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 large pressure ulcer is left open and fills in with new tissue from its base. This is called healing by:

  1. ASecondary intention
  2. BTertiary intention
  3. CDelayed intention
  4. DPrimary intention
2.护理学基础困难

A patient with diabetes has had foot-care teaching. Which statement shows a need for further teaching?

  1. A"I'll wear shoes that fit well and never walk barefoot."
  2. B"I'll check my feet every day, using a mirror if needed."
  3. C"I'll soak my feet in hot water every evening."
  4. D"I'll dry carefully between my toes after washing."
3.感染控制与患者安全中等

Why does a nurse wear chemotherapy-tested gloves and a gown when emptying the urinal of a patient who recently had chemotherapy?

  1. AThe body fluids can contain active drug for a time after treatment
  2. BChemotherapy makes the urine strongly acidic and corrosive
  3. CThe urine always contains infectious bacteria after chemotherapy
  4. DThe patient is on airborne precautions after treatment
4.感染控制与患者安全困难

A nurse calls a provider using SBAR about a patient with falling blood pressure. Which statement is the “Recommendation”?

  1. A“I am calling about Mr. Jansen in room 12, who is hypotensive.”
  2. B“His blood pressure has fallen from 130/80 to 88/50 over the last two hours.”
  3. C“I think he needs to be assessed now. Can you come within the next 15 minutes?”
  4. D“He is 72 and had a bowel resection yesterday.”
5.优先排序与委派中等

A nurse needs to give report on a patient to a colleague. Which information is the most important to include?

  1. AThe patient’s favorite television programs and hobbies
  2. BPersonal opinions about the patient’s family members and their visiting habits
  3. CDetails of the nurse’s own break times that shift
  4. DThe patient’s current condition, recent changes and pending tasks
6.优先排序与委派困难

A patient with untreated hyperthyroidism has surgery and develops a temperature of 40 °C, a heart rate of 160/min and severe agitation. What is most likely happening?

  1. AOpioid withdrawal
  2. BMyxedema coma
  3. CThyroid storm
  4. DA normal reaction to pain
7.临床护理中等

What is the most common cause of hypernatraemia in frail older inpatients?

  1. ATaking too many vitamins
  2. BToo much exercise
  3. CEating too much salt in one meal
  4. DNot drinking enough water
8.临床护理困难

A catheterised postoperative patient has passed only 10 mL of urine in the last two hours. What should the nurse check first?

  1. AThe patient's cholesterol level from the admission bloods
  2. BWhether the patient has eaten breakfast
  3. CThe patient's weight from last year
  4. DThat the catheter and tubing are not kinked or blocked
9.实验室检查值与电解质中等

对于疑似脓毒症的患者，应在何时采集血培养？

  1. A仅在发热持续超过三天时
  2. B在首剂抗生素之前，且不要过多延误给药
  3. C任何时候，因为抗生素不影响结果
  4. D在前三剂抗生素之后
10.实验室检查值与电解质困难

A nursing student has a positive interferon-gamma release assay (IGRA) for tuberculosis, no symptoms and a normal chest X-ray. What does this most likely mean?

  1. ALatent TB infection, which is not contagious
  2. BA false result, as the test does not detect TB
  3. CPast BCG vaccination only, with no infection
  4. DActive pulmonary TB, which is contagious
11.药理学中等

After instilling eye drops, why should the patient press gently on the inner corner of the eye for a minute or two?

  1. ATo spread the drop evenly over the eyelid
  2. BTo reduce drainage into the nose and absorption into blood
  3. CTo make the pupil dilate faster
  4. DTo stop the eye from producing tears for about an hour
12.药理学困难

A ventilated ICU patient receives vecuronium, a neuromuscular blocker. Why must sedation and pain relief also be given?

