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

A patient refuses their regular evening tablets. What should the nurse do first?

  1. AInsist until the patient takes them
  2. BHide the tablets in their food
  3. CThrow the tablets away without telling anyone
  4. DExplore the reason for refusing
2.护理学基础困难

On the day after surgery, a patient's new stoma has turned dark purple. What should the nurse do?

  1. AWait a week to see whether it changes
  2. BReport it urgently, as the stoma may be losing its blood supply
  3. CClean it firmly to remove the colour
  4. DRecord it as normal bruising after surgery and recheck tomorrow
3.感染控制与患者安全中等

Many intensive care units bathe patients daily with chlorhexidine. What is the main purpose?

  1. ATo moisturize dry skin in older patients
  2. BTo treat existing wound infections without the need for antibiotics
  3. CTo reduce skin bacteria and bloodstream infections linked to central lines
  4. DTo lower the patient’s body temperature
4.感染控制与患者安全困难

Only one airborne infection isolation room (negative pressure) is free. Which newly admitted patient should be placed in it?

  1. AA patient with C. difficile diarrhea
  2. BA patient with an MRSA wound infection
  3. CA patient with confirmed seasonal influenza and a cough
  4. DA patient with suspected active pulmonary tuberculosis
5.优先排序与委派中等

A patient has a new plaster cast that is still drying. How should the nurse handle it?

  1. ABy covering it tightly with a plastic sheet
  2. BWith the palms of the hands, not the fingertips
  3. CWith the fingertips, pressing firmly to test it
  4. DBy resting it directly on a hard surface
6.优先排序与委派困难

A dehydrated child is to receive IV fluids with added potassium. Which finding should the nurse confirm first?

  1. AThat the child’s temperature is normal
  2. BThat the child is passing urine
  3. CThat the child is hungry
  4. DThat the child can walk without help
7.临床护理中等

How should a nurse communicate with a patient who has impaired hearing?

  1. AFace the patient, speak clearly and reduce background noise
  2. BTalk to the patient's relative instead of to the patient directly
  3. CShout loudly from the end of the bed so they can hear
  4. DSpeak very quickly to save time
8.临床护理困难

Why can pulse oximetry be misleading in carbon monoxide poisoning?

  1. AStandard oximeters cannot tell carboxyhaemoglobin from oxyhaemoglobin
  2. BCarbon monoxide makes the oximeter read zero even in a well patient
  3. CThe oximeter overheats in smoke-exposed patients
  4. DCarbon monoxide only affects the heart rate reading
9.实验室检查值与电解质中等

A nurse has a needlestick injury from a patient with unknown HIV status. Which test is usually done for the nurse as soon as possible?

  1. AA thyroid panel test
  2. BA sweat chloride test
  3. CA serum lipase test
  4. DA baseline HIV test
10.实验室检查值与电解质困难

Which cerebrospinal fluid (CSF) pattern most strongly suggests bacterial meningitis?

  1. ACloudy fluid, low glucose, high protein, many neutrophils
  2. BClear fluid, high glucose, low protein, many red cells
  3. CClear fluid, normal glucose, normal protein, no white cells
  4. DClear fluid, normal glucose, mildly raised protein, lymphocytes
11.药理学中等

恩格列净等 SGLT2 抑制剂如何降低血糖？

  1. A使肝脏储存更多糖原
  2. B刺激 β 细胞释放胰岛素
  3. C增加葡萄糖从尿中的丢失
  4. D减慢胃排空
12.药理学困难

A patient with type 2 diabetes starts a high dose of prednisolone for a flare of COPD. Which change should the nurse expect?

  1. ANo change in glucose, as steroids act only in the lungs
  2. BLower blood glucose, so the diabetes medicines should be stopped
  3. CLower potassium only, with no effect on glucose
  4. DHigher blood glucose, so more frequent glucose checks are needed
13.内外科护理：心血管与呼吸中等

During airway suctioning, when should suction be applied?

