NCLEX-PN 形式の練習問題（LPN/LVN）：直前対策パック

A patient with capacity wants to leave hospital against medical advice. What should the nurse do?

1. AExplain the risks, inform the doctor and document the discussion
2. BHide the patient's clothes so they cannot leave
3. CLock the ward door to keep the patient in until the doctor arrives
4. DLet them go without telling anyone

A urine culture reports a mixed growth of several organisms. What is the most likely explanation?

1. AThe patient is resistant to all antibiotics
2. BThe patient has several serious infections at once
3. CThe laboratory used the wrong test
4. DThe sample was contaminated during collection

A nurse has just given an intramuscular injection with a safety needle. What should the nurse do next with the needle?

1. AActivate the safety device and drop it into a sharps container at once
2. BBend the needle to make it unusable, then discard it
3. CLay it on the medication tray and discard it later
4. DRecap it carefully with both hands and dispose of it after the drug round

The laboratory reports that a blood sample labeled with one patient’s name has a blood group different from that patient’s previous result. What is the most likely problem and response?

1. AA laboratory machine fault, so no action is needed
2. BThe previous result was wrong, so it is deleted
3. CA wrong-patient sample, so the test is repeated and the event reported
4. DA normal change in the patient’s blood group over the years since the last test

Before giving a scheduled dose of metoprolol, which assessment is most important?

1. AApical pulse and blood pressure
2. BTemperature and the latest pain score
3. CBowel sounds and urine color
4. DBlood glucose and weight

A patient has central chest pain that started 30 minutes ago at rest and has not eased with rest or nitroglycerin. What does this suggest?

1. AMuscle strain that needs a warm compress
2. BStable angina that will pass without treatment
3. CA possible myocardial infarction that needs urgent action
4. DIndigestion that is best treated with an antacid and a glass of milk

Which oxygen device delivers a precise, fixed concentration of oxygen?

1. ANasal cannula
2. BSimple face mask
3. CNon-rebreathe mask
4. DVenturi mask

Which type of drug is commonly used to treat neuropathic pain?

1. AProton pump inhibitors such as omeprazole
2. BAntibiotics such as amoxicillin, given as a long course
3. CAntihistamines such as cetirizine
4. DSome anticonvulsants or antidepressants, such as gabapentin

Which technique is recommended for a capillary blood glucose test on an adult's finger?

1. APrick the side of the fingertip
2. BUse the same finger every time
3. CPrick the center of the fingertip
4. DSqueeze the finger very hard

糖尿病性ケトアシドーシスの患者の、インスリン点滴を開始する前のカリウムが 3.0 mEq/L です。看護師は何を予想すべきですか？

1. Aカリウムを先に補充し、インスリンは、プロトコルに従って濃度が安全になるまで待つ
2. Bただちに、より高い速度でインスリンを開始する
3. Cカリウムが正常になるまで、輸液を止める
4. Dインスリンがカリウムを上げるので、カリウムは補充しない

ネオスチグミンは重症筋無力症でどのように筋力を改善しますか？

1. A受容体に対する自己抗体を遮断する
2. B筋肉のムスカリン受容体を直接刺激する
3. Cアセチルコリンエステラーゼを阻害し、より多くのアセチルコリンが受容体に届くようにする
4. D神経筋接合部のアセチルコリン受容体の数を増やす

A patient taking furosemide has a serum potassium of 2.9 mmol/L (mEq/L). Which ECG change is typical of this level?

1. ATall, peaked T waves
2. BWidened QRS with a sine-wave pattern
3. CFlattened T waves and prominent U waves
4. DA short QT interval with high R waves

After thrombolysis for a myocardial infarction, which complication is the nurse most concerned to detect?

1. ABleeding, including a sudden change in neurological status
2. BA skin rash appearing at the sites of the ECG electrodes
3. CConstipation from bed rest
4. DA high blood glucose caused by the thrombolytic drug itself

心臓手術の1時間後、縦隔ドレーンから鮮紅色の血液が350 mL排液され、心拍数が上昇しています。看護師はどうすべきですか？

1. A量を記録し、1時間ごとの確認を続ける
2. B5分ごとにチューブを強くしごく
3. Cさらなる出血を止めるため、ドレーンをクランプする
4. D直ちに外科チームに報告する

A patient with a suspected basal skull fracture needs a gastric tube. Which route is preferred?

1. AThrough the mouth (orogastric)
2. BThrough the nose (nasogastric)
3. CThrough the nose with a guidewire
4. DThrough a fine-bore nasal tube

甲状腺全摘術の後、患者が不安を訴え、ストライダーと頸部の緊満した腫れがあります。看護師が最初にすべきことは何ですか？

1. A声を調べるため、できるだけ話してもらう
2. B緊急の応援を呼ぶ。血腫が気道を圧迫しているかもしれない
3. C首にアイスパックを当て、患者を仰向けに寝かせる
4. D鎮痛薬を投与し、1時間後に再び腫れを評価する

Why are laxatives and enemas avoided when appendicitis is suspected?

