NCLEX-PN 形式の練習問題（LPN/LVN）：直前対策パック

Before discharge, what is most important to confirm about the patient's new medicines?

1. AThat they know which company makes each drug
2. BThat they know the price of each medicine and where to buy it
3. CThat they know how and when to take them and what to report
4. DThat they know the chemical name of each drug

A recently discharged patient sends the nurse a friend request on social media. What is the most appropriate response?

1. ADecline it, to keep a professional boundary
2. BAccept it but only post about work
3. CAccept it, since the patient has gone home
4. DAccept it and ask how they are getting on

A confused patient keeps pulling at an IV line. Which is a less restrictive option to consider before wrist restraints?

1. ATying both arms to the bed frame
2. BUsing a vest restraint in the chair so that the patient’s hands stay down
3. CGiving a sedative every few hours
4. DCovering the site with a sleeve or using hand mitts with supervision

A patient with dementia is often found at the exit doors trying to leave the unit. Which measure is most appropriate?

1. AKeep the patient in a chair with a vest restraint
2. BUse an electronic wander alert, supervise closely and offer meaningful activity
3. CLock the patient alone in a single room so that they cannot reach the exit doors
4. DGive a sedative each time the patient goes to the door

Straight after birth, what is the first priority for a healthy-looking newborn?

1. AWeigh and measure the baby on the scale
2. BGive the vitamin K injection before anything else is done
3. CDry and warm the baby while checking that it is breathing
4. DGive the first bath to remove the blood and vernix

A patient has a wrist restraint. The nurse finds the fingers on that hand pale, cool and tingling. What should the nurse do first?

1. ALoosen the restraint and assess the circulation
2. BTighten the restraint so the patient moves less
3. CRaise the arm on a pillow and check again in two hours
4. DDocument the finding and continue with the medication round

Which group of symptoms suggests hypercalcaemia?

1. ATingling lips, muscle cramps and spasms of the hands and feet
2. BThirst, constipation, confusion and abdominal pain
3. CWeight gain, feeling cold and a slow pulse
4. DSweating, tremor and sudden hunger

During a blood transfusion, an older patient with heart failure becomes breathless with a rising blood pressure, raised JVP and crackles in the lungs. What is the most likely cause?

1. ATransfusion-related acute lung injury with hypotension
2. BA febrile non-haemolytic reaction
3. CTransfusion-associated circulatory overload
4. DAnaphylaxis

A patient's potassium is unexpectedly 5.8 mEq/L. The sample was taken after the tourniquet was on for several minutes while the patient pumped their fist. What is the best interpretation?

1. AThe result confirms true hyperkalemia and needs no further checking
2. BFist pumping lowers potassium, so the true level is even higher
3. CThe result may be falsely high and should be repeated with better technique
4. DTourniquet time affects only the glucose result, not the potassium

A health care worker's hepatitis B tests show: HBsAg negative, anti-HBs positive, anti-HBc positive. What does this mean?

1. APast infection that has resolved, with immunity
2. BCurrent chronic hepatitis B infection
3. CImmunity from vaccination only, never infected
4. DNot immune and never exposed to the virus

During an infusion of a vesicant chemotherapy drug, the patient reports burning, and the site is swollen. What should the nurse do first?

1. AFlush the line with a large volume of saline
2. BStop the infusion, leave the cannula in and follow the protocol
3. CRemove the cannula at once and massage the area firmly
4. DIncrease the infusion rate to finish quickly

A patient taking long-term morphine for cancer pain becomes very sedated with slow breathing. Why is naloxone given in small, diluted doses?

1. ABecause naloxone is much more potent and toxic in patients with cancer
2. BTo make the effect of naloxone last longer than morphine
3. CTo restore breathing without causing severe withdrawal and pain
4. DBecause naloxone is toxic to the liver in large doses

喘息の患者が、発作時用の吸入器を週に3回より多く使っています。これは何を示唆しますか？

1. A発作時用の薬がもう効かないので、中止すべきである
2. B現在の計画で喘息はよくコントロールされている
3. C喘息のコントロールが不良で、治療の見直しが必要である
4. D予防吸入薬はもう必要ない

A patient with pneumonia has a heart rate of 118/min, BP 86/50 mmHg, RR 28/min and a high lactate. Sepsis is recognised. Which action should not be delayed?

