Simulation question 2:
1. Patient, a 58-year-old male, had difficulty in urination and increased nocturia. Diagnosed as benign prostatic hyperplasia. B-ultrasound should not only make a further diagnosis, but also make sure.
A. the degree of hematuria
B. Degree of frequent urination
C. Degree of dysuria
D. Do you have urinary retention?
E. How much urine is left?
Answer: e
Analysis: To explore the auxiliary examination of benign prostatic hyperplasia. B-ultrasound can measure the volume of prostate and check whether the internal structure protrudes into the bladder. At present, ultrasonic method is widely used to measure residual urine. Before the examination, instruct the patient to urinate by himself and empty the bladder as much as possible.
2. The earliest symptom of benign prostatic hyperplasia is
A. Dysuria
B. Thinning of urethra
C. Urine outflow
D. frequent urination
E. Acute urinary retention
Answer: d
Analysis: To explore the clinical manifestations of benign prostatic hyperplasia. Frequent urination is the first symptom of patients with benign prostatic hyperplasia. The frequency of nocturia in the early stage increased obviously, and with the aggravation of obstruction, frequent urination can also occur during the day.
3. The patient, male, 75 years old, was diagnosed as benign prostatic hyperplasia. Yesterday, laboratory tests showed poor renal function. Which of the following measures should nurses take?
A. Continuous drainage with indwelling catheter
B. Prohibition of protein diet
C. Active preoperative preparation
D. cooperate with the doctor to perform suprapubic bladder puncture.
E. educate patients to take drugs harmful to the kidneys carefully.
A: A.
Analysis: To explore the nursing measures of benign prostatic hyperplasia. Patients with benign prostatic hyperplasia who have residual urine or renal insufficiency due to urinary retention should be indwelling catheter for continuous drainage to improve bladder detrusor and renal function.
4. The patient, male, 62 years old, has progressive dysuria, frequent nocturia and obvious increase in the front row of digital rectal examination, which should be considered as the first place.
A. Bladder cancer
B. Bladder stones
C. Prostatic hyperplasia
D. urethral stricture
E. bladder tuberculosis
Answer: c
Analysis: To explore the clinical manifestations of benign prostatic hyperplasia. Frequent urination is the first symptom of patients with benign prostatic hyperplasia. The frequency of nocturia in the early stage increased obviously, and with the aggravation of obstruction, frequent urination can also occur during the day. Progressive dysuria is a typical symptom of patients with benign prostatic hyperplasia. The patient has progressive dysuria, increased nocturia frequency, and significantly increased in the front row of rectal digital examination, which is considered as benign prostatic hyperplasia.
5. The patient, male, 7 1 year-old, suffered from benign prostatic hyperplasia and underwent selective transurethral prostatectomy. Four hours after operation, the patient was fidgety, nausea and vomiting, and had difficulty breathing. What complications may the patient have?
A.TURP syndrome
B. Acute renal failure and acute pulmonary edema
C. Shocked
D. Systemic infection
E. urinary retention
A: A.
Analysis: To explore the postoperative nursing care of benign prostatic hyperplasia. Patients with transurethral resection of the uterus may have dysphoria, nausea, vomiting, convulsion and coma within a few hours after operation, and in severe cases, pulmonary edema, cerebral edema and heart failure, which is called TURP syndrome. The patient developed dysphoria, nausea, vomiting and dyspnea 4 hours after operation, and was considered as TURP syndrome.
6. Elderly male patients with progressive dysuria are common in
A. Prostate cancer
B. Prostate hypertrophy
C. Bladder stones
D. urethral stricture
E. phimosis
Answer: b
Analysis: To explore the clinical manifestations of benign prostatic hyperplasia. Progressive dysuria is the most important symptom in patients with benign prostatic hyperplasia.
7. The main treatment for acute urinary retention in elderly men after drinking alcohol is
A. acupuncture
B. intramuscular injection of carbachol
C. suprapubic cystostomy
D. Bladder puncture
E. Trial catheterization and indwelling catheter
Answer: e
Analysis: To explore the nursing measures of benign prostatic hyperplasia. If severe dysuria and acute urinary retention occur, catheterization or indwelling catheterization should be performed, and suprapubic cystostomy can also be performed if necessary. The patient is an elderly male with acute urinary retention after drinking alcohol. The main treatment is to try catheterization and indwelling catheter.
