NCLEX-PN 风格练习题（LPN/LVN）：速成包

公式表、每个专题的关键方法步骤和 34 道练习题，完整解答附在最后。

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1公式与方法

感染控制与患者安全

方法

  1. 对每位患者都从标准预防开始：手卫生、针对预期暴露的个人防护装备、安全使用锐器。
  2. 按传播途径追加预防措施：接触传播（隔离衣、手套）、飞沫传播（外科口罩）、空气传播（N95、负压病房）。
  3. 保持无菌物品的无菌状态：如有疑问就视为不无菌；更换，绝不擦拭。
  4. 预防环境中的伤害：防跌倒措施，约束仅作为最后手段，火灾时用 RACE 和 PASS。
  5. 核对给药的正确原则、两个身份识别信息，以及对高警示药物的额外保障；报告差错和险兆事件。

优先排序与委派

方法

  1. 问自己：如果什么都不做，什么会最快伤害患者。
  2. 应用 ABC（心脏骤停时为 C-A-B），然后是 Maslow 需求层次：生理需要先于安全，安全先于心理需要。
  3. 比较各选项：急性先于慢性，不稳定先于稳定，意外先于预期，全身性先于局部，并将每项发现与患者的基线对照。
  4. 除非是紧急情况，否则先评估再行动；然后选择其他步骤所依赖的那一步。
  5. 委派时核对五项正确：任务、情境、人员、指示和监督。评估、宣教和评价仍由注册护士负责。

实验室检查值与电解质

方法

  1. 把数值与本实验室自己的参考范围比较，再与患者的基线和趋势比较。
  2. 检查标本：溶血、延迟，或在静脉输液附近采血都可能得出错误结果。
  3. 把数值与其典型体征以及引起它的药物和疾病联系起来。
  4. 注意相互作用：低钾或低镁会增加地高辛中毒的风险；脱水会使锂浓度升高。
  5. 对患者采取行动：评估，血药浓度不安全时暂停用药，复述危急值并通知开医嘱的医生。

内外科护理：心血管与呼吸

方法

  1. 说出问题所在：泵衰竭、动脉阻塞、节律、血栓、气道狭窄、感染或设备问题。
  2. 先检查危险征象：低氧、低血压、胸痛、新出现的意识模糊、冰冷无脉搏的肢体。
  3. 让氧疗与患者相匹配：大多数人为 94–98%，有 CO₂ 潴留风险者为 88–92%。
  4. 把每种药物与其检测和风险联系起来：华法林与 INR，肝素与 aPTT 和血小板，利尿剂与血钾。
  5. 选择安全的第一步措施，然后升级处理并重新评估。

内外科护理：神经、内分泌与肾脏

方法

  1. 对每位新出现意识模糊、乏力或癫痫发作的患者都检查血糖。
  2. 把意识水平作为脑部问题最早的警示；瞳孔变化和库欣三联征出现得较晚。
  3. 对于糖尿病急症，要区分 DKA（酮体、酸中毒）和 HHS（渗透压很高、脱水）；先补液。
  4. 对于钠和水，要判断是 ADH 过多（SIADH）还是缺乏（尿崩症），并缓慢纠正慢性变化。
  5. 对于肾脏问题，把原因分为肾前性、肾性或肾后性，并监测血钾和液体。

内外科护理：消化、围手术期与肿瘤

方法

  1. 想一想可能隐藏着什么：内出血、无发热的感染、SpO₂ 正常背后的通气不足。
  2. 利用术后的时间来缩小并发症的范围：出血在数小时内，胸部问题在数天内，伤口和吻合口漏出现得更晚。
  3. 对于疼痛，要评估、用多模式镇痛治疗、重新评估，并且在每次使用阿片类药物时监测镇静程度。
  4. 对于癌症患者，把低谷期的任何疾病都当作中性粒细胞减少性脓毒症处理，并了解肿瘤急症。
  5. 对于烧伤，只计算浅二度/深二度和三度的面积，从烧伤的时刻开始计算 Parkland 时间，并根据尿量调整。

产科护理

方法

  1. 把产妇放在时间轴上定位：孕周、产程阶段或产后第几天，再判断此时什么是正常的。
  2. 找出处于危险中的对象：母亲、胎儿或新生儿，或者其中不止一个。
  3. 把发现与其原因联系起来：减速用 VEAL CHOP，出血用四个 T，产后用 BUBBLE-HE。
  4. 优先选择改善血流和氧合的措施（侧卧、停用缩宫素、宫底按摩），然后再升级处理。

