NCLEX-PN 形式の練習問題（LPN/LVN）：直前対策パック

A nurse posts about an "interesting patient" on social media without naming them. Why is this a problem?

1. AIt is only a problem if the post also includes a photograph of the patient
2. BIt is not a problem if the account is private
3. CIt is not a problem because no name was given
4. DThe patient may still be identifiable, which breaches confidentiality

A patient taking furosemide has a serum potassium of 3.0 mmol/L (3.0 mEq/L). Why is this important?

1. ALow potassium only causes mild thirst
2. BLoop diuretics cause potassium loss, and low levels can cause arrhythmias
3. CThe level is normal and needs no action
4. DFurosemide raises potassium, so this level is falsely low and can be ignored

A patient has a very low platelet count. Which safety measure is appropriate?

1. AUse a firm toothbrush and a safety razor
2. BFloss hard each day to keep the gums healthy
3. CTake rectal temperatures for accuracy
4. DUse a soft toothbrush and an electric razor

A nurse calculates a child’s prescribed dose and finds it is ten times higher than the usual dose for the child’s weight. What should the nurse do?

1. AHold the dose and verify it with the prescriber and pharmacist
2. BGive half the dose and watch the child closely
3. CGive one-tenth of the dose without telling anyone about it
4. DGive it, because the prescriber must have a reason

A patient receiving an aminoglycoside antibiotic, such as gentamicin, reports ringing in the ears. What should the nurse do?

1. AGive the next dose early to finish the course
2. BAdvise the patient to use ear drops
3. CHold the next dose and report it promptly
4. DReassure the patient that it is a normal effect

Which assignment by the charge nurse should be changed?

1. AA nursing assistant is assigned to help several stable patients with their meals
2. BAn RN is assigned to a patient receiving a blood transfusion
3. CAn LPN/LVN is assigned to give oral medications to stable patients
4. DAn LPN/LVN is assigned to admit a new patient from the emergency department

A very anxious patient breathes rapidly for a long period. Which change is expected?

1. AMetabolic acidosis from a low bicarbonate
2. BRespiratory alkalosis from a low PaCO₂
3. CMetabolic alkalosis from vomiting
4. DRespiratory acidosis from a high PaCO₂

In a patient with a head injury, which is usually the earliest sign of rising intracranial pressure?

1. AA fixed, dilated pupil on both sides
2. BA slow pulse with high blood pressure
3. CA change in level of consciousness
4. DIrregular breathing pauses

A patient's potassium is 7.0 mEq/L. Which ECG change would the nurse expect?

1. ADelta waves before the QRS
2. BFlattened T waves
3. CProminent U waves
4. DTall, peaked T waves

The nurse teaches a patient who is collecting a 24-hour urine sample at home. Which statement shows a need for further teaching?

1. A"I'll keep the container cool as the laboratory told me to"
2. B"I'll empty my bladder at the end time and add that urine"
3. C"I'll ask whether any foods or drugs should be avoided first"
4. D"If I forget to save one void, I'll just carry on to the end"

ヘンレ係蹄の太い上行脚に作用する利尿薬は？

1. A浸透圧利尿薬
2. Bカリウム保持性利尿薬
3. Cチアジド系利尿薬
4. Dフロセミドなどのループ利尿薬

A patient with type 2 diabetes starts a high dose of prednisolone for a flare of COPD. Which change should the nurse expect?

1. AHigher blood glucose, so more frequent glucose checks are needed
2. BNo change in glucose, as steroids act only in the lungs
3. CLower potassium only, with no effect on glucose
4. DLower blood glucose, so the diabetes medicines should be stopped

Why must inspired air be humidified for a patient with a tracheostomy?

1. AHumidified air contains more oxygen than dry air at the same flow
2. BHumidification prevents the cuff from deflating
3. CThe nose and upper airway, which warm and moisten air, are bypassed
4. DDry air is needed to stop secretions forming in the trachea

A patient on a morphine PCA after surgery is very drowsy, with a respiratory rate of 7/min and pinpoint pupils. SpO₂ is 89%. What should the nurse do first?

1. ALeave the patient to sleep and recheck the observations in an hour
2. BEncourage the patient to keep pressing the PCA button for comfort
3. CStop the PCA, support breathing, give oxygen and get naloxone
4. DGive a sedative to keep the patient comfortable

Which statement about giving IV potassium is correct?

