Magnesium sulfate solution for hypertonic enema is usually used in concentration а - 20-30 % b – 10-20 % c - 30-40 % d – 5-10 % 012. Flash enema is applied at а - dynamic or mechanical ileus b – enteritis c - diarrhea d - peritonitis 013. Flash enema isn’t applied at а - dynamic or mechanical ileus b – enteritis c - embolism of mesentery vessels 014. Irrigating enema is applied at а - gastrointestinal bleeding and necrotic tumor of a large intestine b – acute appendicitis and peritonitis c - colitis with constipation d – colitis with diarrhea 015. Irrigating enema isn’t applied at а - before applying medical enema b – acute appendicitis and peritonitis c - colitis 016. Volume of medicinal enema is usually а - 30-50 ml b – 50-100 ml c - 100-200 ml d – 150-200 ml 017. For medicinal enema a nurse usually uses а - collargol solution b – serum solution c - collagen solution 018. Dropper enema is applied at а - persistent vomiting b – persistent nausea 39 c - persistent constipation 019. Dropper enema is applied at а - dehydratation b – hydrophobia c - hydrolysis 020. Endoscopic investigation of abdominal cavity is named а - esophagogastroduodenoscopy b – rectoromanoscopy c - colonoscopy d – laparoscopy 021. Before cholecystography it’s necessary а - applying oil enema b – applying flash enema c - applying irrigating enema d – applying barium enema 022. Endoscopic investigation of large intestine is named а - esophagogastroduodenoscopy b – rectoromanoscopy c - colonoscopy d – laparoscopy 023. X-ray investigation of gall bladder is named а - cholegraphy b – cholangiography c - cholecystography 024. X-ray investigation of biliary ducts is named а - cholegraphy b – cholangiography c - cholecystography 025. Before cholecystography it’s necessary to keep diet with exclusion а - cabbage, black bread, milk b – cabbage, white and black bread, milk c - white and black bread, milk 026. At flush enema a patient should have position а - half sedentary b – Sims’ position c - right-lateral Sims’ position d - left-lateral Sims’ position 027. Contraindications for setting irrigating enema include а - ulcerative lesion of large intestine, acute appendicitis, acute rhinitis b – ulcerative lesion of large intestine, acute appendicitis, chronic rhinitis c - ulcerative lesion of large intestine, acute appendicitis, acute urticaria d - ulcerative lesion of large intestine, severe heart failure 40 028. At expressed flatulence to remove gases a nurse usually uses a colonic tube introduced through the rectum for а - 20-30 cm b – 30-40 cm c - 40-50 cm d - 30-50 cm 029. At expressed flatulence to remove gases a colonic tube is applying no more а - 0.1 hour b – 1 hour c - 1.5 hour d - 2 hours 030. The preparation for rectoromanoscopy includes usually а - oil enema b – irrigating enema c - dropper enema d – barium enema e – medicinal enema 41 Tests for lesson № 17. Care of the patients whis urinary tract diseases. 001. The following are the common symptoms of renal disease except a) pain in the lumbar region; b) disordered urination; c) oedema; d) dry cough. 002. The following is the main symptom of renal colic a) sharp, suddenly developing pain in the lumbar region; b) dyspnoea; c) deranged vision; d) oedema. 003. If daily amount of urine exceeds 2 liters, this symptom is called a) anuria; b) oliguria; c) polyuria; d) nycturia. 004. A complete absence of urine or daily urine excretion rate less than 200 ml is called a) anuria; b) oliguria; c) polyuria; d) nycturia. 005. The following are the common symptom of renal hypertension except a) headache; b) deranged vision; c) vertigo; d) edema. 006. Normally daily urinary protein excretion rate a) is less than 50 mg; b) varies from 50 to 150 mg c) varies from 0,5 to1 g; d) exceeds 1 g. 007. The following elements can be detected in urinary sediment except a) leucocytes; b) erythrocytes; c) casts; d) proteins. 008. How many red cells can be fined normally in one vision field of a light microscope? a) no more than one; b) ranges 2-5; c) ranges 5-10; d) more than 10. 42 009. How many white cells can be fined normally in one vision field of a light microscope? a) no more than one; b) 1-3 in male, 3-5in female; c) ranges 5-10; d) more than 10. 010. The following type of casts can be detected in healthy person after physical exhaustion a) hyaline casts; b) granular casts; c) waxy casts. 