儿科护理

方法

  1. 先记下患儿的年龄：它决定正常生命体征、发育里程碑和合适的疼痛量表。
  2. 评估气道、呼吸和循环，记住儿童代偿很久之后会迅速恶化。
  3. 让措施与发育阶段相匹配，并让家属参与。
  4. 检查答案对儿童是否安全：按体重计算，病毒感染不用阿司匹林，12 岁以下不用可待因。

精神科护理

方法

  1. 判断是否存在即时风险：自杀、暴力、药物急症或躯体疾病。
  2. 先保障安全：观察、移除危险物品、缓和局面、停用有害药物、寻求帮助。
  3. 选择治疗性回应：承认感受、陈述现实，避免虚假的安慰和“为什么”式提问。
  4. 尊重权利：采用限制最少的方案，知情同意，以及保密及其限度。

护理数学与单位换算

公制进位
1 kg = 1000 g, 1 g = 1000 mg, 1 mg = 1000 mcg, 1 L = 1000 mL
体重和长度
1 kg = 2.2 lb, 1 lb = 16 oz, 1 in = 2.54 cm, 1 ft = 12 in
家用计量
1 tsp = 5 mL, 1 tbsp = 15 mL, 1 fl oz = 30 mL, 1 cup = 8 fl oz = 240 mL
温度
°C = (°F − 32)·5/9, °F = °C·9/5 + 32
24 小时制
PM 1–11 点：加 12； 12 AM = 00:xx； 12 PM = 12:xx
给药速率
mcg/min × 60/1000 = mg/h
实验室换算系数
葡萄糖 1 mmol/L = 18 mg/dL； 肌酐 1 mg/dL = 88.4 µmol/L； Hb 1 g/dL = 10 g/L

方法

  1. 写出已知量及其单位，以及你想要的单位。
  2. 选定等量关系：kg、g、mg 和 mcg 之间，或 L 和 mL 之间为 1000；1 kg = 2.2 lb；1 tsp = 5 mL，1 tbsp = 15 mL，1 fl oz = 30 mL，1 cup = 240 mL。
  3. 写成分数，使不需要的单位相互约去；对于速率，每个变化的单位用一个分数。
  4. 检查方向：单位越小，数字越大。
  5. 只对最终答案取整，精度按题目所述。

剂量计算

由浓度计算剂量
体积 = 剂量 / 浓度
按体重给药
剂量 = mg/kg × 体重
片剂
片数 = 剂量 / 每片规格
单位
1 g = 1000 mg, 1 mg = 1000 mcg

方法

  1. 把医嘱剂量和药品规格换算为同一单位。
  2. 用“需要量除以现有量再乘以数量”：(D/H) × Q。
  3. 按体重给药时，先乘以以 kg 计的体重，再用日剂量除以给药次数。
  4. 先估算，再检查答案是否合理。

静脉输液速度

泵速
mL/h = volume (mL)/time (h)
滴速
drops/min = volume (mL) × drop factor / time (min)
输注时间
time (h) = volume (mL)/rate (mL/h)

方法

  1. 泵速 mL/h：体积除以以小时计的时间。
  2. 滴速 drops/min：体积 × 滴系数，再除以以分钟计的时间。
  3. 剩余时间：剩余体积除以速率。
  4. 按题目或设备的要求取整。

静脉输液与液体平衡

Holliday–Segar 每小时量
4 mL/kg（前 10 kg）+ 2 mL/kg（次 10 kg）+ 1 mL/kg（20 kg 以上每 kg）
Holliday–Segar 每日量
相同分段分别为 100 / 50 / 20 mL/kg
液体平衡
入量 − 出量
冰屑
按其体积的一半计算
尿量
mL/kg/h = mL / (kg × h)
输注时间
时间 (h) = 剩余体积 (mL) / 速率 (mL/h)
已输入体积
mL = 速率 × 时间

临床评估评分

格拉斯哥昏迷量表
GCS = E (1–4) + V (1–5) + M (1–6) = 3–15
Apgar
5 项体征 × 0–2 = 0–10； 7–10 令人放心， 4–6 中度异常， 0–3 低
Braden 量表
5 × (1–4) + 1 × (1–3) = 6–23； ≤ 18 有风险
Morse 跌倒评分
跌倒 25， 诊断 15， 辅助 15/30， 静脉输液 20， 步态 10/20， 精神状态 15
NEWS2 风险
0–4 低； 单项 3 分为中低； 5–6 中； ≥ 7 高
平均动脉压
MAP = (SBP + 2·DBP)/3 = DBP + PP/3
脉压和休克指数
PP = SBP − DBP, SI = HR/SBP
体质指数
BMI = kg/m² = 703·lb/in²