  1. AOnly while withdrawing the catheter
  2. BOnly while inserting the catheter
  3. CBefore the catheter enters the airway
  4. DContinuously for at least 30 seconds
14.内外科护理：心血管与呼吸困难

After four days of antibiotics for pneumonia, a patient still has fever and pleuritic pain. There is dullness and reduced breath sounds at the right base. What complication should be suspected?

  1. ANormal recovery from pneumonia
  2. BAsthma triggered by the infection
  3. CA parapneumonic effusion or empyema
  4. DAn allergic reaction to the antibiotic
15.内外科护理：神经、内分泌与肾脏中等

Which CSF result is most typical of bacterial meningitis?

  1. ACloudy fluid, many neutrophils, low glucose and high protein
  2. BBlood-stained fluid that clears in later tubes
  3. CClear fluid, many lymphocytes, normal glucose and slightly raised protein
  4. DClear fluid with normal cells, glucose and protein
16.内外科护理：神经、内分泌与肾脏困难

Which task for a stroke patient can a registered nurse safely delegate to a healthcare assistant (nursing assistant)?

  1. ACarrying out the first bedside water swallow screen after admission
  2. BTeaching the patient how to take a new anticoagulant
  3. CAssessing a new weakness the patient reports in the leg
  4. DRepositioning the patient every two hours as set out in the care plan
17.内外科护理：消化、围手术期与肿瘤中等

Which advice helps a patient with haemorrhoids?

  1. ASit on the toilet for long periods to empty fully
  2. BTake a codeine-based painkiller every day
  3. CEat more fibre, drink enough fluid and avoid straining
  4. DEat less fibre so that stools are smaller
18.内外科护理：消化、围手术期与肿瘤困难

Why is folinic acid (leucovorin) given after high-dose methotrexate?

  1. ATo rescue normal cells from methotrexate toxicity
  2. BTo increase the anticancer effect on the tumour
  3. CTo treat the patient's anaemia only
  4. DTo prevent hair loss during treatment
19.产科护理中等

Why are afterpains often stronger in multiparous women?

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

在新生儿复苏中，何时需要进行胸外按压？

  1. A尽管已进行至少 30 秒的有效通气，心率仍低于 60 次/分
  2. B只要 APGAR 评分低于 7 分
  3. C1 分钟时心率低于 120 次/分，即使尚未给予任何通气
  4. D婴儿出生时一旦不哭
21.儿科护理中等

When is the best time to tell a 2-year-old about an upcoming procedure?

  1. ANot at all, to avoid upsetting the child beforehand
  2. BThe day before, with a detailed explanation
  3. CAbout a week before, so there is time to get used to it
  4. DJust before it happens, in simple, concrete words
22.儿科护理困难

In England, a 15-year-old asks a nurse for contraception and does not want her parents told. Which principle applies?

  1. AShe can never receive contraception without written consent from a parent
  2. BThe nurse must inform her parents and her school straight away
  3. CShe may consent herself if judged competent (Gillick and Fraser)
  4. DContraception may only be given once she reaches the age of 18
23.精神科护理中等

How does obsessive-compulsive personality disorder differ from obsessive-compulsive disorder?

  1. APeople with it always feel that their behaviour is senseless and unwanted
  2. BIt is a lasting pattern of perfectionism and control without true obsessions and compulsions
  3. CIt starts suddenly in later life after a stressful event and goes away on its own within a few months
  4. DIt always involves repeated hand washing and checking rituals
24.精神科护理困难

A patient who has taken haloperidol for many years now has repeated lip smacking and tongue movements. Which action is most appropriate?

