NCLEX-PN 形式の練習問題（LPN/LVN）：直前対策パック

インフォームド・コンセントとは何ですか？

1. A判断能力のある患者が十分な説明を受けたうえで自発的に同意すること
2. B家族の誰かの署名
3. C処置のあとに得た同意
4. D処置によって生じたいかなる害についても、スタッフのあらゆる責任を免除する署名済みの書式

A patient standing for the first time after surgery becomes pale, sweaty and dizzy. What should the nurse do first?

1. ALeave the patient standing and fetch the blood pressure machine
2. BHelp the patient sit or lie down safely
3. CGive the patient a sugary drink while standing
4. DEncourage the patient to keep walking to build strength

Why is “QD” (once daily) on The Joint Commission’s “Do Not Use” list?

1. AIt is only allowed for intravenous medicines
2. BIt means “every day at bedtime” in some hospitals
3. CIt is a Latin abbreviation, and only plain English abbreviations may be used
4. DIt can be misread as QID or QOD, so the drug is given too often or too rarely

A patient with fever and a spreading rash is suspected of having smallpox. Which precautions are needed?

1. AAirborne and contact precautions
2. BDroplet precautions with a surgical mask
3. CStandard precautions only
4. DContact precautions only

Which medication order should the nurse question?

1. APotassium chloride by IV push
2. BPotassium chloride oral solution diluted in juice
3. COral potassium chloride with food
4. DPotassium chloride diluted in an IV bag via a pump

大きな手術の後の患者の尿量が 2 時間にわたって 15 mL/時で、心拍数が 115 回/分、手が冷たいです。看護師が最初にすべきことは何ですか？

1. A尿量が改善するかどうか、さらに 2 時間待つ
2. B出血などのショックの徴候をアセスメントし、エスカレーションする
3. Cカテーテルをフラッシュし、明日の朝に尿量を再確認する
4. D水をもっと飲むよう勧め、あとで再確認する

Why is an ankle–brachial pressure index (ABPI) measured before applying compression bandages to a leg ulcer?

1. ATo work out the patient's fluid needs
2. BTo exclude significant arterial disease, as compression could cut off blood flow
3. CTo check for a urinary tract infection that could delay ulcer healing
4. DTo measure how deep the ulcer is and how much exudate it produces

A patient admitted after a fall takes many regular medicines. Which safety step on admission helps prevent medication errors?

1. APrescribing only the medicines that the patient can remember taking
2. BMedicines reconciliation against reliable sources, such as primary care records
3. CStopping all regular medicines until the day the patient is discharged
4. DDoubling the doses to make up for any missed while at home

A nurse has a needlestick injury from a patient with unknown HIV status. Which test is usually done for the nurse as soon as possible?

1. AA sweat chloride test
2. BA serum lipase test
3. CA thyroid panel test
4. DA baseline HIV test

A patient on hemodialysis receives epoetin, but the hemoglobin has not risen in 2 months. Which results should be checked first?

1. ATSH and the free T₃ level
2. BAmylase and lipase levels
3. CTroponin and creatine kinase
4. DFerritin and transferrin saturation

A patient uses a salbutamol (albuterol) inhaler and a corticosteroid inhaler at the same time of day. Which order is usually taught?

1. AUse the steroid first, then the salbutamol right after without any gap
2. BUse both in the same breath to save time
3. CUse the salbutamol first, wait a few minutes, then use the steroid
4. DThe order does not matter and no waiting is needed

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

A patient with COPD uses an inhaled corticosteroid combination inhaler. Which risk should the nurse be aware of?

1. AAn increased risk of high blood pressure crises
2. BHearing loss after every dose
3. CAn increased risk of pneumonia
4. DA sharp drop in potassium after each dose

A patient with obstructive sleep apnoea who uses CPAP at home is having surgery. Which plan is safest after the operation?

1. ALeave the CPAP machine at home, as it is not needed while in hospital
2. BGive extra opioids so the patient sleeps through the night
3. CNurse the patient lying flat on their back to keep the airway open
4. DUse their CPAP machine and monitor closely, using opioids with caution

Which measure best prevents catheter-associated urinary tract infection?

