[Yu Yue education] reference materials for surgical skills teaching in Tongji University

education
- Surgical skill teaching - Chapter materials, examination materials - Tongji University 【】
The first 1 Talk about unit tests
1、【 Single topic selection 】 Drug concentration of drug immersion disinfection , Which of the following is not true ？
A、65% alcohol
B、1:1000 New Jermaine
C、2% Glutaraldehyde
D、1:1000 Washing must be too
E、10% formaldehyde
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2、【 Single topic selection 】 The most widely used and effective sterilization method in clinical practice is ：
A、 High temperature sterilization
B、 Low temperature sterilization
C、 Ionizing radiation sterilization
D、 Drug immersion disinfection
E、 Formaldehyde steam fumigation
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3、【 Single topic selection 】 Which of the following methods is the least harmful to human body ？
A、 Electrostatic adsorption air disinfector
B、 Circulating air ultraviolet air disinfector
C、 Peracetic acid disinfection
D、 Effective chlorine disinfection
E、 Formaldehyde steam fumigation
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4、【 Single topic selection 】 Aseptic surgery does not include which of the following ?
A、 Apply antibiotics
B、 Sterilization
C、 Aseptic operation procedures
D、 Disinfection
E、 Management system
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5、【 Single topic selection 】 Pressure of pressure steam sterilization 104.0-137.3Kpa, The temperature is , continued 30 Minutes can achieve the purpose of sterilization .
A、121-126℃
B、111-120℃
C、115-121℃
D、121-136℃
E、126-131℃
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6、【 Single topic selection 】 Hand hygiene refers to ：
A、 wash hands
B、 Sanitary hand disinfection
C、 Surgical hand disinfection
D、 Medical staff wash their hands 、 General term for sanitary hand disinfection and surgical hand disinfection
E、 Wash your hands before eating
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The first 2 Talk about unit tests
1、【 Single topic selection 】 In the following aseptic operation rules , Which is wrong
A、 When the room temperature is too high, you can use an electric fan to blow it to the operator , To prevent its sweat drops from falling into the operating field
B、 Gloves should be replaced immediately if they are found to have small cracks
C、 When the sterile operation sheet is wet , The dry sterility sheet should be stamped
D、 Instruments and articles falling below the operating table are not allowed to be picked up and reused
E、 It is forbidden to pass sterile instruments and objects over the head or behind other operating personnel
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2、【 Single topic selection 】 After transverse colostomy, the patient underwent fistula closure , The order of skin disinfection in the operation area is
A、 Smear from the periphery of the operation area to the periphery of the fistula
B、 Wipe from the center of the operation area to the surrounding
C、 Wipe from the top to the bottom of the operation area
D、 Wipe from one side of the operation area to the other
E、 None of the options are correct
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3、【 Single topic selection 】 When wearing sterile gloves , Only hands without gloves are allowed to touch
A、 The outside of the outward folding part of the glove cover
B、 Fingers of gloves
C、 Palm side of gloves
D、 The back side of the glove
E、 The inner surface of the outward folding part of the glove cover
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4、【 Single topic selection 】 Scope of skin disinfection in the operation area , It should at least include the area around the surgical incision
A、15cm
B、5cm
C、10cm
D、20cm
E、25cm
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5、【 Single topic selection 】 Operation in progress , The operator's forearm touched the infected part , At this time
A、 Change sterile surgical clothes or wear sterile sleeves
B、 Wash your hands again , Wear sterile clothes 、 Wear sterile gloves
C、 use 75% Alcohol disinfector's forearm sleeve
D、 Replace the sterile operation sheet
E、 Replace sterile gloves
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6、【 Single topic selection 】 About brushing your hands before surgery , The following description is correct ：
A、 At present, the hand brush has been improved , The operation can be carried out only by disinfecting the hands and forearms with cleansing soft gel twice .
B、 If you brush your hands with soapy water , It should be brushed twice , Time sharing 10 minute .
C、 When wiping hands, use a sterile small square towel from hand to forearm 、 Wipe the elbow to the upper arm in sequence , Dry one side first , Turn the towel over and wipe the other side , The towel that has wiped the elbow can no longer touch the hand and forearm .
D、 After hand brushing , Touch your upper arm clothes , Soak again 75% alcohol 5 minute , You don't have to brush your hands again .
E、 Simple brushing method when brushing hands , The hand brushing time can be shortened to 1 minute .
