NCLEX 形式の練習問題（RN）：直前対策パック

Why is an IV giving set primed before connecting it to the patient?

1. ATo remove air from the line
2. BTo test whether the patient is allergic to the fluid
3. CTo check the speed of the pump
4. DTo warm the fluid to body temperature

A pulse oximeter reads 82% on a patient with cold hands who is talking in full sentences with a normal respiratory rate. What is the best first action?

1. ARemove any oxygen because the reading must be wrong
2. BCheck the patient and probe, then warm the hand or move the probe
3. CIgnore the reading because the patient looks well
4. DRecord the reading and recheck it at the next routine set of observations

A patient walking with a gait belt suddenly starts to fall. What should the nurse do?

1. ALet go of the belt and run to call for help
2. BHold the belt, widen the stance and ease the patient gently to the floor
3. CGrab the patient under both arms and try hard to keep them standing up
4. DPull the patient backwards quickly toward the bed

A patient on oxygen needs an MRI scan. Which plan is safe?

1. AUse only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room
2. BTake the usual steel cylinder into the room if it is tightly strapped to the trolley frame
3. CLeave the steel cylinder on the patient’s bed during the scan
4. DRemove the oxygen for the scan without telling anyone

An arterial blood gas shows pH 7.28, PaCO₂ 40 mmHg (5.3 kPa) and HCO₃⁻ 16 mEq/L (mmol/L). How should the nurse interpret it?

1. AMetabolic alkalosis
2. BRespiratory alkalosis
3. CRespiratory acidosis
4. DMetabolic acidosis

A patient who is 7 weeks pregnant has one-sided lower abdominal pain, pain in the shoulder tip, a heart rate of 120/min and a blood pressure of 88/54 mmHg. What is most likely?

1. AA urinary tract infection
2. BA ruptured ectopic pregnancy
3. CA normal early pregnancy
4. DSevere morning sickness

Which equipment must always be kept at the bedside of a patient with a tracheostomy?

1. AA blood pressure cuff and a spare nasal cannula and oxygen mask only
2. BA peak flow meter and a nebuliser
3. CA blood glucose meter and a spare urinary catheter of the same size
4. DSpare tracheostomy tubes, including one a size smaller, and working suction

A patient taking regular ibuprofen suddenly develops severe upper abdominal pain, a rigid abdomen and becomes tachycardic. What is most likely?

1. AIndigestion that will settle with antacids
2. BIrritable bowel syndrome
3. CConstipation
4. DA perforated peptic ulcer

A pregnant woman's blood type is O Rh-negative, and her antibody screen (indirect Coombs test) is negative. What is usually offered at about 28 weeks?

1. AAnti-D immunoglobulin (Rho(D) immune globulin)
2. BAn IV dose of vitamin K given for the fetus
3. CA transfusion of group O Rh-positive red cells
4. DDaily oral iron and folic acid supplements only

A patient with acute kidney injury after severe dehydration has a rising creatinine. Which urine findings support a prerenal cause rather than acute tubular necrosis (ATN)?

1. ARed cell casts with heavy protein loss in the urine
2. BWhite cell casts with positive nitrites on the dipstick
3. CHigh urine sodium and dilute urine with muddy brown granular casts
4. DLow urine sodium and concentrated urine with a high specific gravity

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

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

Before starting long-term bisphosphonate treatment, a patient is advised to have a dental check-up. Why?

1. AThey are linked to osteonecrosis of the jaw after dental surgery
2. BBisphosphonates dissolve tooth enamel within weeks
3. CBisphosphonates cause severe gum overgrowth
4. DBisphosphonates stain the teeth black if taken for many years

A patient taking isosorbide mononitrate asks about sildenafil for erectile dysfunction. What is the main danger?

1. ASevere hypotension
2. BSevere hypertension
3. CBleeding from the gums
4. DA very high potassium level

A patient with a tracheostomy suddenly becomes distressed, and a suction catheter will not pass down the tube. What should the nurse do first?

1. AGive a nebulised bronchodilator
2. BIncrease the oxygen and wait
3. CRemove the inner cannula
4. DInflate the cuff with more air

Which CSF result is most typical of bacterial meningitis?

1. ABlood-stained fluid that clears in later tubes
2. BClear fluid, many lymphocytes, normal glucose and slightly raised protein
3. CCloudy fluid, many neutrophils, low glucose and high protein
4. DClear fluid with normal cells, glucose and protein

A patient with an external ventricular drain sat up in bed without help. The drain stayed at its old height, and the drainage bag filled quickly. The patient now has a headache. What is the concern?

1. AOverdrainage of CSF, so act per protocol and inform the team
2. BAn infected drain, so the dressing should be removed
3. CNo concern, because more drainage always lowers the ICP safely
4. DUnderdrainage, so the drain should be lowered further

After a percutaneous liver biopsy, how is the patient usually positioned at first?

1. AOn the left side, to drain the liver
2. BOn the right side, to press on the puncture site
3. CProne, with the head lower than the feet
4. DSitting upright, with the legs over the edge of the bed

A patient with three fractured ribs is taking shallow breaths because of pain. Why is effective analgesia a priority?

