NCLEX-PN 形式の練習問題（LPN/LVN）：直前対策パック

Which of these is one of the five rights of delegation?

1. AThe right time of year
2. BThe right uniform
3. CThe right supervision
4. DThe right salary

Why must a needlestick injury be reported straight away rather than at the end of the shift?

1. AThe injury must be documented within ten minutes for the report to be valid
2. BThe source patient will be discharged soon
3. CReporting late means the nurse has to pay for the tests
4. DPost-exposure prophylaxis works best when it is started as soon as possible

A newly hired nurse had BCG vaccine as a child. Which TB screening test is usually preferred?

1. ANo screening, because BCG prevents all TB
2. BA tuberculin skin test, which is read 24 hours after it is placed
3. CAn interferon-gamma release assay (IGRA) blood test
4. DA chest x-ray every month for the first year

A nurse often skips barcode scanning to save time, as many colleagues do. In a just culture, how is this behavior classed?

1. AReckless behavior, managed by immediate dismissal and reporting to the licensing board
2. BAt-risk behavior, managed by coaching and fixing the system pressures behind it
3. CSimple human error, managed only by consoling the nurse and moving on
4. DAcceptable behavior, because it is common on the unit

Which postoperative patient should the nurse see first?

1. APain of 4/10 one hour after an oral analgesic
2. BWants help with washing her hair before her visitors arrive this afternoon
3. CAsking when the urinary catheter will be removed
4. DDressing soaked with bright red blood and a heart rate rising to 118/min

持続膀胱洗浄を伴う経尿道的前立腺切除術のあとに、予測されず、対応が必要な患者の所見はどれですか？

1. A処方された鎮痙薬で和らぐ、軽い膀胱けいれん
2. Bカテーテルがあるのに、尿を出したい感じがする
3. C凝血を伴う鮮紅色の尿と、カテーテルからの流出の減少
4. D日中にだんだんきれいになる、薄いピンク色の尿

甲状腺の手術後、患者に口の周りのしびれと筋肉のけいれん（こむら返り）があります。どの電解質の問題を疑うべきですか？

1. A低カルシウム血症
2. B高マグネシウム血症
3. C高カリウム血症
4. D高ナトリウム血症

An adult with capacity refuses a blood transfusion for religious reasons, even though it may save their life. What should the nurse do?

1. ARespect the refusal, check it is informed and document it, and inform the team
2. BAsk a family member to consent instead
3. CSedate the patient so the transfusion can be given
4. DGive the transfusion while the patient is asleep, as it is in their best interests

A patient with a potassium of 2.8 mEq/L has potassium chloride prescribed IV. Which statement about giving it is correct?

1. AIt is given as an undiluted bolus into a large vein to avoid irritation
2. BIt may be given as a slow IV push over one minute if the level is very low
3. CIt is added to the IV bag without mixing, so it stays at the bottom
4. DIt is always diluted and given by infusion pump, never as an IV push

Which set of results best shows that diabetic ketoacidosis is resolving?

1. AA falling glucose with a falling serum bicarbonate
2. BA falling glucose with a still widening anion gap
3. CA rising potassium with a falling bicarbonate
4. DA closing anion gap with a rising bicarbonate and pH

A patient is due the first dose of IV cefuroxime. Which question is most important before giving it?

1. A"Have you ever had a reaction to penicillin or another antibiotic?"
2. B"Have you eaten anything in the last two hours?"
3. C"Do you prefer the drip in your left arm or in your right arm?"
4. D"Have you taken paracetamol today?"

A drug is ordered at 5 micrograms/kg/min for an 80 kg patient. The infusion contains 1,600 micrograms per mL. What rate in mL/h is needed?

1. A25 mL/h
2. B15 mL/h
3. C4 mL/h
4. D150 mL/h

A patient choosing between a mechanical and a biological heart valve asks about the main difference. Which answer is accurate?

1. AMechanical valves wear out within one year
2. BMechanical valves last longer but need lifelong anticoagulation
3. CBiological valves last longer but need lifelong warfarin
4. DBoth types need no medicines after surgery

A patient has new chest pain at rest. The ECG shows ST depression, but serial troponins remain normal. Which diagnosis fits best?

