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

How should a patient walk with a standard (non-wheeled) walking frame?

  1. APush the frame along the floor while walking quickly
  2. BStep forward first, then pull the frame after
  3. CLean forward on the frame and slide the feet
  4. DLift the frame forward, then step into it
2.护理学基础困难

Which statement about the use of physical restraint is correct?

  1. AIt is a last resort, uses the least restrictive option and needs regular checks
  2. BIt never needs to be documented if it is used only overnight
  3. CIt is the best way to stop older patients from falling
  4. DIt can be used whenever a patient is confused, without further assessment
3.感染控制与患者安全中等

A nurse has just given an intramuscular injection with a safety needle. What should the nurse do next with the needle?

  1. ALay it on the medication tray and discard it later
  2. BRecap it carefully with both hands and dispose of it after the drug round
  3. CBend the needle to make it unusable, then discard it
  4. DActivate the safety device and drop it into a sharps container at once
4.感染控制与患者安全困难

A nurse teaches the daughter of a patient with moderate Alzheimer’s disease about home safety. Which statement shows a need for further teaching?

  1. A“We put locks high up on the outside doors.”
  2. B“She wears an ID bracelet in case she gets lost.”
  3. C“I keep her medicines locked away and give each dose to her myself.”
  4. D“I let Mom cook alone on the gas stove because she enjoys it.”
5.优先排序与委派中等

一名通常在产科工作的护士被调派到成人内科病房。最适合分配给这名护士的患者是哪一位？

  1. A新做气管切开的患者
  2. B口服抗生素治疗稳定的肺炎患者
  3. C因糖尿病酮症酸中毒持续输注胰岛素的患者
  4. D活动性上消化道出血的患者
6.优先排序与委派困难

A patient in labor is receiving oxytocin, and the fetal monitor shows repeated late decelerations. What should the nurse do first?

  1. AEncourage the patient to start pushing
  2. BPlace the patient flat on her back
  3. CStop the oxytocin infusion
  4. DIncrease the oxytocin rate
7.临床护理中等

一名患者的癫痫发作已持续超过五分钟。这意味着什么？

  1. A约束四肢以停止抽动
  2. B这是正常的，无须治疗
  3. C往口里塞东西以防咬伤舌头
  4. D应按癫痫持续状态处理并给予急救药物
8.临床护理困难

哪项护理评估最有助于及早发现大手术后患者的病情恶化？

  1. A定期测量全套生命体征，使用早期预警评分并评估变化趋势
  2. B只问患者是否感觉良好
  3. C只在出院时检查伤口
  4. D每天测一次体温
9.实验室检查值与电解质中等

A patient with suspected pulmonary TB needs sputum samples for acid-fast bacilli. Which instruction is correct?

  1. AGive several deep-cough samples, often first thing in the morning
  2. BGive one sample after brushing with mouthwash so it is clean
  3. CGive several samples of nasal mucus blown into a tissue
  4. DGive one sample of saliva collected from the mouth at any time of day
10.实验室检查值与电解质困难

A patient has a continuous heparin infusion for a pulmonary embolism. A new nurse plans to adjust the infusion using today's INR of 1.1. What should the experienced nurse explain?

  1. AHeparin needs no laboratory monitoring once the infusion is started
  2. BThe INR is the correct test, and 1.1 means heparin is therapeutic
  3. CThe INR of 1.1 means the heparin rate must be doubled at once
  4. DHeparin is adjusted using the aPTT or anti-Xa level, not the INR
11.药理学中等

A nurse has a needlestick injury from a patient with HIV. When should post-exposure prophylaxis start?

  1. AAfter one week, when the risk of infection is clearer
  2. BAs soon as possible, and within 72 hours at the latest
  3. COnly if the patient's viral load is above a set level
  4. DOnly after the nurse's HIV test turns positive
12.药理学困难

A nurse gave a patient ten times the prescribed dose of hydromorphone. The patient is currently alert. What is the most appropriate sequence of actions?

  1. AGive another dose later to balance it out
  2. BSay nothing because the patient is alert
  3. CMonitor closely, have naloxone ready, inform the prescriber and report
  4. DChange the chart so that it shows the correct dose, and continue to monitor
13.内外科护理：心血管与呼吸中等

一名患者出现胸骨后胸痛，心电图显示 STEMI。这通常需要什么处理？

  1. A收入院，次日早晨复查心电图
  2. B紧急再灌注，首选直接 PCI
  3. C口服 β 受体阻滞剂，疼痛缓解后出院
  4. D在作任何治疗决定前先等肌钙蛋白结果
14.内外科护理：心血管与呼吸困难

Two adults with cystic fibrosis are admitted to the same ward. What is the correct infection-control plan?

