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。

新题目返回课程

在打印窗口中选择“另存为 PDF”，即可在设备上保存一份副本。

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 smoker says, "I know I should stop, and I'm thinking about it some time in the next few months." Which stage of change is this?

  1. AMaintenance
  2. BContemplation
  3. CPreparation
  4. DPrecontemplation
2.护理学基础困难

A colleague asks the nurse to countersign the controlled drug register for a dose the nurse did not see being prepared or given. What should the nurse do?

  1. ASign, but only if the colleague is senior
  2. BSign it later, at the end of the shift, once the colleague explains
  3. CRefuse, as they can only sign for what they have witnessed
  4. DSign, as the colleague is trustworthy
3.感染控制与患者安全中等

When should blood specimen tubes be labeled?

  1. AAt the nurses’ station before going to the patient, to save time
  2. BBack at the station after all the samples are collected
  3. CBy the laboratory staff after the tubes arrive
  4. DAt the bedside, in front of the patient, right after collection
4.感染控制与患者安全困难

Several patients arrive with suspected inhalational anthrax after a deliberate release. Which precautions are needed for their care?

  1. AContact precautions with gowns and gloves
  2. BStandard precautions, because it is not spread from person to person
  3. CAirborne precautions in negative-pressure rooms, because spores are inhaled
  4. DDroplet precautions with surgical masks
5.优先排序与委派中等

A woman calls to say her husband suddenly has a drooping face and slurred speech. What should the nurse advise?

  1. ALet him lie down and see if it improves
  2. BDrive him to the hospital yourself after he has eaten dinner
  3. CCall emergency services now and note the time it started
  4. DBook an appointment with his doctor next week
6.优先排序与委派困难

四名患者同时到达急诊科。应先看谁？

  1. A一名手臂有伤口、出血已控制的青少年
  2. B一名偏头痛、血压 150/90 mmHg 的成人
  3. C一名脚踝畸形但足部脉搏正常的成人
  4. D一名 2 岁的儿童，流口水，身体前倾，有喘鸣
7.临床护理中等

Why can a very low serum albumin contribute to oedema?

  1. AIt lowers the oncotic pressure that holds fluid in the blood vessels
  2. BIt makes the kidneys retain potassium
  3. CIt raises the blood pressure in the capillaries and pushes fluid out
  4. DIt increases the number of red cells
8.临床护理困难

Four call bells ring at the same time. Which patient should the nurse see first?

  1. AA patient asking for pain relief for chronic back pain that they rate as 3/10
  2. BA patient who has just become breathless after starting an IV antibiotic
  3. CA patient asking what time they will be discharged
  4. DA patient who needs help to go to the toilet and has rung twice
9.实验室检查值与电解质中等

一名服用地高辛的患者血药水平为 2.8 ng/mL，心率 52 次/分。护士最好的措施是什么？

  1. A给药，一个月后复查血药水平
  2. B暂停该剂量并通知开医嘱者
  3. C给予双倍剂量以纠正心律
  4. D给药，因为心率高于 50 次/分
10.实验室检查值与电解质困难

An older adult with type 2 diabetes is drowsy and very dehydrated. Glucose 920 mg/dL (51 mmol/L), serum osmolality 350 mOsm/kg, pH 7.36, urine ketones negative or trace. Which condition fits best?

  1. ASyndrome of inappropriate ADH (SIADH)
  2. BDiabetic ketoacidosis (DKA)
  3. CMetformin-related lactic acidosis
  4. DHyperosmolar hyperglycemic state (HHS)
11.药理学中等

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

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

Ten days after chemotherapy, a patient has a temperature of 38.5 °C (101.3 °F) but says she feels fine. What should happen?

  1. AUrgent cultures and IV broad-spectrum antibiotics without delay
  2. BWait 48 hours to see whether the fever settles
  3. CParacetamol at home and review at the next routine clinic visit
  4. DStart oral antibiotics only if a rash develops
13.内外科护理：心血管与呼吸中等

Which finding shows that long-standing hypertension has caused target organ damage?

  1. ALeft ventricular hypertrophy on the ECG
  2. BA heart rate of 72/min
  3. CA normal fasting glucose
  4. DClear lung fields on the chest X-ray
14.内外科护理：心血管与呼吸困难

A patient with a valid, documented do-not-attempt-CPR decision (DNACPR in the UK, DNR or DNAR in the US) is found in cardiac arrest. What should the nurse do?

