问题 单项选择题 案例分析题

患者男性,54岁,因情绪激动突然倒地、呼之不应伴呕吐咖啡样物半小时呼救。既往有高血压10年,糖尿病病史5年,间断服降压药及降糖药。现场检查发现:浅昏迷,有鼾音,双侧瞳孔等圆等大,对光反射灵敏;P64次/分,心率64次/分,律齐,未闻及心脏杂音;R16次/分,Bp200/120mmHg;右侧鼻唇沟变浅,右侧上、下肢体肌力0级,针刺无反应;右侧巴宾斯基征阳性。

下列院前处置哪项不妥()

A.卡托普利25~50mg或尼卡地平10~20mg口服。如无效可用拉贝洛尔10~20mg缓慢静注,每隔5~10分钟可重复或加倍给药,尽量避免将血压快速降至过低。

B.安置心脏临时起搏器。

C.用10%GS250ml加6U胰岛素、西咪替丁0.4g静脉滴注,呋塞米20mg静注。

D.向家属说明初步诊断并交待病情的严重性,需要立即转入专科医院做颅脑CT以进一步确立诊断,了解出血部位和出血量,以便拟定治疗方案。

E.平稳搬至救护车上,头偏向一侧并抬高15°~30°,吸氧,监测生命征。及时联系并转送至专科医院。

答案

参考答案:B

单项选择题
阅读理解

阅读理解。

       Patricia asked for the cheapest car available at Acme Car Rental. She needed a car for 48

hours. Because it was the weekend,there was only one car available at the moment-an SUV.

Patricia was an environmentalist. SUVs,which are big cars consuming a lot of gasoline,offended

her greatly.

       But she needed something to get to Baker,a town that was 100 miles from the small airport.

So she went, RentMe instead. "I need a car for 48 hours," she said," and I don't want an SUV.

I want something cheap. "They told her they had just the vehicle for her,a 1998Toyota. Thirty

dollars a day,including insurance and other incidental fees. All she had to do was to pay forher

own gasoline. Patricia was very pleased. Thirty dollars a day was a good rate even for a weekday.

She signed all the paperwork,and they gave her the keys.

        The Toyota was a 4-speed,4-cylinder,2-door beauty,the paint,tires,and the interior were like

the new. It was comfortable, even though the air-conditioner was not the frostiest(结霜的) . She

got in and drove north. It was a two-lane road all the way to Baker,with only one town between

the airport and Baker. That town was Noms,40 miles from Baker.

        Patricia didn't make it to Norris. The car refused to run 30 minutes after she had been driving

it. Fortunately,her cell phone was able to connect back to the RentMe desk. "My car stopped

running. and I'm out here in the middle of nowhere in the hot sun! " she said.

       "That doesn't make any sense," said the clerk."You did put gas in the car before you left town,

didn't you? "

        "No. Of course not ! "  yelled Patricia. " Why would Iput gas in the car before I even got out

of town?" "Well,why do you think you got such a good

rate-we save money by having the customer gas up instead of us having to put gas in the car. "

       "I was in a hurry,"said Patricia.

       "Well,sometimes you pay a price for being in a hurry," said the clerk. " We'II send a man out

with some spare gas for you:if you'd like. ,,"

       Of course l'd like , " said Patria.ia. " How long willit be?"

       The clerk told her it would be within the hour. He didn't tell her that there would be a  $ 50

service charge for delivering the gas,or that the 3 gallons of fuel would cost her $ 7 a gallon. She

would get that bad news when she retumed the car to the airport.

1. Why didn't Patricia want to rent an SUV?     

A. Because it was a big car that would need a lot of gasoline.

B. Because she failed to carry enough money with her.

C. Because she was not used to driving suc, h a big car.

D. Because it was not easy to drive since it was so old.

2. How much would Patricia have to pay at least when she returned the car to the airport?  

A. $ 161.                          

B. $ 60.

C. $ 131.                          

D. $ 80.

3. Which of the following is true?    

A. Patricia did put gas in the car before she left town.

B. The air-conditioner of the Toyota was functioning perfectly.

C. The car broke down halfway there and needed repairing.

D. Patricia was quite satisfied with the price at first.

4.The underlined word "offended" in the first paragraph means "       "    

A. hurt the feelings of

B. excited

C. amused

D. suited