8. Patient, a 60-year-old male, hesitated to urinate and had increased nocturia. The prostate is big and hard. Which of the following tests should be done to rule out prostate cancer?
A. Serum alpha-fetoprotein
Serum carcinoembryonic antigen (CEA)
C. serum prostate specific antigen
D. digital rectal examination
E. b-ultrasound
Answer: c
Analysis: To explore the auxiliary examination of benign prostatic hyperplasia. When the prostate is large, nodular or hard, serum prostate specific antigen (PSA) should be determined to rule out the possibility of prostate cancer.
9. The typical symptoms of benign prostatic hyperplasia are
A. frequent urination
B. Urgency
C. dysuria
D. urinary incontinence
E. progressive dysuria
Answer: e
Analysis: To explore the clinical manifestations of benign prostatic hyperplasia. Progressive dysuria is a typical symptom of patients with benign prostatic hyperplasia. It is characterized by slow urination, intermittent urination and dripping after urination. Patients with severe urinary tract obstruction have difficulty urinating, shortened range, thin and weak urinary line, and finally drip.
10. The patient was a 64-year-old male with benign prostatic hyperplasia and progressive dysuria over 1 year. Which of the following factors is mainly related to his prostatic hyperplasia?
A. drink less water
B. Habitual constipation
C. Urinary tract infection
D. Urinary calculi
E. Abnormal hormone metabolism in men
Answer: e
Analysis: To explore the etiology of benign prostatic hyperplasia. The imbalance between androgen and estrogen in human body is the cause of benign prostatic hyperplasia.
1 1. Male, 6 1 year old, benign prostatic hyperplasia, no obvious symptoms, no enuresis. At present, the main treatment methods are
A. observation, regular outpatient review
B. drug therapy
C. surgical therapy
D. laser therapy
E. placing prostate and urethral stent.
A: A.
Analysis: To explore the treatment principles of benign prostatic hyperplasia. Patients with benign prostatic hyperplasia without clinical symptoms and residual urine do not need special treatment, but they need follow-up.
12. The patient, a 58-year-old male, hesitated and labored in urination, with increased nocturia. Diagnosed as benign prostatic hyperplasia. Perform a prostatectomy. Nursing after operation 1 week, which is inappropriate.
A. Place two catheters
B. bladder irrigation fluid is injected from the balloon catheter.
C, irrigation fluid flows out from the suprapubic ostomy tube.
D. Patients with abdominal distension should exhaust through anal canal.
E. If necessary, add a hemostatic agent to the flushing fluid.
Answer: d
Analysis: To explore the nursing measures of benign prostatic hyperplasia. It is forbidden to enema or anal exhaust early after prostate surgery to avoid bleeding in prostate fossa.
13. The patient, a 58-year-old male, hesitated and labored in urination, with increased nocturia. Diagnosed as benign prostatic hyperplasia. Perform a prostatectomy. The problem of postoperative nursing is that
A. continuous irrigation with normal saline after operation.
B, irrigation fluid enters from the catheter and is discharged from the cystostomy tube.
C./kloc-pull out the balloon catheter in about 0/0 days.
D patients with constipation 3 days after operation should be enema.
E. the temperature of the rinsing liquid is close to the body temperature.
Answer: d
Analysis: To explore the nursing measures of benign prostatic hyperplasia. In order to prevent bleeding, early enema is forbidden for patients after prostate surgery.
14. The patient was a 64-year-old male with benign prostatic hyperplasia and progressive dysuria over 1 year. The first choice for relieving urinary retention is
A. Massage the abdomen
B. Catheter insertion
C. Acupuncture induction
D. listen to the sound of running water
E. suprapubic cystostomy
Answer: b
Analysis: To explore the nursing measures of benign prostatic hyperplasia. The cause of this patient's urinary retention is mechanical obstruction. Massage abdomen, acupuncture induction, listening to the sound of running water and other measures have little effect on this kind of reason. A more effective urination measure for this patient is catheterization.