方法

  1. 找出题目使用的评分表及其范围（GCS 3–15，Apgar 0–10，Braden 6–23，Morse 0–125）。
  2. 分别为每个条目评分，将描述与其对应的等级匹配。
  3. 把各条目得分相加，并检查总分是否在范围内。
  4. 应用分界值：对于 NEWS2，还要查看是否有单项参数得 3 分。
  5. 对于导出的数值，使用 MAP = (SBP + 2·DBP)/3，PP = SBP − DBP，SI = HR/SBP，BMI = kg/m²。

2练习题

1.护理学基础中等

What is tolerance to an opioid?

  1. ANeeding a higher dose to get the same pain relief
  2. BA craving to take the drug for its mental effects
  3. CFeeling no side effects at all from the drug
  4. DAn allergic reaction to the drug
2.护理学基础困难

A patient has been taught how to prevent constipation. Which statement shows a need for further teaching?

  1. A"I'll go to the toilet when I first feel the urge."
  2. B"I'll drink plenty of fluids during the day."
  3. C"I'll take a strong laxative every day just in case."
  4. D"I'll eat more fruit, vegetables and wholegrains."
3.感染控制与患者安全中等

An order uses the abbreviation “MS”. Why is this unsafe?

  1. AIt can mean either morphine sulfate or magnesium sulfate
  2. BIt is the abbreviation for milliseconds, not a drug
  3. CIt is reserved for drugs used in multiple sclerosis
  4. DIt means the drug must be given by mouth only
4.感染控制与患者安全困难

A patient restrained because of violent behavior is now calm, oriented and following instructions. What should the nurse do?

  1. AKeep the restraints until the order expires
  2. BKeep the restraints until the next provider visit
  3. CRemove the restraints, because the reason for them has ended
  4. DRemove one restraint each day to test the patient’s behavior
5.优先排序与委派中等

A patient with a spinal cord injury at T4 suddenly has a severe headache, flushing above the injury and a blood pressure of 200/110 mmHg. What does the nurse do first?

  1. AGive a warm drink and recheck the blood pressure in an hour
  2. BApply extra blankets to keep the patient warm and calm
  3. CLay the patient flat with the legs raised
  4. DSit the patient upright with the legs lowered
6.优先排序与委派困难

Which patient with cirrhosis should the nurse see first?

  1. AWants to talk about stopping drinking alcohol for good
  2. BLong-standing jaundice and itchy skin, asking for cream
  3. CLarge ascites that is unchanged from yesterday
  4. DVomiting bright red blood, heart rate 120/min
7.临床护理中等

Why are patients with atrial fibrillation often given anticoagulants?

  1. ATo reduce the risk of stroke from clots in the atria
  2. BTo convert the rhythm back to normal
  3. CTo lower the blood pressure
  4. DTo slow the heart rate directly and prevent palpitations
8.临床护理困难

The fluid in an underwater seal chest drain has stopped swinging with breathing. What could this mean?

  1. AThe water seal has been set up correctly for the first time
  2. BThe drain is working perfectly and needs no checks
  3. CThe tube may be kinked or blocked, or the lung may have fully re-expanded
  4. DThe patient's breathing has become normal and the drain can be pulled out by the nurse
9.实验室检查值与电解质中等

A patient with schizophrenia is starting clozapine. Which laboratory value must be monitored regularly?

  1. ASerum lithium level
  2. BInternational normalized ratio
  3. CAbsolute neutrophil count
  4. DSerum amylase
10.实验室检查值与电解质困难

护士应首先报告哪位患者的结果？

  1. A一名已知稳定 CKD 的患者肌酐 1.6 mg/dL（141 µmol/L）
  2. B总胆固醇略高于目标
  3. C一名 2 型糖尿病患者 HbA1c 7.4%（57 mmol/mol）
  4. D一名出汗并意识模糊的患者血糖 42 mg/dL（2.3 mmol/L）
11.药理学中等

How should a patient take oral alendronate?

  1. AWith plain water on an empty stomach, staying upright for 30 minutes
  2. BWith breakfast and coffee to protect the stomach
  3. CWith milk at bedtime, then lying down straight away to aid absorption
  4. DCrushed into yoghurt with calcium supplements
12.药理学困难

A patient taking hydralazine for several months develops joint pain, fever and a rash. Anti-histone antibodies are positive. What is the most likely diagnosis?