  1. AVecuronium stops working unless a sedative is also given
  2. BNeuromuscular blockers paralyse muscles but do not cause sedation or analgesia
  3. CVecuronium causes severe pain at the injection site
  4. DSedatives are needed to prevent vecuronium from causing seizures and agitation
13.内外科护理：心血管与呼吸中等

心肌梗死两天后，一名患者突发呼吸困难、出现湿啰音和新的响亮收缩期杂音。应怀疑哪种并发症？

  1. A梗死后心包炎引起心包摩擦音
  2. B由应激诱发的新发稳定型心绞痛
  3. C乳头肌断裂伴急性二尖瓣反流
  4. D长期卧床引起的肺栓塞
14.内外科护理：心血管与呼吸困难

A patient who injects drugs has a fever, a new heart murmur and splinter haemorrhages. Before antibiotics are started, what is most important?

  1. ATake a single blood culture from the cannula
  2. BWait for an echocardiogram before taking any samples
  3. CArrange an exercise ECG test
  4. DTake several sets of blood cultures from separate sites
15.内外科护理：神经、内分泌与肾脏中等

A stroke patient with dysphagia has been started on a modified diet. Which action best reduces the risk of aspiration?

  1. AGive fluids through a straw so they flow more slowly
  2. BSit the patient fully upright for meals and for a while afterwards
  3. CLay the patient flat straight after meals so they can rest and digest
  4. DFeed quickly so the patient does not tire during the meal
16.内外科护理：神经、内分泌与肾脏困难

On the first day after a kidney transplant, urine output suddenly falls from 200 mL/h to 10 mL/h. What should the nurse check first?

  1. AWhether the patient has eaten
  2. BThe patient's blood glucose level
  3. CThe patient's temperature and pulse
  4. DThat the catheter is not blocked or kinked
17.内外科护理：消化、围手术期与肿瘤中等

How are skin staples usually removed from a healed incision?

  1. AThe staples are left in permanently under the skin
  2. BAll staples at once by pulling each one straight up from the skin
  3. COnly the staples at each end, leaving the others for good
  4. DAlternate staples first, then the rest if the wound holds
18.内外科护理：消化、围手术期与肿瘤困难

On day 5 after hip surgery, a patient suddenly becomes breathless, with sharp chest pain on breathing in, a pulse of 120/min and SpO₂ 89%. What should the nurse suspect and do first?

  1. AAnxiety; give reassurance and repeat the observations in an hour's time
  2. BWound infection; take a wound swab and wait for results
  3. CPulmonary embolism; sit up, give oxygen and call for urgent help
  4. DSimple atelectasis; encourage walking around the ward
19.产科护理中等

Which nursing measure is used during phototherapy?

  1. ATurn the baby often and monitor hydration
  2. BRemove the eye shields while the lights are on
  3. CKeep the baby fully clothed under the lights
  4. DLimit feeds to reduce stooling
20.产科护理困难

妊娠 7 周时，一名女性主诉下腹一侧突发剧烈疼痛、肩尖痛和头晕。护士应怀疑什么？

  1. ABraxton Hicks 宫缩
  2. B子宫增大引起的正常圆韧带痛
  3. C妊娠剧吐
  4. D异位妊娠破裂伴内出血
21.儿科护理中等

为什么不推荐 12 岁以下儿童使用可待因和曲马多？

  1. A它们总是引起过敏
  2. B有些儿童代谢它们非常快，导致危险的呼吸抑制
  3. C它们太弱，无法缓解中度疼痛，所以总是首选更强的阿片类药物
  4. D它们只能静脉给药
22.儿科护理困难

A child has a swollen, red eyelid with fever, pain on moving the eye and blurred vision. What should the nurse suspect?

  1. ASimple conjunctivitis, treated with eye drops at home
  2. BA stye, which will drain on its own with warm compresses
  3. COrbital cellulitis, which needs urgent review and IV antibiotics
  4. DAn insect bite, which needs only a cold compress
23.精神科护理中等

Which statement about benzodiazepines in anxiety disorders is correct?

  1. AThey give rapid relief but are generally used only short-term because of tolerance and dependence
  2. BThey take 4–6 weeks to have any effect on anxiety, like antidepressants
  3. CThey are the preferred long-term treatment for generalised anxiety disorder
  4. DThey are safe to stop suddenly after many months of daily use
24.精神科护理困难

An 83-year-old becomes confused and constipated and cannot pass urine. She takes amitriptyline, oxybutynin and an over-the-counter sleep aid with diphenhydramine. What is the most likely cause?

