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

Using Maslow's hierarchy, which patient need should the nurse address first?

  1. AA patient who is short of breath after walking to the toilet
  2. BA patient who feels lonely because no visitors have come
  3. CA patient who is worried about how the wound will look
  4. DA patient who wants advice on returning to work
2.护理学基础困难

A patient says, "I've bought nicotine patches and I'm stopping smoking on Monday." Which stage of change is this?

  1. AContemplation
  2. BPreparation
  3. CMaintenance
  4. DAction
3.感染控制与患者安全中等

A parent calls because a toddler has swallowed some household cleaner. The child is awake and breathing normally. What should the nurse advise first?

  1. AGive syrup of ipecac from the medicine cabinet
  2. BMake the child vomit, using a finger at the back of the throat
  3. CWait to see whether any symptoms develop over the next day
  4. DContact the local poison advice service now for specific advice
4.感染控制与患者安全困难

A patient’s allergy band says “penicillin”, and an order has been written for amoxicillin. What should the nurse do?

  1. AAsk the patient whether they would like to take it anyway
  2. BGive an antihistamine first and then the drug
  3. CHold the drug and contact the prescriber
  4. DGive the drug and watch the patient closely
5.优先排序与委派中等

A patient has a blood pressure of 210/120 mmHg. Which finding would make this a hypertensive emergency?

  1. AForgetting to take the blood pressure tablet this morning
  2. BA history of high blood pressure for ten years
  3. CMild anxiety about the high reading on the monitor
  4. DNew chest pain or confusion suggesting organ damage
6.优先排序与委派困难

交班后，护士应首先评估哪位患者？

  1. A胆囊手术后第 2 天：疼痛 6/10，下一次镇痛药 30 分钟后到期
  2. B经股动脉心导管术后 1 小时：新出现背痛，脉搏 118 次/分，血压 92/58 mmHg
  3. CCOPD，吸氧 2 L/min：SpO₂ 90%，呼吸频率 22 次/分，处于平时的基线
  4. D2 型糖尿病：午餐前血糖 210 mg/dL（11.7 mmol/L），无症状
7.临床护理中等

Which technique is correct when suctioning through a tracheostomy?

  1. AKeep suctioning for at least a minute each time to clear all the secretions
  2. BSuction every 15 minutes whether or not secretions are present
  3. CApply suction only while withdrawing the catheter, for no more than about 10–15 seconds
  4. DApply suction continuously while inserting the catheter as far as it will go
8.临床护理困难

A patient with hyperkalaemia is given IV insulin with glucose. What is the purpose, and what must be monitored?

  1. ATo treat hidden diabetes; HbA1c must be checked daily
  2. BTo remove potassium from the body; urine output must be stopped for a time
  3. CTo protect the heart muscle directly; the patient must be kept nil by mouth
  4. DTo shift potassium into cells; blood glucose must be monitored for hypoglycaemia
9.实验室检查值与电解质中等

对于出现意识模糊和扑翼样震颤的严重肝病患者，哪项实验室数值最能反映原因？

  1. A血清氨升高
  2. B血清脂肪酶降低
  3. C肌钙蛋白升高
  4. D仅血清钾降低
10.实验室检查值与电解质困难

A patient with long-term heavy alcohol use is admitted with alcohol withdrawal. Which group of electrolyte problems is most common?

  1. AHigh magnesium, high phosphate and high potassium
  2. BLow magnesium, low phosphate and low potassium
  3. CLow chloride, high bicarbonate and high calcium
  4. DHigh sodium, high calcium and high glucose
11.药理学中等

A patient is starting lisinopril. Which rare but serious adverse effect should the nurse teach the patient to report immediately?

  1. AA harmless rash on the palms of the hands
  2. BAn increase in appetite in the evening
  3. CSwelling of the lips, tongue or face
  4. DDarker skin after exposure to sunlight
12.药理学困难

A patient receives high-dose IV aciclovir for herpes encephalitis. Which nursing action reduces the main risk to the kidneys?

