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1、试卷代号：1323中央广播电视大学2013-2014学年度第二学期“开放本科”期末考试内科护理学试题一、单选题(每题2分。共60分)1下列与COPD发生及加重均有关的重要因素是( D )。 A吸烟 B大气污染 C气候变化 D感染2缩唇呼气的作用是( C )。 A加强呼吸运动 B减轻胸痛 C防止小气道过早陷闭 D减轻呼吸肌劳累3支气管哮喘急性发作时以下护理措施不妥的是( A )。 A限制水摄人 B半坐位 C吸氧 D禁用普萘洛尔4对肺炎球菌肺炎病人的护理，不妥的是( D )。 A卧床休息，避免疲劳 B鼓励多饮水 C胸痛病人应取患侧卧位 D发热的病人应早期给予药物降温5结核杆菌在下列哪一种情况下容易
2、被消灭?( A ) A阳光下曝晒 B暴露在空气中 C在胃分泌物中 D用强碱性肥皂6肺动脉高压形成最主要的功能性因素是( A )。 A缺氧所致的肺血管收缩 B肺血管重构 C血黏度增加和血容量增多 D肺泡内压升高7患者，女性，36岁，慢性纤维空洞型肺结核10年，今晨剧烈咳嗽时咳出大口鲜血，后不断咯出鲜血，lO分钟后患者咯血突然中断，呼吸极度困难，喉部有痰鸣音，表情恐怖，两手乱抓，首先要做的是( C )。 A立即通知医师 B给予高流量氧气吸人C清除呼吸道积血 D应用呼吸兴奋剂8不稳定型心绞痛患者药物治疗病情不能控制，故急诊冠脉介入治疗，术前医生给予血小板糖蛋白ba受体拮抗剂(即阿昔单抗)，该药物作用
3、不妥的是( C )。 A减少血栓形成 B减少冠脉闭塞 C全身出血增加 D提高急诊介入安全性9护士对心功能级患者活动的指导应为( D )。 A不限制任何活动 B不限制一般体力活动，避免剧烈运动和重体力活动 C可适当轻体力活动，下午应多休息 D卧床休息为主，限制一般体力活动10下列关于高血压病治疗目标及治疗原则的叙述不妥的是( D )。 A一般人群降压目标，血压为小于14090mmHg B伴糖尿病或肾病的高危患者血压目标为小于13080mmHg C一般需长期甚至终身治疗 D目标值控制后半年可停药观察(第l113题共用题干)女性，55岁，高血压25年，半年来常有夜间憋醒、气短，需坐起。医生诊断为高血
4、压心脏病，左室扩大。一直服用硝苯地平治疗。今晨购物时稍感劳累，突感胸闷、气急，咳泡沫痰。急诊人院查体：Bpl80120mmHg，端坐体位,心率120次分。双肺布满湿啰音，双下肢无水肿。11该病人目前可能的诊断为( C )。 A急性心肌梗死 B全心衰竭 C急性左心衰 D心绞痛12该病可能的诱发因素是( B )。 A急性呼吸道感染 B体力过劳、血压增高 C精神紧张 D电解质紊乱13对该患者的护理措施不妥的是( C )。 A注意保暖，避免受凉 B给予高流量吸氧 C平卧位，头偏向一侧 D给予少盐、易消化饮食l4减少胃酸分泌，促进溃疡愈合的药物是(A )。 A西咪替丁 B硫糖铝 C胶体次枸橼酸铋 D前列
5、腺素15不同病程阶段，溃疡性结肠炎患者均具有的症状是( C )。 A高热 B关节痛 C腹泻 D全腹痛16肝硬化患者出现肝掌、蜘蛛痣的原因是( A )。 A肝脏灭活雌激素的功能降低 B脾功能亢进 C肝脏合成凝血因子减少 D体内醛固酮水平增加17治疗肝性脑病时灌肠应禁用(A )。 A肥皂水 B生理盐水 C石蜡油 D弱酸溶液18慢性肾小球肾炎必有的临床表现是( C )。 A水肿 B血尿C蛋白尿 D高血压19导致肾病综合征复发及疗效不佳的主要原因是( D )。 A肾功能不全 B动脉粥样硬化 C肾静脉血栓 D感染20我国慢性肾功能衰竭的最常见病因为(A )。 A慢性肾小球肾炎 B慢性肾盂肾炎 C慢性尿路
6、梗阻 D肾结核21缺铁性贫血的主要病因是( D )。 A需铁量增加而摄人不足 B铁吸收不良 C胃大部切除 D慢性失血22疑似白血病患者为确诊应做下列哪项检查?( B ) A血小板计数 B骨髓检查 C出、凝血时间 D血红蛋白量测定23目前认为Graves病发病相关因素下列不妥的是( B )。 A自身免疫 B病毒RDA刺激甲状腺增生 C遗传因素 D精神刺激、感染等为本病重要诱因24糖尿病综合治疗中哪项是关系治疗成败的关键?( B ) A饮食、运动治疗 B糖尿病教育 C血糖监测 D药物治疗25系统性红斑狼疮最常累及的关节是( A )。 A指间、腕、膝等关节 B髋关节 C足趾、踝关节 D肩、肘关节26
7、类风湿性关节炎较常见的关节外表现是( D )。 A胸膜炎 B贫血 C血管炎 D类风湿结节27一氧化碳中毒时最敏感、最易遭受损害的脏器是( B )。 A肺泡细胞 B大脑及心脏 C心肌细胞 D大脑血管及脊神经28热射病需积极抢救降温，速度决定预后，要求1小时内直肠温度降低至( C )。 A36 365 B37375 C378389 D3929高血压性脑出血最常见的部位是( B )。 A脑室 B基底节 C脑桥 D小脑30病毒性肝炎的传播途径下列不妥的是( D )。 A甲型、戊型肝炎以粪一口传播为主 B乙丙丁型肝炎主要通过血液、血制品传播 C乙型还可通过母婴传播及性接触传播D戊型还可通过飞沫、尘埃传播