15. The correct guidance of outpatient nurses for patients with vulvitis is
A. After removal of vestibular gland cyst, scrub vulva 1 time every day.
B. Give local cold compress or physical therapy care.
C. it is not necessary to stop bathing during menstruation.
D. Do not use irritating drugs or cleaning solutions locally.
E. there is no special requirement for food intake during illness.
Answer: d
Analysis: To explore the nursing measures of vulvitis. The vulva should be kept clean and dry, especially during menstruation, pregnancy and puerperium. Wash the vulva every day, and do not use irritating soap. Pay attention to the solution concentration, temperature and bathing time for local bathing, and don't do it during menstruation. Elderly patients should pay attention to the water temperature to prevent burns. Drainage should be done after incision and drainage of vestibular abscess, and the dressing should be changed 1 time every day; Scrub vulva with chlorhexidine cotton ball twice a day; After the wound is healed, you can take a bath with 1∶8000 nitrofurazone solution twice a day.
16. A 23-year-old woman with pruritus vulvae and increased vaginal discharge was diagnosed as vulvitis. The following is related to etiology.
A. Wearing tight underwear has poor air permeability
B. Prolonged menstrual cycle
C. The estrogen level is too high
D. Low progesterone level
E. Standing for a long time
A: A.
Analysis: Investigate the causes of vulvitis. The cause of vulvitis is that the local air permeability of tights is poor, and vaginal secretions, urine and feces stimulate vulvar skin; The vulva is not cleaned in time; Wearing chemical fiber underwear.
17. The patient was a 58-year-old female with senile vulvitis, and the doctor asked her to take a bath. One of the mistakes that nurses make when instructing patients to sit in the bath is
A. the perineum should be soaked in medicine.
B. The water temperature should be around 40℃
C. each time 10 minute.
D. it is forbidden to sit in the bath during menstruation.
E. twice a day
Answer: c
Analysis: To explore the nursing measures of vulvitis. Teach patients the methods and precautions of sitz bath: local use of 1: 5 000 potassium permanganate solution, water temperature about 40℃, about 20 minutes each time, twice a day. If you have ulcers, you can apply antibiotic ointment; When taking a bath, the perineum should be immersed in the potion; Don't take a bath during menstruation.
18. The patient was a 58-year-old female. The doctor diagnosed vulvitis, and the nurse correctly guided the patient's health education.
A. Scratch when it itches
B. You can burn the perineum with hot water.
C. It is recommended to wear tight underwear
D. infusion therapy
E. take a sitz bath with 1:5000 potassium permanganate solution.
Answer: e
Analysis: To explore the health education of vulvitis. The cause of vulvitis is that the local air permeability of tights is poor, and vaginal secretions, urine and feces stimulate vulvar skin, so tights are not suitable for wearing. When sitting in the bath, use 1: 5000 potassium permanganate solution locally, the water temperature is about 40℃, each time is about 20 minutes, twice a day. Don't scratch
Simulation question 2:
1. The patient is a 36-year-old male. The right waist collision causes local pain, swelling and hematuria. Considering kidney injury, the time to get out of bed is
A. After the pain is obviously relieved
B. After hematuria disappears
C. the waist mass did not continue to increase.
D.2 ~ 4 weeks later
E. after the vibration is corrected.
Answer: d
Analysis: To explore the treatment principle of renal injury. Patients with kidney injury must stay in bed for 2-4 weeks. Premature exercise may lead to rebleeding.
2. Patient female, 30 years old. Local pain and swelling after right waist collision. There was reddish hematuria, which was diagnosed as right renal contusion and was not treated surgically. Which of the following nursing measures is wrong?
A. Observe the changes of abdominal pain
B. Pay attention to hematuria
C. stay in bed for at least two weeks.
D, monitoring hematuria changes, color deepening indicates that bleeding is aggravated.
E. hematuria has disappeared, and you can go to the fields.
Answer: e
Analysis: To explore the nursing measures of renal injury. Patients with kidney injury must stay in bed for 2 ~ 4 weeks, even if hematuria disappears, they still need to stay in bed for a predetermined time.
3. The patient is a 26-year-old female with bladder contusion caused by kicking her lower abdomen. For non-surgical treatment, the catheter should be kept.
Answer: 2 ~ 3 days.
B.7 ~ 10 days
C.34 weeks
D.5 weeks
E.6 weeks
Answer: b
Analysis: To explore the treatment principle of bladder injury. Bladder contusion or early slight bladder rupture, only a small amount of urine extravasated during cystography, indwelling catheter continued to drain urine smoothly for 7 ~ 10 days, and the rupture could heal itself.
