公式集、全トピックの解法の要点、14 問の演習問題。完全な解答は巻末にあります。
A malnourished patient admitted with alcohol use disorder needs IV glucose. Which vitamin is given before or with it?
A child is admitted with a suspected Wilms tumor (nephroblastoma). Which instruction is most important for all staff?
A patient is admitted to an inpatient mental health unit. Why are personal belongings checked?
Shortly after a patient falls, the team holds a brief “post-fall huddle”. What is its main purpose?
A patient without symptoms has a fasting plasma glucose of 132 mg/dL (7.3 mmol/L) on Monday and 138 mg/dL (7.7 mmol/L) on Thursday. What does this show?
患者のカリウムは数か月間 3.4–3.6 mEq/L で、今日の1回の結果が 5.4 mEq/L です。患者は元気で、心電図は正常です。最もよい次のステップはどれですか？
1 型糖尿病の患者で、血糖 25 mmol/L、深く速い呼吸、尿ケトン陽性です。考えられる診断は？
An older patient with delirium is trying to leave the ward at night, saying he must go home. What is the best initial approach?
A patient is starting doxazosin, an alpha-blocker, for hypertension. Which advice is most important?
A patient with known left-sided lung cancer starts coughing up large amounts of fresh blood. While help is called, how should the patient be positioned?
An older patient with a long-term catheter has bacteria in the urine but no symptoms. What is usually appropriate?
発作が12分続いています。ベンゾジアゼピンが2回投与されましたが、発作は続いています。気道と酸素は管理されています。一般的なプロトコルでの次の段階は何ですか？
Which burn should usually be discussed with a specialist burns service even if it is small?
A patient with gastric outlet obstruction has vomited repeatedly for several days. Which blood picture is most likely?
答え: D · Thiamine (vitamin B1)
Thiamine deficiency is common in heavy alcohol use, and giving glucose without thiamine can trigger Wernicke encephalopathy. Thiamine is given before or with glucose.
答え: B · Do not palpate the abdomen
Palpating a Wilms tumor can rupture the capsule and spread cancer cells. A sign is often put on the bed to warn staff not to palpate the abdomen.
答え: A · To remove items that could be used to harm self or others
Belongings are searched with the patient, according to policy, for items such as sharp objects, cords, drugs and lighters. These are stored safely to reduce the risk of self-harm or violence.
答え: D · To find out quickly why the fall happened and change the care plan to prevent another
A post-fall huddle brings the team together soon after the fall to identify causes such as toileting, medication or footwear and to update the plan. It supports a just culture rather than blame.
答え: C · The results meet the criteria for diabetes
Two fasting results of 126 mg/dL (7.0 mmol/L) or more confirm diabetes in a person without symptoms. Prediabetes is 100–125 mg/dL. The nurse helps the patient understand the next steps, including education and follow-up.確認に用いた資料: Diabetes · MedlinePlus (NIH) (2025)
答え: D · 検体の採取方法を確認し、患者をアセスメントして、再検査する
突然の単発の上昇は、新しい薬や腎障害などによる真の変化か、溶血や処理の遅れなどの検体の問題かもしれません。看護師は患者をアセスメントし、医療者に知らせ、再検査を手配します。確認に用いた資料: Hyperkalemia · StatPearls (NCBI Bookshelf) (2025)
答え: A · 糖尿病ケトアシドーシス
高血糖、ケトン、アシドーシスとクスマウル呼吸は DKA を示します。輸液、インスリン、カリウムの厳密な観察で治療します。
答え: D · Calmly reassure and redirect him while the team assesses his capacity and safety
De-escalation, reorientation and supervision come first. If he lacks capacity, the team must act in his best interests using the least restrictive measures, following local law and policy.
答え: A · Take the first dose at bedtime, as dizziness and fainting can occur
Alpha-blockers can cause marked first-dose postural hypotension. Taking the first dose at bedtime and rising slowly reduces the risk of falls. They are also used for symptoms of an enlarged prostate.
答え: D · Lying on the left side, with the bleeding lung down
In massive haemoptysis, the patient is positioned with the bleeding lung lowermost so blood does not flood the healthy lung. Oxygen, suction, IV access and urgent senior help follow. Treatment may include bronchial artery embolisation.
答え: D · No antibiotics, as long as there are no symptoms
Nearly all long-term catheters become colonised. Treating asymptomatic bacteriuria does not improve outcomes and promotes resistance. Antibiotics are reserved for symptomatic infection.
答え: B · レベチラセタムやフェニトインなどの第二選択の静注薬
ベンゾジアゼピンを2回投与した後も続くてんかん重積状態（確立したてんかん重積状態）は、第二選択の静注薬で治療します。それでも続く場合（難治性重積状態）には、集中治療での麻酔と挿管が必要です。血糖、気道、モニタリングは全体を通して続けます。ベンゾジアゼピンの繰り返しは、大きな追加の利益なしに呼吸抑制を増やします。
答え: B · A partial-thickness burn on the hand
Burns of the face, hands, feet, genitalia, perineum and major joints, as well as circumferential, chemical, electrical and inhalation injuries, usually need specialist advice because of their risks and functional impact.
答え: A · Low chloride, low potassium and metabolic alkalosis
Loss of gastric acid causes a hypochloraemic metabolic alkalosis. Hypokalaemia follows from vomiting and kidney potassium loss as the body tries to save volume. Treatment includes IV saline with potassium.
これは独自の練習教材です。ExamProblems はこの試験を実施する団体とは提携しておらず、その承認も受けていません。試験名は内容を説明するためにのみ使用しています。 NCLEX®, NCLEX-RN® and NCLEX-PN®はthe National Council of State Boards of Nursing, Inc. (NCSBN)の商標です。同団体はExamProblemsと提携しておらず、推奨も正確性の保証もしていません。
ExamProblems · examproblems.com/courses/nclex-style-prioritization-and-delegation