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7、【 Single topic selection 】 After brushing and disinfecting the arms of the operating personnel , The arm position should be ：
A、 Raise your arms up
B、 The arms droop naturally
C、 Chest arched posture
D、 Stretch your arms forward
E、 Put your hands behind your back
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8、【 Single topic selection 】 Upper abdominal surgery towel , The first towel should be laid on ：
A、 Above the incision
B、 The opposite side of the incision
C、 The incision is on the side
D、 Below the incision
E、 Shop casually
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9、【 Multiple choice 】 About the six steps of washing hands , Which of the following are correct ？
A、 Wash hands with running water , Soak your hands thoroughly
B、 Take an appropriate amount of soap , Apply evenly to the whole palm 、 Back of hand 、 Fingers and fingers
C、 Rub your hands at least 15 second
D、 Rinse your hands thoroughly under running water , wipe and dry
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10、【 Multiple choice 】 Thyroid adenoma surgery （ Two sets of ）, The gloves were not broken after the first operation , You don't have to brush your hands again , But before putting on sterile surgical clothes and sterile gloves again , What measures are right ？
A、 Put your hands 、 Forearm and elbow 150px soak 75% alcohol 5 minute
B、 Put your hands 、 Forearm and elbow 150px soak 0.1% Benzalkonium bromide solution 5 minute
C、 Sterilization King wiped his hands and forearms once
D、 Cleanse and disinfect your hands and forearms with gel
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The first 3 Talk about unit tests
1、【 Single topic selection 】 The commonly used methods of holding needle forceps are
A、 Master the method 、 Fingertip method 、 Palm fingering
B、 Master the method 、 Fingertip method
C、 Fingertip method 、 Palm fingering
D、 Master the method 、 Palm fingering
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2、【 Single topic selection 】 Sewing needles are divided into
A、 All options are correct
B、 Round head
C、 Cusp
D、 Shovel head
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3、【 Single topic selection 】 Which of the following incision methods is wrong
A、 Peritoneal incision is suitable for bowing
B、 Bowing technique ： It is suitable for large thoracoabdominal incision
C、 Grasp method ： It is suitable for cutting large pieces of tissue in a wide range , Such as amputation
D、 Writing skills ： It is suitable for small skin incision or anatomy of fine tissue
E、 Reverse flip ： Suitable for bile duct 、 Incision of intestines , Local small abscess incision, etc
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4、【 Single topic selection 】 Correct knife holding methods do not include ：
A、 Holding
B、 Writing style
C、 Flip over
D、 Palm and finger
E、 Bow holding
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5、【 Single topic selection 】 Triangle needle is suitable for sewing ：
A、 Gastrointestinal tract
B、 the peritoneum
C、 nerve
D、 blood vessel
E、 The skin
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6、【 Judgment questions 】 Suture is divided into absorbable suture and non absorbable suture
A、 correct
B、 error
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7、【 Judgment questions 】Allis Forceps have less squeezing effect on tissues , It can be used to clamp soft tissue , Not easy to slip .
A、 correct
B、 error
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The first 4 Talk about unit work
The first 5 Talk about unit tests
1、【 Single topic selection 】 Which of the following is not the purpose of surgical drainage ？
A、 Filling tissue defect , Achieve local hemostasis , Promote the accumulation of inflammatory cells
B、 Prevent blood 、 Pus 、 Exudate 、 Fluid from the digestive tract or urinary tract accumulates in tissues or body cavities
C、 Relieve local pressure , Avoid the compression and tissue damage of effusion to adjacent organs
D、 Prevent premature closure of wound skin , Extend drainage time , It is conducive to the reduction of purulent cavity or effusion cavity
E、 Create conditions for granulation tissue to grow from its base , Help the wound heal well
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2、【 Single topic selection 】 Which of the following skin incision operations is wrong
A、 Cut it gradually , In case of cutting too deep
B、 Properly fix the skin
C、 Before the operation, mark the predetermined incision
D、 The scalpel is perpendicular to the incision skin
E、 The depth of skin incision is consistent
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3、【 Single topic selection 】 Which of the following hemostatic methods is commonly used for extensive subcutaneous capillary hemorrhage
A、 Compression hemostasis
B、 Ultrasonic knife hemostasis
C、 Ligation hemostasis
D、 Suture hemostasis
E、 Argon knife hemostasis
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4、【 Single topic selection 】 The following is a description of the preparations before incision , The wrong is ：
A、 Check the clinical data of patients before operation 、 Lesion site 、 Surgical procedure
B、 Routine disinfection of the operating area 、 Towel laying and anesthesia