  1. AUse standard precautions only, as CF is not infectious
  2. BNurse them in separate single rooms and keep them apart
  3. CPut them in the same bay so they can support each other
  4. DLet them share physiotherapy sessions and equipment
15.内外科护理：神经、内分泌与肾脏中等

Before surgery for a phaeochromocytoma, why is an alpha-blocker started before any beta-blocker?

  1. AA beta-blocker alone can cause a dangerous rise in BP
  2. BAlpha-blockers lower the blood glucose before surgery
  3. CBeta-blockers given first would make the tumour grow faster
  4. DThe order of the two drugs makes no difference
16.内外科护理：神经、内分泌与肾脏困难

A patient with Guillain–Barré syndrome has a blood pressure that swings between 80/50 and 190/100 mmHg and a heart rate that changes suddenly. What does this suggest?

  1. AA faulty blood pressure cuff that should be replaced and the readings ignored
  2. BAnxiety that will settle with reassurance alone
  3. CA drug reaction that means all medicines must stop
  4. DAutonomic dysfunction, which needs continuous cardiac monitoring
17.内外科护理：消化、围手术期与肿瘤中等

How can low-dose opioids help a patient with breathlessness from advanced cancer?

  1. AThey increase the oxygen level in the blood
  2. BThey open the airways like an inhaler
  3. CThey reduce the feeling of breathlessness
  4. DThey cure the underlying lung disease
18.内外科护理：消化、围手术期与肿瘤困难

An older patient with atrial fibrillation has sudden severe abdominal pain, but the abdomen is soft with little tenderness. Lactate is raised. What should the nurse suspect?

  1. ASimple constipation
  2. BAcute mesenteric ischaemia
  3. CIrritable bowel syndrome
  4. DMuscle strain from coughing
19.产科护理中等

A woman at 24 weeks reports burning on urination and urinary frequency. What is the priority action?

  1. AAdvise her to drink less to reduce frequency
  2. BCollect a urine sample for culture and inform the provider
  3. CReassure her that urinary frequency is normal in pregnancy
  4. DAdvise cranberry juice and no further action
20.产科护理困难

A woman at 32 weeks with type 1 diabetes has nausea, vomiting, abdominal pain, rapid breathing and a glucose of 16 mmol/L (about 290 mg/dL). Which complication should be suspected?

  1. ANormal pregnancy nausea
  2. BHyperemesis gravidarum
  3. CDiabetic ketoacidosis
  4. DHypoglycaemia
21.儿科护理中等

Which diet is usually advised for a child with nephrotic syndrome while there is oedema?

  1. ANo added salt
  2. BA high-salt diet to replace losses in the urine
  3. CA carbohydrate-free diet to reduce fluid retention
  4. DA protein-free diet to rest the kidneys completely
22.儿科护理困难

The safe dose range of a drug is 25–50 mg/kg per day, divided every 8 hours. A 12 kg child is prescribed 250 mg every 8 hours. What should the nurse do?

  1. AGive the dose, because 250 mg is within the range for a single dose
  2. BGive half the dose and inform the prescriber at the next round
  3. CGive the dose, because the minimum safe daily dose is 300 mg
  4. DContact the prescriber, because 750 mg a day is above the maximum of 600 mg
23.精神科护理中等

应教导服用氯氮平的患者立即报告什么？

  1. A想多吃东西
  2. B晚间服药后轻度嗜睡
  3. C发热、咽痛或其他感染征象
  4. D夜间唾液增多
24.精神科护理困难

After her house burned down, a woman developed delusions and disorganised speech. Ten days later the symptoms have gone completely and she is back to normal. Which diagnosis best fits?