011. What test is used to determine the number of erythrocytes and leucocytes; in daily amount of urine? a) Addis-Kakovsky’s test; b) Nechiporenko’s test; c) Zimnitsky’s test; d) Rehberg’s test. 012. What test is used to determine the number of red and white cells in 1 ml of urine? a) Addis-Kakovsky’s test; b) Nechiporenko’s test; c) Zimnitsky’s test; d) Rehberg’s test. 013. Normally specific gravity of morning urine a) should be less than 1010; b) ranges 1005-1015; c) should be more than 1018; d) ranges 1030-1040. 014. Zimnitsky’s test is used to estimate a) daily urinary protein excretion rate; b) concentrative function.of the kidney; c) glomerular filtration and tubular reabsorbtion; d) endocrine function.of the kidney. 015. Rehberg’s test is used to estimate a) daily urinary protein excretion rate; b) concentrative function.of the kidney; c) glomerular filtration and tubular reabsorbtion; d) endocrine function.of the kidney. 016. Normally creatinine clearance a) dosn’t exceed 60 ml/min; b) ranges 80-120 ml/min; c) exceeds 140 m,/min; d) ranges 20-50 ml/min. 017. Routine bladder drainage with rubber catheter is performed a) to control daily diuresis; 43 b) to provide continuous urine drainage; c) to decreased risk of urinary tract infection; d) in patients with absent bladder function. 018. To perform routine bladder drainage in male the rubber catheter is inserted a) about 3 cm; b) about 7-8 cm; c) about 17-22 cm; d) about 25-30 cm. 019. To perform routine bladder drainage in female the rubber catheter is inserted a) about 3 cm; b) about 7-8 cm; c) about 17-22 cm; d) about 25-30 cm. 020. Insertion indwelling urinary catheter in the bladder is used a) to control daily diuresis; b) to provide continuous urine drainage; c) to decreased risk of urinary tract infection; d) to prevent overdistention of the bladder. 44 Tests for lesson № 18 001. Which one of the following subjects studies of dying process mechanism (clinical, biochemical, morphological): a) cardiology b) pulmonology c) nephrology d) thanatology 002. What is the name of the state boundary between life and death? a) coma b) collapse c) heart failure d) terminal 003. Stages of terminal states include all the following, except: a) coma b) preagonal c) agony d) clinical death 004. What is name of second stage of terminal states? a) Agony b) preagonal c) coma d) clinical death 005. What is name of first stage of terminal states? a) Agony b) preagonal c) coma d) clinical death 6. What is name of third stage of terminal states? 007. In the preagonal state all the following are true, except: a) gradual oppression of consciousness b) fall of blood pressure c) rapid heart beat and breath, turning to slow d) slow heart beat and breath, turning to rapid 008. What is duration of preagonal period in case of myocardial infarction and sever arrhythmias? a) absent b) several hours 009. What is the duration of preagonal period in chronic diseases: a) absent b) several hours 010. In terminal pause of preagonal state next is true: a) short-term termination of breath from 5-10 seconds to 3-4 minutes b) mild-term termination of breath from 10 minutes to 15 minutes 45 c) long-term termination of breath from 1 hour to 2 hours 011. Which one of the following character of agony is true? a) short-term activation of mechanisms directed to maintenance of process of ability to live b) mild-term activation of mechanisms directed to maintenance of process of ability to live c) long-term activation of mechanisms directed to maintenance of process of ability to live 012. Which one of the following signs in the beginning of agony is true: a) some rising blood pressure b) decreasing blood pressure c) decreasing heart rate 013. Which one of the following signs in the beginning of agony is true: a) decreasing blood pressure b) decreasing heart rate c) increasing heart rate 014. Which one of the following signs in the beginning of agony is not true: a) disappearing pain sensitivity b) lost corneal, tendinous and skin reflexes c) common tonic spasms d) frequent, long and superficial breath 015. Which one of the following signs in the beginning of agony is true: a) no change in the pain sensitivity b) presence of corneal, tendinous and skin reflexes c) rare, short and deep breath d) heart rhythm 60-80 016. Which one of the following signs in the beginning of agony is not true: a) slowing heart rate b) involuntary miction and defecation c) tonic spasms d) presence of corneal, tendinous and skin reflexes 017. Which one of the following signs of clinical death is not true: a) irreversible changes in organs and tissues b) reversible changes in organs and tissues c) disappearance of breath and heart beats 018. Which one of the following of clinical death is true: a) clinical death lasts 3-4 minutes b) clinical death lasts 5-6 minutes c) clinical death lasts 10-12 