1. AThey may increase the risk of perforation
2. BThey make the blood tests impossible to read
3. CThey stop antibiotics from being absorbed
4. DThey always cause the appendix to bleed heavily

On the morning of elective hip surgery, a patient says she took her usual warfarin last night despite being told to stop. What should the nurse do?

1. AGive a double dose of vitamin K by mouth without waiting for a prescription
2. BProceed with the usual checklist and say nothing
3. CInform the surgical and anaesthetic teams, who will check the INR
4. DTell her the surgery must be cancelled for a month

ある女性が妊娠しています。過去に妊娠 35 週で双子（2 人とも生存）を出産し、妊娠 10 週で流産しています。この女性の GTPAL はどれですか？

1. AG2 T0 P1 A1 L2
2. BG3 T1 P0 A1 L2
3. CG3 T0 P1 A1 L2
4. DG4 T0 P2 A1 L2

A labouring woman refuses a recommended caesarean for fetal distress after a full explanation. She has decision-making capacity. What should the nurse do?

1. AAsk her partner to consent instead
2. BRespect her decision, document it and inform the team
3. CStop caring for her because she refused advice
4. DPrepare her for surgery anyway because the baby is at risk

How is urine output measured in an infant wearing nappies?

1. ACount only the number of nappy changes in each shift
2. BSqueeze the nappy out into a measuring jug and read the volume
3. CWeigh the wet nappy and subtract the dry weight; 1 g is about 1 mL
4. DEstimate it from how heavy the nappy feels in the hand

A 5-year-old with leukaemia tells the nurse she is ill because she was naughty. What is the best response?

1. AReassure her clearly that nothing she did or thought made her ill
2. BExplain the cell biology of leukaemia to her in detail
3. CAgree that being good may help her get better faster
4. DIgnore the remark, as she is too young to understand

A patient stopped paroxetine suddenly a few days ago. She now has dizziness, irritability, flu-like symptoms and brief "electric shock" feelings. What is the most likely cause?

1. ANeuroleptic malignant syndrome
2. BA relapse of her depression into a severe psychotic depression
3. CSerotonin syndrome
4. DAntidepressant discontinuation syndrome

During a ward community meeting, several patients complain that the ward is too noisy at night. What reflects a therapeutic milieu?

1. ATell the patients that the rules cannot be changed
2. BAsk the patients to write their complaints down and then do nothing
3. CEnd the meeting so the complaint is not discussed further
4. DDiscuss the problem openly and involve patients in finding a solution

練習問題（数値は架空のもので、臨床上の指針ではありません）。 ある新生児の体重は 9 lb 15 oz です。1 lb = 16 oz と 1 kg = 2.2 lb を使って、体重 m をキログラムで求めてください。小数第2位に丸めてください。

練習問題（数値は架空のもので、臨床上の指針ではありません）。 処方箋に、経口懸濁液 12時間ごと を ½ tbsp、7 日間と書かれています。1 tbsp = 15 mL を用いて、全期間に必要な mL V はいくつですか。

患者の体重は 60 kg です。指示量は 1 日 10 mg/kg で、4 回に等分して投与します。1 回あたり何 mg D 投与しますか？

処方は 850 単位で、薬は 1000 単位/mL で供給されます。1 mL の注射器に用量を吸い上げます：何 mL V を投与しますか？

500 mL を 10 時間で投与するよう指示されています。5 時間後、バッグにまだ 310 mL 残っていることがわかりましたが、予定どおりの時間に終える必要があります。 ポンプを何 mL/h の速度 R に設定し直す必要がありますか？

バッグは 100 mL 中に薬を 1000 mg 含み、8 mL/h で投与されています。患者が受け取るのは 1 時間あたり何 mg D ですか？

練習問題（数値は架空のもので、臨床上の指針ではありません）。 記録は、ある患者の 8 時間勤務帯 1 回分の摂取量と排泄量を示しています。点滴は勤務帯の間ずっと表示の流量で投与されました。水分出納 B = 摂取量 − 排泄量 を mL で求めてください（負の答えは正味の喪失を意味します）。

練習問題（数値は架空のもので、臨床上の指針ではありません）。 500 mL の輸液を 10:00 に 120 mL/h で開始します。2 時間後に流量を 150 mL/h に変更し、その後は変更しません。開始から何時間後 t にバッグは空になりますか？ 小数第 1 位まで四捨五入してください。

練習問題（数値は架空のもので、臨床上の指針ではありません）。 ある患者の脈拍は 115/分、血圧は 86/52 mmHg です。ショック指数 SI = HR/SBP を求めてください。小数第2位に丸めてください。

練習問題（数値は架空のもので、臨床上の指針ではありません）。 ある成人の体重は 57 kg、身長は 184 cm です。BMI を計算し、WHO の体重区分をクリックしてください。

1. 1低体重（やせ）
2. 2普通体重
3. 3過体重
4. 4肥満クラスI
5. 5肥満クラスII
6. 6肥満クラスIII