  1. ASchizophreniform disorder
  2. BBrief psychotic disorder
  3. CDelusional disorder
  4. DSchizophrenia
25.护理数学与单位换算中等
94969810010210410635363738394041°F°C95.7 °F? °C

练习题（虚构数值，不作为临床指导）。 一位患者的体温为 95.7 °F。用 °C = (°F − 32) × 5/9 把它换算为摄氏度T。取到一位小数。

95.7 °F
T = °C
26.护理数学与单位换算困难
19.9 mmol/L? mg/dL1 mmol/L = 18 mg/dL

练习题（虚构数值，不作为临床指导）。 血糖结果为 19.9 mmol/L。按葡萄糖 1 mmol/L = 18 mg/dL，求以 mg/dL 表示的c，取到最接近的整数。

19.9 mmol/L1 mmol/L = 18 mg/dL
c = mg/dL
27.剂量计算中等
30 kg2 mg/kg/天3× 每天D = ? mg

某患者体重 30 kg。医嘱剂量为每天 2 mg/kg，分 3 次等量给药。每次给多少毫克 D？

30 kg2 mg/kg/天3× 每天
D = mg
28.剂量计算困难
20k 件500 mL? mL/h800 件/h

一袋输液在 500 mL 中含 20000 单位药物。医嘱为每小时 800 单位。泵速 R 应设为多少 mL/h？

20000 件/500 mL800 件/h
R = mL/h
29.静脉输液速度中等
500 mL20 gtt/mL8 h? gtt/min

用滴系数为 20 滴/mL 的输液器在 8 小时内输入 500 mL。求滴速 R（滴/分）。 取整到最接近的整数。

500 mL8 h20 gtt/mL
R = gtt/min
30.静脉输液速度困难
4 g1000 mL? mL/h1 mg/min

一袋中含有 4 g 药物，溶于 1000 mL。医嘱为每分钟 1 mg。泵速 R 应设为多少 mL/h？

4 g/1000 mL1 mg/min
R = mL/h
31.静脉输液与液体平衡中等
入量出量12 小时班次牛奶200 mL水200 mL果冻120 mL冰屑200 mL静脉输液75 mL/h × 12 h静脉抗生素2 × 100 mL尿液250 mL尿液200 mL尿液200 mL伤口引流90 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。求总入量 I，以 mL 计。 冰屑按其体积的一半计。

牛奶: 200 mL水: 200 mL果冻: 120 mL冰屑: 200 mL静脉输液: 75 mL/h × 12 h静脉抗生素: 2 × 100 mL
I = mL
32.静脉输液与液体平衡困难
1000 mL125 mL/h开始 11:1513:15: ? mL

练习题（虚构数值，不作为临床指导）。 一袋 1000 mL 的液体于 11:15 开始用输液泵以 125 mL/h 输注。到 13:15 时袋中还剩多少 mL V？

1000 mL125 mL/h11:15 → 13:15
V = mL
33.临床评估评分中等
轻度中度重度

练习题（虚构数值，不作为临床指导）。 一位头部损伤后的练习患者呼唤时睁眼，能说成句子但意识模糊，最佳运动反应表现为：把肢体从压迫处缩回（正常屈曲）。 算出 GCS 并据此对头部损伤分级。点击你的答案。

  1. 1轻度
  2. 2中度
  3. 3重度
34.临床评估评分困难
107?SBPDBPmmHgMAP = 65

练习题（虚构数值，不作为临床指导）。 团队的目标是平均动脉压至少为 65 mmHg。一位患者的收缩压为 107 mmHg。使用 MAP = (SBP + 2·DBP)/3，仍能使 MAP 达到 65 mmHg 的最低舒张压DBP是多少？

MAP 65 mmHgSBP 107 mmHg
DBP = mmHg

3溶液

1.护理学基础

答案: D · Lift the frame forward, then step into it

为什么是这个答案

The frame is lifted a short step forward with all four feet placed down, then the patient steps into it, usually leading with the weaker leg.

答案

D · Lift the frame forward, then step into it
2.护理学基础

答案: A · It is a last resort, uses the least restrictive option and needs regular checks

为什么是这个答案

Restraint carries risks such as injury, distress and pressure damage. It is used only when alternatives have failed, in the least restrictive form, for the shortest time, with monitoring and documentation.

答案

A · It is a last resort, uses the least restrictive option and needs regular checks
3.感染控制与患者安全

答案: D · Activate the safety device and drop it into a sharps container at once

为什么是这个答案

Used needles are never recapped with two hands, bent or left lying around. The safety feature is activated straight away and the needle goes into a puncture-resistant sharps container at the point of use.