  1. AThe combined anticholinergic effects of her medicines
  2. BSudden-onset Alzheimer's disease
  3. CThe normal effects of ageing
  4. DA sign that she needs a higher dose of amitriptyline
25.护理数学与单位换算中等
94969810010210410635363738394041°F°C? °F39 °C

练习题（虚构数值，不作为临床指导）。 一位患者的体温为 39 °C。用 °F = °C × 9/5 + 32 把它换算为华氏度T。取到一位小数。

39 °C
T = °F
26.护理数学与单位换算困难
2 tsp? mL3 tbsp? mL½ fl oz? mL¾ 杯? mLΣ = ? mL

练习题（虚构数值，不作为临床指导）。 一个班次中，患者摄入了2 tsp / 止咳糖浆, 3 tbsp / 液体营养补充剂, ½ fl oz / 果汁, ¾ 杯 / 茶。按给出的等量关系，求以 mL 表示的口服总摄入量V。

1 tsp = 5 mL1 tbsp = 15 mL1 fl oz = 30 mL1 杯 = 8 fl oz = 240 mL
V = mL
27.剂量计算中等
0.5%50 mLm = ? mg

50 mL 的 0.5%（w/v）溶液中含有多少毫克药物 m？

0.5% w/v50 mL
m = mg
28.剂量计算困难
250 mg/5 mLV = ? mL

一名患者体重 180.4 lb。医嘱为单次剂量 1 mg/kg，储备液为 5 mL 中含 250 mg。按 1 kg = 2.2 lb 计算，你应给予多少容量 V？ 保留一位小数。

180.4 lb1 mg/kg250 mg/5 mL1 kg = 2.2 lb
V = mL
29.静脉输液速度中等
500 mL20 gtt/mL12 h? gtt/min

用滴系数为 20 滴/mL 的输液器在 12 小时内输入 500 mL。求滴速 R（滴/分）。 取整到最接近的整数。

500 mL12 h20 gtt/mL
R = gtt/min
30.静脉输液速度困难
100 mg100 mL30 mL/h? mg/h

一袋液体在 100 mL 中含药 100 mg，以 30 mL/h 的速度输注。患者每小时获得多少毫克 D？

100 mg/100 mL30 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茶240 mL果汁150 mL冰屑120 mL静脉输液80 mL/h × 8 h静脉抗生素1 × 50 mL尿液475 mL尿液200 mL伤口引流90 mL呕吐物200 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。患者体重 49 kg。求平均尿量 U，以 mL/kg/h 计。 保留两位小数。

49 kg8 h尿液: 475 mL尿液: 200 mL伤口引流: 90 mL呕吐物: 200 mL
U = mL/kg/h
32.静脉输液与液体平衡困难
500 mL300 mL 已输入150 mL/h16:30t = ? h

练习题（虚构数值，不作为临床指导）。 一袋 500 mL 的液体用输液泵以 150 mL/h 输注。到 16:30 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。

500 mL300 mL 已输入150 mL/h
t = h
33.临床评估评分中等
E1 / 4+V1 / 5+M? / 6GCS 4?

练习题（虚构数值，不作为临床指导）。 一张练习图表记录了 GCS 4，其中 E1 和 V1。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 4E1V1
M =
34.临床评估评分困难
低风险中度风险高风险

练习题（虚构数值，不作为临床指导）。 用 Morse 跌倒评分评估一位练习患者：过去 3 个月内的跌倒史: 否; 次要诊断: 是; 行走辅助: 拐杖、手杖或助行器; 静脉输液或封管: 是; 步态: 正常、卧床休息或轮椅; 精神状态: 了解自身局限。使用分界值 0–24 低，25–44 中度，45 或以上高，点击跌倒风险等级。

  1. 1低风险
  2. 2中度风险
  3. 3高风险

3溶液

1.护理学基础

答案: A · Secondary intention

为什么是这个答案

Wounds with tissue loss that cannot be closed heal by secondary intention, with granulation filling the wound and more scarring. Tertiary (delayed primary) closure is when a wound is left open first and closed later.