C、 Generally, there is no need to book the incision and draw lines for small and medium-sized surgery
D、 Choose the right scalpel
E、 Hold the back side of the blade with the needle holder , It can be embedded with the knife handle groove
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5、【 Single topic selection 】 Which of the following is not an indication for surgical drainage
A、 Purulent inflammation in the early stage , Abscess has not yet formed
B、 Localized abscess
C、 Gastrointestinal fistula
D、 Pathological effusion
E、 Urinary leakage
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6、【 Single topic selection 】 Electrocoagulation hemostasis is often used to stop bleeding in which of the following situations
A、 Extensive bleeding points in superficial parts
B、 Appendiceal artery bleeding
C、 Bleeding from the great arteries of the limbs
D、 Portal vein rupture and bleeding
E、 The aneurysm ruptured and bled
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7、【 Single topic selection 】 How long can the rubber drainage piece be placed
A、24-48 Hours
B、12 Hours
C、72 Hours
D、1 Zhou
E、1 month
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8、【 Single topic selection 】 Which of the following is wrong about ligation hemostasis
A、 It is often used for extensive bleeding of subcutaneous tissue
B、 It is one of the most reliable hemostatic methods
C、 Commonly used vascular forceps clamp broken ends of blood vessels and a small amount of surrounding tissue, and then ligate with silk thread under the vascular forceps to achieve the purpose of hemostasis
D、 It is required that the tissue clamped by the vascular forceps should be as few as possible during hemostasis
E、 When simple ligation and hemostasis are difficult , Consider “8” Stop bleeding by sewing and binding
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9、【 Single topic selection 】 Which of the following is not a cautionary point for cigarette drainage when changing dressing ？
A、 Clamp the edge with tweezers , Lift up and down moderately
B、 Insert the needle into the central latex tube to extract the accretion liquid
C、 If it needs to be replaced or unplugged , After surgery 2~3 God
D、 After removal, it should be replaced by yarn drainage
E、 The drainage tube should be slightly away from the bottom of the wound , In order to heal the wound
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10、【 Single topic selection 】 Dressing change for patients with intestinal fistula , What kind of drainage material is more appropriate ？
A、 Silicone drainage strip
B、 Cigarette drainage strip
C、 Negative pressure ball
D、 Yarn strips
E、 Double sleeve
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11、【 Multiple choice 】 Which of the following hemostatic methods are commonly used in surgery ？
A、 Compression hemostasis
B、 Ligation hemostasis
C、 Electrocoagulation hemostasis
D、 Freeze hemostasis
E、 Laser hemostasis
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The first 6 Talk about unit tests
1、【 Single topic selection 】 Which of the following methods is often used to anastomose blood vessels
A、 Eversion sewing
B、 Continuous stitching at the seam
C、 Varus suture
D、 Purse stitching
E、 Continuous full-thickness horizontal mattress varus suture
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2、【 Single topic selection 】 About stitching , Which of the following is wrong ？
A、 If sewing with needle is used, the step of holding needle can be omitted
B、 When entering the needle, the needle tip should be perpendicular to the tissue surface of the needle entry point
C、 When inserting the needle, you need to use the rotating force of your wrist and forearm
D、 Rotate the needle holder in the original position when feeding the needle
E、 When pulling out the needle, it should be perpendicular to the surface of the point of pulling out the needle
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3、【 Single topic selection 】 Which of the following is wrong about thread cutting
A、 Thread cutting of deep thread knot , It can slide down the suture to the knot , Finish thread cutting by feeling without looking directly
B、 Thread cutting is that the opening of thread cutting should not be too large
C、 When cutting thread , The length of the thread end varies with the number of side turns
D、 When cutting subcutaneous ligation hemostatic suture , It should be cut as short as possible , Subject to not cutting off line knots
E、 Skin suture ends to stay 0.5-1.0cm It is advisable to
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4、【 Single topic selection 】 The key points of skin suture are wrong
A、 The tighter the suture is, the better
B、 The tissues on both sides of the incision should be closely and correctly aligned according to the level
C、 Needle pitch 、 The margins should be consistent on both sides
D、 Leave no dead space
E、 Wrist force , Go vertically 、 Take out the needle , Smooth arc needle pulling
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5、【 Single topic selection 】 Purse string suture is often used for which of the following operations
A、 Embedding of appendix stump
B、 Loose the suture of skin wounds
C、 Anastomosis of blood vessels