1. AIt can be given quickly as a push to correct the level fast
2. BIt is safest given through a small vein in the hand at a fast rate
3. CIt is diluted and given through an infusion pump, never as a bolus
4. DIt needs no monitoring at all once the infusion is running

A patient with acute glomerulonephritis has a BP of 190/115 mmHg, a severe headache and blurred vision. Which is the priority?

1. AGive extra oral fluids to correct the low urine output
2. BUrgent escalation for BP control and close neuro checks
3. CEncourage a walk to relieve the headache
4. DRecheck the BP at the next routine round

Why are antiemetics usually given before chemotherapy starts?

1. APreventing nausea works better than treating it later
2. BThey stop the chemotherapy from causing hair loss and mouth sores
3. CThey cannot be given once nausea has started
4. DAntiemetics make the chemotherapy work better

A patient has a category (stage) 2 pressure ulcer on the sacrum. Which plan is most appropriate?

1. ASit the patient upright in a chair for most of the day
2. BOffload the area, manage moisture, support nutrition and dress it
3. CMassage around the wound every hour to stimulate blood flow to the skin
4. DLeave it uncovered and dry it with a hair dryer

A woman with pre-eclampsia is on magnesium sulfate. Why does the nurse monitor her urine output closely?

1. AMagnesium is cleared by the kidneys, so oliguria raises the risk of toxicity
2. BLow urine output shows that the magnesium is working
3. CMagnesium causes a large diuresis that leads to dehydration
4. DUrine output tells the nurse exactly when to stop the infusion after the birth

Which statement by a woman with postnatal depression shows that the nurse's teaching has been effective?

1. A"I will tell my midwife or doctor if I have thoughts of harming myself."
2. B"I should keep my feelings to myself so I don't worry my family."
3. C"If I take medicine I can never breastfeed again."
4. D"Depression after birth means I am a bad mother."

同じ受診で、子どもが複数の異なるワクチンの接種予定です。一般原則はどれですか？

1. A1 か月に 1 種類のワクチンしか接種できない
2. Bすべてのワクチンを 1 本の注射器で混ぜるべきである
3. C同じ受診で、別々の接種部位に接種できる
4. Dそれぞれ半量を数週間に分けて接種すべきである

生後 2 か月の赤ちゃんが、両頬にあざがある状態で連れてこられました。親は、赤ちゃんは「物にぶつかる」と言います。看護師は何をすべきですか？

1. A赤ちゃんはよく物にぶつかるものなので、説明を受け入れる
2. B他の家族の前で、親を虐待で非難する
3. C報告することを親に伝えたうえで、検討される前に赤ちゃんを連れて帰らせる
4. D所見を客観的に記録し、虐待防止（セーフガーディング）の手順に従って懸念を報告する

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. BAntidepressant discontinuation syndrome
3. CSerotonin syndrome
4. DA relapse of her depression into a severe psychotic depression

A patient with PTSD is having a nightmare and thrashing in bed. What is the safest way for the nurse to wake him?

1. AStand at a safe distance, say his name clearly and tell him where he is
2. BShake him firmly by the shoulders until he is fully awake
3. CTurn on all the lights and shout loudly so that he wakes up quickly
4. DHold his arms down firmly so that he cannot hit anyone or hurt himself while he is still asleep

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 38.5 °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）。 ある点滴が 19:20 に始まり、翌朝の 06:00 に終了しました（24時間表記）。何分 t 続きましたか。

体重 25 kg の子どもに、4 mg/kg の薬が処方されています。原液は 25 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？

処方は 410 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 8 時間で投与するよう指示されています。6 時間後、バッグにまだ 130 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 50 mL 中に薬を 200 mg 含み、12 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）。 1000 mL のバッグを 11:30 に開始し、ポンプで 125 mL/h で投与しています。17:30 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 圧迫（痛み刺激）にのみ開眼する、うめき声など、理解できない声のみを出す、そして最良運動反応として次を示します：全く動かない。 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）。 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: いいえ; 2つ以上の疾患: いいえ; 歩行補助具: なし、ベッド上安静、または看護師の介助; 点滴治療または生理食塩水ロック: いいえ; 歩行: 障害あり; 精神状態: 自分の限界を理解している。カットオフ値 0～24 が低リスク、25～44 が中等度リスク、45 以上が高リスクを使って、転倒リスクのレベルをクリックしてください。

1. 1低リスク
2. 2中等度リスク
3. 3高リスク