ࡱ> -(  t /Thttp://en.wikipedia.org/wiki/United_StatesThttp://en.wikipedia.org/wiki/United_States >http://en.wikipedia.org/wiki/UK>http://en.wikipedia.org/wiki/UK!Lhttp://en.wikipedia.org/wiki/NitrationLhttp://en.wikipedia.org/wiki/Nitration"Jhttp://en.wikipedia.org/wiki/GlycerolJhttp://en.wikipedia.org/wiki/Glycerol#Lhttp://en.wikipedia.org/wiki/ExplosiveLhttp://en.wikipedia.org/wiki/Explosive$Jhttp://en.wikipedia.org/wiki/DynamiteJhttp://en.wikipedia.org/wiki/Dynamite%Rhttp://en.wikipedia.org/wiki/ConstructionRhttp://en.wikipedia.org/wiki/Construction&Nhttp://en.wikipedia.org/wiki/DemolitionNhttp://en.wikipedia.org/wiki/Demolition'Jhttp://en.wikipedia.org/wiki/MedicineJhttp://en.wikipedia.org/wiki/Medicine(Rhttp://en.wikipedia.org/wiki/VasodilationRhttp://en.wikipedia.org/wiki/Vasodilation)Rhttp://en.wikipedia.org/wiki/Blood_vesselRhttp://en.wikipedia.org/wiki/Blood_vessel*Xhttp://en.wikipedia.org/wiki/Angina_pectorisXhttp://en.wikipedia.org/wiki/Angina_pectoris+Vhttp://en.wikipedia.org/wiki/Blood_pressureVhttp://en.wikipedia.org/wiki/Blood_pressure,hhttp://en.wikipedia.org/wiki/Orthostatic_hypotensionhhttp://en.wikipedia.org/wiki/Orthostatic_hypotension-Dhttp://en.wikipedia.org/wiki/BowelDhttp://en.wikipedia.org/wiki/Bowel`/ 0DArialngs8 0z[ 0"DWingdings8 0z[ 0@ .  @n?" dd@  @@``   p -sopqrstuvwxyz{|}~#$%&' 0AA ff@8yy\ ʚ;q.ʚ;g4.d.d z[ 0ppp@ <4ddddL 0  <4!d!dL< 0<4BdBdL< 0$W0___PPT10 ___PPT9:United States$ UK2!Nitration0"Glycerol2#Explosive0$Dynamite8%Construction4&Demolition0'Medicine8(Vasodilation8)Blood vessel>*Angina pectoris<+Blood pressureN,.Orthostatic hypotension*- Bowel?  O  = CGFNS          Cardiac markers or cardiac enzymes are proteins that leak out of injured myocardial cells through their damaged cell membranes into the bloodstream. Until the 1980s, the enzymes SGOT and LDH were used to assess cardiac injury. Now, the markers most widely used in detection of MI are MB subtype of the enzyme creatine kinase and cardiac troponins T and I as they are more specific for myocardial injury. The cardiac troponins T and I which are released within 4 6 hours of an attack of MI and remain elevated for up to 2 weeks, have nearly complete tissue specificity and are now the preferred markers for asssessing myocardial damage Elevated troponins in the setting of chest pain may accurately predict a high likelihood of a myocardial infarction in the near future. New markers such as glycogen phosphorylase isoenzyme BB are under investigationvTPFffIf(fFU 0U 0U 05DU 0QZU 0;/TP colonh !$%'=@GHQTWmrtv~h$stomach & duodenum4 -048V liver)/12579;<?DJLMNOXYZ\qx{|\4mouth, tongue & oesophagus&(,Kz&rectum & anal canalD .2ETmrst}0appendix6AS&abdomen"P~nutrition\#>CFIU]nu4pancreas 3BJintestine( Ropwz ! ` 3L:̪3fܗ` =XL=xt=x̙` 3fL3[[E)̙` ff` 3F433` f3ϫ̙` ff̙f` @K=3NLGwt` geff>?" dd@,?" dd@   " @ `"  n?" dd@   @@``PT    @ ` `6p>> PH(  Z  # "2   BCDEF"d@ @`s"*X#X# X#    c BCDEF"v @ @`" *   BtCDEF"d@ tttt@`s"*X#X# X# i` Z P # "P  c B CDEF @))<  _ wv J c /JVJBeW<_JW R"R"F(.6 JJJQ^tkK-,&k < < TX@`"x\  P  " P   BCDE<FF|urBAwK-Id<|u $@`"lP   BCaDE@FJ$6B*r0a6T~~xZB<$$"$@`"u / [   BzCDE,F6  (<y6"zL^Z6@`" 5P D   BCBDE4F> rN<`*B~rr @`",d   B*CHDE4F> $  $**0 H$$ @`"  d  c TBCDEF @88 1$s[6C6&fH~fM~ vpjd^ L@. $*<HW090HH<< HC<=<1HNZxNrt@`"Z  # "^  BmCDEdFn<BlU1mg~Or+ZH6$k_H B 6*48@`"F  BCDEXFb`$ <hZg gnm\=.0@`"F  BGC<DEXFb 5;A*G6G<;6/*$* 000$.0@`"&m,&  BCDEHFR0Hr `6`<fHlTx`r`f6&(@`"W  B;C<DE4F> ;))$/*565</6#0$;; @`"Kf  (BCDEhFr$*TM/TYB;$  /MSYe } $$68@`"  6  " ``   B Click to edit Master title style!  