8、二、名词解释(每题3分共15分)31慢性阻塞性肺疾病(COPD)COPD是一组以气流受限为特征的肺部疾病，其气流受限不完全可逆，呈进行性发展。32心律失常凡各种原因引起心脏冲动形成或冲动传导异常均能使心脏活动的规律发生紊乱，称之为心律失常。33白血病白血病是一类原因未明的造血干细胞的恶性克隆性疾病。由于干细胞恶性克隆改变，白血病细胞增殖失控、分化成熟障碍、凋亡受阻，而停滞在细胞发育的不同阶段。34慢性肾衰竭慢性肾衰竭简称慢性肾衰，是各种慢性肾脏疾病缓慢进展恶化的最终结局，主要表现为肾功能进行性减退，代谢产物潴留引起全身各系统症状，水、电解质紊乱、酸碱平衡失调的一组临床综合征。35传染病 传染病
9、是由各种病原微生物(如细菌、病毒、立克次体等)和寄生虫(原虫、蠕虫)感染人体后所引起的一组具有传染性的疾病。三、简答题 36简述哮喘患者健康教育的主要内容。 答：(1)帮助病人识别过敏因素针对性采用相应的措施。 (2)按医嘱合理用药，正确使用定量吸入器。对医生处方的每种吸入器都要给予病人正确指导。 (3)自我监测病情，做好哮喘日记(哮喘日记应记录每日症状，用药及效果)，购买峰速仪，按医嘱记录峰流速的变化。 (4)了解哮喘发作的警告，及时控制急性发作嘱病人随身携带止喘气雾剂，强调出现哮喘发作先兆时，及时吸入2受体激动剂，同时使患者保持平静，以迅速控制症状，防止严重哮喘发作。37肿性脑病患者饮食护
10、理要点。 答：保证足够热量：以碳水化合物功能为主； 限制蛋白摄人：开始数日内禁食蛋白质，神志清楚后可逐渐增加，一、二期患者开始数日内限制蛋白质人量在20gd内，病情好转后每隔35天增加10g，逐渐增加至0.810g(kg?d)，纠正负氮平衡首选植物蛋白； 少进食脂肪，饮食中应富含维生素，不宜用维生素B6。试卷代号：1323中央广播电视大学2010-201l学年度第二学期“开放本科”期末考试内科护理学试题一、单选题(每题2分。共60分)1下列使呼吸道的防御功能降低的因素不包括( A )。A经鼻呼吸 B高浓度吸氧C气管插管或气管切开 D使用麻醉药2支气管哮喘急性发作时，控制症状首选的药物是( A
11、)。A2受体激动剂 B糖皮质激素C抗胆碱能药物 D茶碱类3关于结核菌素试验结果的描述下列正确的是(D )。A结核菌素试验阴性可除外结核 B结核菌素试验阳性，肯定有结核病C重症肺结核的结素反应均呈阳性 D结核菌素试验阳性仅表示曾有结核感染4胸腔穿刺抽液时，病人出现头晕、出汗、面色苍白、四肢发凉，应立即采取的措施是( B )。A减慢抽液速度 B停止抽液，平卧观察血压C皮下注射01肾上腺素 D高浓度吸氧5下列m气检测结果哪项为I型呼衰?( C )APaO2 95mnlHg，PaCO2 30mmHg BPaO2 80mmHg，PaCO2 45mmHgCPaO2 55mmHg，PaCO2 45nlmHg
12、 DPaO2 40nlmHg，PaCO2 60rnmHg6气管内吸痰时，每次插管吸痰时间不宜超过( C )。A5秒 B10秒C15秒 D30秒7患者男性，60岁，慢性肺原性心脏病20年，近日受凉后咳黏脓痰，查体：体温384，端坐位，唇发绀，颜面、下肢浮肿，两肺散在干湿啰音，叩诊心界不大，心率88次分，律齐，肝肋下2cm。下列措施中重要环节是( B )。A持续低流量吸氧 B静脉补液以稀释痰液且给予广谱抗生素C必要时给予强心剂 D使用利尿剂8患者，男，68岁，房颤20年，服用地高辛控制心室率5年，近3天患者突然出现恶心，呕吐等消化道症状，同时伴有心悸、头痛、头晕症状，视物模糊，查心电图：室性早搏二
13、联律，该患者可能是发生了( D )。A消化性溃疡 B心绞痛C低血压 D洋地黄中毒9患者，男，52岁，近半年来常于劳累后感疲乏，伴劳力性呼吸困难和发作性心前区闷痛，休息后稍好转。外院诊断为“二度型房室传导阻滞”，治疗情况不详。半天前，患者在超市购物时突然发生晕厥，伴抽搐，查体：心率30次分，律不齐，血压8555mmHg。急诊以“晕厥待查”收入院。引起该患者发生晕厥的原因是( A )。A心源性晕厥 B脑源性晕厥C血管神经性晕厥 D颈动脉窦过敏10稳定型心绞痛与不稳定型心绞痛临床表现不同点是( C )。A胸痛可放射到左肩、左上肢内侧B胸痛为压迫性或紧缩感C胸痛发作频繁，疼痛持续时间可达30分钟以上D
14、疼痛部位为胸骨后11患者，63岁，高血压10余年，因广泛前壁急性心肌梗死3小时入院。下列情况中不能应用溶栓治疗的是( D )。A伴室性早搏 B血压15090mmHgC伴慢性左心衰竭 D近期有大手术史12使用药物氢氯噻嗪降压治疗的过程中，护士应尤其注意观察( B )。A心率 B血钾浓度C血氧饱和度 D血压13高血压病非药物治疗下列哪项不妥?( D )A戒烟、限制钠摄入 B减轻体重C适量运动有利调节中枢功能 D摄人刺激性食物以保证充足食量14某男性患者疑为急性胰腺炎，病程12小时，此时最具有诊断价值的实验室检查为( B )。A血清淀粉酶测定 B尿淀粉酶测定C血钙测定 D血糖测定15上消化道出血病因