  1. ARheumatoid arthritis
  2. BAn acute viral infection
  3. CDrug-induced lupus
  4. DGout
13.内外科护理：心血管与呼吸中等

A patient has pneumonia in the right lung only. In which side-lying position will oxygenation usually be best?

  1. ALying on the right side, with the affected lung down
  2. BProne with the head down
  3. CLying on the left side, with the healthy lung down
  4. DFlat on the back with no pillows
14.内外科护理：心血管与呼吸困难

A ventilated patient suddenly desaturates to 82%. The cause is not obvious and the ventilator alarms are sounding. What should the nurse do first?

  1. ADisconnect and hand-ventilate with 100% oxygen while calling for help
  2. BChange the ventilator settings to a higher rate
  3. CSilence the alarm and wait for the result of the next routine blood gas
  4. DIncrease the sedation and watch the monitor for the next half hour
15.内外科护理：神经、内分泌与肾脏中等

A patient has just started haemodialysis. What usually happens to their protein needs?

  1. AThey fall to almost zero to rest the kidneys
  2. BThey increase, because dialysis removes amino acids
  3. CThey stay exactly the same as they were before dialysis
  4. DProtein must be replaced only by IV infusion
16.内外科护理：神经、内分泌与肾脏困难

一名肺癌合并 SIADH 的患者血钠 112 mmol/L，正在抽搐。最恰当的治疗是什么？

  1. A大量口服水以帮助稀释尿液
  2. B在最初六小时内迅速纠正到 140 mmol/L
  3. C在监护下使用高渗盐水，限制上升速度
  4. D以高速率静脉输注 5% 葡萄糖，直到抽搐停止
17.内外科护理：消化、围手术期与肿瘤中等

Which statement about pain relief in acute pancreatitis is correct?

  1. APain relief should be withheld until the diagnosis is certain
  2. BOpioids can be used, and good analgesia is a priority
  3. COpioids must never be used in pancreatitis
  4. DOnly paracetamol may be given
18.内外科护理：消化、围手术期与肿瘤困难

腹部手术后第 6 天，一名患者说咳嗽时有东西“裂开了”，并且伤口处可见肠管。护士应立即做什么？

  1. A在等待团队时给患者吃点轻食以使其平静
  2. B轻轻把肠管推回去，用胶带把伤口边缘牢牢粘在一起
  3. C不覆盖伤口，让患者在床上完全坐直
  4. D用生理盐水浸湿的无菌敷料覆盖，屈膝，呼叫外科医生
19.产科护理中等

Why are afterpains often stronger in multiparous women?

  1. ATheir uterus is always infected
  2. BTheir uterus contracts and relaxes more irregularly
  3. CThey have a smaller uterus than first-time mothers
  4. DThey produce no oxytocin after birth
20.产科护理困难

Why does the foramen ovale close soon after birth?

  1. ABlood flow to the lungs decreases after birth
  2. BProstaglandin levels rise in the newborn's blood
  3. CLeft atrial pressure rises above right atrial pressure
  4. DThe umbilical vein carries more blood to the heart
21.儿科护理中等

18 个月检查时，哪项发现需要转诊做发育评估？

  1. A孩子还不能独立行走
  2. B孩子只会说几个词
  3. C孩子在其他孩子旁边玩，而不是和他们一起玩
  4. D孩子害怕陌生人
22.儿科护理困难

一名镰状细胞病患儿出现新的胸痛、咳嗽、发热，血氧饱和度 90%。护士应怀疑什么？

  1. A肢体危象的正常疼痛
  2. B轻度感冒
  3. C急性胸部综合征，属于急症
  4. D对住院的焦虑
23.精神科护理中等

Which question is the best way to ask a patient about suicidal thoughts?

  1. A"You wouldn't hurt yourself, would you?"
  2. B"You're not thinking of doing anything silly, are you?"
  3. C"Things aren't that bad, are they?"
  4. D"Are you having thoughts of killing yourself?"
24.精神科护理困难

A patient with OCD asks the nurse many times an hour, "Are you sure the door is locked?" What is the most helpful approach in his care plan?