0  " `   RClick to edit Master text styles Second level Third level Fourth level Fifth level!      6  #" `` `   Z*   6  #" ``    \*   6  #" `` `   \* T  <v޽h @ ? 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3380___PPT10.KICj &(  ~  s *  `   H  0޽h ? ̙33y___PPT10Y+D=' = @B +@    m(  W  0     Typhoid fever is transmitted by a) Contaminated food and fluid b) Droplet nuclei c) Infected syringes and neddles d) Sexual intercourse$p`Pp  0  0 ,$  0 BThe answer is a 2$H  0޽h ? ̙33  ___PPT10.+wgiD' = @B D>' = @BA?%,( < +O%,( < +Du' =%(D' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?RCBBCB#ppt_wB*Y3>B ppt_w<*D' =+4 8?RCBBCB#ppt_hB*Y3>B ppt_h<*D' =+K4 8?CBB#ppt_x+(cos(-2*pi*(1-$))*-#ppt_x-sin(-2*pi*(1-$))*(1-#ppt_y))*(1-$)CB?B*Y3>B ppt_x<*D' =+K4 8?CBB#ppt_y+(sin(-2*pi*(1-$))*-#ppt_x+cos(-2*pi*(1-$))*(1-#ppt_y))*(1-$)CB?B*Y3>B ppt_y<*+8+0+  +7   0^(  I  0T   Red raised patches of skin covered with silvery scales is seen in a) Scabies b) Pemphigus vulgaris c) Psoariasis d) Contact dermatitis$p`Pp  0(  p4 ,$ 0 AThe answer is c 2$H  0޽h ? ̙33 ___PPT10.+ϐ(D' = @B DD' = @BA?%,( < +O%,( < +D{' =%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*+8+0+  +   F>@(    0D9  TLD___PPT9& The normal serum potassium level is : a) 2 - 2.5 mEq/liter b) 2.1 - 2.3 mEq/liter c) 6 - 6.5 mEq/liter d) 3.5 - 5.5 mEq/liter 45 $$p`Pp  0D<  t ,$ 0 EThe answer is d 2$H  0޽h ? ̙33 ___PPT10.+ϐ(D' = @B DD' = @BA?%,( < +O%,( < +D{' =%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*+8+0+  +7   P^(  H  0Z    The primary goal in withholding food before surgery is to prevent a) Abdominal distension b) Aspiration c) Infection d) Obstruction$p`Pp  0\ p p@ ,$ 0 BThe answer is b 2 H  0޽h ? ̙33 ___PPT10.+ϐ(D' = @B DD' = @BA?%,( < +O%,( < +D{' =%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*+8+0+  +   PH`(    0̨   j$ When vomiting occurs in the immediate post-operative period the most important nursing intervention is to a) Measure the amount and record b) Offer tepid water or juice c) Support the wound d) Turn the patient's head to one side to prevent aspiration into lungs.%% p`Pp  0  p@-,$ 0 BThe answer is d 2 H  0޽h ? ̙33 ___PPT10.+ϐ(D' = @B DD' = @BA?%,( < +O%,( < +D{' =%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*+8+0+  +j   p[(  E  0   An early sign of cancer of the larynx is a) Burning of throat when hot liquids are ingested b) Enlarged cervical nodes c) Hoarseness of voice d) Dysphagia p`Pp  0L   ,$ 0 BThe answer is c  2 H  0޽h ? ̙33G ? ___PPT10 .+ϐ(D' = @B DB' = @BA?%,( < +O%,( < +D{' =%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*D' =%(D' =%(DF' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =-u6Bdiamond(in)*<3<*+p+0+  ++0+  +H   yq (    0@%   9Nursing intervention for a patient who is scheduled for bronchoscopy includes a) An informed consent to be obtained b) Food and fluids are whthheld for 6 hours . before the test c) Premedication is given as prescribed d) All of the above(: P p`Pp  0 ` @ ,$ 0 BThe answer is d 2 H  0޽h ? ̙33w o ___PPT10O .+ϐ(D' = @B Dr' = @BA?%,( < +O%,( < +D{' =%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*D&' =%(D' =%(Dv' =A@BBBB0B%()))D' =1:Bvisible*o3>+B#style.visibility<*%(D' =-u6Bdiamond(in)*<3<*+p+0+  ++0+  +   H(  0  0$2  P  The drug of choice for bacterial pneumonia is a) Erythromycin b) Penicillin c) Clindamycin d) Streptomycin p`Pp  0@= P P ,$ 0 DThe answer is b 2H  0޽h ? ̙33  ___PPT10 .+ϐ(D ' = @B D ' = @BA?