  1. AGive a loop diuretic before each dose
  2. BRestrict oral and IV fluids to prevent brain swelling
  3. CKeep the patient well hydrated and give the infusion slowly
  4. DGive the infusion as a rapid push
13.内外科护理：心血管与呼吸中等

Which emergency equipment should be kept at the bedside of a patient with a tracheostomy?

  1. ASpare tubes (same size and one smaller), suction and oxygen
  2. BA urinary catheter set, a blood glucose meter and a thermometer
  3. COnly a spare oxygen mask, since the tube rarely causes problems
  4. DA nasogastric tube and a feeding pump
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. ACall the arrest team and let them decide whether to resuscitate
  2. BNot start CPR, call for support, and provide dignity and comfort
  3. CStart CPR but use only chest compressions
  4. DStart full CPR because the patient's family is not present
15.内外科护理：神经、内分泌与肾脏中等

哪项护理措施有助于预防颅内压升高？

  1. A鼓励每小时用力咳嗽
  2. B把所有护理和吸痰集中在一次长时间操作中
  3. C让患者平躺，髋部屈曲成锐角
  4. D预防便秘，并分散安排护理操作
16.内外科护理：神经、内分泌与肾脏困难

A patient's potassium is 7.1 mmol/L, and the ECG shows peaked T waves and broad QRS complexes. What is the first treatment?

  1. AOral sodium bicarbonate
  2. BIV calcium gluconate
  3. CIV furosemide
  4. DOral potassium binder
17.内外科护理：消化、围手术期与肿瘤中等

Why are many patients screened for MRSA before planned surgery?

  1. ASo that carriers can be decolonised to reduce infection
  2. BTo decide which anaesthetic drug to use
  3. CTo check whether the patient has had a flu vaccine
  4. DSo that surgery can be cancelled for all positive patients
18.内外科护理：消化、围手术期与肿瘤困难

一名患者正在接受负压伤口治疗。泵报警，敷料失去了密封。最恰当的措施是什么？

  1. A恢复密封；如果及时无法恢复，改用湿性敷料
  2. B在泡沫上用干纱布填塞伤口，并用胶带贴紧
  3. C把泡沫留在伤口内、不吸引，直到数天后复查
  4. D把吸力调到最大设置以拉回密封
19.产科护理中等

Which factor most increases a postnatal woman's risk of venous thromboembolism?

  1. ACaesarean birth
  2. BEarly walking after birth
  3. CBreastfeeding
  4. DNormal blood loss
20.产科护理困难

At 18 weeks, a woman's maternal serum alpha-fetoprotein is well above the normal range for her dates. Which condition does this result most suggest?

  1. AGestational diabetes
  2. BDown syndrome (trisomy 21)
  3. CAn open neural tube defect
  4. DPre-eclampsia
21.儿科护理中等

Which sign shows that a baby is ready to start solid foods?

  1. ASits with support, holds the head steady and shows interest in food
  2. BHas reached 6 weeks of age
  3. CStarts waking more often during the night and seems hungry after milk feeds
  4. DHas cut a first tooth
22.儿科护理困难

A 15-year-old boy with mumps develops a painful, swollen testis. What is the most likely explanation?

  1. AMumps orchitis, a known complication after puberty
  2. BAn inguinal hernia caused by coughing
  3. CA late side effect of the MMR vaccine given in childhood
  4. DTesticular cancer unrelated to the infection
23.精神科护理中等

According to DSM-5, how long must signs of the disturbance last before schizophrenia can be diagnosed?

  1. AAt least 2 weeks of continuous symptoms
  2. BAt least 6 months, including at least 1 month of active symptoms
  3. CAt least 1 month, with no further time required
  4. DAt least 2 years, including 6 months of active symptoms
24.精神科护理困难

The parent of a 16-year-old taking a stimulant for ADHD says her son's friends keep asking him for his tablets. What should the nurse teach?

