NCLEX-PN 形式の練習問題（LPN/LVN）：直前対策パック

看護診断は医学診断とどう違いますか？

1. A健康問題に対する患者の反応を表す
2. B医師が行い、看護師が書き写す
3. C手術後にだけ使う
4. D患者の症状の原因となる病気や病態を特定する

判断能力のある成人の患者が、自分のがんの診断を家族に伝えないよう看護師に頼みました。看護師はどうすべきですか？

1. A重大な診断について親族には知る権利があるので、家族に伝える
2. B家族が直接尋ねた場合にだけ伝える
3. Cいずれにせよ家族に伝えるよう医師に頼む
4. D依頼を尊重し、家族とその情報を共有しない

A nurse finds a used needle in a patient’s bed linen. What should the nurse do?

1. APick it up by the hub or with forceps, put it in a sharps container and report it
2. BLeave it where it is for the housekeeping staff to remove later in the day
3. CRecap it with two hands before throwing it away
4. DFold it into the linen and send it to the laundry

A patient after heart surgery has temporary epicardial pacing wires. Why do staff take special care with electrical safety?

1. APacing wires can only carry current coming from the pacemaker box itself
2. BSmall currents can travel along the wires straight to the heart and cause arrhythmias
3. CThe wires make the patient immune to electric shock
4. DElectrical safety only matters for patients who have permanent implanted pacemakers

Which practice makes a shift handover safest?

1. AA structured format, such as SBAR, with time for questions
2. BHanding over only the patients who had problems during the shift
3. CA quick chat in the corridor with no notes taken
4. DLeaving a sticky note on the computer screen for the next nurse

看護師が最初に診るべき子どもはどれですか？

1. A鼻翼呼吸、陥没呼吸があり、SpO₂ が 89 % の RS ウイルス感染症の乳児
2. B体温が 38.4 °C だが、おもちゃで遊んでいる幼児
3. Cピークフローが自己最良値の 90 % の、喘息の 10 代の若者
4. D下肢にギプスをつけていて、飲み物を求めている学童

A patient on the ward has shingles with open blisters. Which people are most at risk from contact?

1. APregnant women and immunocompromised people who have not had chickenpox
2. BPeople who have already had chickenpox in childhood and are now healthy
3. COnly people over 80 who have already had shingles themselves
4. DNo one, because shingles cannot spread

A patient with diabetes is found confused with slurred speech and weakness on one side. What should the nurse check first?

1. ASerum cholesterol
2. BUrine output for the last day
3. CBody mass index
4. DCapillary blood glucose

Which instruction is correct for a patient starting oral iron tablets?

1. ATake each tablet with milk to protect the stomach
2. BYour urine will turn bright orange while you take it
3. CTake the tablet with an antacid to improve absorption
4. DYour stools may turn dark green or black

A patient has taken metformin for 8 years and now has numbness in the feet, a hemoglobin of 10.2 g/dL (102 g/L) and an MCV of 108 fL. Which deficiency is most likely?

1. AIron deficiency from gut loss
2. BVitamin B₁₂ deficiency
3. CVitamin K deficiency
4. DVitamin D (calciferol) deficiency

When should a patient take a once-daily proton pump inhibitor such as omeprazole?

1. AOnly when heartburn is severe
2. BWith a glass of milk at bedtime, when acid output is highest
3. CAbout 30–60 minutes before the first meal of the day
4. DStraight after a large evening meal

A patient with epilepsy needs pain relief. Why is tramadol used with caution?

1. AIt speeds up the metabolism of all antiepileptic drugs
2. BIt causes a sharp rise in blood glucose
3. CIt lowers the seizure threshold
4. DIt always causes respiratory arrest in epilepsy

Which history is a contraindication to thrombolysis for a STEMI?

1. AMild asthma controlled with inhalers
2. BA previous haemorrhagic stroke
3. CTreated high blood pressure
4. DA previous appendicectomy many years ago

During a cardiac arrest, the monitor shows an organised rhythm, but there is no pulse. What should the team do?

1. ADeliver an unsynchronised shock at once and then check the pulse
2. BGive adenosine to slow the rhythm down
3. CContinue CPR and give adrenaline (epinephrine), as the rhythm is non-shockable
4. DStop CPR, because an organised rhythm on the monitor means recovery

Why must Parkinson's medicines be given on time in hospital?