15、诊断的首选检查方法是( C )。A血、便常规检查 BX线钡餐造影检查C胃镜检查 D选择性动脉造影检查16十二指肠溃疡患者痊愈出院，护士的出院指导中错误的是( D )。A保持心情舒畅 B注意饮食规律C避免进食刺激性食物 D酸性药物或食物可促进食欲17下列不属于门脉高压症的临床表现的是( C )。A脾肿大 B腹水C肝掌 D食管、胃底静脉曲张18肾病综合征患者最明显的体征是( B )。A高血压、手脚麻木 B水肿C面色苍白、乏力 D肺部有少量干湿啰音19肾盂肾炎最常见的感染途径是( D )。A血行感染 B淋巴道感染C直接感染 D上行感染20患者男性，46岁，慢性肾炎病史15年，病情稳定。近1周来，受凉
16、后出现发热、咳嗽，自行服药，效果欠佳，遂来就诊，查体双侧眼睑浮肿，双下肢水肿(+)；化验示Hbl20gL，血BUNl89mmolL，Ccr340mmolL。导致该患者病情加重的诱因是( C )。A劳累 B高血压C感染 D服用肾毒性药物21特发性血小板减少性紫癜首选治疗药物为( D )。A硫唑嘌呤 B环磷酰胺C长春新碱 D糖皮质激素22确诊淋巴瘤的主要依据是( C )。A无痛性淋巴结肿大 B肝脾肿大C淋巴结活检 D原因不明的高热(第2324题共用题于)患者，男性，18岁，患1型糖尿病多年，因感冒，体温39、食欲减退、呕吐及腹痛而人院。检查发现该患者呈嗜睡状态，呼吸加深加快，呼气中有烂苹果味，皮肤
17、干燥。23该患者最可能发生( D )。A急性脑炎 B急性胃炎C低血糖 D酮症酸中毒24有关该患者的饮食治疗，错误的是( C )。A告知饮食与糖尿病的关系B按规定食谱供给饮食C如出现低血糖症状，可额外增加进食量D控制碳水化合物、蛋白质、脂肪的摄人25目前最佳的系统性红斑狼疮筛选试验是(D )。A抗Sm抗体 B抗双链DNA抗体C抗组织细胞抗体 D抗核抗体26干燥综合征患者特征性的皮疹表现为( A )。A紫癜样皮疹 B荨麻疹样皮疹C结节红斑 D盘状红斑27中暑热射病类型的发病机制是(A )。A高温大量出汗不足以散热、后汗闭使体温迅速升高B丢失盐过多，补充不足C血容量不足致周围循环衰竭D头部受热血管扩
18、张28下列关于帕金森病患者的震颤的描述，不妥的是( A )。A常为双侧上肢开始 B多为首发症状C静止时震颤明显 D入睡后消失29传染源不包括下列哪类?( C )A病人、隐性感染者 B病原携带者C空气、飞沫、尘埃 D受感染的动物30有关狂犬病流行病学、治疗要点的内容不妥的是( D )。A主要传染源为狂犬 B狂犬病毒主要通过病兽咬伤侵人人体C人群普遍易感 D目前已有特效疗法二、名词解释31社区获得性肺炎社区获得性肺炎是指在医院外罹患的感染性肺实质炎症，包括具有明确潜伏期的病原体感染而在人院后平均潜伏期内发病的肺炎。32心绞痛是在冠状动脉粥样硬化的基础上，由于发生血管管腔狭窄，血栓形成，张力改变和或
19、痉挛，引起一过性心肌缺血，导致以发作性胸痛或胸部不适为主要表现的一组临床综合征。33急性胰腺炎急性胰腺炎是多种病因引起胰酶在胰腺内被激活后引起胰腺组织自身消化、水肿、出血甚至坏死的炎症反应。34上消化出血上消化道出血指屈氏韧带以上的消化道(包括食管、胃、十二指肠、胰腺或胆道、胃空肠吻合术后的空肠)病变引起的出血。35传染病隔离传染病隔离是指在传染期内，将传染病患者、疑似传染病患者或动物传染源与易感者分开，防止或限制病原体向易感者传播。同时对患者进行及时和适当的治疗，消除其传染性。三、简答题36简述冠心病的主要易患因素(危险因素)及硝酸甘油的用药护理。答：(1)主要易患因素：高血压、高血脂、糖尿
20、病、吸烟等。(2)硝酸甘油的用药护理：发作时舌下含服，或轻轻嚼碎后继续含服，若服药后35分钟仍不缓解，可再服1次，对于心绞痛发作频繁或古服硝酸甘油效果差的患者，遵医嘱静滴硝酸甘油；监测血压及心率的变化，静滴时注意控制滴速，并嘱患者不可擅自调节滴速，以免造成低血压；部分患者用药后可出现面部潮红、头胀痛、心悸等症状，应告诉患者是由于药物扩张头面部血管所致，以解除其顾虑；第1次用药，应避免站立体位，且剂量不宜过大；硝酸甘油见光易分解，应避光保存，最好6个月更换1次。37简述运动治疗对糖尿病患者的作用及选择运动方式、运动时间和运动开始合适时间。答：(1)运动治疗的作用：有利于减轻体重；改善血糖、血脂代
21、谢；提高胰岛素敏感性；有利预防冠心病、防止骨质疏松、减轻精神压力和紧张。(2)选择运动方式：轻、中度有氧运动如散步、慢跑等；运动时间一般每日坚持3060分钟，每周至少运动3天；运动开始合适时间宜选择餐后l小时，既安全又可达到较好降糖效果。请您删除一下内容，O(_)O谢谢！【Chinas 10 must-see animations】The Chinese animation industry has seen considerable growth in the last several years. It went through a golden age in the late 1970s
22、 and 1980s when successively brilliant animation work was produced. Here are 10 must-see classics from Chinas animation outpouring that are not to be missed. Lets recall these colorful images that brought the country great joy. Calabash Brothers Calabash Brothers (Chinese: 葫芦娃) is a Chinese animatio