1. AChange the catheter for a new one every day
2. BDisconnect the bag regularly to empty it
3. CRemove the catheter as soon as it is no longer needed
4. DKeep the drainage bag above bladder level

A man who takes tamsulosin for BPH is listed for cataract surgery. Which statement is correct?

1. AIt should be swapped for oxybutynin the night before to protect the eye
2. BThe dose should be doubled before surgery to prevent urinary retention
3. CTamsulosin has no effects outside the urinary tract, so nothing changes
4. DThe eye surgeon must be told, as it can cause floppy iris during surgery

大手術の後の最初の数日間、「必要時」の投与より定期的（スケジュール化）な鎮痛が好まれることが多いのはなぜですか？

1. A薬の濃度が安定し、激しい痛みのピークを防げるから
2. Bオピオイドの副作用が完全に防げるから
3. C日中に患者の痛みをアセスメントする必要がなくなるから
4. D1日の最大限度を超える用量を投与できるから

Six hours after surgery, a patient has not passed urine, has lower abdominal discomfort and a bladder scan shows 750 mL. What should the nurse do?

1. AWait another twelve hours before acting
2. BCatheterise as per protocol or prescription
3. CRestrict fluids until the urge returns
4. DGive a diuretic to increase urine flow

Misoprostol is given for postpartum haemorrhage. Which side effect is common?

1. ABradycardia and hypoglycaemia
2. BShivering and fever
3. CBronchospasm in all patients
4. DSevere hypertension

A multiparous woman arrives with strong contractions and the baby is born within an hour of their onset. What should the nurse monitor closely afterwards?

1. AOnly the newborn's blood glucose
2. BThe mother's ability to walk alone
3. COnly the mother's temperature
4. DUterine tone, bleeding and newborn injury

看護師は 4 歳児を処置にどのように備えさせるべきですか？

1. A内臓の図を見せる
2. B怖がらせないよう、何も説明しない
3. C1 週間前に詳しく説明する
4. D直前に簡単な言葉で短く説明し、子どもに器具を触らせたり、人形で遊ばせたりする

The mother of a 5-day-old breastfed baby asks how she can tell her baby is getting enough milk. Which answer is best?

1. AThe baby should feed for exactly 10 minutes on each side at every feed, day and night
2. BThe baby should sleep through the night without waking for feeds
3. CHer breasts should always feel full and hard between feeds
4. DAbout 6 or more wet nappies a day, regular yellow stools and steady weight gain

ウェルニッケ脳症の古典的な三徴はどれですか？

1. A振戦、筋強剛、動作の緩慢さ
2. B錯乱、運動失調、異常な眼球運動
3. C発熱、発疹、項部硬直
4. D頭痛、嘔吐、霧視のみ

A depressed patient says, "I don't enjoy anything any more, so there's no point in doing anything." Which intervention best reflects behavioural activation?

1. AEncourage him to rest in bed as much as possible until the medicine works
2. BPlan small, scheduled activities with him and review how he felt afterwards
3. CTell him that his thoughts are irrational and he should stop thinking that way
4. DWait until his mood improves before suggesting activities

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）。 投与が 3:00 AM と記録されています。24時間表記で同じ時刻の記載はどれですか。クリックしてください。

1. 115:00
2. 202:00
3. 304:00
4. 403:00

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 3 カップ / お茶, ½ tbsp / 液体サプリメント, 8 fl oz / ジュース 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。

体重 6 kg の子どもに、20 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？

処方は 4400 単位で、薬は 10000 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？

20 滴/mL の輸液セットで 250 mL を 10 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。

薬剤 1000 mg を 500 mL に希釈し、20 滴/mL のセットで自然落下で投与します。指示は 1 時間あたり 60 mg です。滴下速度 R を 1 分あたりの滴数で求めなさい。

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）。 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）。 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 60 mL/h で投与しています。13:00 の時点で 50 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）。 練習用の患者をブレーデンスケールで評価します：知覚の認知: 全く知覚できない; 湿潤: ときどき湿っている; 活動性: 臥床; 可動性: やや制限されている; 栄養状態: 良好; 摩擦とずれ: 潜在的に問題あり。ブレーデンスケールの合計 B 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 60 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 100 mmHg です。MAP = (SBP + 2·DBP)/3 を使って、MAP が 60 mmHg になる最低の拡張期血圧 DBP はいくつですか。