NCLEX-PN 形式の練習問題（LPN/LVN）：直前対策パック

Why does long-term immobility increase the risk of kidney stones?

1. ALying flat makes the kidneys produce extra uric acid
2. BPatients on bed rest drink too much fluid
3. CThe kidneys stop producing urine during bed rest
4. DCalcium released from bone raises the calcium in the urine

Five days after hip surgery, a patient suddenly becomes breathless with sharp chest pain and a fast heart rate. What should the nurse suspect?

1. AA chest infection developing slowly
2. BA pulmonary embolism
3. CAnxiety about going home
4. DNormal recovery after hip surgery

A patient with diabetes will use lancets and insulin needles at home. Which teaching about disposal is correct?

1. ARecap each needle with two hands before putting it in the kitchen trash
2. BPut them loose in the household trash bag, as long as the bag is tied shut
3. CFlush the used lancets and needles down the toilet
4. DPut them in a puncture-resistant container with a lid and follow local disposal rules

A nurse teaches a patient about care of a surgical incision at home. Which statement shows a need for further teaching?

1. A“I will wash my hands with soap before I touch or change the dressing.”
2. B“If the wound gets red and drains pus, I will wait for my appointment next month.”
3. C“I will call the clinic if I get a fever or more pain around the wound.”
4. D“I will keep the dressing clean and dry as I was shown.”

Which infant with gastroenteritis should the nurse see first?

1. AAlert, crying with tears, had a wet diaper an hour ago
2. BMild diaper rash, otherwise playful
3. CTwo loose stools today, feeding well
4. DLethargic, sunken fontanel, no wet diaper for 8 hours

A child who had a tonsillectomy this morning is swallowing again and again while asleep. What should the nurse suspect?

1. ABleeding from the operation site
2. BHunger after fasting for surgery
3. CNormal swallowing during sleep
4. DA sore throat from the breathing tube

A patient with anaphylaxis is hypotensive but has no breathing difficulty. How should they be positioned?

1. ALying face down
2. BLying flat, with the legs raised
3. CSitting upright with the legs dangling
4. DStanding up and walking around

Why must severe chronic hyponatraemia be corrected slowly?

1. AFast correction causes severe hypoglycaemia and seizures in most patients
2. BFast correction makes the kidneys stop producing urine
3. CToo-rapid correction can cause osmotic demyelination in the brain
4. DSodium given quickly causes immediate cardiac arrest

A patient with pneumonia had a CRP of 180 mg/L on admission and 40 mg/L after 4 days of antibiotics. What does this most likely show?

1. AThe patient has developed a new infection
2. BThe infection has spread to another organ
3. CThe inflammation is settling with treatment
4. DThe antibiotic is causing liver damage

A patient with cirrhosis and ascites has fever and abdominal tenderness. The ascitic fluid neutrophil count is 400 cells/mm³. What does this indicate?

1. ASpontaneous bacterial peritonitis
2. BMalignant ascites from cancer
3. CNormal ascitic fluid in cirrhosis
4. DBleeding into the abdominal cavity

A nurse realises that a patient has been given the wrong dose of a medicine. What is the first action?

1. AAssess the patient for effects of the error
2. BCorrect the chart so it shows the right dose
3. CComplete the incident report before anything else
4. DWait to see whether the patient notices

A nurse calculates a child's dose and finds it is ten times higher than the usual range in the drug reference. What should the nurse do?

1. AGive one tenth of the dose without telling anyone
2. BWithhold it, recheck the calculation and clarify with the prescriber
3. CGive half the dose as a compromise
4. DGive the dose, because the prescriber is responsible for the order

A patient in cardiac rehabilitation asks how hard to exercise. Which simple guide is commonly taught?

1. AExercise until chest pain starts, then stop
2. BExercise only until the heart rate rises even slightly
3. CExercise so they are a little breathless but can still talk
4. DExercise until they are too breathless to speak at all

A patient is listed for coronary angiography in the morning. Which pre-procedure result should the nurse report to the team?

1. AA markedly reduced eGFR
2. BA haemoglobin in the normal range
3. CA normal platelet count
4. DA blood glucose of 5.4 mmol/L (97 mg/dL)

Which picture fits Brown-Séquard syndrome?

1. AWeakness of both arms with normal strength in the legs
2. BParalysis of both legs, with normal sensation everywhere in the body
3. CLoss of all feeling but normal movement on both sides
4. DWeakness on the same side and loss of pain on the opposite side

A patient on warfarin starts levothyroxine for hypothyroidism. What should the nurse expect to monitor more closely?