minutes 019. In the biological death all the following are true, except: a) body temperature between 30 o C to 35 o C b) rigor mortis c) death sports in 2-4 hours after heart arrest d) death sports after in one hour after heart arrest e) true a),b),c) f) true a),c),d) 46 020. All the following causes of sudden cardiac and respiratory arrest are true, except: a) myocardial infarction b) traumatic chock c) carbon monoxide poisoning d) chronic cholecystitis 021. If the patient stops breathing which of the following manipulation nurse should do first? a) check pulse on a.radialis b) check pulse on a.carotis c) auscultate the heart 022. If the patient has died in a hospital which of the following first manipulation should be done? a) tied the lower jaw b) covered a corpse by besheet c) left a corpse in the department for 2 hours d) write in the history of fact of death and exact time of death 023. If the patient has died in a hospital the nurse should do all the following, except: a) write by ink on the thigh the surname and initials of the dead patient b) write in the history of fact of the death and exact time of the death c)write on the thigh of case history number of the dead patient 024. Which of the following guidelines apply occurs when the death is happened less than 3 hours? a) body warm, no rigor b) body warm, rigor present c) body cold, rigor present d) body cold, no rigor 025.Which of the following guidelines apply occurs when the death is happened 3-8 hours before the inspection time? a) body warm, no rigor b) body warm, rigor present c) body cold, rigor present d) body cold, no rigor 026. Which of the following guidelines apply occurs when the death is happened 8-36 hours before the inspection time? a) body warm, no rigor b) body warm, rigor present c) body cold, rigor present d) body cold, no rigor 027. The resuscitative measures are carried our in all the following, except: a) acute myocardial infarction b) electric shock c) sever traumas d) last stage of malignant tumor 028. The general resuscitative departments are for resuscitative manipulations in all the following, except: 47 a) traumatic shock b) massive blood loss c) acute heart failure d) observation and treatment of post-operative patients 029. The specialized centers and departments of reanimation include all the following,except: a) cardio-reanimation b) the treatment of the patients with renal failure c) treatment of the patients with poisoning d) treatment of the patients with massive blood loss 030. In hemodialysis one of the following is true: a) filtering of blood from various toxic substances by selective diffusion b) extracting toxins from blood with help of sorbents c) high pressure oxigination 031. Where is the intensive care unit located? a) near a surgery department b) near a reception department c) near a cardiology department d) near a nephrology department 032. The express diagnostics analysis in reanimation departments include all the following, except: a) investigation of total blood protein b) investigation of blood gases c) investigation of acid base balance d) investigation of electrolyte balance of blood and urine 033. The necessity of artificial respiration arises in all the following, except: a) disorders of brain circulation b) brain edema c) poliomyelitis d) arthritis 034. Before starting artificial respiration nurse should provide a) empty digestive tract b) empty urinal bladder c) free respiratory tract from water and mucus 035. During artificial respiration nurse should do all the following, except: a) place the patient on his abdomen b) loosen any tight clothing around his neck or chest c) lift up the chin and tilt head back as far as possible d) pinch the patient's nostrils for closing by fingers 036. If patient is revived after artificial respiration which one of the following is true? a) keep him in cold place d) do not move him at least 30 minutes c) keep him in cold place and do not move him at least 45 minutes d) keep him in warm place and don't move him at least one half hour 48 037. Which one of the following bags is called as hand-operated? a) urine bag b) Ambu bag c) King bag d) Soft bag 038. In external cardiac massage which one of the following is true? a) supine on a flat, hard surface b) supine on a bed c) supine on flat, soft surface 039. Which one of the following is true? a) cardiac massage is accompanied with artificial ventilation started at once b) cardiac massage is accompanied with artificial ventilation started after 2 min c) cardiac massage is accompanied with artificial ventilation started after 5 min 040. Which one of