  1. ATell him firmly that if he asks about the door again, he will lose his privileges on the ward for the day
  2. BReassure him every time he asks, as often as he needs
  3. CLock and unlock the door in front of him each time he asks
  4. DAnswer once, then follow the agreed plan to limit repeated reassurance
25.护理数学与单位换算中等
9 lb 4 oz? kg1 lb = 16 oz1 kg = 2.2 lb

练习题（虚构数值，不作为临床指导）。 一名新生儿体重 9 lb 4 oz。按 1 lb = 16 oz 和 1 kg = 2.2 lb，求以千克表示的体重m。取到两位小数。

9 lb 4 oz1 lb = 16 oz1 kg = 2.2 lb
m = kg
26.护理数学与单位换算困难
1 tsp · 4/天 · 10 d? mL1 tsp = 5 mL

练习题（虚构数值，不作为临床指导）。 一张处方写着口服混悬液1 tsp，每天四次，共 10 天。按1 tsp = 5 mL，整个疗程需要多少 mLV？

1 tsp每天四次10 天1 tsp = 5 mL
V = mL
27.剂量计算中等
15 kg20 mg/kgD = ? mg

某患者体重 15 kg，医嘱为单次给药 20 mg/kg。求剂量 D（mg）。

15 kg20 mg/kg
D = mg
28.剂量计算困难
20%储备液V₁ = ? mL

你需要用 20%（w/v）储备液配制 500 mL 2.5%（w/v）溶液。 你需要多少容量的储备液 V₁？

C₁ = 20%C₂ = 2.5%V₂ = 500 mL
V₁ = mL
29.静脉输液速度中等
60 gtt/mL100 mL/h? gtt/min

医嘱要求以 100 mL/h 输液，但没有输液泵。改用滴系数为 60 gtt/mL 的输液器重力滴注。求滴速 R，以每分钟滴数表示。

100 mL/h60 gtt/mL
R = gtt/min
30.静脉输液速度困难
50 mg250 mL3 mL/h? mcg/min

50 mg 药物溶于 250 mL 的输液以 3 mL/h 运行。患者每分钟接受多少微克 D？

50 mg/250 mL3 mL/h
D = mcg/min
31.静脉输液与液体平衡中等
入量出量12 小时班次牛奶240 mL汤200 mL冰屑120 mL静脉输液75 mL/h × 12 h静脉抗生素1 × 50 mL尿液200 mL尿液475 mL尿液250 mL尿液425 mL

练习题（虚构数值，不作为临床指导）。 记录显示了一名患者在一个 12 小时班次中的出入量。静脉输液在整个班次中按所示速率输注。求液体平衡 B = 入量 − 出量，以 mL 计（答案为负表示净丢失）。 冰屑按其体积的一半计。

牛奶: 240 mL汤: 200 mL冰屑: 120 mL静脉输液: 75 mL/h × 12 h静脉抗生素: 1 × 50 mL尿液: 200 mL尿液: 475 mL尿液: 250 mL尿液: 425 mL
B = mL
32.静脉输液与液体平衡困难
1000 mL300 mL 已输入50 mL/h10:00t = ? h

练习题（虚构数值，不作为临床指导）。 一袋 1000 mL 的液体用输液泵以 50 mL/h 输注。到 10:00 时已输入 300 mL。还要多少小时 t 袋子才会输完？ 保留一位小数。

1000 mL300 mL 已输入50 mL/h
t = h
33.临床评估评分中等
8949SBPDBPmmHgHR 56/min · SI = ?

练习题（虚构数值，不作为临床指导）。 一位患者的脉搏为 56 次/分，血压为 89/49 mmHg。求休克指数SI = HR/SBP。取到两位小数。

HR 56/minBP 89/49 mmHg
SI =
34.临床评估评分困难
体重过轻健康体重超重肥胖 I 级肥胖 II 级肥胖 III 级

练习题（虚构数值，不作为临床指导）。 一名成人体重 111 kg，身高 156 cm。计算 BMI 并点击 WHO 体重分类。

111 kg156 cm
  1. 1体重过轻
  2. 2健康体重
  3. 3超重
  4. 4肥胖 I 级
  5. 5肥胖 II 级
  6. 6肥胖 III 级

3溶液

1.护理学基础

答案: A · Needing a higher dose to get the same pain relief

为什么是这个答案

Tolerance is a physical adaptation in which the same dose has less effect over time. It is not the same as addiction, which involves craving and harmful use.

答案

A · Needing a higher dose to get the same pain relief
2.护理学基础

答案: C · "I'll take a strong laxative every day just in case."

为什么是这个答案

Fluids, fibre, activity and responding to the urge prevent constipation. Taking stimulant laxatives every day without need is not advised and can lead to dependence and electrolyte problems.

答案

C · "I'll take a strong laxative every day just in case."
3.感染控制与患者安全

答案: A · It can mean either morphine sulfate or magnesium sulfate

为什么是这个答案

“MS”, “MSO4” and “MgSO4” can be confused, and giving one drug instead of the other can cause serious harm. Drug names are written in full.