  1. AStart full CPR because the patient's family is not present
  2. BNot start CPR, call for support, and provide dignity and comfort
  3. CStart CPR but use only chest compressions
  4. DCall the arrest team and let them decide whether to resuscitate
15.内外科护理：神经、内分泌与肾脏中等

Which complication is a particular risk in nephrotic syndrome?

  1. AHypoglycaemia
  2. BVenous thrombosis
  3. CLow cholesterol
  4. DBleeding from low platelets
16.内外科护理：神经、内分泌与肾脏困难

An adult stares blankly for about a minute, smacks their lips and fumbles with their clothes. Afterwards they are confused for ten minutes and remember nothing. Which seizure type fits best?

  1. AMyoclonic seizure
  2. BAbsence seizure
  3. CAtonic (drop) seizure with a fall
  4. DFocal impaired awareness seizure
17.内外科护理：消化、围手术期与肿瘤中等

Why is the Lund and Browder chart preferred to the rule of nines for children?

  1. AIt counts superficial burns as well
  2. BIt is faster to use than any other method of estimation
  3. CIt is used only for burns of the hands
  4. DIt adjusts for body proportions that change with age
18.内外科护理：消化、围手术期与肿瘤困难

A patient with bone metastases is starting regular zoledronic acid. Which advice is important?

  1. ATake extra calcium only on the day of infusion
  2. BAvoid all physical activity for six months
  3. CStop drinking all fluids on the day of each infusion
  4. DHave a dental check and report jaw pain or loose teeth
19.产科护理中等

Why do newborns become cold so easily?

  1. AThey cannot produce heat at all
  2. BThey have a large surface area and little fat
  3. CTheir blood is thicker than adult blood
  4. DThey sweat more than adults
20.产科护理困难

A woman had a classical (vertical upper-segment) caesarean in her last pregnancy. She asks about her plan for this birth. Which answer is accurate?

  1. AHer previous incision makes no difference to the plan
  2. BShe should wait until 42 weeks and then decide
  3. CA planned repeat caesarean before labour is advised
  4. DShe should try for a vaginal birth with oxytocin induction
21.儿科护理中等

Which early sign may tell a child with haemophilia that a joint bleed is starting?

  1. AA cold, pale hand or foot
  2. BA sudden fever with a rash
  3. CAn itchy feeling on the skin over the elbow
  4. DTingling or warmth in the joint
22.儿科护理困难

A child with a new forearm cast has severe pain not relieved by analgesia and screams when the nurse gently moves the fingers. What should the nurse suspect?

  1. AAnxiety; distract the child with play
  2. BItching under the cast; give an antihistamine
  3. CNormal pain after a fracture; give more time
  4. DCompartment syndrome; report it at once
23.精神科护理中等

Which side effects are most common with quetiapine?

  1. AA cough and swollen ankles
  2. BHigh prolactin with breast enlargement in almost every patient
  3. CInsomnia and severe weight loss
  4. DSedation, dizziness when standing and weight gain
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
12345678910111214:55?2:55 AM1:55 PM2:55 PM4:55 PM

练习题（虚构数值，不作为临床指导）。 一个剂量记录在 14:55（24 小时制）。哪个条目是 12 小时制中的同一时间？点击它。

14:55
  1. 12:55 AM
  2. 21:55 PM
  3. 32:55 PM
  4. 44:55 PM
26.护理数学与单位换算困难
½ tbsp · 2/天 · 7 d? × 100 mL1 tbsp = 15 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½ tbsp，每 12 小时一次，共 7 天。混悬液每瓶 100 mL。按1 tbsp = 15 mL，必须提供多少整瓶N才能完成疗程？

½ tbsp每 12 小时一次7 天100 mL1 tbsp = 15 mL
N =
27.剂量计算中等
23 kgBSA = 0.84 m²20 mg/m²D = ? mg

一名体重 23 kg 的患者体表面积为 0.84 m²。医嘱为 20 mg/m²。求剂量 D，以 mg 表示。

23 kgBSA = 0.84 m²20 mg/m²
D = mg
28.剂量计算困难
40 mg/1 mLV = ? mL

一名体重 20 kg 的儿童，医嘱为口服混悬液每次 10 mg/kg，该混悬液每 1 mL 含 40 mg。你应给多少体积 V？

20 kg10 mg/kg40 mg/1 mL
V = mL
29.静脉输液速度中等
1000 mL15 gtt/mL6 h? gtt/min

用滴系数为 15 滴/mL 的输液器在 6 小时内输入 1000 mL。求滴速 R（滴/分）。 取整到最接近的整数。

1000 mL6 h15 gtt/mL
R = gtt/min
30.静脉输液速度困难
250 mg500 mL8 mL/h? mg/h

一袋液体在 500 mL 中含药 250 mg，以 8 mL/h 的速度输注。患者每小时获得多少毫克 D？

250 mg/500 mL8 mL/h
D = mg/h
31.静脉输液与液体平衡中等
入量出量12 小时班次汤150 mL果汁120 mL静脉输液75 mL/h × 12 h静脉抗生素2 × 50 mL尿液350 mL尿液275 mL尿液425 mL尿液500 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）。