1. ALate doses can soon cause stiffness, falls and poor swallowing
2. BLate doses cause the patient to develop high blood glucose
3. CGiving them on time prevents the disease from getting worse
4. DLate doses build up in the blood and cause an overdose

The nurse has four urology patients. Which one needs to be seen first?

1. AA patient with a nephrostomy who has rigors and a BP of 86/50 mmHg
2. BA patient after TURP with light pink drainage and mild discomfort
3. CA patient with stress incontinence asking about pelvic floor exercises
4. DA patient with a suprapubic catheter due for a routine change

Why are laxatives and enemas avoided when appendicitis is suspected?

1. AThey make the blood tests impossible to read
2. BThey stop antibiotics from being absorbed
3. CThey may increase the risk of perforation
4. DThey always cause the appendix to bleed heavily

A 76-year-old with a past peptic ulcer needs long-term anti-inflammatory treatment for arthritis. Which plan best reduces GI bleeding risk?

1. AUse the highest NSAID dose to shorten the course
2. BConsider an alternative; if an NSAID is needed, add a PPI
3. CTake the NSAID with a glass of milk instead of food
4. DCombine two different NSAIDs at lower doses

A woman whose first language is not English is in labour. Which action best ensures informed consent for a caesarean?

1. AUse gestures and simple English only
2. BAsk her partner to sign for her
3. CAsk her 10-year-old child to interpret
4. DUse a professional interpreter

妊娠 10 週の女性が数日間嘔吐を続けており、尿中ケトンが陽性で、体重が 6 % 減少し、立ち上がるとめまいがします。優先すべきことは何ですか？

1. A処方に従い、輸液と電解質で脱水を補正する
2. B1 日 3 回たっぷり食べるよう助言する
3. C妊娠初期を過ぎれば自然に治るので、フォローアップは不要だと伝える
4. D減量のための食事療法を始める

A 6-year-old with a life-limiting illness asks the nurse, "Am I going to die?" What is the best response?

1. ATell the child firmly that this will not happen
2. BFind out what prompted the question, then answer honestly and simply, with the family
3. CTell the child that only the doctor is allowed to talk about this subject with children
4. DChange the subject quickly so the child is not upset

Two healthcare rescuers are giving CPR to an infant. Which compression technique is recommended?

1. ACompressions with one finger over the upper sternum
2. BThe two-thumb technique with the hands encircling the chest
3. CBoth hands placed one on top of the other over the upper abdomen
4. DBoth hands interlocked over the centre of the chest, with arms straight

What must a patient be told for consent to a new psychotropic medicine to be valid?

1. ANothing at all, because psychiatric patients cannot give consent
2. BOnly the name of the medicine and the time of day it will be given
3. COnly the benefits, so that the patient is not frightened by the side effects
4. DThe expected benefits, the main risks and the alternatives, including no treatment

For 8 months, a woman has worried about her job, money and family's health nearly every day. She has muscle tension, tiredness and poor sleep, but no sudden attacks of fear. Which diagnosis fits best?

1. APanic disorder
2. BAcute stress disorder after a recent trauma
3. CSpecific phobia
4. DGeneralised anxiety disorder

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）。 ある患者の身長は 4 ft 8 in です。1 ft = 12 in と 1 in = 2.54 cm を使って、身長 h をセンチメートルで、cm の整数に丸めて求めてください。

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）。 ヘモグロビンの結果は 127 g/L です。これを g/dL Hb で表してください。

体重 17 kg の子どもに、10 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 12 kg の子どもに、5 mL 中に 250 mg を含む経口懸濁液が一回 20 mg/kg で処方されています。与える量 V はいくらですか？

40 mL/h での輸液が指示されていますが、ポンプがありません。60 滴/mL の輸液セットを使って自然落下で投与します。滴下速度 R を 1 分あたりの滴数で求めなさい。

バッグは 50 mL 中に薬を 500 mg 含み、25 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。患者の体重は 75 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）。 1000 mL の輸液を 11:00 に 120 mL/h で開始します。4 時間後に流量を 125 mL/h に変更し、その後は変更しません。開始から何時間後 t にバッグは空になりますか？ 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）。 ある患者の脈拍は 133/分、血圧は 94/56 mmHg です。ショック指数 SI = HR/SBP を求めてください。小数第2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）。 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 89 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。