答案

A · Secondary intention
2.护理学基础

答案: C · "I'll soak my feet in hot water every evening."

为什么是这个答案

People with diabetic neuropathy may not feel heat, and soaking softens the skin, so long hot soaks are avoided. Daily inspection, good footwear and careful drying are correct.

答案

C · "I'll soak my feet in hot water every evening."
3.感染控制与患者安全

答案: A · The body fluids can contain active drug for a time after treatment

为什么是这个答案

Many hazardous drugs are excreted in urine, stool and vomit for a period after treatment. Staff wear protective gloves and gowns when handling these fluids, according to policy.

答案

A · The body fluids can contain active drug for a time after treatment
4.感染控制与患者安全

答案: C · “I think he needs to be assessed now. Can you come within the next 15 minutes?”

为什么是这个答案

In SBAR, the situation names the problem, the background gives the history, the assessment shares the nurse’s findings and judgement, and the recommendation states a clear request with a time frame.

答案

C · “I think he needs to be assessed now. Can you come within the next 15 minutes?”
5.优先排序与委派

答案: D · The patient’s current condition, recent changes and pending tasks

为什么是这个答案

Effective handover covers the current status, changes, risks and outstanding tasks, often using a structure such as SBAR. Opinions and unrelated details distract from what matters.

答案

D · The patient’s current condition, recent changes and pending tasks
6.优先排序与委派

答案: C · Thyroid storm

为什么是这个答案

Thyroid storm is a life-threatening surge of thyroid hormone, with fever, tachycardia and agitation or confusion. It needs urgent treatment; myxedema coma is the opposite extreme of hypothyroidism.

答案

C · Thyroid storm
7.临床护理

答案: D · Not drinking enough water

为什么是这个答案

Hypernatraemia usually reflects water deficit, often in patients who are confused, unable to drink independently or losing fluid through fever or diarrhoea. Supporting fluid intake prevents it.

答案

D · Not drinking enough water
8.临床护理

答案: D · That the catheter and tubing are not kinked or blocked

为什么是这个答案

A sudden fall in catheter output may be due to a kinked, clamped or blocked catheter. If it is draining freely, the nurse assesses fluid status and vital signs and escalates possible hypovolaemia or AKI.

答案

D · That the catheter and tubing are not kinked or blocked
9.实验室检查值与电解质

答案: B · 在首剂抗生素之前，且不要过多延误给药

为什么是这个答案

血培养应在使用抗生素之前采集，因为即使一剂抗生素也可能使细菌无法生长而掩盖病因。抗生素仍应尽快开始，最好在一小时内。核对依据: Sepsis · MedlinePlus (NIH) (2024)

答案

B · 在首剂抗生素之前，且不要过多延误给药
10.实验室检查值与电解质

答案: A · Latent TB infection, which is not contagious

为什么是这个答案

A positive IGRA with no symptoms and a normal chest X-ray indicates latent TB infection, which cannot spread to others. Treatment of latent TB is often offered to prevent later active disease. The IGRA is much less likely than the skin test to give a false-positive result after BCG vaccination.核对依据: Tuberculosis Screening · MedlinePlus (NIH) (2026); PPD skin test · MedlinePlus (NIH) (2025)

答案

A · Latent TB infection, which is not contagious
11.药理学

答案: B · To reduce drainage into the nose and absorption into blood

为什么是这个答案

Nasolacrimal occlusion keeps the drop in the eye longer and reduces systemic absorption through the nasal mucosa. This matters for drugs such as timolol, which can cause bradycardia or bronchospasm.

答案

B · To reduce drainage into the nose and absorption into blood
12.药理学

答案: B · Neuromuscular blockers paralyse muscles but do not cause sedation or analgesia

为什么是这个答案

Neuromuscular blockers cause paralysis but leave awareness and pain sensation intact. Without sedation and analgesia, the patient could be awake and in pain while unable to move.