%,( < +O%,( < +D{' =%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*D{' =%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?dCB1+#ppt_h/2BCB#ppt_yB*Y3>B ppt_y<*+p+0+  ++0+  +  $(    0F  P  <The most specific enzyme analysis in the diagnosis of acute myocardial infarction is : a) Serum glutamic oxaloacetic transaminase (SGOT) b) Creatine kinase (CK) c) Serum glutamic pyruvic transaminase (SGPT) d) Aspartate aminotransferase (AST)p`Pp  0R  0W ,$  0 DThe answer is b 2H  0޽h ? ̙33___PPT10b.+n-`D' = @B D' = @BA?%,( < +O%,( < +D' =%(D' =%(DD' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D'  =-s6Bwipe(down)*<3<*+8+0+  +d   (  s  0    QRS complex in an E.C.G. represents a) Atrial muscle depolarization b) Atrial muscle re-polarization c) Ventricular muscle repolarization d) Ventricular muscle depolarization$p`Pp  0 0 @ ,$ 0 DThe answer is d 2$H  0޽h ? ̙33 ___PPT10.+ϐ(D' = @B DD' = @BA?%,( < +O%,( < +D{' =%(D#' =%(D' =A@BBBB0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?dCB0-#ppt_w/2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*+8+0+  +  v(  >  0`d    The most specific enzyme analysis in the diagnosis of acute myocardial infarction is : a) Serum glutamic oxaloacetic transaminase . (SGOT) b) Creatine kinase (CK) c) Serum glutamic pyruvic transaminase (SGPT) d) Aspartate aminotransferase (AST)( p`PpH  0޽h ? ̙33NF___PPT10&.+D' = @B D' = @BA?%,( < +O%,( < +D' =%(D' =%(D' =4@BBBB%(D' =,54 f*3>!Bstyle.color='`B@BPB<*D' =4@BBBB%(D' =,54 f*3>!Bstyle.color='`B@BPB<*+#  :2@(    s | 0e0e #" 0e w   <w  ,The diagnosis of myocardial infarction requires two out of three components (history, ECG, and enzymes). When damage to the heart occurs, levels of cardiac markers rise over time, which is why blood tests for them are taken over a 24-hour period. Because these enzyme levels are not elevated immediately following a heart attack, patients presenting with chest pain are generally treated with the assumption that a myocardial infarction has occurred and then evaluated for a more precise U 0H  0޽h ? 3F433___PPT10i.+D=' = @B +  G(    0  0 z___PPT9\T     m A common side-effect of nitroglycerine is Musculo-skeletal weakness Hypertension Headache Bradycardia ~.  .     p`PpH  0޽h ? ̙33___PPT10.+DZ' = @B D' = @BA?%,( < +O%,( < +DL' =%(D' =%(D' =4@BBBB%(D' =,54 *3>!Bstyle.color='`B@BPB<*W`+  (  f  0h    Rheumatic endocarditis is an inflammatory reaction to a) Pseudomonas aeruginosa b) Staphylococcus aureus c) Group A streptococcus d) Serratia marcescens4 p`PpH  0޽h ? ̙33___PPT10.+DZ' = @B D' = @BA?%,( < +O%,( < +DL' =%(D' =%(D' =4@BBBB%(D' =,54 *3>!Bstyle.color='`B@BPB<*y+  ~(  F  0   Post-operative nursing management for vein ligation and stripping includes all of the following except : a) Dangling the legs over the side of the bed for 10 minutes every 4 hours for the first 24 hours b) Elevating the foot of the bed to promote venous blood return c) Maintaining elastic compression of the leg for 1 week d) Ambulating the patient 24 - 48 hours after surgery4 p`PpH  0޽h ? ̙33___PPT10.+DZ' = @B D' = @BA?%,( < +O%,( < +DL' =%(D' =%(D' =4@BBBB%(D' =,54 *3>!Bstyle.color='`B@BPB<*j+  (  Q  0x!   |t___PPT9VN    e . For a patient diagnosed as having iron deficiency anemia, the nurse should recommend an increased intake of Fresh citrus fruits Milk and cheese Organ meat d) Whole grain breadrx x     p`PpH  0޽h ? ̙33___PPT10.+DZ' = @B D' = @BA?