汤: 150 mL果汁: 120 mL静脉输液: 75 mL/h × 12 h静脉抗生素: 2 × 50 mL尿液: 350 mL尿液: 275 mL尿液: 425 mL尿液: 500 mL
B = mL
32.静脉输液与液体平衡困难
1000 mL80 mL/h开始 13:0019:00: ? mL

练习题（虚构数值，不作为临床指导）。 一袋 1000 mL 的液体于 13:00 开始用输液泵以 80 mL/h 输注。到 19:00 时袋中还剩多少 mL V？

1000 mL80 mL/h13:00 → 19:00
V = mL
33.临床评估评分中等
E3 / 4+V3 / 5+M? / 6GCS 12?

练习题（虚构数值，不作为临床指导）。 一张练习图表记录了 GCS 12，其中 E3 和 V3。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 12E3V3
M =
34.临床评估评分困难
令人放心中度异常低

练习题（虚构数值，不作为临床指导）。 一名练习用新生儿出生后 1 分钟时：躯干粉红，手脚青紫，心率 75 次/分，刺激时哭叫、咳嗽或打喷嚏，活动活跃，呼吸缓慢、不规则，哭声微弱。 为 Apgar 评分并点击该评分的解读。

  1. 1令人放心
  2. 2中度异常
  3. 3低

3溶液

1.护理学基础

答案: B · Contemplation

为什么是这个答案

In the stages-of-change model, contemplation means considering change within about six months without a firm plan. Precontemplation means not thinking about change yet.

答案

B · Contemplation
2.护理学基础

答案: C · Refuse, as they can only sign for what they have witnessed

为什么是这个答案

Countersigning means confirming that you witnessed the check and administration. Signing for something you did not see is dishonest and removes an important safety check.

答案

C · Refuse, as they can only sign for what they have witnessed
3.感染控制与患者安全

答案: D · At the bedside, in front of the patient, right after collection

为什么是这个答案

Labeling tubes at the bedside, using two patient identifiers and in the patient’s presence, prevents wrong-patient specimens. Pre-labeled or later-labeled tubes are easily mixed up.

答案

D · At the bedside, in front of the patient, right after collection
4.感染控制与患者安全

答案: B · Standard precautions, because it is not spread from person to person

为什么是这个答案

Inhalational anthrax is caught by breathing in spores from the environment and does not spread from person to person, so standard precautions are enough. Decontamination may still be needed for people with spores on their skin or clothing.

答案

B · Standard precautions, because it is not spread from person to person
5.优先排序与委派

答案: C · Call emergency services now and note the time it started

为什么是这个答案

Stroke is time-critical. Emergency services can begin assessment on the way and take the patient to a stroke center; the time of onset guides treatment.

答案

C · Call emergency services now and note the time it started
6.优先排序与委派

答案: D · 一名 2 岁的儿童，流口水，身体前倾，有喘鸣

为什么是这个答案

流口水、前倾（三脚架）姿势和喘鸣提示严重的上气道梗阻，如会厌炎，可能迅速变成完全梗阻。应让孩子保持平静，在气道专家到场之前不要检查咽喉。

答案

D · 一名 2 岁的儿童，流口水，身体前倾，有喘鸣
7.临床护理

答案: A · It lowers the oncotic pressure that holds fluid in the blood vessels

为什么是这个答案

Albumin creates oncotic pressure, drawing fluid into the capillaries. When it is low, as in liver disease, nephrotic syndrome or malnutrition, fluid leaks into the tissues.

答案

A · It lowers the oncotic pressure that holds fluid in the blood vessels
8.临床护理

答案: B · A patient who has just become breathless after starting an IV antibiotic

为什么是这个答案

Breathlessness soon after a new IV antibiotic suggests possible anaphylaxis, an airway and breathing emergency. The infusion should be stopped and the patient assessed immediately.