答案

B · Neuromuscular blockers paralyse muscles but do not cause sedation or analgesia
13.内外科护理：心血管与呼吸

答案: C · 乳头肌断裂伴急性二尖瓣反流

为什么是这个答案

心肌梗死后乳头肌（或室间隔）破裂会产生新的杂音，并引起突发心力衰竭或休克。这是外科急症。心包炎引起的是胸膜性胸痛和摩擦音，而不是伴新杂音的急性肺水肿。

答案

C · 乳头肌断裂伴急性二尖瓣反流
14.内外科护理：心血管与呼吸

答案: D · Take several sets of blood cultures from separate sites

为什么是这个答案

Suspected infective endocarditis requires multiple sets of blood cultures taken with careful aseptic technique, ideally before antibiotics, to identify the organism and guide weeks of IV therapy. Echocardiography looks for vegetations but should not delay cultures or, in a very sick patient, antibiotics.

答案

D · Take several sets of blood cultures from separate sites
15.内外科护理：神经、内分泌与肾脏

答案: B · Sit the patient fully upright for meals and for a while afterwards

为什么是这个答案

Sitting upright during and after meals helps food pass safely and reduces reflux and aspiration. Small mouthfuls, unhurried feeding and the textures advised by the speech and language therapist are also important.

答案

B · Sit the patient fully upright for meals and for a while afterwards
16.内外科护理：神经、内分泌与肾脏

答案: D · That the catheter is not blocked or kinked

为什么是这个答案

A sudden drop in output after transplant may be caused by a blocked catheter, often from clots. The nurse checks the tubing and may flush the catheter per protocol, and then escalates urgently, because vascular thrombosis or rejection are also possible.

答案

D · That the catheter is not blocked or kinked
17.内外科护理：消化、围手术期与肿瘤

答案: D · Alternate staples first, then the rest if the wound holds

为什么是这个答案

Removing alternate staples first allows the nurse to check that the wound edges stay together. If the wound is secure, the rest are removed, and adhesive strips can be applied for support.

答案

D · Alternate staples first, then the rest if the wound holds
18.内外科护理：消化、围手术期与肿瘤

答案: C · Pulmonary embolism; sit up, give oxygen and call for urgent help

为什么是这个答案

Sudden pleuritic chest pain, breathlessness, tachycardia and hypoxia after surgery strongly suggest PE. The nurse supports breathing with oxygen, escalates urgently and prepares for investigations and anticoagulation.

答案

C · Pulmonary embolism; sit up, give oxygen and call for urgent help
19.产科护理

答案: A · Turn the baby often and monitor hydration

为什么是这个答案

The baby is undressed except for a small nappy, eyes are shielded, position is changed and temperature and hydration are monitored. Frequent feeds help excrete bilirubin through stools.

答案

A · Turn the baby often and monitor hydration
20.产科护理

答案: D · 异位妊娠破裂伴内出血

为什么是这个答案

妊娠早期单侧疼痛、肩尖痛和头晕提示异位妊娠破裂。这是急症：监测生命体征，建立静脉通路，并紧急寻求医疗救助。

答案

D · 异位妊娠破裂伴内出血
21.儿科护理

答案: B · 有些儿童代谢它们非常快，导致危险的呼吸抑制

为什么是这个答案

在超快代谢者中，可待因迅速转化为吗啡，可引起危及生命的呼吸抑制。监管机构建议 12 岁以下儿童不要使用可待因和曲马多，18 岁以下儿童在扁桃体或腺样体手术后也不要使用。

答案

B · 有些儿童代谢它们非常快，导致危险的呼吸抑制
22.儿科护理

答案: C · Orbital cellulitis, which needs urgent review and IV antibiotics

为什么是这个答案

Painful eye movements, reduced vision or proptosis with eyelid swelling suggest orbital cellulitis, which can spread to the brain. The child needs urgent assessment, imaging if indicated and IV antibiotics.

答案

C · Orbital cellulitis, which needs urgent review and IV antibiotics
23.精神科护理

答案: A · They give rapid relief but are generally used only short-term because of tolerance and dependence

为什么是这个答案

Benzodiazepines act quickly by enhancing GABA, but long-term use leads to tolerance, dependence and withdrawal. SSRIs and psychological therapy are first-line long-term treatments for most anxiety disorders.