1. AThe potassium, because it may rise
2. BThe INR, because it may rise
3. CThe blood glucose, because it may fall
4. DThe urine output, because it may stop

In the UK National Early Warning Score (NEWS2), what does an aggregate score of 5 or more usually trigger?

1. ANo change unless the patient complains
2. BAn urgent review by a clinician skilled in acute illness
3. CRoutine observations once every 12 hours, with no other change in care
4. DDischarge planning for the next day

A patient taking oral capecitabine reports red, painful, peeling palms and soles. What should the nurse do?

1. ATell the patient to take a double dose next time
2. BAdvise hot soaks for the hands and feet
3. CReassure that it is a sign of an unrelated allergy to washing powder
4. DReport it; this is hand-foot syndrome and treatment may need changing

Which statement about the lactational amenorrhoea method (LAM) is correct?

1. AIt is reliable even when the baby is formula-fed at night
2. BIt becomes more reliable after the periods return
3. CIt works for as long as the mother breastfeeds at all
4. DIt needs full breastfeeding, no periods and a baby under 6 months

A nurse is teaching a mother how to prevent shaken baby syndrome. Which statement shows a need for further teaching?

1. A"I can call someone to help when I feel overwhelmed."
2. B"Crying often increases in the first weeks, and that can be normal."
3. C"If I get too frustrated, I will put him in his cot and step away for a few minutes."
4. D"If I feel very angry, it is fine to shake him a little to stop the crying."

After a cardiac catheterisation through the femoral artery, which assessment is essential?

1. AUrine specific gravity at every void
2. BPupil size and reaction every 15 minutes
3. CBowel sounds, abdominal girth and stool colour every 15 minutes for the first hours
4. DPulse, colour, warmth and sensation of the leg below the puncture site

今朝、扁桃摘出術を受けた子どもが、頻繁に唾を飲み込み、鮮紅色の血を吐き出しています。看護師が最初にすべきことは何ですか？

1. Aのどとバイタルサインをアセスメントし、至急、外科医に報告する
2. Bうがいを勧める
3. C記録に書き、次の定期的な観察時に再評価する
4. Dのどを落ち着かせるために温かい飲み物を与える

Why is giving approval, such as saying "That's good" about a patient's decision, considered non-therapeutic?

1. AIt suggests that the patient's choices are judged against the nurse's standards
2. BIt always makes the patient angry and more likely to become aggressive towards staff
3. CIt shows that the nurse is not listening at all
4. DIt is against the law in mental health settings

After witnessing a serious accident, a woman suddenly cannot move her legs. Full investigations are normal. Which nursing approach is most appropriate?

1. ATell her that the paralysis is fake and that she should stand up
2. BFocus every conversation on the details of her leg weakness
3. CIgnore her requests for help completely until she agrees to try to walk again on her own
4. DAccept that the symptom is real for her, help with mobility needs and gently explore recent stress

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 39.4 °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）。 ある点滴は 15 mcg/min を投与します。この投与速度 D を mg/h で表してください。

体重 22 kg の子どもに、5 mg/kg の薬が処方されています。原液は 50 mg/mL を含みます。用量を吸い上げます：何 mL V を投与しますか？

体重 16 kg の子どもに、5 mL 中に 100 mg を含む経口懸濁液が一回 10 mg/kg で処方されています。与える量 V はいくらですか？

1500 mL を 10 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 1040 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 250 mL 中に薬を 100 mg 含み、30 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 12 時間勤務帯 1 回分の摂取量と排泄量を示しています。患者の体重は 77 kg です。平均尿量 U を mL/kg/h で求めてください。 小数第 2 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）。 500 mL のバッグを 10:30 に開始し、ポンプで 60 mL/h で投与しています。13:30 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）。 頭部外傷後の練習用の患者は 呼びかけると開眼する、不適切で脈絡のない言葉を言う、そして最良運動反応として次を示します：圧迫部位に手を持っていく（疼痛部位を認識）。 GCS を求め、それによって頭部外傷を分類してください。答えをクリックしてください。

1. 1軽症
2. 2中等症
3. 3重症

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 65 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 87 mmHg です。MAP = (SBP + 2·DBP)/3 を使って、MAP が 65 mmHg になる最低の拡張期血圧 DBP はいくつですか。