D、 End to end anastomosis of small intestine
E、 Suture of peritoneum
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6、【 Single topic selection 】 The following key points of suture method selection , The wrong is ：
A、 Simple continuous suture is suitable for the suture of tissues with high tension, such as aponeurosis
B、“8” Word stitching is suitable for stitching and hemostasis
C、 The effect of closure and hemostasis by continuous sewing is better
D、 The inside pouches are suitable for appendiceal stumps 、 Closure of the small intestine breach
E、Lembert Suture is suitable for the seromuscular suture of gastrointestinal anastomosis
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7、【 Multiple choice 】 Which of the following suture methods are commonly used for gastrointestinal anastomosis
A、 Intermittent vertical mattress varus suture
B、 Continuous full-thickness horizontal mattress varus suture
C、 Simple intermittent suture
D、 Intermittent vertical mattress valgus suture
E、 Intermittent horizontal mattress eversion suture
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8、【 Multiple choice 】“8” Which of the following operations are commonly used for word stitching
A、 Suture of larger blood vessels to stop bleeding
B、 Tendons 、 Suture of ligaments
C、 Suture of peritoneum
D、 Valgus suture of loose skin
E、 End to end anastomosis of small intestine
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9、【 Multiple choice 】 The suture method belonging to simple involution is ：
A、 Continuous sewing
B、 Intermittent sewing
C、 Purse stitching
D、 Carpet edge stitching
E、 Mattress stitching
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The first 7 Talk about unit tests
1、【 Single topic selection 】 Patient male ,52 year , After cholecystectomy 5 God , Low heat , When changing the dressing, I found that the skin at the eye of the needle was red and swollen , No pus is found . After treatment, the inflammation dissipated , Wound healing , Then the wound healing belongs to
A、Ⅱ Class B
B、Ⅰ Class B
C、Ⅱ Class C
D、Ⅲ Class B
E、Ⅲ Class C
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2、【 Single topic selection 】 women ,25 year , Breast fibroadenoma resection , The wound became red and swollen after operation 、 Scleroma , Increased skin temperature , But no wave motion . When the patient's wound was changed , What's not right is
A、 Open drainage
B、 Iodophor disinfection
C、 If the dressing is wet, it needs to be replaced in time
D、 Local hot compress
E、 Infrared radiation
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3、【 Single topic selection 】 Description of dressing change operation , Which of the following is not true
A、 If the inner dressing adheres to the wound , The adhesion can be cut with a blade
B、 Remove the outer dressing by hand
C、 Remove the inner dressing with tweezers
D、 Change the dressing with tweezers in both hands
E、 Items used after dressing change for specific infected wounds need to be treated separately
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4、【 Single topic selection 】 The wound that should be changed first is
A、 Aseptic surgical wound stitching
B、 Bedsore wound
C、 Tetanus wound
D、 Gas gangrene infected wound
E、 Incision and drainage of abscess
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5、【 Single topic selection 】 The incision was slightly inflamed after subtotal gastrectomy , Not suppurated , The right way to deal with it is
A、75% Wet compress with ethanol
B、0.02% Furacilin wet compress
C、10% Ichthyol ointment is applied externally
D、30% Magnesium sulfate wet compress
E、 Thread removal and drainage
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6、【 Single topic selection 】 For infected wounds or anus 、 Disinfection of perineum , Which of the following is true ？
A、 From left to right
B、 From the center to the surrounding
C、 From all around to the center
D、 From top to bottom
E、 From bottom to top
F、 From right to left
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7、【 Single topic selection 】 The correct time for stitching removal after surgery is ：
A、 After elbow surgery 9-11 God
B、 After scalp suture 8-9 God
C、 After appendectomy 7-9 God
D、 After abdominal wall tension reduction suture 8-9 God
E、 After forearm surgery 7-9 God
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8、【 Single topic selection 】 During the disconnection operation , Which of the following is wrong ：
A、 Use tweezers to lift the outer suture and cut
B、 Cut the suture under the thread knot of the thread head
C、 Cut the suture in the subcutaneous segment
D、 Pull out the suture on the side of the cut line
E、 Avoid the outer segment of the skin passing under the skin
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9、【 Single topic selection 】 Which of the following situations should be removed ：
A、 After elbow surgery 10 God , Discomfort at the end of the thread
B、 After subtotal gastrectomy 5 God , The wound hurt
C、 After scalp suture 3 God , Local pain
D、 After appendicitis surgery 3 God , Cut lipstick 、 Swelling , There is exudation
E、 After abdominal hernia repair 3 God , Local dull pain
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10、【 Single topic selection 】 Which of the following is not a factor that needs to delay the removal of stitches ：