答案

B · A patient who has just become breathless after starting an IV antibiotic
9.实验室检查值与电解质

答案: B · 暂停该剂量并通知开医嘱者

为什么是这个答案

2.8 ng/mL 的水平高于通常范围，心率慢也符合中毒。护士应暂停该剂量，检查钾和心电图并通知开医嘱者。

答案

B · 暂停该剂量并通知开医嘱者
10.实验室检查值与电解质

答案: D · Hyperosmolar hyperglycemic state (HHS)

为什么是这个答案

HHS causes extreme hyperglycemia and high osmolality with severe dehydration, but enough insulin is present to prevent significant ketosis, so the pH is near normal. DKA has ketones and acidosis; SIADH has low osmolality.核对依据: Ketoacidosis · StatPearls (NCBI Bookshelf) (2023); Osmolality blood test · MedlinePlus (NIH) (2025)

答案

D · Hyperosmolar hyperglycemic state (HHS)
11.药理学

答案: C · Use the salbutamol first, wait a few minutes, then use the steroid

为什么是这个答案

The bronchodilator opens the airways so that the inhaled steroid can reach further into the lungs. A short wait between the inhalers is usually advised.

答案

C · Use the salbutamol first, wait a few minutes, then use the steroid
12.药理学

答案: A · Urgent cultures and IV broad-spectrum antibiotics without delay

为什么是这个答案

Fever during neutropenia is treated as a medical emergency because infection can progress rapidly. Cultures are taken and empirical IV antibiotics are started promptly, ideally within one hour.

答案

A · Urgent cultures and IV broad-spectrum antibiotics without delay
13.内外科护理：心血管与呼吸

答案: A · Left ventricular hypertrophy on the ECG

为什么是这个答案

Target organ damage from hypertension includes left ventricular hypertrophy, retinopathy, chronic kidney disease with proteinuria, and stroke. Its presence changes treatment urgency and targets.

答案

A · Left ventricular hypertrophy on the ECG
14.内外科护理：心血管与呼吸

答案: B · Not start CPR, call for support, and provide dignity and comfort

为什么是这个答案

A valid do-not-attempt-CPR decision means CPR is not attempted. Other appropriate care continues, the senior team and family are informed and the patient is cared for with dignity. Nurses should check that the decision is valid and applies to the situation.

答案

B · Not start CPR, call for support, and provide dignity and comfort
15.内外科护理：神经、内分泌与肾脏

答案: B · Venous thrombosis

为什么是这个答案

In nephrotic syndrome, anticoagulant proteins such as antithrombin are lost, and clotting factors made by the liver rise, so venous thrombosis is more likely. Infection and high cholesterol are other complications.

答案

B · Venous thrombosis
16.内外科护理：神经、内分泌与肾脏

答案: D · Focal impaired awareness seizure

为什么是这个答案

Focal impaired awareness seizures often come from the temporal lobe. They last about a minute or two, with automatisms such as lip smacking and fumbling, and are followed by confusion. Absence seizures are shorter and have no postictal phase.

答案

D · Focal impaired awareness seizure
17.内外科护理：消化、围手术期与肿瘤

答案: D · It adjusts for body proportions that change with age

为什么是这个答案

The Lund and Browder chart gives different percentages for the head and legs at different ages, so it is more accurate in children and is also widely used in adults.

答案

D · It adjusts for body proportions that change with age
18.内外科护理：消化、围手术期与肿瘤

答案: D · Have a dental check and report jaw pain or loose teeth

为什么是这个答案

Bisphosphonates can cause osteonecrosis of the jaw, especially after dental extractions. A dental check before starting, good oral hygiene and reporting jaw symptoms are advised. Kidney function and calcium are also monitored.

答案

D · Have a dental check and report jaw pain or loose teeth
19.产科护理

答案: B · They have a large surface area and little fat

为什么是这个答案

Newborns have a large surface area relative to body mass, little subcutaneous fat and thin skin with blood vessels near the surface. They rely on brown fat and cannot shiver effectively.

答案

B · They have a large surface area and little fat
20.产科护理

答案: C · A planned repeat caesarean before labour is advised

为什么是这个答案

A classical uterine scar carries a high risk of rupture during labour, so trial of labour is contraindicated. A repeat caesarean is planned before labour starts, and she should come in at once if contractions begin.

答案

C · A planned repeat caesarean before labour is advised
21.儿科护理

答案: D · Tingling or warmth in the joint

为什么是这个答案

Many children with haemophilia feel tingling, warmth or tightness in a joint before pain, swelling and reduced movement develop. Treating early with factor replacement limits joint damage.