23、n TV series produced byShanghaiAnimationFilmStudio. In the 1980s the series was one of the most popular animations in China. It was released at a point when the Chinese animation industry was in a relatively downed state compared to the rest of the international community. Still, the series was tran
24、slated into 7 different languages. The episodes were produced with a vast amount of paper-cut animations. Black Cat Detective Black Cat Detective (Chinese: 黑猫警长) is a Chinese animation television series produced by the Shanghai Animation Film Studio. It is sometimes known as Mr. Black. The series wa
25、s originally aired from 1984 to 1987. In June 2006, a rebroadcasting of the original series was announced. Critics bemoan the series violence, and lack of suitability for childrens education. Proponents of the show claim that it is merely for entertainment. Effendi Effendi, meaning sir andteacher in
26、 Turkish, is the respectful name for people who own wisdom and knowledge. The heros real name was Nasreddin. He was wise and witty and, more importantly, he had the courage to resist the exploitation of noblemen. He was also full of compassion and tried his best to help poor people. Adventure of Shu
27、ke and Beita【舒克与贝塔】 Adventure of Shuke and Beita (Chinese: 舒克和贝塔) is a classic animation by Zheng Yuanjie, who is known as King of Fairy Tales in China. Shuke and Beita are two mice who dont want to steal food like other mice. Shuke became a pilot and Beita became a tank driver, and the pair met acc
28、identally and became good friends. Then they befriended a boy named Pipilu. With the help of PiPilu, they co-founded an airline named Shuke Beita Airlines to help other animals. Although there are only 13 episodes in this series, the content is very compact and attractive. The animation shows the pr
29、eciousness of friendship and how people should be brave when facing difficulties. Even adults recalling this animation today can still feel touched by some scenes. Secrets of the Heavenly Book Secrets of the Heavenly Book, (Chinese: 天书奇谈)also referred to as Legend of the Sealed Book or Tales about t