  1. AReport the movements, assess them with a scale such as the AIMS and ask for a medication review
  2. BReassure the patient that the movements will soon stop on their own
  3. CGive benztropine, because it reliably reverses these movements
  4. DIncrease the haloperidol dose, because a higher dose suppresses the abnormal movements of the mouth and tongue
25.护理数学与单位换算中等
181 cm1 in = 2.54 cmh = ? in

练习题（虚构数值，不作为临床指导）。 一位患者身高 181 cm。按 1 in = 2.54 cm，求以英寸表示的身高h。取到一位小数。

181 cm1 in = 2.54 cm
h = in
26.护理数学与单位换算困难
1½ tsp · 3/天 · 10 d? × 150 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1½ tsp，每 8 小时一次，共 10 天。混悬液每瓶 150 mL。按1 tsp = 5 mL，必须提供多少整瓶N才能完成疗程？

1½ tsp每 8 小时一次10 天150 mL1 tsp = 5 mL
N =
27.剂量计算中等
90 kg30 mg/kg/天3× 每天D = ? mg

某患者体重 90 kg。医嘱剂量为每天 30 mg/kg，分 3 次等量给药。每次给多少毫克 D？

90 kg30 mg/kg/天3× 每天
D = mg
28.剂量计算困难
120 mg/5 mLV = ? mL

一名体重 28 kg 的儿童，医嘱为口服混悬液每次 12.5 mg/kg，该混悬液每 5 mL 含 120 mg。你应给多少体积 V？ 保留一位小数。

28 kg12.5 mg/kg120 mg/5 mL
V = mL
29.静脉输液速度中等
15 gtt/mL40 mL/h? gtt/min

医嘱要求以 40 mL/h 输液，但没有输液泵。改用滴系数为 15 gtt/mL 的输液器重力滴注。求滴速 R，以每分钟滴数表示。

40 mL/h15 gtt/mL
R = gtt/min
30.静脉输液速度困难
200 mg500 mL15 mL/h? mg/h

一袋液体在 500 mL 中含药 200 mg，以 15 mL/h 的速度输注。患者每小时获得多少毫克 D？

200 mg/500 mL15 mL/h
D = mg/h
31.静脉输液与液体平衡中等
入量出量8 小时班次牛奶200 mL果冻120 mL冰屑200 mL静脉输液100 mL/h × 8 h静脉抗生素2 × 50 mL尿液475 mL尿液225 mL尿液350 mL尿液425 mL伤口引流120 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 8 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: 200 mL果冻: 120 mL冰屑: 200 mL静脉输液: 100 mL/h × 8 h静脉抗生素: 2 × 50 mL尿液: 475 mL尿液: 225 mL尿液: 350 mL尿液: 425 mL伤口引流: 120 mL
B = mL
32.静脉输液与液体平衡困难
500 mL→ 75 mL/h开始 09:30t总数​ = ? h80 mL/h × 2 h

练习题（虚构数值，不作为临床指导）。 一份 500 mL 的输液于 09:30 开始以 80 mL/h 输注。2 小时后速率改为 75 mL/h，之后不再改变。从开始算起多少小时 t 后袋子会输完？ 保留一位小数。

500 mL80 mL/h · 2 h75 mL/h
t = h
33.临床评估评分中等
E2 / 4+V2 / 5+M? / 6GCS 8?

练习题（虚构数值，不作为临床指导）。 一张练习图表记录了 GCS 8，其中 E2 和 V2。记录的运动评分M是多少，它描述的是哪种反应？请给出数字。

GCS 8E2V2
M =
34.临床评估评分困难
无风险轻度风险中度风险高风险极高风险

练习题（虚构数值，不作为临床指导）。 用 Braden 量表评估一位练习患者：感觉知觉: 轻度受限; 潮湿程度: 非常潮湿; 活动: 卧床不起; 活动能力: 不受限制; 营养: 极好; 摩擦力和剪切力: 有问题。使用的分级为：19–23 无风险，15–18 轻度，13–14 中度，10–12 高，9 或以下极高。点击风险等级。

  1. 1无风险
  2. 2轻度风险
  3. 3中度风险
  4. 4高风险
  5. 5极高风险

3溶液

1.护理学基础

答案: D · Explore the reason for refusing

为什么是这个答案

Patients with capacity may refuse medicines. The nurse explores why, for example side effects or misunderstanding, gives information, documents the refusal and informs the prescriber if needed.