the following place in cardiac massage is true? a) the heel of one hand over the upper third of the sternum b) the heel of one hand over the lower third of the sternum c) the heel of one hand over the middle third of the sternum 041. the pressure applied in the cardiac massage should be one of the following: a) 10-15 kg b) 20-30 kg c) 35-45 kg d) 5-10 kg 042. The movement of chest wall in adult patients in the cardiac massage should be one of the following: a) 3-4 cm b) 5-6 cm c) 6-7 cm d) 1-2 cm 043. Which one of the following is true? a) cardiac compressions should be 60 per minute b) cardiac compressions should be 70 per minute c) cardiac compressions should be 75 per minute 044. Which one of the ration of cardiac compression to ventilation should be if do it by 2 persons? a) 3:1 b) 6:1 c) 8:1 d) 10:1 045.Indicationns for starting of external cardiac compression are based on all the following signs except: a) sudden arrest of breath b) absence of pulse on carotid arteries c) redness of skin and narrowing of pupils d) loss of consciousness 49 046. Most frequent complication of indirect heart massages is on of the following: a) damages of lungs and heart b) fracture of ribs and sternum c) rupture of lien d) rupture of liver 047. Signs of efficiency of external cardiac compression are all the following, except: a) extension of pupils b) appearance of pulse on carotid arteries c) increase of blood pressure d) narrowing of pupils 048. At revealing fibrillation of ventricles one of the following is true: a) external cardiac compression b) intracardiac injection of 5 ml of 10% calcium chloride solution c) defibrillation 50 Keys to Subject 1. “ISSUES OF GENERAL MEDICAL CARE.” 001– a 002– b 003– d 004– c 005– c 006– d 007– e 008– d 009– e 010– b 011– a 012– c 013– b 014– d 015– b 016– a 017– b 018– b 019– b 020– a Keys to Subject 2. “HOSPITAL RECEPTION ROOM. DOCUMENTATION.” 001– b 002– c 003– a 004– b 005– b 006– a 007– a 008– a 009– b 010– d 011– a 012– c 013– a 014– b 015– c 016– c 017– b 018– a 019– b 020– c 51 Keys to Subject 3. “PERSONAL HYGIENE OF THE PATIENT” 001– b 002– b 003– c 004– c 005– b 006– c 007– b 008– c 009– d 010– d 011– c 012– a 013– c 014– b 015– c 016– a 017– c 018– b 019– b 020– c KEY № 6. 001.a 002.a 003.b 004.c 005.a 006.b 007.c 008.a 009.d 010.b 011. a 012. b 013. c 014. a 015. b 016. c 017. a 018. c 019. b 020. d 021. a 022. b 023. b 024. d 025. d KEY № 7: 001.A 002.A 003.E 004.A 005.B 006.C 007.B 008.A 009.C 010.C 011. B 012. B 013. D 014. A 015. B 016. A 017. A 018. D 019. D 020. C 021. A 022. C 023. B 024. C 025.A 52 KEY № 8: 001. c 002 .c 003. a 004 .a 005. d 006. b 007. c 008. a 009. c 010. a 011. d 012. a 013. d 014. a 015. c 016. a 017. a 018. a 019. d 020. b 021. a 022. a 023. e 024. a 025. e Right answers for lesson № 9. 001-c; 002-a; 003-a; 004-a; 005-b; 006-c; 007-b; 008-b; 009-a; 010-b; 011-c; 012-b; 013-a; 014-a; 015-c; 016-d; 017-a; 018-a; 019-d; 020-b. Right answers for lesson № 10. 001-b; 002-d; 003-d; 004-c; 005-d; 006-d; 007-c; 53 008-d; 009-d; 010-b; 011-b; 012-a; 013-a; 014-b; 015-b; 016-b; 017-d; 018-d; 019-a; 020-d. Right answers for lesson № 12. 001-d 002-a 003-d 004-a 005-a 006-d 007-a 008-b 009-e 010-e 011-a 012-b 013-b 014-c 015-c 016-b 017-a 018-d 019-e 020-a 021-d 022-e 023-e 024-a 025-a 026-b Right answers for lesson № 13. 001-c 002-c 003-d 004-d 005-d 006-b 007-c 008-g 54 009-d 010-a 011-a 012-b 013-b 014-b 015-a 016-a 017-b 018-e 019-a 020-g 021-b 022-d 023-c 024-b 025-d 026-b Right answers for lesson № 14. 001a 002-b 003-a 004-e 005-d 006-e 007-a 008-b 009-a 010-a 011-a 012-b 013-d 014-d 015-a 016-a 017-c 018-a 019-b 020-a 021-d 022-b 023-a 024-b 025-a 026-b 027-c 028-c 029-d 030-c Right answers for lesson № 15. 001-b 002-a 003-b 004-a 005-d 55 006-a 007-a 008-d 009-a 010-c 011-a 012-b 013-b 014-c 015-a 016-b 017-c 018-b 019-a 020-d 021-a 022-b 023-c 024-d 025-a 026-b 027-d 028-a 029-c 030-e Right answers for lesson № 16. 001-d 002-a 003-b 004-d 005-a 006-a 007-b 008-c 009-b 010-e 011-a 012-a 013-c 014-c 015-b 016-b 017-a 018-a 019-a 020-d 021-c 022-c 023-c 024-a 025-a 026-d 027-d 028-a 029-d 030-b 56 Right answers for lesson № 17 001-d; 002-d; 003-c; 004-a; 005-d; 006-b; 007-d; 008-a; 009-b; 010-a; 011-a; 012-b; 013-c; 014-b; 015-c; 016-b; 017-d; 018-c; 019-b; 020-b. Right answers for lesson № 18 001-b 002-d 003-a 004-a 005-b 006-d 007-d 008-a 009-b 010-a 011-a 012-a 013-c 014-d 015-d 016-d 017-a 018-b 019-e 020-d 021-b 022-d 023-b 024-a 025-b 026-c 57 027-d 028-d 029-d 030-a 031-b 032-a 033-d 034-c 035-a 036-d 037-b 038-a 039-a 040-b 041-b 042-a 043-a 044-b 045-c 046-b 047-a 048-c 58