  1. AStore it securely and never share it, because stimulants are controlled drugs
  2. BGive the friends a smaller dose if they ask, so that they do not have side effects
  3. CSharing is fine as long as the friends are the same age
  4. DStop the medicine so that there is no risk of sharing
25.护理数学与单位换算中等
167 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 167 cm。按 1 in = 2.54 cm，求以英寸表示的身高h。取到一位小数。

167 cm1 in = 2.54 cm
h = in
26.护理数学与单位换算困难
1 tsp · 3/天 · 5 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，每天三次，共 5 天。按1 tsp = 5 mL，整个疗程需要多少 mLV？

1 tsp每天三次5 天1 tsp = 5 mL
V = mL
27.剂量计算中等
80 kg5 mg/kgD = ? mg

某患者体重 80 kg，医嘱为单次给药 5 mg/kg。求剂量 D（mg）。

80 kg5 mg/kg
D = mg
28.剂量计算困难
00.10.20.30.40.50.60.70.80.911 mL

处方剂量为 1.92 mg。安瓿每 mL 含 4000 微克。请用 1 mL 注射器抽取剂量：应给多少体积 V？

1.92 mg4000 mcg/mL
V = mL
29.静脉输液速度中等
V = ?20 gtt/mL30 gtt/min8 h

滴注以 30 gtt/min 的速度通过滴系数为 20 gtt/mL 的输液器。患者在 8 小时内接受多少毫升 V？

30 gtt/min20 gtt/mL8 h
V = mL
30.静脉输液速度困难
270 mL剩余? mL/h5 h 剩余

医嘱要求在 10 小时内输入 500 mL。5 小时后你发现袋中还剩 270 mL，而输液仍须按时完成。 原来的泵速必须提高百分之多少 Δ？

500 mL / 10 h经过 5 h: 270 mL
Δ = %
31.静脉输液与液体平衡中等
入量出量8 小时班次果汁200 mL汤150 mL静脉输液125 mL/h × 8 h静脉抗生素1 × 100 mL尿液275 mL尿液275 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。求总入量 I，以 mL 计。

果汁: 200 mL汤: 150 mL静脉输液: 125 mL/h × 8 h静脉抗生素: 1 × 100 mL
I = mL
32.静脉输液与液体平衡困难
500 mL100 mL 已输入120 mL/h18:00t = ? 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 120 mL/h 输注。到 18:00 时已输入 100 mL。还要多少小时 t 袋子才会输完？ 保留一位小数。

500 mL100 mL 已输入120 mL/h
t = h
33.临床评估评分中等
3210123RR≤89–1112–2021–24≥25SpO₂≤9192–9394–95≥96空气 / O₂O₂空气SBP≤9091–100101–110111–219≥220HR≤4041–5051–9091–110111–130≥131ACVPUAC, V, P, UT °C≤35.035.1–36.036.1–38.038.1–39.0≥39.1

练习题（虚构数值，不作为临床指导）。 对这些观察结果使用 NEWS2 图表（SpO₂ 量表 1）：呼吸频率 7 次/分，SpO₂ 94%正在补充吸氧，血压 222/134 mmHg，脉搏 38 次/分，清醒，体温 36.5 °C。NEWS2 总分是多少？

RR 7SpO₂ 94%O₂SBP 222HR 38AT 36.5 °C
NEWS2 =
34.临床评估评分困难
3210123RR≤89–1112–2021–24≥25SpO₂≤9192–9394–95≥96空气 / O₂O₂空气SBP≤9091–100101–110111–219≥220HR≤4041–5051–9091–110111–130≥131ACVPUAC, V, P, UT °C≤35.035.1–36.036.1–38.038.1–39.0≥39.1低中低中高

练习题（虚构数值，不作为临床指导）。 对这些观察结果使用 NEWS2 图表（SpO₂ 量表 1）：呼吸频率 16 次/分，SpO₂ 89%吸室内空气，血压 130/78 mmHg，脉搏 82 次/分，清醒，体温 37.8 °C。患者属于哪个临床风险组？点击它。

RR 16SpO₂ 89%空气SBP 130HR 82AT 37.8 °C
  1. 1低
  2. 2中低
  3. 3中
  4. 4高

3溶液

1.护理学基础

答案: A · A patient who is short of breath after walking to the toilet

为什么是这个答案

Physiological needs such as breathing come first. Psychological and social needs matter too but are addressed after basic survival needs are met.