4. The patient is a 45-year-old male. Rupture of urethral bulb caused by riding injury. Transperineal urethroplasty. The main measures to prevent postoperative urethral stricture are
A. Prevention of infection
B. indwelling catheter for 7 ~ 10 days
C. antibiotic injection
D. urethral dilatation should be done regularly in the later stage.
E. local physical therapy
Answer: d
Analysis: To explore the health education of urethral injury. After surgical treatment and repair of anterior and posterior urethral injuries, patients often have urethral stricture, which requires regular urethral dilatation to avoid dysuria caused by urethral stricture.
5. The patient is a male, 3 1 year-old, with dull pain in the lower abdomen and dysuria after lower abdominal trauma, considering bladder injury. In order to make a definite diagnosis, the following tests should be carried out
A. X-ray inspection
B. urethral catheterization test
C. Urine cytology
D. excretory urography
E. b-ultrasound
A: A.
Analysis: Auxiliary examination was used to investigate bladder injury. X-ray examination can diagnose bladder injury.
6. The patient is a 25-year-old male. When you fall from a height of 3 cm and ride on a wooden pole, the most likely part to cause urethral injury is
A. Urethral prolapse
B. urethral ball
C. membranous part
D. prostatic urethra
E. internal urethral orifice
Answer: b
Analysis: To explore the etiology of urethral injury. Perineal straddle injury can cause urethral bulb injury, which is the most common urethral injury.
7. The patient is a 32-year-old female with kidney damage caused by a right waist collision. Which of the following situations should be operated urgently?
A. obvious hematuria
B. Severe shock cannot be corrected
C. Urine extravasation
D. Combined with rib fracture
E. high fever
Answer: b
Analysis: To explore the treatment principle of renal injury. Patients with severe renal laceration, renal fragmentation, renal pedicle injury, open renal injury and other serious organ injuries should be operated as soon as possible.
8. The most common cause of membrane damage is
A. Pelvic fracture
B. Injuries during the operation
C. External violence
D. riding injury
E. Injury during cystoscope insertion
A: A.
Analysis: To explore the etiology of urethral injury. Perineal straddle injury can lead to urethral bulb injury. Fracture of pelvis causes tearing or tearing of urethral membrane.
9. Usually the first choice for closed renal injury is
A. Early drainage of perirenal hematoma
B. observation and supportive therapy
C. flush the renal pelvis with a catheter.
D. Partial nephrectomy
E. Total nephrectomy
Answer: b
Analysis: To explore the treatment principle of renal injury. If there are no other organ injuries, most renal contusions and lacerations can be treated without surgery.
10. Clinically, the most common renal injury is
A. Renal contusion
B. Renal capsule injury
C. Partial renal laceration
D. Renal pedicle injury
E. Full-thickness renal laceration
A: A.
Analysis: To explore the clinical manifestations of renal injury. Renal contusion is characterized by slight damage to renal parenchyma, complete renal capsule and subcapsular hematoma. If renal injury involves the renal collecting system, a small amount of hematuria may occur, and most patients belong to this kind of injury.
1 1. The patient is a 28-year-old male. Local pain, swelling and hematuria caused by right waist collision. Considering kidney injury, the most serious injury type is
A. Renal contusion
B. Partial laceration of renal pelvis
C. Partial laceration of renal cortex
D. Full-thickness renal laceration
E. Renal pedicle injury
Answer: e
Analysis: To explore the clinical manifestations of renal injury. According to the degree of injury, renal injury can be divided into renal contusion, partial renal laceration, full-thickness renal laceration and renal pedicle injury. When the renal pedicle is torn or combined with other organ injuries, shock often occurs due to trauma and blood loss, even life-threatening. This is the most serious kidney injury.
12. The patient, a 43-year-old female, had a little gross hematuria after pelvic fracture. The urinary catheter was successfully inserted into the bladder, and 200ml of normal saline was injected, but only 50ml was withdrawn. Consideration should be given to
A. Posterior urethral injury
B. Bladder injury with posterior urethral rupture
C. Anterior urethral injury
D. Bladder rupture
E. rupture of lower ureter
Answer: d
Analysis: Auxiliary examination was used to investigate bladder injury. When the bladder is ruptured by catheterization test, although the catheter can be inserted into the bladder smoothly, only a small amount of hematuria will flow out. 200ml of normal saline was injected through the catheter and sucked out after 5 minutes. If there is a big difference between the amount of fluid in and out, it means that the bladder is broken. Only 50 ml was taken, considering bladder rupture.