A、 Severe anemia 、 Emaciation , Mild cachexia
B、 The surface of the incision is uneven , The suture spacing is different
C、 massive ascites
D、 People with a history of diabetes
E、 People who take glucocorticoids
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Lesson 8 test
1、【 Single topic selection 】 The best time to perform debridement should be
A、 After injury 8 Within hours
B、 After injury 2 Within hours
C、 After injury 4 Within hours
D、 After injury 12 Within hours
E、 After injury 24 Within hours
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2、【 Single topic selection 】 Which of the following is wrong about the postoperative treatment of debridement
A、 Wound drainage strip , Generally, it should be based on the condition of drainage , After surgery 72 Remove within hours
B、 Infusion or blood transfusion according to the general condition
C、 Rational use of antibiotics , Prevent wound infection , Promote inflammation to subside
D、 Tetanus antitoxin injection ; If the wound is deep , The pollution is heavy , The gas gangrene antiserum should be injected into the muscle at the same time
E、 Pay attention to the blood supply of the injured limb 、 Whether the wound dressing is appropriate 、 Whether there is bleeding in the wound
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3、【 Single topic selection 】 The mistake about debridement and suture is
A、 The joints 、 Wounds with large blood vessels or nerves exposed are not sutured after debridement
B、 Remove dirt and foreign matters from the wound , Remove dead tissue
C、 Debridement is best done after injury 6～8 Within hours
D、 The wound on the head and neck of the face exceeds 12 Hours , Suture as much as possible after debridement
E、 A badly polluted wound , No suture after debridement
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4、【 Single topic selection 】 Debridement which of the following is wrong
A、 Deep wound should not be enlarged
B、 The greasy dirt around the wound should be wiped off with turpentine
C、 Use iodine on the skin around the wound 、 Alcohol disinfection
D、 Remove the dead tissue and obviously bruised wound margin tissue
E、 Wash the wound with sterile normal saline or hydrogen peroxide
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5、【 Single topic selection 】 Injured up to 12 Hours of serious pollution wounds , Should take ：
A、 Debridement and primary suture
B、 Debridement and delayed suture
C、 No suture after debridement
D、 There is no need for debridement
E、 Continue to observe 24 Hours , Treat again according to the condition of the wound
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6、【 Single topic selection 】 During debridement , Which of the following is wrong ：
A、 Brush the skin around the wound twice with soapy water and tap water
B、 use 2.5% Iodine tincture and 75% Alcohol disinfects the wound and surrounding skin
C、 Cut off the inactive tissue and contaminated skin margin
D、 Remove all foreign matters in the wound and brush the skin around the wound twice with soapy water and tap water
E、 The severely polluted nerve tissue only needs to be carefully stripped of the outer membrane
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7、【 Single topic selection 】 Which of the following is not suitable for immediate debridement ？
A、 No more than 24 Hours of slightly polluted wounds
B、 injured 24~48 Hours of head and face wounds
C、 There is active bleeding 、 Patients with shock
D、 injured 6~8 Hours of fresh wounds
E、 Patients have no money to pay medical expenses
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8、【 Single topic selection 】 About debridement and suture , Which of the following is not true ？
A、 Generally, local infiltration anesthesia can be done in the wound
B、 Only the skin or subcutaneous fissure can be sutured in a single layer
C、 Those with serious wound pollution , The skin suture can not be ligated temporarily ,24 Ligation was performed after hours without infection
D、 Remove dirt 、 Foreign matter , Remove the inactive tissue , Completely stop bleeding
E、 First aid treatment when the patient is in shock
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9、【 Judgment questions 】 Debridement is only suitable for cleaning wounds
A、 correct
B、 error
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10、【 Judgment questions 】 Debridement and suture should not be performed on infected wounds
A、 correct
B、 error
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11、【 Judgment questions 】 In debridement and suture, for the skin flap peeled off by avulsion injury , Immediately, properly and completely sew back to the original position , To protect subcutaneous tissue and promote wound healing .
A、 correct
B、 error
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12、【 Judgment questions 】 During debridement, the wound is usually washed with sterile normal saline , And gently wipe the dirt and foreign bodies in the wound with sterile small gauze balls , use 3% Rinse with hydrogen peroxide solution , After the wound presents foam, rinse it with sterile normal saline .
A、 correct
B、 error
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