1. AUnstable angina
2. BStable angina
3. CST-elevation myocardial infarction
4. DNon-ST-elevation myocardial infarction

C6の急性脊髄損傷のある患者で、神経原性ショックを示唆する状態はどれですか？

1. A高血圧、遅い脈、ズキズキする頭痛
2. B低血圧、遅い脈、温かく乾いた皮膚
3. C正常な血圧、速い脈、高熱
4. D低血圧、速い脈、冷たく湿った皮膚

Which statement correctly distinguishes spinal shock from neurogenic shock?

1. ASpinal shock is lost reflexes; neurogenic shock is low BP and slow pulse
2. BThey are two names for exactly the same condition
3. CSpinal shock is low blood pressure; neurogenic shock is the loss of reflexes
4. DNeurogenic shock is caused by blood loss; spinal shock is caused by infection

Which advice helps a patient with haemorrhoids?

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

Hours after an oesophageal dilatation, a patient has chest pain, fever and crackling swelling under the skin of the neck. What should the nurse suspect?

1. AOesophageal perforation
2. BAn allergic reaction to the sedative
3. CSimple reflux after the dilatation
4. DNormal discomfort after the procedure

When the Moro reflex is tested, the baby moves only one arm. What could this suggest?

1. AA normal finding in all term babies
2. BHearing loss in the ear on that side
3. CLow blood glucose only
4. DA clavicle fracture or nerve injury

A newborn boy's scrotum is empty on one side and the testis cannot be felt in the groin. What is appropriate?

1. AMassage the groin daily to push it down
2. BArrange emergency surgery on the testis today
3. CRecord it and arrange follow-up; many descend later
4. DTell the parents it will never descend

A 2-year-old says "No!" when it is time for his liquid medicine. What is the best approach?

1. AOffer a limited choice, such as the cup or the syringe
2. BTell him he is a bad boy for refusing
3. CAsk him whether he wants to take his medicine or not
4. DWait until he agrees to take it, even if the dose is hours late

A 4-year-old chokes on a sweet but is coughing forcefully and can speak. What should the nurse do?

1. AGive back blows straight away to dislodge the sweet
2. BEncourage her to keep coughing and stay with her, watching closely
3. CDo a finger sweep of the mouth to find the sweet
4. DGive her a large drink of water to try to wash the sweet down

How should a nurse screen a patient for intimate partner violence?

1. AOnly ask patients who have visible injuries
2. BAsk in front of the partner to see how he reacts
3. CAsk in private, without the partner or family present
4. DAsk the partner instead of the patient

A patient who used methamphetamine heavily for weeks stopped 2 days ago. He sleeps most of the day, is very low and says life is pointless. What is the priority?

1. AEncourage him to exercise hard to raise his energy
2. BWake him often so that his sleep pattern returns to normal
3. CAssess his suicide risk
4. DGive a stimulant to relieve the low mood

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 7:45 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. 119:45
2. 206:45
3. 308:45
4. 407:45

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）。 処方箋に、経口懸濁液 1日3回 を 2 tsp、5 日間と書かれています。1 tsp = 5 mL を用いて、全期間に必要な mL V はいくつですか。

アドレナリン（エピネフリン）のプレフィルドシリンジに 1:10 000（0.1 mg/mL）と表示されています。指示は心停止に対する 1 mg の静注（IV）です。投与する量 V はいくらですか？

25%（w/v）の原液から 2%（w/v）の溶液を 200 mL 調製する必要があります。 原液は何 mL V₁ 必要ですか？

20 滴/mL の輸液セットで 500 mL を 5 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。

1500 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 450 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。患者の体重は 58 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 08:15 に開始し、ポンプで 150 mL/h で投与しています。09:45 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）。 練習用の患者をブレーデンスケールで評価します：知覚の認知: かなり制限されている; 湿潤: ときどき湿っている; 活動性: 臥床; 可動性: 制限なし; 栄養状態: やや不足; 摩擦とずれ: 明らかな問題なし。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 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 119 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。