答案

D · Explore the reason for refusing
2.护理学基础

答案: B · Report it urgently, as the stoma may be losing its blood supply

为什么是这个答案

A dusky, purple or black stoma suggests ischaemia or necrosis, which can need surgery. The nurse reports it to the surgical team at once.

答案

B · Report it urgently, as the stoma may be losing its blood supply
3.感染控制与患者安全

答案: C · To reduce skin bacteria and bloodstream infections linked to central lines

为什么是这个答案

Daily chlorhexidine bathing lowers the number of organisms on the skin, reducing central line-associated bloodstream infections and the spread of resistant bacteria in ICUs.

答案

C · To reduce skin bacteria and bloodstream infections linked to central lines
4.感染控制与患者安全

答案: D · A patient with suspected active pulmonary tuberculosis

为什么是这个答案

Tuberculosis needs airborne precautions in a negative-pressure room. Influenza needs droplet precautions and MRSA and C. difficile need contact precautions, which can be given in an ordinary single room.

答案

D · A patient with suspected active pulmonary tuberculosis
5.优先排序与委派

答案: B · With the palms of the hands, not the fingertips

为什么是这个答案

A wet plaster cast can be dented by fingertips, causing pressure points under the cast. It is handled with the palms, supported on pillows and left uncovered to dry.

答案

B · With the palms of the hands, not the fingertips
6.优先排序与委派

答案: B · That the child is passing urine

为什么是这个答案

Potassium is not added to IV fluids until the child is passing urine, because poor kidney function can let potassium build up to dangerous levels.

答案

B · That the child is passing urine
7.临床护理

答案: A · Face the patient, speak clearly and reduce background noise

为什么是这个答案

Facing the patient in good light, speaking clearly at a normal pace, checking hearing aids and reducing noise improves communication. Written information can also help.

答案

A · Face the patient, speak clearly and reduce background noise
8.临床护理

答案: A · Standard oximeters cannot tell carboxyhaemoglobin from oxyhaemoglobin

为什么是这个答案

Standard SpO2 can appear normal despite severe tissue hypoxia. Carboxyhaemoglobin is measured on a blood gas, and high-concentration oxygen is given.

答案

A · Standard oximeters cannot tell carboxyhaemoglobin from oxyhaemoglobin
9.实验室检查值与电解质

答案: D · A baseline HIV test

为什么是这个答案

After an occupational exposure, the wound is washed and the incident is reported at once. Baseline tests for HIV, hepatitis B and hepatitis C are taken, and post-exposure prophylaxis is started as soon as possible if indicated, ideally within hours.

答案

D · A baseline HIV test
10.实验室检查值与电解质

答案: A · Cloudy fluid, low glucose, high protein, many neutrophils

为什么是这个答案

Bacterial meningitis typically gives cloudy CSF with many neutrophils, high protein and low glucose, because bacteria and white cells use glucose. Viral meningitis usually shows lymphocytes with a normal glucose; option C is normal CSF.核对依据: CSF glucose test · MedlinePlus (NIH) (2025); CSF cell count · MedlinePlus (NIH) (2025); CSF total protein · MedlinePlus (NIH) (2025)

答案

A · Cloudy fluid, low glucose, high protein, many neutrophils
11.药理学

答案: C · 增加葡萄糖从尿中的丢失

为什么是这个答案

SGLT2 在近端小管中重吸收大部分滤过的葡萄糖。阻断它可以让葡萄糖随尿排出，这也解释了生殖器真菌感染风险增加的原因。

答案

C · 增加葡萄糖从尿中的丢失
12.药理学

答案: D · Higher blood glucose, so more frequent glucose checks are needed

为什么是这个答案

Glucocorticoids raise blood glucose by increasing liver glucose production and insulin resistance. Glucose is monitored more often, and diabetes treatment may need to be increased during the course.

答案

D · Higher blood glucose, so more frequent glucose checks are needed
13.内外科护理：心血管与呼吸

答案: A · Only while withdrawing the catheter

为什么是这个答案

The catheter is inserted without suction and suction is applied as it is withdrawn, with each pass kept short. This limits mucosal trauma and hypoxaemia. The patient is monitored for desaturation and bradycardia.