答案

A · They give rapid relief but are generally used only short-term because of tolerance and dependence
24.精神科护理

答案: A · The combined anticholinergic effects of her medicines

为什么是这个答案

Several drugs with anticholinergic effects add up, increasing the risk of delirium, constipation and urinary retention in older adults. A medicine review aims to reduce the total anticholinergic burden.

答案

A · The combined anticholinergic effects of her medicines
25.护理数学与单位换算

答案: T = 102.2 °F

温度：°C = (°F − 32) × 5/9，°F = °C × 9/5 + 32。从 °F 换算时先减 32 再乘，从 °C 换算时先乘再加 32。快速核对：37 °C 为 98.6 °F，每 1 °C 相当于 1.8 °F。

乘以 9/5

39·9/5 = 70.2

加 32

T = 70.2 + 32 = 102.2 °F

答案

T = 102.2 °F
26.护理数学与单位换算

答案: V = 250 mL

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。

每一项的 mL 数

2 tsp = 2·5 = 10 mL
3 tbsp = 3·15 = 45 mL
½ fl oz = 0.5·30 = 15 mL
¾ 杯 = 0.75·240 = 180 mL

相加

V = 10 + 45 + 15 + 180 = 250 mL

答案

V = 250 mL
27.剂量计算

答案: m = 250 mg

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.

浓度

0.5% = 0.5 g/100 mL = 5 mg/mL

药物质量

m = 5·50 = 250 mg

答案

m = 250 mg
28.剂量计算

答案: V = 1.6 mL

Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.

体重 (kg)

180.4/2.2 = 82 kg

剂量

1·82 = 82 mg

体积

V = (82/250)·5 = 1.64 ≈ 1.6 mL

答案

V = 1.6 mL
29.静脉输液速度

答案: R = 14 gtt/min

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。

以分钟计的时间

12·60 = 720 min

滴速

R = 500·20/720 = 13.89 ≈ 14 gtt/min

答案

R = 14 gtt/min

床旁取最接近的整滴：14 滴/分。

30.静脉输液速度

答案: D = 30 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

100/100 = 1 mg/mL

给药速率

D = 1·30 = 30 mg/h

答案

D = 30 mg/h
31.静脉输液与液体平衡

答案: U = 1.72 mL/kg/h

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。

总尿量

475 + 200 = 675 mL

每千克每小时

U = 675/(49·8) = 1.722 ≈ 1.72 mL/kg/h

答案

U = 1.72 mL/kg/h
32.静脉输液与液体平衡

答案: t = 1.3 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

500 − 300 = 200 mL

时间

t = 200/150 = 1.333 ≈ 1.3 h

答案

t = 1.3 h

约为 1 h 20 min，所以袋子大约在 17:50 输完。

33.临床评估评分

答案: M = 2

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 = 4 − 1 − 1 = 2
M2: 手臂和腿伸直（异常伸展）

答案

M = 2
34.临床评估评分

答案: 高风险

Morse 跌倒评分：六个条目。跌倒史：否 0 分，是 25 分。次要诊断：否 0 分，是 15 分。行走辅助：无、卧床休息或护士协助 0 分；拐杖、手杖或助行器 15 分；扶着家具 30 分。静脉输液或封管：否 0 分，是 20 分。步态：正常、卧床休息或轮椅 0 分；虚弱 10 分；受损 20 分。精神状态：了解自身局限 0 分；高估或忘记自身局限 15 分。总分为 0 至 125。各医院的风险分界值不同；常用的一套是 0–24 低风险，25–44 中度风险，45 及以上为高风险。

为每个条目评分

过去 3 个月内的跌倒史: 否 → 0
次要诊断: 是 → 15
行走辅助: 拐杖、手杖或助行器 → 15
静脉输液或封管: 是 → 20
步态: 正常、卧床休息或轮椅 → 0
精神状态: 了解自身局限 → 0

相加

Morse 总分 = 0 + 15 + 15 + 20 + 0 + 0 = 50

风险等级

50 → 高风险

答案

高风险

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