1. AWait for the sputum culture result before choosing an antibiotic
2. BGive oral antibiotics and reassess the next day
3. CDelay fluids until a chest X-ray has been reported
4. DTake blood cultures and give IV antibiotics within the first hour

Several hours after a carotid endarterectomy, which finding needs the most urgent action?

1. AMild pain at the incision site
2. BA blood pressure slightly above the baseline
3. CAn expanding neck swelling with noisy breathing
4. DA small amount of dried blood on the dressing

During a TURP, a patient becomes confused and nauseated, with a slow pulse and a raised BP. The sodium is 121 mmol/L. What is most likely?

1. ATURP syndrome from absorbed irrigation fluid
2. BAn allergic reaction to the catheter
3. CHypoglycaemia from fasting for many hours before surgery
4. DA normal reaction to the spinal anaesthetic

Which advice helps a patient with haemorrhoids?

1. AEat more fibre, drink enough fluid and avoid straining
2. BSit on the toilet for long periods to empty fully
3. CTake a codeine-based painkiller every day
4. DEat less fibre so that stools are smaller

A patient took a large paracetamol (acetaminophen) overdose 6 hours ago and says they feel completely well. Which statement is correct?

1. ALiver damage after paracetamol occurs only within the first hour or so
2. BFeeling well means the dose was too small to cause harm
3. CLiver damage may still develop, and appears only days later
4. DTreatment is not needed if the patient has not vomited

B 群溶血性レンサ球菌（GBS）の 全例スクリーニングが行われている地域では、腟・直腸の擦過検体は通常いつ採取しますか？

1. A妊娠 20 週ごろ
2. B妊娠 36～37 週ごろ
3. C初回の妊婦健診
4. D分娩中の破水後

A newborn's heart rate is 80/min after 30 seconds of positive-pressure ventilation and the chest is not moving. What should the nurse do next?

1. AStart chest compressions immediately at a 3:1 ratio
2. BCorrect the ventilation, starting with mask and airway
3. CGive IV adrenaline straight away
4. DStop ventilation and give oxygen by mask only

Using the 100–50–20 rule, what is the daily maintenance fluid requirement for a 15 kg child?

1. A1250 mL per day
2. B1000 mL per day
3. C750 mL per day
4. D1500 mL per day

A parent asks why the HPV vaccine is offered in early adolescence (at about 11 to 13 years, depending on the country). Which answer is best?

1. AIt is only effective if given in the first year of secondary school, before exams start
2. BIt is given at this age because it prevents chickenpox in adolescence
3. CChildren of this age are already likely to have the virus, so it treats the infection
4. DIt works best before any exposure to the virus, and young adolescents respond strongly

A 24-year-old woman with bipolar disorder is starting valproate. What is the most important teaching point?

1. AIt must be taken with grapefruit juice to be absorbed
2. BIt can seriously harm an unborn baby, so effective contraception and specialist advice are essential
3. CIt is safe in pregnancy and needs no special precautions
4. DIt will cause her to lose weight quickly, so she should eat extra meals and snacks every day

看護師が最初に診るべき患者はどれですか？

1. A声が窓から飛び降りろと言っていると話す、入院したばかりの患者
2. B朝の病棟回診の前に、退院計画について話し合いたい不安のある患者
3. C眠れるよう助けを求めている、うつ状態の患者
4. D手に細かい振戦がある、リチウム服用中の患者

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 39.1 °C です。°F = °C × 9/5 + 32 を使って華氏 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 tbsp / 液体サプリメント, ½ fl oz / ジュース, 1½ カップ / お茶, ½ tsp / 咳止めシロップ 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 5 mg/kg で、2 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？

10%（w/v）の原液から 5%（w/v）の溶液を 200 mL 調製する必要があります。 原液に水を何 mL W 加える必要がありますか？

15 滴/mL の輸液セットで 1000 mL を 8 時間かけて投与します。滴下速度 R を 1 分あたりの滴数で求めなさい。 最も近い整数に丸めてください。

500 mL を 12 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 330 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 12 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）。 氷片は体積の半分として数えます。

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 のバッグをポンプで 150 mL/h で投与しています。06:30 の時点で 200 mL がすでに投与されています。バッグが空になるまであと何時間 t ですか？ 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）。 練習用のチャートに GCS 14、E3、V5 と記録されています。記録された運動反応のスコア M はいくつで、どの反応を表していますか。数字で答えてください。

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 68 kg、身長は 162 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