答案

A · Only while withdrawing the catheter
14.内外科护理：心血管与呼吸

答案: C · A parapneumonic effusion or empyema

为什么是这个答案

Persistent fever and signs of pleural fluid suggest a parapneumonic effusion, which may become infected (empyema). Ultrasound and diagnostic pleural aspiration are needed, and an infected collection usually needs a chest drain in addition to antibiotics.

答案

C · A parapneumonic effusion or empyema
15.内外科护理：神经、内分泌与肾脏

答案: A · Cloudy fluid, many neutrophils, low glucose and high protein

为什么是这个答案

Bacterial meningitis usually gives turbid CSF with raised neutrophils and protein and low glucose. Viral meningitis typically shows clear fluid with lymphocytes and normal glucose.

答案

A · Cloudy fluid, many neutrophils, low glucose and high protein
16.内外科护理：神经、内分泌与肾脏

答案: D · Repositioning the patient every two hours as set out in the care plan

为什么是这个答案

Repositioning to a set plan is a routine task that trained assistants can carry out. Swallow screening, assessing new symptoms and medication teaching need the nurse's clinical judgement and stay with the registered nurse.

答案

D · Repositioning the patient every two hours as set out in the care plan
17.内外科护理：消化、围手术期与肿瘤

答案: C · Eat more fibre, drink enough fluid and avoid straining

为什么是这个答案

Soft stools reduce straining and pressure on the anal cushions. Long sitting on the toilet and constipating drugs such as codeine should be avoided.

答案

C · Eat more fibre, drink enough fluid and avoid straining
18.内外科护理：消化、围手术期与肿瘤

答案: A · To rescue normal cells from methotrexate toxicity

为什么是这个答案

Methotrexate inhibits dihydrofolate reductase. Timed folinic acid bypasses this block in normal cells, reducing toxicity such as mucositis and myelosuppression, while methotrexate levels and kidney function are monitored.

答案

A · To rescue normal cells from methotrexate toxicity
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: A · 尽管已进行至少 30 秒的有效通气，心率仍低于 60 次/分

为什么是这个答案

如果有效通气后心率仍低于 60 次/分，则开始按压，按压与通气之比为 3:1。大多数新生儿仅靠良好的通气就会好转。

答案

A · 尽管已进行至少 30 秒的有效通气，心率仍低于 60 次/分
21.儿科护理

答案: D · Just before it happens, in simple, concrete words

为什么是这个答案

Toddlers do not understand future time, so preparation long in advance only creates anxiety. A short, honest explanation immediately before, with a parent present and a comfort object, works best.

答案

D · Just before it happens, in simple, concrete words
22.儿科护理

答案: C · She may consent herself if judged competent (Gillick and Fraser)

为什么是这个答案

Under the Gillick case and Fraser guidelines, a young person under 16 who understands the treatment and its implications can consent to contraception. Staff encourage involving parents and assess for any safeguarding concerns.

答案

C · She may consent herself if judged competent (Gillick and Fraser)
23.精神科护理

答案: B · It is a lasting pattern of perfectionism and control without true obsessions and compulsions

为什么是这个答案

In OCPD, rigid perfectionism, orderliness and control are part of the personality and usually feel right to the person. In OCD, the person has intrusive obsessions and compulsions that they usually find distressing.

答案

B · It is a lasting pattern of perfectionism and control without true obsessions and compulsions
24.精神科护理

答案: A · Report the movements, assess them with a scale such as the AIMS and ask for a medication review

为什么是这个答案

These are signs of tardive dyskinesia, which can be permanent. Early detection and review of the antipsychotic are key; anticholinergic drugs do not treat tardive dyskinesia and may worsen it.