答案

D · Tingling or warmth in the joint
22.儿科护理

答案: D · Compartment syndrome; report it at once

为什么是这个答案

Rising pressure within a muscle compartment cuts off blood supply. Severe pain unrelieved by analgesia and pain on passive movement are early signs; pulselessness is late. The prescriber is told immediately, the limb is not elevated above heart level and the cast may need splitting.

答案

D · Compartment syndrome; report it at once
23.精神科护理

答案: D · Sedation, dizziness when standing and weight gain

为什么是这个答案

Quetiapine commonly causes drowsiness, orthostatic hypotension and metabolic effects. It has a lower risk of extrapyramidal effects and raised prolactin than many other antipsychotics.

答案

D · Sedation, dizziness when standing and weight gain
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: 2:55 PM

24 小时制：下午 1 点起，小时数加 12（下午 3:45 = 15:45）。午夜到凌晨 12:59 为 00:00–00:59，中午 12:00–12:59 仍为 12:00–12:59。反过来换算时，13–23 点减 12 并标为下午；00 点变为凌晨 12 点。跨午夜计算时间要分两段：先算到 24:00（00:00），再从 00:00 算起。

换算小时

14 − 12 = 2 → PM

答案

2:55 PM

答案

2:55 PM
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 × 2 × 7 = 105 mL

瓶数

105/100 = 1.05 → N = 2

答案

N = 2
27.剂量计算

答案: D = 16.8 mg

Body-surface-area dosing: many cytotoxic and some paediatric doses are prescribed per square metre of body surface area: dose (mg) = dose per m² × BSA (m²). The Mosteller formula estimates BSA = √(height (cm) × weight (kg)/3600).

剂量

D = 20·0.84 = 16.8 mg

答案

D = 16.8 mg
28.剂量计算

答案: V = 5 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

10·20 = 200 mg

体积

V = (200/40)·1 = 5 mL

答案

V = 5 mL
29.静脉输液速度

答案: R = 42 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

6·60 = 360 min

滴速

R = 1000·15/360 = 41.67 ≈ 42 gtt/min

答案

R = 42 gtt/min

床旁取最接近的整滴：42 滴/分。

30.静脉输液速度

答案: D = 4 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

250/500 = 0.5 mg/mL

给药速率

D = 0.5·8 = 4 mg/h

答案

D = 4 mg/h
31.静脉输液与液体平衡

答案: B = −280 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: 150 + 120 = 270 mL
静脉输液: 75·12 = 900 mL
静脉抗生素: 2·50 = 100 mL
总入量 = 1270 mL

总出量

350 + 275 + 425 + 500 = 1550 mL

平衡

B = 1270 − 1550 = −280 mL

答案

B = −280 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: V = 520 mL

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。

经过的时间

13:00 → 19:00 = 6 h

已输入体积

80·6 = 480 mL

剩余体积

V = 1000 − 480 = 520 mL

答案

V = 520 mL
33.临床评估评分

答案: M = 6

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 = 12 − 3 − 3 = 6
M6: 遵嘱动作

答案

M = 6
34.临床评估评分

答案: 令人放心

Apgar 评分：五项体征，每项评 0、1 或 2 分，在出生后 1 分钟和 5 分钟检查。外观（肤色）：青紫或苍白 0 分，躯干粉红、四肢青紫 1 分，全身粉红 2 分。脉搏：无 0 分，低于 100 次/分 1 分，100 次/分或以上 2 分。反射（反射应激性）：无 0 分，做鬼脸 1 分，哭叫、咳嗽或打喷嚏 2 分。肌张力（活动）：松软 0 分，略有屈曲 1 分，活动活跃 2 分。呼吸：无 0 分，缓慢或不规则、哭声微弱 1 分，良好、哭声响亮 2 分。总分 7–10 为令人放心，4–6 为中度异常，0–3 为低。

为每项体征评分

外观: 躯干粉红，手脚青紫 → 1
脉搏: 75/min → 1
反射: 刺激时哭叫、咳嗽或打喷嚏 → 2
活动: 活动活跃 → 2
呼吸: 呼吸缓慢、不规则，哭声微弱 → 1

相加

APGAR = 1 + 1 + 2 + 2 + 1 = 7

解读

7 → 令人放心

答案

令人放心

本内容为独立练习材料。ExamProblems 与该考试的主办机构没有隶属关系，也未获其认可，考试名称仅用于描述内容。 NCLEX®, NCLEX-RN® and NCLEX-PN® 是 the National Council of State Boards of Nursing, Inc. (NCSBN) 的商标，该机构与 ExamProblems 无关，不为其背书，也不保证其准确性。

ExamProblems · examproblems.com/courses/nclex-pn-practice-questions