答案

A · A patient who is short of breath after walking to the toilet
2.护理学基础

答案: B · Preparation

为什么是这个答案

In preparation the person intends to act soon and has taken small steps, such as buying patches. Action begins when they actually stop smoking.

答案

B · Preparation
3.感染控制与患者安全

答案: D · Contact the local poison advice service now for specific advice

为什么是这个答案

A poison advice service (poison control in the US, or NHS 111 in the UK) can give advice for the exact product. Inducing vomiting is not recommended, because corrosive products can burn the esophagus again and vomit can be aspirated. Emergency services are called if the child has trouble breathing or is drowsy.

答案

D · Contact the local poison advice service now for specific advice
4.感染控制与患者安全

答案: C · Hold the drug and contact the prescriber

为什么是这个答案

Amoxicillin is a penicillin, so it could cause a serious allergic reaction. The nurse holds the drug, clarifies the allergy and contacts the prescriber for a safe alternative.

答案

C · Hold the drug and contact the prescriber
5.优先排序与委派

答案: D · New chest pain or confusion suggesting organ damage

为什么是这个答案

Severe hypertension becomes an emergency when there is acute organ damage, such as chest pain, neurological changes or kidney injury. It needs urgent, controlled lowering of the blood pressure.

答案

D · New chest pain or confusion suggesting organ damage
6.优先排序与委派

答案: B · 经股动脉心导管术后 1 小时：新出现背痛，脉搏 118 次/分，血压 92/58 mmHg

为什么是这个答案

股动脉穿刺后出现背痛、心动过速和低血压，提示腹膜后出血，这种出血可能隐匿而致命。COPD 患者处于基线，疼痛是预期的且正在处理，血糖偏高但不是急症。

答案

B · 经股动脉心导管术后 1 小时：新出现背痛，脉搏 118 次/分，血压 92/58 mmHg
7.临床护理

答案: C · Apply suction only while withdrawing the catheter, for no more than about 10–15 seconds

为什么是这个答案

Suctioning only on withdrawal and keeping it brief reduces hypoxia and mucosal damage. Suction is performed when needed, not routinely, and the patient is pre-oxygenated if required.

答案

C · Apply suction only while withdrawing the catheter, for no more than about 10–15 seconds
8.临床护理

答案: D · To shift potassium into cells; blood glucose must be monitored for hypoglycaemia

为什么是这个答案

Insulin drives potassium into cells, temporarily lowering serum levels. Glucose is given to prevent hypoglycaemia, but glucose monitoring is still needed for several hours.

答案

D · To shift potassium into cells; blood glucose must be monitored for hypoglycaemia
9.实验室检查值与电解质

答案: A · 血清氨升高

为什么是这个答案

衰竭的肝脏无法将氨转化为尿素，因此氨蓄积，导致肝性脑病。乳果糖常用于减少肠道对氨的吸收。核对依据: Ammonia Levels · MedlinePlus (NIH) (2026); Loss of brain function - liver disease · MedlinePlus (NIH) (2025)

答案

A · 血清氨升高
10.实验室检查值与电解质

答案: B · Low magnesium, low phosphate and low potassium

为什么是这个答案

Poor diet, vomiting, diarrhea and alcohol's effect on the kidneys commonly cause low magnesium, phosphate and potassium. These worsen arrhythmia and seizure risk, so they are checked and replaced, together with thiamine.

答案

B · Low magnesium, low phosphate and low potassium
11.药理学

答案: C · Swelling of the lips, tongue or face

为什么是这个答案

ACE inhibitors can cause angioedema, which can obstruct the airway and needs emergency care. It is linked to raised bradykinin levels and can occur even after long use.