答案

A · Report the movements, assess them with a scale such as the AIMS and ask for a medication review
25.护理数学与单位换算

答案: h = 71.3 in

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。

厘米换算为英寸

h = 181/2.54 = 71.26 ≈ 71.3 in

答案

h = 71.3 in
26.护理数学与单位换算

答案: N = 2

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。

总体积

7.5 mL × 3 × 10 = 225 mL

瓶数

225/150 = 1.5 → N = 2

答案

N = 2
27.剂量计算

答案: D = 900 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。

每日总量

30·90 = 2700 mg

每次剂量

D = 2700/3 = 900 mg

答案

D = 900 mg
28.剂量计算

答案: V = 14.6 mL

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。

按体重计算剂量

12.5·28 = 350 mg

体积

V = (350/120)·5 = 14.58 ≈ 14.6 mL

答案

V = 14.6 mL
29.静脉输液速度

答案: R = 10 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

40/60 = 0.6667 mL/min

滴速

R = 0.6667·15 = 10 gtt/min

答案

R = 10 gtt/min
30.静脉输液速度

答案: D = 6 mg/h

输注速率：输液泵按 mL/h = 体积/时间（小时）设定。重力滴注按每分钟滴数计：gtt/min = 体积 (mL) × 滴系数 (gtt/mL)/时间 (min)。 滴系数印在输液器包装上：普通输液器为 10、15 或 20 gtt/mL（输血器在美国常为 10 gtt/mL，在英国为 15），微量输液器为 60 gtt/mL。务必使用题目或包装给出的滴系数。

浓度

200/500 = 0.4 mg/mL

给药速率

D = 0.4·15 = 6 mg/h

答案

D = 6 mg/h
31.静脉输液与液体平衡

答案: B = −275 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: 200 + 120 = 320 mL
冰屑: 200/2 = 100 mL
静脉输液: 100·8 = 800 mL
静脉抗生素: 2·50 = 100 mL
总入量 = 1320 mL

总出量

475 + 225 + 350 + 425 + 120 = 1595 mL

平衡

B = 1320 − 1595 = −275 mL

答案

B = −275 mL

为负：患者丢失的液体多于摄入的液体。

32.静脉输液与液体平衡

答案: t = 6.5 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。

第一部分

80·2 = 160 mL
500 − 160 = 340 mL 剩余

第二部分

340/75 = 4.533 h

总时间

t = 2 + 4.533 = 6.533 ≈ 6.5 h

答案

t = 6.5 h

约为 6 h 32 min，所以袋子大约在 16:02 输完。

33.临床评估评分

答案: M = 4

格拉斯哥昏迷量表：把三个方面的最佳反应相加。睁眼 E：4 自发，3 对声音或言语，2 对压迫，1 无。言语 V：5 定向正常，4 意识模糊，3 用词不恰当，2 发出无法理解的声音，1 无。运动 M：6 遵嘱动作，5 定位，4 正常屈曲（回缩），3 异常屈曲，2 伸展，1 无。总分为 3 至 15。头部损伤后，13–15 通常称为轻度，9–12 为中度，3–8 为重度。

运动评分

M = 8 − 2 − 2 = 4
M4: 把肢体从压迫处缩回（正常屈曲）

答案

M = 4
34.临床评估评分

答案: 轻度风险

Braden 量表：评估压力性损伤风险的六个分项。感觉知觉、潮湿程度、活动、活动能力和营养各评 1 至 4 分，从最差水平（1）到无问题（4）；摩擦力和剪切力评 1 至 3 分。总分为 6 至 23，总分越低风险越高。常用分级：19–23 无风险，15–18 轻度风险，13–14 中度风险，10–12 高风险，9 分及以下为极高风险。

为每个分项评分

感觉知觉: 轻度受限 → 3
潮湿程度: 非常潮湿 → 2
活动: 卧床不起 → 1
活动能力: 不受限制 → 4
营养: 极好 → 4
摩擦力和剪切力: 有问题 → 1

相加

Braden 总分 = 3 + 2 + 1 + 4 + 4 + 1 = 15

风险等级

15 → 轻度风险

答案

轻度风险

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