30、he Heavenly Book, was released in 1983. The film was produced with rigorous dubbing and fluid combination of music and vivid animations. The story is based on the classic literature Ping Yao Zhuan, meaning The Suppression of the Demons by Feng Menglong. Yuangong, the deacon, opened the shrine and ex
31、posed the holy book to the human world. He carved the books contents on the stone wall of a white cloud cave in the mountains. He was then punished with guarding the book for life by the jade emperor for breaking heavens law. In order to pass this holy book to human beings, he would have to get by t
32、he antagonist fox. The whole animation is characterized by charming Chinesepainting, including pavilions, ancient architecture, rippling streams and crowded markets, which fully demonstrate the unique beauty of Chinas natural scenery. Pleasant Goat and Big Big Wolf【喜洋洋与灰太狼】 Pleasant Goat and Big Big
33、 Wolf (Chinese:喜羊羊与灰太狼) is a Chinese animated television series. The show is about a group of goats living on the Green Pasture, and the story revolves around a clumsy wolf who wants to eat them. It is a popular domestic animation series and has been adapted intomovies. Nezha Conquers the Dragon Kin
34、g（Chinese: 哪吒闹海）is an outstanding animation issued by the Ministry of Culture in 1979 and is based on an episode from the Chinese mythological novel Fengshen Yanyi. A mother gave birth to a ball of flesh shaped like a lotus bud. The father, Li Jing, chopped open the ball, and beautiful boy, Nezha, s
35、prung out. One day, when Nezha was seven years old, he went to the nearby seashore for a swim and killed the third son of the Dragon King who was persecuting local residents. The story primarily revolves around the Dragon Kings feud with Nezha over his sons death. Through bravery and wit, Nezha fina
36、lly broke into the underwater palace and successfully defeated him. The film shows various kinds of attractive sceneries and the traditional culture of China, such as spectacular mountains, elegant sea waves and exquisite ancient Chinese clothes. It has received a variety of awards. Havoc in Heaven
