NCLEX-PN 形式の練習問題（LPN/LVN）：直前対策パック

Which measure is appropriate for a patient with a fever who feels hot and uncomfortable?

1. ALight bedclothes, plenty of fluids and a prescribed antipyretic
2. BExtra blankets to make the patient sweat it out
3. CRestricting fluids so the patient sweats less during the fever
4. DAn ice bath until the patient shivers

What is the effect of deflating the blood pressure cuff too quickly?

1. AThe reading becomes more accurate because it is faster
2. BOnly the pulse rate is affected, not the blood pressure
3. CBoth the systolic and diastolic will be read too high
4. DThe systolic may be read too low and the diastolic too high

Which measure reduces errors caused by interruptions during medication preparation?

1. AA quiet “no interruption” zone or signal while preparing medications
2. BPreparing medications for all patients at once
3. CAnswering phone calls and pages while counting tablets, to save time
4. DPreparing medications at the busiest place on the ward

A 2-year-old living in a house built many decades ago has anemia, irritability and poor appetite. Which cause should the nurse suspect?

1. AIron overload from eating too much red meat
2. BCarbon dioxide from a gas cooker
3. CA food allergy to cow’s milk proteins
4. DLead poisoning from old paint dust or chips

A patient uses patient-controlled analgesia (PCA) after surgery. Which statement by a family member shows a need for further teaching?

1. A“The pump has limits set by the nurse so she cannot get too much at once.”
2. B“I will press the button for her while she is asleep so she stays comfortable.”
3. C“Only she should press the button when she needs pain relief.”
4. D“I will tell the nurse if she becomes very sleepy or hard to wake.”

A patient has a heart rate of 38/min, feels dizzy and has a blood pressure of 80/50 mmHg. Which drug is usually given first, as prescribed?

1. AAtropine
2. BDigoxin
3. CDiltiazem
4. DMetoprolol

Which type of painkiller should a patient with liver cirrhosis usually avoid?

1. ALocal anaesthetic creams
2. BNon-steroidal anti-inflammatory drugs such as ibuprofen
3. CParacetamol (acetaminophen), given in a carefully reduced and monitored dose
4. DHot packs applied to a painful joint

トリアージで最初に診るべき患者は？

1. A2 日前からのどが痛い患者
2. B処方の継続を希望する患者
3. Cピーナッツを食べたあと呼吸音が大きく、唇が腫れている患者
4. D足首の捻挫で軽い腫れのある患者

A patient with hyponatremia from SIADH starts tolvaptan. Why is the serum sodium checked frequently in the first day?

1. AThe sodium can rise too quickly
2. BThe drug causes severe hyperkalemia
3. CThe drug lowers blood glucose sharply
4. DThe sodium always falls further

The nurse teaches a patient with thrombocytopenia (platelets 25 × 10³/µL) about home safety. Which statement shows a need for further teaching?

1. A"I'll use a soft-bristled toothbrush"
2. B"I'll use an electric razor to shave"
3. C"I'll take aspirin if I get a headache"
4. D"I'll blow my nose gently, not forcefully"

A patient starting niacin (nicotinic acid) complains of flushing and warmth after doses. Which advice may reduce this?

1. ATake it on an empty stomach in a hot bath
2. BTake aspirin 30 minutes before the niacin, if the prescriber agrees
3. CTake the niacin with a hot drink so that it dissolves and acts faster
4. DDouble the dose to build tolerance faster

A patient with severe liver cirrhosis needs a benzodiazepine for alcohol withdrawal. Why is lorazepam often chosen instead of diazepam?

1. ALorazepam is excreted unchanged in the urine without any metabolism
2. BLorazepam does not cause sedation in liver disease
3. CLorazepam is a stronger anticonvulsant than all other benzodiazepines
4. DLorazepam is cleared by simple conjugation and has no active metabolites

Virchow's triad describes three factors that promote venous thrombosis. Which patient factor represents venous stasis?

1. ADamage to a vein during hip surgery
2. BAn inherited clotting disorder
3. CTaking an oestrogen-containing pill
4. DImmobility after major surgery

A fit 24-year-old marathon runner has a resting heart rate of 46/min on admission for minor surgery. He has no dizziness, chest pain or breathlessness, and his BP is 118/70 mmHg. What is the appropriate response?