答案

A · It can mean either morphine sulfate or magnesium sulfate
4.感染控制与患者安全

答案: C · Remove the restraints, because the reason for them has ended

为什么是这个答案

Restraints are used only as long as needed to keep people safe. Once the patient no longer presents a danger, the restraints are removed, even if the order has not yet expired.

答案

C · Remove the restraints, because the reason for them has ended
5.优先排序与委派

答案: D · Sit the patient upright with the legs lowered

为什么是这个答案

Autonomic dysreflexia is an emergency in injuries at T6 or above. Sitting the patient up lowers the blood pressure; the nurse then looks for the trigger, most often a full bladder or constipation.

答案

D · Sit the patient upright with the legs lowered
6.优先排序与委派

答案: D · Vomiting bright red blood, heart rate 120/min

为什么是这个答案

Vomiting blood with a fast pulse suggests bleeding esophageal varices, which can quickly be fatal. The other findings are chronic or stable.

答案

D · Vomiting bright red blood, heart rate 120/min
7.临床护理

答案: A · To reduce the risk of stroke from clots in the atria

为什么是这个答案

In AF the atria do not contract effectively, so blood can pool and clot, especially in the left atrial appendage. A clot can travel to the brain, so anticoagulation reduces stroke risk.

答案

A · To reduce the risk of stroke from clots in the atria
8.临床护理

答案: C · The tube may be kinked or blocked, or the lung may have fully re-expanded

为什么是这个答案

Loss of swing can mean a kinked, clamped or blocked tube, or re-expansion of the lung. The nurse checks the tubing and the patient and reports the finding.

答案

C · The tube may be kinked or blocked, or the lung may have fully re-expanded
9.实验室检查值与电解质

答案: C · Absolute neutrophil count

为什么是这个答案

Clozapine can cause severe neutropenia (agranulocytosis), so the ANC is checked before starting and regularly during treatment. A sore throat, fever or other sign of infection must be reported at once.

答案

C · Absolute neutrophil count
10.实验室检查值与电解质

答案: D · 一名出汗并意识模糊的患者血糖 42 mg/dL（2.3 mmol/L）

为什么是这个答案

有症状的低血糖可迅速导致惊厥和脑损伤，因此应按规程立即处理。其他结果是慢性的或稳定的，可以稍后讨论。核对依据: Low blood sugar · MedlinePlus (NIH) (2026)

答案

D · 一名出汗并意识模糊的患者血糖 42 mg/dL（2.3 mmol/L）
11.药理学

答案: A · With plain water on an empty stomach, staying upright for 30 minutes

为什么是这个答案

Alendronate is taken first thing in the morning with water only, before food or other drugs. Staying upright reduces the risk of oesophageal ulceration, and food or calcium blocks its absorption.

答案

A · With plain water on an empty stomach, staying upright for 30 minutes
12.药理学

答案: C · Drug-induced lupus

为什么是这个答案

Hydralazine and procainamide are classic causes of drug-induced lupus, especially in slow acetylators. Symptoms usually resolve after the drug is stopped.

答案

C · Drug-induced lupus
13.内外科护理：心血管与呼吸

答案: C · Lying on the left side, with the healthy lung down

为什么是这个答案

Blood flow goes preferentially to the dependent lung. Placing the healthy lung down matches more blood to the well-ventilated lung, improving oxygenation ("good lung down"). Exceptions include a lung abscess or bleeding, when the affected lung is placed down to protect the healthy one.

答案

C · Lying on the left side, with the healthy lung down
14.内外科护理：心血管与呼吸

答案: A · Disconnect and hand-ventilate with 100% oxygen while calling for help

为什么是这个答案

When a ventilated patient deteriorates suddenly, bag-valve ventilation with 100% oxygen takes the ventilator out of the picture. The nurse then checks for displacement, obstruction, pneumothorax and equipment failure (often remembered as DOPE) and calls for senior help.

答案

A · Disconnect and hand-ventilate with 100% oxygen while calling for help
15.内外科护理：神经、内分泌与肾脏

答案: B · They increase, because dialysis removes amino acids

为什么是这个答案

Before dialysis, a moderate protein intake may be advised. Dialysis removes amino acids and protein, so needs rise, and malnutrition is a common risk. A renal dietitian sets individual targets.

