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《急救护理学》期末考试题(试题二)

《急救护理学》期末考试题(试题二)
《急救护理学》期末考试题(试题二)

《急救护理学》期末考试题(试题二)

一、单项选择题

1.急诊科相对固定的急诊护士应不少于在岗护士的(C)

A.50%

B.30%

C.75%

D.80%

E.60%

2.大叶性肺炎患者在急性期最常表现的热型为(A)

A.稽留热

B.弛张热

C.间歇热

D.回归热

E.消耗热

3.在灾难现场检伤分类标准中,第二优先的标志用什么颜色(A)

A.黄色

B.绿色

C.黑色

D.红色

E.白色

4.轻度高渗性脱水时,缺水量为体重的(B)

A.1%~2%

B.2%~4%

C.4%~6%

D.7%~9%

E.8%~10%

5.下列关于被毒蛇咬伤后的急救措施,说法错误的是(A)

A.结扎越紧越好

B.在送医院途中应每隔15~20分钟放松一次

C.结扎时间越早越好

D.待伤口彻底清创处理和使用有效抗毒血清后再去除结扎带

E.在受伤部位的近心端5~10cm处压迫结扎

6.最少有多少血液进入肠道即会出现板油样便(D)

A.30ml

B.40ml

C.50ml

D.60ml

E.20ml

7.病人咯出血的颜色为(A)

A.鲜红

B.暗红

C.黑色

D.紫色

E.棕色

8.休克指数的计算方法是(C)

A.血压比脉率

B.血氧分压比吸入氧浓度

C.脉率与收缩压之比

D.收缩压比舒张压

E.脉率与舒张压之比

9.下列不属于急性肾衰竭病因的是(D)

A.血容量不足

B.心排出量减少

C.肾移植排斥

D.心排出量过高

E.尿路内外梗阻

10.下列哪种药物不属于急救药品(D)

A.强心药

B.升压药

C.止痛药

D.生理盐水

E.解毒药

11.下列关于创伤初始评估错误的是(D)

A.固定颈椎

B.维持呼吸道通畅

C.维持循环

D.避免暴露身体检查

E.控制出血

12.下列不属于急救护理学范畴的是(D)

A.院前急救

B.医院急诊救护

C.重症加强治疗病房

D.手术室进行手术治疗

E.急救护理的人才培养和科研工作

13.成人心脏骤停最常见的心电图节律表现是(A)

A.室颤

B.心室肥大

C.心室停顿

D.心肌缺血

E.三度房室传导阻滞

14.中心静脉压的正常值为(C)

A.1~6cm

B.7~16cm

C.5~12cm

D.13~16cm

E.15~20cm

15.下列哪一项不属于急性胰腺炎的临床表现(B)

A.恶心、呕吐

B.血糖降低

C.休克

D.皮下淤血

E.黄疸

二、多项选择题

16.下列对急性冠脉综合征的急诊处理中,正确的是(ABCDE)

A.绝对卧床休息

B.建立静脉通路

C.吸氧

D.进行心电监测

E.进行血氧饱和度监测

17.下列哪几项属于非入住ICU指征(ABC)

A.慢性消耗性疾病

B.肿瘤的终末状态

C.不可逆性疾病

D.急性器官功能衰竭

E.存在各种高危因素,具有潜在生命危险

18.下列属于休克病人呼吸功能监测指标的是(ABCD)

A.呼吸节律

B.动脉血气

C.呼吸频率

D.呼吸幅度

E.是否为胸式呼吸

19.下列属于严重创伤现场急救任务的是(ABCD)

A.脱离险境

B.报警呼救

C.判断和识别伤情

D.采取初步急救措施

E.立即进行手术

20.急性呼吸衰竭的临床表现包括(ABDE)

A.呼吸浅弱无力

B.发绀

C.心动过缓

D.弥散性血管内凝血

E.蛋白尿

21.能够引起心脏骤停的非心脏性因素包括(ABCDE)

A.呼吸系统疾病

B.麻醉意外

C.中枢神经系统疾病

D.严重的水、电解质及代谢紊乱

E.急性中毒

22.美蓝小剂量时可以治疗(ABC)

A.亚硝酸盐中毒

B.苯胺中毒

C.硝基化合物中毒

D.阿托品中毒

E.氰化物中毒

23.下列关于灾难检伤分类场所的正确的是(ABCDE)

A.远离危险源的安全场所

B.伤员容易看到的地方

C.便于陆地和空中通道疏散的地方

D.免受气候条件影响的地方

E.靠近灾难现场但与现场要有一定的距离,伤员相对集中、有足够面积的地域

24.目前,灾难救援护理人员的基本要求包括(ABCDE)

A.具备良好的专业技能

B.具备良好的身体素质

C.具备良好的心理素质

D.具备良好的观察能力

E.具备良好的沟通能力

25.下列说法中正确的是(ABDE)

A.分诊护士应主动热情地接待每一位前来就诊的病人

B.第一个接待急诊就诊病人的医生为首诊医生

C.常规抢救工作仅由当班护士长负责

D.危重病人抢救应由急诊科主任和护士组织抢救

E.遇到大批伤员时,急诊科主任负责组织相关的医生共同参与抢救

26.下列关于生存链的描述正确的是(ABCD)

A.早期通知急救系统

B.早期心肺复苏

C.早期除颤

D.早期给予高级心脏生命支持的急救

E.早期判断患者是否为呼吸缺失

27.脊柱骨折合并脊髓损伤的治疗原则为(BCDE)

A.早期心肺复苏

B.整复骨折脱位

C.稳定脊柱

D.恢复椎管

E.脊髓减压

28.压榨性胸痛痊于心前区,伴胸闷、呼吸困难、大汗淋漓,不可能是(ABDE)