1. ADocument and report it, as this is often normal in an athlete
2. BCancel the surgery and arrange a permanent pacemaker urgently
3. CStart chest compressions
4. DGive IV atropine straight away to bring the rate above 60/min

下垂体手術の後、患者が3時間にわたって1時間に400 mLの尿を出し、比重が低くなっています。看護師は何を疑うべきですか？

1. ASIADH
2. B急性腎障害
3. C正常な利尿
4. D尿崩症

Why might a frail 88-year-old with type 2 diabetes have a less strict HbA1c target?

1. ATo save money on blood tests and drugs
2. BBecause older people cannot use any glucose medicines
3. CTo reduce the risk of hypos, falls and confusion
4. DBecause diabetes cannot damage older people

Why is it important to prevent perioperative hypothermia?

1. AIt increases bleeding, wound infection and heart complications
2. BIt lowers the risk of pain after surgery
3. CIt reduces the amount of anaesthetic needed, which is unsafe
4. DIt makes patients wake up from the anaesthetic too quickly

On day 2 of nasogastric feeding, a severely malnourished patient becomes weak and breathless with ankle swelling. Phosphate is 0.4 mmol/L. What is most likely?

1. ARefeeding syndrome
2. BAn allergy to the feed formula
3. CToo little calorie intake
4. DNormal adjustment to the new feed

A newborn's blood glucose is low but the baby is well and able to feed. What is the usual first step?

1. AFeed the baby and recheck the glucose
2. BGive the baby plain water by bottle
3. CGive IV insulin immediately
4. DWithhold feeds and observe for 6 hours

A deceleration lasts 3 minutes before the baseline recovers. How is this classified?

1. AA prolonged deceleration
2. BA change of baseline
3. CA variable acceleration
4. DAn early deceleration

A child has impetigo. Which advice helps to stop it spreading?

1. AUse separate towels, wash hands often and keep nails short
2. BShare flannels and towels so the whole family is treated
3. CPick the crusts off daily so the skin heals faster
4. DCover the crusts with a thick layer of petroleum jelly and leave them

A 3-month-old has large, flat, blue-grey patches over the lower back and buttocks. The parents say they have been there since birth. What is the best action?

1. ADocument them with size and location as congenital dermal melanocytosis (Mongolian spots)
2. BRequest urgent clotting tests and a full blood count to look for a bleeding disorder
3. CApply cold packs several times a day to reduce the discoloration
4. DReport them straight away to the safeguarding team as suspected physical abuse

According to DSM-5, how long must signs of the disturbance last before schizophrenia can be diagnosed?

1. AAt least 1 month, with no further time required
2. BAt least 2 years, including 6 months of active symptoms
3. CAt least 2 weeks of continuous symptoms
4. DAt least 6 months, including at least 1 month of active symptoms

A patient with an anxiety disorder speaks so quickly about her worries that the nurse cannot follow. Which response is most helpful?

1. A"Let's slow down and talk about one thing at a time. What worries you most right now?"
2. B"Let me tell you what I think your problem is, and then we can talk."
3. C"There's really nothing to worry about, so just try to relax."
4. D"You're talking too fast, so we'll have to stop for today."

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）。 ある患者の体温は 97.6 °F です。°C = (°F − 32) × 5/9 を使って摂氏 T に換算してください。小数第1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）。 ある患者が1勤務帯の間に 1 fl oz / ジュース, ¾ カップ / お茶, 4 tbsp / 液体サプリメント を摂取しました。与えられた換算値を使って、経口摂取量の合計 V を mL で求めてください。

患者の体重は 12 kg です。指示量は 1 日 20 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 55 マイクログラムです。アンプルは 0.5 mg/mL を含みます。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？

1000 mL を 8 時間で投与するよう指示されています。4 時間後、バッグにまだ 530 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？

1000 mL を 8 時間で投与するよう指示されています。3 時間後、バッグにまだ 790 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。 元のポンプ速度を何パーセント Δ 上げる必要がありますか？

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 のバッグを 13:00 に開始し、ポンプで 120 mL/h で投与しています。14:00 の時点でバッグには何 mL V 残っていますか？

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）。 練習用の患者をモース転倒スケールで評価します：過去3か月以内の転倒歴: はい; 2つ以上の疾患: はい; 歩行補助具: 家具につかまる; 点滴治療または生理食塩水ロック: はい; 歩行: 正常、ベッド上安静、または車椅子; 精神状態: 能力を過大評価する、または限界を忘れる。モース転倒スケールの合計 MFS を求めてください。

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）。 チームは平均動脈圧が少なくとも 70 mmHg になることを目標としています。ある患者の収縮期血圧は 86 mmHg です。MAP = (SBP + 2·DBP)/3 を使って、MAP が 70 mmHg になる最低の拡張期血圧 DBP はいくつですか。