答案

C · Swelling of the lips, tongue or face
12.药理学

答案: C · Keep the patient well hydrated and give the infusion slowly

为什么是这个答案

Aciclovir can crystallise in the tubules and cause acute kidney injury. Good hydration, slow infusion and monitoring of kidney function reduce this risk.

答案

C · Keep the patient well hydrated and give the infusion slowly
13.内外科护理：心血管与呼吸

答案: A · Spare tubes (same size and one smaller), suction and oxygen

为什么是这个答案

Bedside equipment usually includes spare tracheostomy tubes (same size and one size smaller), an obturator if used, suction with catheters, oxygen, a bag-valve-mask and tracheal dilators where policy requires. It is checked at every shift.

答案

A · Spare tubes (same size and one smaller), suction and oxygen
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: D · 预防便秘，并分散安排护理操作

为什么是这个答案

用力排便、咳嗽、长时间吸痰、髋部屈曲、疼痛和躁动都会使颅内压升高。使用大便软化剂、充分镇痛，以及分散安排护理使颅内压能在两次操作之间恢复，有助于使其保持较低水平。

答案

D · 预防便秘，并分散安排护理操作
16.内外科护理：神经、内分泌与肾脏

答案: B · IV calcium gluconate

为什么是这个答案

ECG changes mean the heart is at risk. IV calcium is given first to stabilise the myocardium, followed by insulin with glucose (and often nebulised salbutamol) to shift potassium into cells. Binders or dialysis then remove it.

答案

B · IV calcium gluconate
17.内外科护理：消化、围手术期与肿瘤

答案: A · So that carriers can be decolonised to reduce infection

为什么是这个答案

MRSA carriers have a higher risk of surgical site infection. Screening allows decolonisation with nasal ointment and skin washes, and the right antibiotic prophylaxis.

答案

A · So that carriers can be decolonised to reduce infection
18.内外科护理：消化、围手术期与肿瘤

答案: A · 恢复密封；如果及时无法恢复，改用湿性敷料

为什么是这个答案

NPWT 需要气密的密封。如果密封或吸力丧失且不能及时恢复（许多指南规定约 2 小时内），应取出泡沫并换成标准敷料，以降低感染风险。安全间隔由制造商和当地指南规定。

答案

A · 恢复密封；如果及时无法恢复，改用湿性敷料
19.产科护理

答案: A · Caesarean birth

为什么是这个答案

Pregnancy and the postpartum period are hypercoagulable. Caesarean birth, immobility, obesity, older age and previous VTE add to the risk. Early walking and, where indicated, prophylaxis reduce it.

答案

A · Caesarean birth
20.产科护理

答案: C · An open neural tube defect

为什么是这个答案

High AFP is linked to open neural tube defects and abdominal wall defects, but also to wrong dates or twins. Low AFP is associated with trisomy 21. A detailed ultrasound is the next step.

答案

C · An open neural tube defect
21.儿科护理

答案: A · Sits with support, holds the head steady and shows interest in food

为什么是这个答案

Readiness for solids, usually around 6 months, includes good head control, sitting with support, interest in food and loss of the tongue-thrust reflex. Night waking and teething are not signs of readiness.

答案

A · Sits with support, holds the head steady and shows interest in food
22.儿科护理

答案: A · Mumps orchitis, a known complication after puberty

为什么是这个答案

Orchitis is a common complication of mumps in males after puberty, usually a few days after the parotid swelling. It is painful and, rarely, reduces fertility. Supportive care includes analgesia and scrotal support.

答案

A · Mumps orchitis, a known complication after puberty
23.精神科护理

答案: B · At least 6 months, including at least 1 month of active symptoms

为什么是这个答案

Schizophrenia needs continuous signs for at least 6 months, with at least 1 month of active-phase symptoms such as delusions or hallucinations. An episode of 1 to 6 months is schizophreniform disorder.