答案

B · They increase, because dialysis removes amino acids
16.内外科护理：神经、内分泌与肾脏

答案: C · 在监护下使用高渗盐水，限制上升速度

为什么是这个答案

严重的症状性低钠血症用小剂量高渗盐水推注治疗，使血钠升高几个 mmol/L 并控制抽搐。总体纠正速度要加以限制（24 小时内常不超过约 8–10 mmol/L），以避免渗透性脱髓鞘综合征。应经常检测血钠。

答案

C · 在监护下使用高渗盐水，限制上升速度
17.内外科护理：消化、围手术期与肿瘤

答案: B · Opioids can be used, and good analgesia is a priority

为什么是这个答案

Acute pancreatitis is very painful, and opioids are used as part of multimodal analgesia. There is no good evidence that they worsen the condition. Sedation and breathing are monitored.

答案

B · Opioids can be used, and good analgesia is a priority
18.内外科护理：消化、围手术期与肿瘤

答案: D · 用生理盐水浸湿的无菌敷料覆盖，屈膝，呼叫外科医生

为什么是这个答案

内脏脱出是外科急症。用无菌、生理盐水浸湿的敷料覆盖脏器，让患者取低半卧位并屈膝以减少张力，保持禁食，监测休克并呼叫外科医生。绝不能试图将脏器还纳。

答案

D · 用生理盐水浸湿的无菌敷料覆盖，屈膝，呼叫外科医生
19.产科护理

答案: B · Their uterus contracts and relaxes more irregularly

为什么是这个答案

In multiparas, and after overdistension such as twins, the uterus relaxes and contracts intermittently, causing stronger afterpains. Breastfeeding increases them through oxytocin.

答案

B · Their uterus contracts and relaxes more irregularly
20.产科护理

答案: C · Left atrial pressure rises above right atrial pressure

为什么是这个答案

With the first breaths, pulmonary resistance falls and more blood returns to the left atrium, while cord clamping lowers right-sided pressure. The higher left atrial pressure pushes the flap of the foramen ovale shut.

答案

C · Left atrial pressure rises above right atrial pressure
21.儿科护理

答案: A · 孩子还不能独立行走

为什么是这个答案

到约 18 个月仍不会走是一个危险信号。只会几个词、平行游戏和怕生是这个年龄的典型表现。

答案

A · 孩子还不能独立行走
22.儿科护理

答案: C · 急性胸部综合征，属于急症

为什么是这个答案

急性胸部综合征引起胸痛、发热、呼吸道症状、缺氧和胸部 X 线上的新改变。它是镰状细胞病的主要死因之一，需要紧急治疗。

答案

C · 急性胸部综合征，属于急症
23.精神科护理

答案: D · "Are you having thoughts of killing yourself?"

为什么是这个答案

Asking directly and calmly shows that it is safe to talk. Questions that suggest the "right" answer, or that minimise the problem, make it harder for the patient to be honest.

答案

D · "Are you having thoughts of killing yourself?"
24.精神科护理

答案: D · Answer once, then follow the agreed plan to limit repeated reassurance

为什么是这个答案

Seeking reassurance relieves anxiety only briefly and keeps the OCD cycle going. In line with exposure and response prevention, the team agrees to limit reassurance and support the patient to tolerate the anxiety.

答案

D · Answer once, then follow the agreed plan to limit repeated reassurance
25.护理数学与单位换算

答案: m = 4.2 kg

家用计量和体重：护理考试使用取整的等量关系：1 茶匙（tsp）= 5 mL，1 汤匙（tbsp）= 15 mL = 3 tsp，1 液量盎司（fl oz）= 30 mL = 2 tbsp，1 杯 = 8 fl oz = 240 mL。体重方面，1 kg = 2.2 lb，1 lb = 16 oz；长度方面，1 英寸 = 2.54 cm。设置换算时，要让你不需要的单位相互约去。

盎司换算为磅

4 oz/16 = 0.25 lb
9 + 0.25 = 9.25 lb

磅换算为千克

m = 9.25/2.2 = 4.205 ≈ 4.2 kg

答案

m = 4.2 kg
26.护理数学与单位换算

答案: V = 200 mL

量纲分析：先写出已知量，再乘以写成分数形式的换算系数（例如 60 min/1 h 或 1 mg/1000 mcg），使每个不需要的单位在分子和分母各出现一次并相互约去。只剩下所求单位时再计算。使用题目给出的等量关系，只对最终答案取整。

