1. According to WHO's pain grading standard, when the patient lies on his back, the pain becomes worse when he turns over and coughs, and he can't stand it, and his sleep is disturbed, which belongs to pain:

A.0 level

B. 1 grade

C.2 level

D.3 level

2. The following are non-opioid analgesics:

A. morphine

B. pethidine

C. codeine

D. aspirin

3. The preferred route of administration of opioids is:

A. oral administration

B. rectal administration

C. intramuscular injection

D. intravenous administration

4. The basic principle of three-step analgesic therapy is wrong:

A. oral administration

B. Drug delivery on demand

C. Step by step management

D. individualized management

5. Temporary standby doctor's advice valid time:

A. 12 hours

B.24 hours

About 8 hours

D.6 hours

6. (multi-choice) About sorting out doctor's advice, the statement is correct:

A. Where there are more than three long-term doctor's orders, or there are many adjustment items, the doctor's orders should be reorganized.

B when rearranging the doctor's orders, it should be carried out by the doctor, and a red line should be drawn below the last line of the original doctor's orders.

C. When patients undergo surgery, give birth or change their major, they need to reorganize doctors' orders.

D. After the doctor rearranges the doctor's orders, the nurse on duty will sign the full name in the column of effective doctor's orders executor after checking it.

Reference answer and analysis

1. Reference answer C. Analysis: According to the WHO pain grading standard: 0: painless. 1 grade: mild pain, lying down without pain, turning over and coughing with mild pain, and sleep is not affected. Grade 2: moderate pain, pain when lying down, aggravated when coughing when turning over, unbearable, disturbed sleep, need to use painkillers. Grade 3: Severe pain, severe pain when lying still, unbearable, seriously disturbing sleep, requiring the use of painkillers. So the answer is C.

2. Reference answer D. Analysis: Three-step analgesic therapy: Step 1: Non-opioid analgesics. Common drugs include aspirin, acetaminophen and ibuprofen. Step 2: Weak opioid analgesics, such as codeine and tramadol. Step 3: Strong opioid analgesics, such as morphine, pethidine and methadone. Option AB is a strong opioid analgesic and option c is a weak opioid analgesic, so the answer is D.

3. Reference answer A. Analysis: The preferred route of administration of opioids is oral administration, which has the characteristics of convenient administration, exact curative effect, low price and good safety. Rectal administration is mostly suitable for patients who are fasting, unable to swallow and have severe nausea and vomiting. It is absorbed very quickly by intramuscular injection, but the blood concentration fluctuates greatly after long-term use, which accelerates the drug resistance of opioids, and the analgesic effect and maintenance time are unstable. Intravenous injection is the most rapid, effective and accurate way of administration, and the blood concentration quickly reaches the peak, which immediately produces analgesic effect after administration, but too high blood concentration may cause adverse reactions. So the answer is a.

4. Reference answer B. Analysis: The basic principles of three-step analgesic therapy are: oral administration, timely administration, step-by-step administration, individualized administration, close observation of adverse drug reactions and education. Medication should be given at the time prescribed by the doctor's advice, and the next dose should be given before the effect of the previous administration disappears, so as to maintain the effective blood concentration and ensure the continuous relief of pain. So the answer is B.

5. Reference answer A. Analysis: Temporary standby medical advice handling: written by the doctor on the temporary medical advice list, valid within 12 hours. If it is not carried out, the nurse will write it in red on the doctor's advice column? Useless? Two words.

6. refer to the answer ABCD. Analysis: Reorganize medical orders: If there are more than three long-term medical orders, or there are multiple medical orders that need to be adjusted, it is necessary to reorganize medical orders. When rearranging the doctor's orders, the doctor should draw a red horizontal line under the last line of the original order and write in blue (black) pen under the red line? Reorganize the doctor's advice? , and then copy the effective long-term doctor's advice above the red line to the bottom of the red line in the original date and time order. Copy and check and sign the full name. When patients undergo surgery, childbirth or change their major, they also need to rearrange their doctor's orders, that is, draw a red horizontal line under the last item of the original doctor's orders and write with a blue (black) pen? Postoperative doctor's advice? 、? Delivery order? 、? Seek advice from a doctor? Wait a minute, then start writing a new list, and the list above the red line will stop by itself. After the doctor rearranges the doctor's orders, the nurse on duty checks them and signs the full name in the column of effective doctor's orders executor after completion.