13. Patient, male, 20 years old, fell from a height of 3 meters and rode on a wooden pole. After examination, the penis, perineum and lower abdominal wall were swollen with blood, dysuria and blood dripping at the urethral orifice. This should be considered.
A. perineal contusion
B. Contusion of lower abdomen
C. Anterior urethral injury
D. Posterior urethral injury
E. Bladder injury
Answer: c
Analysis: To explore the clinical manifestations of urethral injury. The obvious swelling of perineum, scrotum and penis suggests anterior urethral injury. The anterior urethra includes the bulbus and penis, and the bulbus is the most common injury, so the injured part of the patient may be the bulbus of urethra.
14. The patient is a 20-year-old male. Riding injury leads to blue swelling of penis, perineum and lower abdominal wall, dysuria and blood dripping from urethral orifice. If the catheter insertion is unsuccessful, the following measures should be taken.
A. continue to use the original catheter for experimental insertion.
B. try again with another catheter.
C. try to insert with a metal probe.
D. Replace the pointed catheter and try to insert it again.
E. suprapubic cystostomy or surgical treatment.
Answer: e
Analysis: To discuss the treatment principle of urethral injury. Patients with urethral injury who fail to insert urethral catheter should consider suprapubic cystostomy or surgical treatment, and repeated attempts will easily aggravate urethral injury.
15. The patient is a 27-year-old male. Local pain and swelling after right waist collision. There is reddish hematuria, and the initial diagnosis is right kidney contusion. After non-surgical treatment, absolute bed rest time is required at least.
A.3 days
B. 10 days
C. 12 days
D. 14 days
E. stay in bed after hematuria turns clear 14 days.
Answer: d
Analysis: To explore the treatment principle of renal injury. Patients with kidney injury must stay in bed for 2-4 weeks. Premature exercise may lead to rebleeding.
16. Patient, male, 26 years old, suffered from kidney injury caused by right waist collision. Under what circumstances can non-surgical treatment be taken?
A. Renal contusion
B. Full-thickness renal laceration
C. Renal pedicle vascular laceration
D. Severe partial renal laceration
E. Renal injury with ureteral injury
A: A.
Analysis: To explore the treatment principle of renal injury. Most renal contusion and laceration can be cured without surgical treatment. Severe renal contusion and laceration, renal fracture, renal pedicle injury and open renal injury should be treated by surgery as soon as possible.
17. The patient was a 33-year-old male with bladder injury due to pubic fracture. Which of the following symptoms will not appear in clinical manifestations?
A. Shocked
B. Abdominal pain
C. dysuria
D. pyuria
E. urinary fistula
Answer: d
Analysis: To explore the clinical manifestations of bladder injury. Purulent urine is the manifestation of urinary tract infection.
Mr. Yan, 45 years old, is suffering from high paraplegia complicated with urinary retention due to a car accident, and needs long-term indwelling catheterization.
18. For this patient, the purpose of changing the catheter regularly is to
A. Prevention of retrograde infection
B. prevent the catheter from aging and breaking.
C. Let the patient have a rest for a while
D. Exercise the reflex function of bladder
E. avoid urine irritation to the skin.
A: A.
Analysis: To explore the nursing measures of indwelling catheter. Generally, the catheter is replaced once a week, and the replacement time of silicone tube can be appropriately extended to prevent retrograde infection.
Mr. Yan, 45 years old, is suffering from high paraplegia complicated with urinary retention due to a car accident, and needs long-term indwelling catheterization.
19. The main purpose of opening the catheter regularly before extubation is
A. prevent catheter from being blocked by crystals.
B. Training the reflex function of bladder
C. Prevention of retrograde urinary tract infection
D. Prevent urine from overflowing
E. prevent bladder overfilling
Answer: b
Analysis: To explore the nursing measures of indwelling catheter. Patients with indwelling catheter should clamp the catheter intermittently and open it every 3 ~ 4 hours 1 time, so that the bladder can be filled and emptied regularly to train the bladder reflex function.
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