每次剂量的体积

1 tsp = 1·5 = 5 mL

整个疗程

V = 5 mL × 4/天 × 10 = 200 mL

答案

V = 200 mL
27.剂量计算

答案: D = 300 mg

剂量计算：给药量等于医嘱剂量除以现有药物的规格，再乘以该规格对应的量：给药量 = (医嘱剂量/储备规格) × 储备体积。始终统一单位（先把 g 换成 mg，mg 换成 mcg），并检查答案是否合理。

剂量

20·15 = 300 mg

答案

D = 300 mg
28.剂量计算

答案: V₁ = 62.5 mL

Solution strengths: a percentage strength is grams per 100 mL, so 1% = 1 g/100 mL = 10 mg/mL. A ratio strength 1:1000 means 1 g in 1000 mL = 1 mg/mL; 1:10 000 is 0.1 mg/mL. For a dilution the amount of drug stays the same: C₁·V₁ = C₂·V₂.

储备液的容量

V₁ = 2.5·500/20 = 62.5 mL

答案

V₁ = 62.5 mL
29.静脉输液速度

答案: R = 100 gtt/min

Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.

每分钟毫升数

100/60 = 1.667 mL/min

滴速

R = 1.667·60 = 100 gtt/min

答案

R = 100 gtt/min

使用微滴输液器（60 gtt/mL）时，gtt/min 等于 mL/h。

30.静脉输液速度

答案: D = 10 mcg/min

Dose-based infusions: concentration = amount of drug in the bag/bag volume. Pump rate (mL/h) = dose per hour/concentration, and dose per hour = mL/h × concentration. Convert per-minute doses to per-hour (× 60) and keep the mass units the same (1 g = 1000 mg, 1 mg = 1000 mcg).

浓度

50000 mcg/250 mL = 200 mcg/mL

每小时剂量

3·200 = 600 mcg/h

每分钟剂量

D = 600/60 = 10 mcg/min

答案

D = 10 mcg/min
31.静脉输液与液体平衡

答案: B = 100 mL

出入量：入量计入所有进入体内的液体（口服液体、静脉输液、静脉用药及冲管液、管饲）；冰屑按其体积的一半计。出量计入尿液、引流液、呕吐物和其他丢失。平衡 = 总入量 − 总出量；平衡为负表示净丢失。 这些数字仅供练习；在临床工作中务必遵循当地规程，高危剂量须经双人核对。

总入量

口服: 240 + 200 = 440 mL
冰屑: 120/2 = 60 mL
静脉输液: 75·12 = 900 mL
静脉抗生素: 1·50 = 50 mL
总入量 = 1450 mL

总出量

200 + 475 + 250 + 425 = 1350 mL

平衡

B = 1450 − 1350 = 100 mL

答案

B = 100 mL

为正：摄入的液体多于排出的液体。

32.静脉输液与液体平衡

答案: t = 14 h

输液时间：时间 (h) = 待输体积 (mL)/速率 (mL/h)；使用袋中剩余的体积，而不是袋的容量。已输入体积 = 速率 × 时间。把小数小时换算为小时和分钟时，用小数部分 × 60（0.5 h = 30 min，而不是 50 min）。 这些数字仅供练习；在临床工作中务必遵循当地规程，高危剂量须经双人核对。

剩余体积

1000 − 300 = 700 mL

时间

t = 700/50 = 14 h

答案

t = 14 h

约为 14 h 00 min，所以袋子大约在 00:00 输完。

33.临床评估评分

答案: SI = 0.63

血压数值：脉压 PP = SBP − DBP。平均动脉压 MAP ≈ (SBP + 2·DBP)/3 = DBP + PP/3，这是基于正常心率下心脏每搏约有三分之二时间处于舒张期的估算（心率快时准确性下降）；MAP 至少约 65 mmHg 是常用的器官灌注目标。休克指数 SI = 心率/SBP，正常约为 0.5–0.7；高于约 1 是休克的警示信号。

休克指数

SI = 56/89 = 0.6292 ≈ 0.63

答案

SI = 0.63

在通常的 0.5–0.7 之内或之下。

34.临床评估评分

答案: 肥胖 III 级

体质指数：BMI = 体重（kg）/身高（m）²，身高要先换算为米。使用磅和英寸时，BMI = 703 × 体重（lb）/身高（in）²。WHO 成人分类：低于 18.5 为体重过轻，18.5–24.9 为健康体重，25.0–29.9 为超重，30.0–34.9 为肥胖 I 级，35.0–39.9 为肥胖 II 级，40 及以上为肥胖 III 级。

BMI

BMI = 111/1.56² = 45.61

分类

肥胖 III 级

答案

肥胖 III 级

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