1. ARib pain always means the heart is damaged
2. BShallow breathing can lead to atelectasis and pneumonia
3. CGood analgesia makes rib fractures heal fully within a few days
4. DPain relief is only needed for the patient's comfort

When the newborn's head is turned to one side, the arm on that side extends and the other arm flexes. Which reflex is this?

1. ATonic neck reflex
2. BPalmar grasp reflex
3. CRooting reflex
4. DMoro reflex

妊娠 31 週の前期破水の女性に、体温 38.3 °C、胎児心拍数基線 175 bpm、子宮の圧痛が現れました。最も考えられるのはどれですか？

1. A仰臥位低血圧症候群
2. B羊水の感染（絨毛膜羊膜炎）
3. C破水後の正常な所見
4. D前置胎盤

コデインとトラマドールが 12 歳未満の子どもに推奨されないのはなぜですか？

1. A非常に速く代謝する子どもがおり、危険な呼吸抑制を起こすため
2. B中等度の痛みには効果が弱すぎ、常により強いオピオイドが望ましいため
3. C静脈内にしか投与できないため
4. D必ずアレルギーを起こすため

A child develops the "slapped cheek" rash of fifth disease. The parent asks whether the child is still infectious. What is the best answer?

1. AThe illness is not infectious at any stage
2. BUsually not; the child was most infectious before the rash appeared
3. CYes, until every trace of the rash has faded from the cheeks and limbs
4. DYes, for 6 weeks after the rash appears

A woman with advanced dementia keeps asking for her mother, who died many years ago. Which response is most appropriate?

1. A"Please stop asking about her now and finish your lunch before it gets cold."
2. B"You're thinking about your mother. Tell me about her."
3. C"Your mother will visit you later this afternoon."
4. D"Your mother died 30 years ago. You know that."

A young man spends hours a day checking his nose in mirrors and has asked for several operations, although others see nothing unusual about it. What is the most likely diagnosis?

1. ADelusional disorder, jealous type
2. BAnorexia nervosa
3. CIllness anxiety disorder
4. DBody dysmorphic 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）。 ある患者の体温は 35.9 °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 0.5 mg/h を投与します。この投与速度 D を mcg/min で表してください。小数第1位に丸めてください。

0.5%（w/v）溶液 20 mL 中に薬剤は何ミリグラム m 含まれていますか？

50%（w/v）の原液から 2.5%（w/v）の溶液を 250 mL 調製する必要があります。 原液に水を何 mL W 加える必要がありますか？

20 滴/mL の輸液セットで 1500 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。

点滴が 60 滴/mL のセットで 25 滴/分で落ちています。バッグには 600 mL 残っています。あと何時間 t で空になりますか？

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）。 バッグには 500 mL 中にヘパリン 20 000 単位が含まれています。体重 54 kg の患者に 15 単位/kg/h の指示が出ています。ポンプの流量 R を何 mL/h に設定しますか？ 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）。 バッグには dobutamine 500 mg が 250 mL 中に含まれています。体重 73 kg の患者に 12.5 mcg/kg/min の指示が出ています。ポンプの流量 R を何 mL/h に設定しますか？ 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）。 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。総摂取量 I を mL で求めてください。

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）。 500 mL のバッグを 06:15 に開始し、ポンプで 150 mL/h で投与しています。07:45 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: 全く知覚できない; 湿潤: めったに湿らない; 活動性: 臥床; 可動性: やや制限されている; 栄養状態: やや不足; 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）。 ある成人の体重は 80 kg、身長は 176 cm です。BMI を計算し、WHO の体重区分をクリックしてください。

1. 1低体重（やせ）
2. 2普通体重
3. 3過体重
4. 4肥満クラスI
5. 5肥満クラスII
6. 6肥満クラスIII

練習用の血液ガスは、HCO₃⁻ 8 mmol/L の代謝性アシドーシスを示しています。ウィンターの式を使って、期待される PaCO₂（範囲の中心）を mmHg で求めてください。

練習用の血液ガスは呼吸性アシドーシスを示しています：pH は 7.19、PaCO₂ は 74 mmHg (9.9 kPa)、HCO₃⁻ は 27 mmol/L です。規則「HCO₃⁻ は 10 mmHg ごとに 1 mmol/L 上昇（急性）、または 10 mmHg ごとに 3.5 mmol/L 上昇（慢性）」を使って分類してください。答えをクリックしてください。

1. 1急性
2. 2慢性
3. 3慢性に急性が重なったもの

この整なII誘導のストリップで QT 間隔と R–R 間隔を測定し、Bazett の式 QTc = QT/√RR（どちらも秒）で心拍数補正した QTc を計算してください。答えは秒単位で小数第3位まで求めてください。

このII誘導のストリップを、5つのステップ（心拍数、リズム、P波、PR 間隔、QRS 幅）の順に解釈してください。最初の異常所見はどのステップで見つかりますか。それをクリックしてください。

1. 1償却率
2. 2リズム
3. 3P波
4. 4PR 間隔
5. 5QRS 幅