37、The story of Havoc in Heaven（Chinese: 大闹天宫）is based on the earliest chapters of the classic storyJourney to the West. The main character is Sun Wukong, aka the Monkey King, who rebels against the Jade Emperor of heaven. The stylized animation and drums and percussion accompaniment used in this film
38、are heavily influenced byBeijingOpera traditions. The name of the movie became a colloquialism in the Chinese language to describe someone making a mess. Regardless that it was an animated film, it still became one of the most influential films in all of Asia. Countless cartoon adaptations that foll
39、owed have reused the same classic story Journey to the West, yet many consider this 1964 iteration to be the most original, fitting and memorable, The Golden Monkey Defeats a Demon【金猴降妖】 The Golden Monkey Defeats a Demon (Chinese: 金猴降妖), also referred as The Monkey King Conquers the Demon, is adapte
40、d from chapters of the Chinese classics Journey to the West, or Monkey in the Western world. The five-episode animation series tells the story of Monkey King Sun Wukong, who followed Monk Xuan Zangs trip to the West to take the Buddhistic sutra. They met a white bone evil, and the evil transformed h
41、uman appearances three times to seduce the monk. Twice Monkey King recognized it and brought it down. The monk was unable to recognize the monster and expelled Sun Wukong. Xuan Zang was then captured by the monster. Fortunately Bajie, another apprentice of Xuan Zang, escaped and persuaded the Monkey
42、 King to come rescue the monk. Finally, Sun kills the evil and saves Xuan Zang. The outstanding animation has received a variety of awards, including the 6th Hundred Flowers Festival Award and the Chicago International Childrens Film Festival Award in 1989. McDull【麦兜】 McDull is a cartoon pig charact
43、er that was created inHong Kongby Alice Mak and Brian Tse. Although McDull made his first appearances as a supporting character in the McMug comics, McDull has since become a central character in his own right, attracting a huge following in Hong Kong. The first McDull movie McMug Story My Life as McDull documented his life and the relationship between him and his mother.The McMug Story My Life as McDull is also being translated into French and shown in France. In this version, Mak Bing is the mother of McDull, not his father.