答案

B · At least 6 months, including at least 1 month of active symptoms
24.精神科护理

答案: A · Store it securely and never share it, because stimulants are controlled drugs

为什么是这个答案

Stimulants can be diverted and misused for studying or recreation. They are controlled drugs, so secure storage, monitoring the number of tablets and not sharing them are important.

答案

A · Store it securely and never share it, because stimulants are controlled drugs
25.护理数学与单位换算

答案: h = 65.7 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 = 167/2.54 = 65.75 ≈ 65.7 in

答案

h = 65.7 in
26.护理数学与单位换算

答案: V = 75 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 × 3/天 × 5 = 75 mL

答案

V = 75 mL
27.剂量计算

答案: D = 400 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

5·80 = 400 mg

答案

D = 400 mg
28.剂量计算

答案: V = 0.48 mL

抽取剂量：体积 = (处方剂量/药物浓度) × 药物体积。先换算成相同的单位，再检查该体积是否适合注射器，并落在它的某一个刻度上。

单位相同

1.92 mg = 1920 mcg

体积

V = 1920/4000 = 0.48 mL

答案

V = 0.48 mL
29.静脉输液速度

答案: V = 720 mL

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.

速度（mL/h）

30·60/20 = 90 mL/h

体积

V = 90·8 = 720 mL

答案

V = 720 mL
30.静脉输液速度

答案: Δ = 8 %

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.

原速率

500/10 = 50 mL/h

新速率

R = 270/5 = 54 mL/h

变化百分比

Δ = (54 − 50)/50·100% = 8%

答案

Δ = 8%

许多医院允许在不重开医嘱的情况下进行不超过 25% 的此类调整；请查阅本院规定。

31.静脉输液与液体平衡

答案: I = 1450 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。

计算入量

口服: 200 + 150 = 350 mL
静脉输液: 125·8 = 1000 mL
静脉抗生素: 1·100 = 100 mL
I = 1450 mL

答案

I = 1450 mL
32.静脉输液与液体平衡

答案: t = 3.3 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 − 100 = 400 mL

时间

t = 400/120 = 3.333 ≈ 3.3 h

答案

t = 3.3 h

约为 3 h 20 min，所以袋子大约在 21:20 输完。

33.临床评估评分

答案: NEWS2 = 12

NEWS2（国家早期预警评分 2，英国皇家内科医师学会 2017）：按图表为七个参数分别评分（呼吸频率、量表 1 的 SpO₂、吸空气还是吸氧、收缩压、脉搏、按 ACVPU 量表评定的意识状态和体温），然后把分数相加。临床风险：0–4 为低；任何单项参数得 3 分为中低；5–6 为中；7 或以上为高。总分 5 或以上需要紧急响应。

为每个参数评分

RR 7/min → 3
SpO₂ 94% → 1
吸氧 → 2
SBP 222 mmHg → 3
HR 38/min → 3
清醒 (A) → 0
T 36.5 °C → 0

相加

NEWS2 = 3 + 1 + 2 + 3 + 3 + 0 + 0 = 12

答案

NEWS2 = 12
34.临床评估评分

答案: 中低

NEWS2（国家早期预警评分 2，英国皇家内科医师学会 2017）：按图表为七个参数分别评分（呼吸频率、量表 1 的 SpO₂、吸空气还是吸氧、收缩压、脉搏、按 ACVPU 量表评定的意识状态和体温），然后把分数相加。临床风险：0–4 为低；任何单项参数得 3 分为中低；5–6 为中；7 或以上为高。总分 5 或以上需要紧急响应。

为每个参数评分

RR 16/min → 0
SpO₂ 89% → 3
吸空气 → 0
SBP 130 mmHg → 0
HR 82/min → 0
清醒 (A) → 0
T 37.8 °C → 0

总分和红色分值

NEWS2 = 0 + 3 + 0 + 0 + 0 + 0 + 0 = 3
至少有一个参数得 3 分。

风险组

中低

答案

中低

即使总分低，单项得 3 分也需要紧急会诊。

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