%,( < +O%,( < +DL' =%(D' =%(D' =4@BBBB%(D' =,54 *3>!Bstyle.color='`B@BPB<*+  D(     0   xph___PPT9JB    ,| The major cause of death in patients with leukemia is believed to be Fever Melena and haematuria Infection Dehydration~G4 5 5 5 G     p`PpH  0޽h ? ̙33___PPT10.+DZ' = @B D' = @BA?%,( < +O%,( < +DL' =%(D' =%(D' =4@BBBB%(D' =,54 *3>!Bstyle.color='`B@BPB<*ep+  0 P*(  X  C    {   S d{  0  {  ,The QRS complex is a recording of a single heartbeat on the ECG that corresponds to the depolarization of the right and left ventricles. Ventricles contain more muscle mass than the atria, therefore the QRS complex is considerably larger than the P wave. The His/Purkinje specialised muscle cells coordinate the depolarization of both ventricles, the QRS complex is 0.08 to 0.12 sec (80 to 120 ms) in duration represented by three small squares or less, but any abnormality of conduction takes longer, and causes widened QRS complexes. H  0޽h ? 3380___PPT10._  0  ~ ` (  X  C    { ~   S | 0  {   Nitroglycerin (NG), (United States spelling) also known as nitroglycerine, (UK Spelling), trinitroglycerin, trinitroglycerine, 1,2,3-trinitroxypropane and glyceryl trinitrate, is a heavy, colorless, oily, explosive liquid obtained by nitrating glycerol. Since the 1860s, it has been used as an active ingredient in the manufacture of explosives, specifically dynamite, and as such is employed in the construction and demolition industries. n medicine, where it is generally called glyceryl trinitrate The principal action of nitroglycerin is vasodilation widening of the blood vessels. Nitroglycerin will dilate veins more than arteries, decreasing cardiac preload and leading to the following therapeutic effects during episodes of angina pectoris: subsiding of chest pain decrease of blood pressure increase of heart rate. orthostatic hypotension The side effects of Nitroglycerin include lack of sexual desire, head ache, painful urination and increased bowel movements  *%U 0" U 0LN!U 0"U 0#U 0NX$U 0go%U 0&U 0'U 0(U 0+)U 0<I*U 0+U 0",U 0=T-U 0H  0޽h ? 3380___PPT10. 0 wp(  X  C    w  S   0   Haemorrhage, generalized or localized, was found to be a primary cause of death in 27% of the cases and contributory to death in 49% of cases. Infections of various types were responsible for death in 35% of the cases and formed important contriburoey factors I another 25%. Staphylococcus pyogenes was a common invading organism in bothe sub groups.12% of patients died of acute and extensive gastrointestinal ulceration. Although staphylococcs pyogenes and candida albicans were predominant in a few cases.H  0޽h ? 3380___PPT10.frt -N_qfsfJXD\TWPkX7E? 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O  = MCQs Starting with typhoid          Cardiac markers or cardiac enzymes are proteins that leak out of injured myocardial cells through their damaged cell membranes into the bloodstream. Until the 1980s, the enzymes SGOT and LDH were used to assess cardiac injury. Now, the markers most widely used in detection of MI are MB subtype of the enzyme creatine kinase and cardiac troponins T and I as they are more specific for myocardial injury. The cardiac troponins T and I which are released within 4 6 hours of an attack of MI and remain elevated for up to 2 weeks, have nearly complete tissue specificity and are now the preferred markers for asssessing myocardial damage Elevated troponins in the setting of chest pain may accurately predict a high likelihood of a myocardial infarction in the near future. 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