A.呼吸衰竭

B.肠穿孔

C.心肌硬死

D.胆结石

E.胃穿孔

29.过敏性休克的症状有(ABCDE)

A.皮肤潮红、瘙痒

B.呼吸道阻塞症状

C.循环衰竭的表现

D.意识方面的改变

E.刺激性咳嗽

30.常用于治疗急性心力衰竭的药物是(ABCDE)

A.吗啡

B.硝普钠

C.呋塞米

D.多巴胺

E.肾上腺素

三、填空题

31.急诊分诊的重要目标不仅是分类,还要分流。

32.脑卒中可分为缺血性脑卒中和出血性脑卒中两大类。

33.腹痛包括内脏性腹痛、躯体性腹痛及感应性腹痛。

34.对于多发伤应遵循的急救和护理原则是“先救病,后治伤”。

35.休克按临床表现可他为冷休克和暖休克。

36.昼夜之间体温波动幅度较大,常超过1度,但最低温度仍在正常体温以上,此热型为弛张热。

37.烧伤面积的计算方法有新九分法和手掌法。

38.灾难伤员转运方式一般可分为地面转运,空中转运和水上转运。

四、名词解释

39.成批伤:是指同一致伤因素引起三人以上同进受伤或中毒。

40.中暑:是由于高温环境引起的体温调节中枢障碍、汗腺功能衰竭

和水、电解质丢失过多而发生的中枢神经系统和心血管系统功能障碍为主要表现的急性疾病。

41.延续生命支持:是指针对原发病或复苏并发症所采取的一系列措施,包括纠正低血压/休克、纠正水、电解质或酸碱平衡失调、防治肾衰竭、改善心肺功能和系统灌注,尤其是脑的灌注,防治脑缺氧和脑水肿。

42.急救半径:是指急救单位执行院外急救服务所覆盖的区域半径,缩小急救半径是急救单位能快速到达现场的重要条件之一。理想的急救半径是5~7公里。

43.急性重症胆管炎:是由于胆管梗阻和细菌感染,胆管内压力升高,肝脏胆-血屏障受损,大量细菌和毒素进入血液循环,造成以肝胆系统损害为主,合并多器官损害的全向严重感染性疾病。

五、简答题

44.简述复苏有效的指征

答:(1)颈动脉搏动:每一次按压均可扪及颈动脉的搏动,说明按压有效;如停止按压,即无颈动脉,说明心搏未恢复,应继续按压;仍可扪及明显的颈动脉搏动,说明心搏已经恢复。每一次按压时均不能扪及颈动脉搏动,说明按压无效;需改进操作手法。

(2)瞳孔:如瞳孔由大变小,对光反射从无到有,从迟钝到活跃,说明复苏有效;如瞳孔逐步由小变大,对光反射逐步消失,则说明复苏无效。

(3)脑组织功能逐步恢复的迹象:病人开始挣扎;肌张力增加;吞

咽动作出现;眼球自主法;自主呼吸出现并逐步规则和加强。

45.简述洗胃的禁忌征

答:(1)腐蚀性毒物中毒者。

(2)食管胃底静脉曲张、上消化道出血或胃穿孔。

(3)严重的心脏疾病或主动脉瘤病人。

(4)急生中毒伴惊厥未控制者。

六、论述题

46.简述先兆中暑与轻症中暑的急救与护理

答:立即将病人转移至阴凉、通风处;解开衣服,安静休息;观察体温、脉搏、呼吸、血压变化;服用防暑降温剂,如仁丹、十滴水等,并补充含盐清凉饮料。

47. 试述淹溺的急救与护理。

答:(1)清除呼吸道异物:去除口、鼻内可见的异物,打开气道,用头低脚高的体位将肺内及胃内积水排出。清除气道内的液体,推荐采用吸引的方法,但是不能因为倒水时间过长而延误复苏。

(2)人工呼吸:对呼吸停止的病人应立即进行人工呼吸。

(3)胸外按压:离开水,在给予2次人工呼吸后,溺水者仍无反应、无呼吸,未触及动脉搏动,应迅速给予胸外按压和人工呼吸,有条件可获取AED,如有除颤节律,应立即行电击除颤。

(4)高级生命支持:溺水者心跳停止需要高级生命支持,包括人工呼吸无效者进行气管插管,机械通气。所有溺水者均应送往医院进行监护,防治心律失常、心力衰竭、脑水肿、急性呼吸窘迫综合征。及

时纠正低血容量,对淡水淹溺血液稀释者,可静脉滴注3%氯化钠溶液500ml。对海水淹溺血浓缩及血容量不足者,可给予5%葡萄糖溶液或低分子右旋糖酐。

48.李某,男,46岁,因“胃溃疡复发”就诊于急诊科。来时病人面色苍白、手脚湿冷,自述心慌难受,呕吐少量咖啡色液体约30ml,排出少量黑色粪便,未解小便。查血压80/60mmHg,脉搏120次/分。(1)此时病人处于什么情况?判断依据是什么?

(2)应立即采取什么样的抢救措施?

答:(1)病人处于休克状态。依据:脉搏增快,大于100次/分;血压降低;脉压差减少,小于30mmHg; 皮肤色泽与温度改变,如面色苍白,四肢湿冷;尿量减小,小于30ml/小时。

(2)急救措施:就地抢救,让病人处于休克体位;快速建立静脉通道,及时补液;保持呼吸道通畅,给氧;注意保暖;采血送检,查血型及配血;留置导尿;作好病人心理护理,让病人保持安静;密切观察病人生命体征变化,做好护理记录。

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