答案

D · Activate the safety device and drop it into a sharps container at once
4.感染控制与患者安全

答案: D · “I let Mom cook alone on the gas stove because she enjoys it.”

为什么是这个答案

People with moderate dementia may forget a lit stove, causing fires or burns. Cooking should be supervised, or stove knobs removed or controls disabled. The other statements show good safety planning.

答案

D · “I let Mom cook alone on the gas stove because she enjoys it.”
5.优先排序与委派

答案: B · 口服抗生素治疗稳定的肺炎患者

为什么是这个答案

被调派的护士应分配到病情稳定、护理使用一般技能的患者。新做气管切开、活动性出血以及因 DKA 使用胰岛素输注，需要本病房专门的经验和密切监测。

答案

B · 口服抗生素治疗稳定的肺炎患者
6.优先排序与委派

答案: C · Stop the oxytocin infusion

为什么是这个答案

Late decelerations point to reduced blood flow through the placenta. Stopping oxytocin reduces contractions; the nurse then turns the patient onto her side, gives IV fluids as prescribed and informs the provider.

答案

C · Stop the oxytocin infusion
7.临床护理

答案: D · 应按癫痫持续状态处理并给予急救药物

为什么是这个答案

发作持续五分钟或更长，或反复发作而意识未恢复，应按癫痫持续状态处理。防止受伤，给氧，并遵医嘱给予急救抗惊厥药。

答案

D · 应按癫痫持续状态处理并给予急救药物
8.临床护理

答案: A · 定期测量全套生命体征，使用早期预警评分并评估变化趋势

为什么是这个答案

NEWS2 等"追踪与触发"系统综合呼吸频率、SpO2、血压、脉搏、意识和体温，以便及早识别病情恶化。

答案

A · 定期测量全套生命体征，使用早期预警评分并评估变化趋势
9.实验室检查值与电解质

答案: A · Give several deep-cough samples, often first thing in the morning

为什么是这个答案

Usually a series of three sputum samples is collected, at least one in the early morning, when secretions have pooled overnight. The patient rinses with water (not mouthwash), takes deep breaths and coughs deeply to bring up sputum, not saliva. Airborne precautions are used.核对依据: Sputum Culture · MedlinePlus (NIH) (2024); Acid-Fast Bacillus (AFB) Tests · MedlinePlus (NIH) (2025)

答案

A · Give several deep-cough samples, often first thing in the morning
10.实验室检查值与电解质

答案: D · Heparin is adjusted using the aPTT or anti-Xa level, not the INR

为什么是这个答案

Unfractionated heparin infusions are adjusted using the aPTT or anti-factor Xa level according to protocol. The INR monitors warfarin and is little affected by heparin at usual doses. Using the wrong test can cause under- or over-anticoagulation.核对依据: Partial Thromboplastin Time (PTT) Test · MedlinePlus (NIH) (2026); Prothrombin Time Test and INR (PT/INR) · MedlinePlus (NIH) (2024)

答案

D · Heparin is adjusted using the aPTT or anti-Xa level, not the INR
11.药理学

答案: B · As soon as possible, and within 72 hours at the latest

为什么是这个答案

Post-exposure prophylaxis aims to stop infection becoming established. It works best when started within hours, is not started after 72 hours, and is usually taken for 28 days.

答案

B · As soon as possible, and within 72 hours at the latest
12.药理学

答案: C · Monitor closely, have naloxone ready, inform the prescriber and report

为什么是这个答案

The patient may become sedated and develop respiratory depression later, so close monitoring and a ready antidote are needed. The prescriber is informed, the patient is told honestly, and the error is reported to improve the system.

答案

C · Monitor closely, have naloxone ready, inform the prescriber and report
13.内外科护理：心血管与呼吸

答案: B · 紧急再灌注，首选直接 PCI

为什么是这个答案

STEMI 通常反映一条冠状动脉完全闭塞。需要尽快紧急再灌注，首选直接 PCI（如果不能及时进行 PCI 则溶栓）；“时间就是心肌”。决策依据的是心电图和症状，而不是肌钙蛋白结果。

答案

B · 紧急再灌注，首选直接 PCI
14.内外科护理：心血管与呼吸

答案: B · Nurse them in separate single rooms and keep them apart

为什么是这个答案

People with CF are colonised with organisms such as Pseudomonas aeruginosa and Burkholderia cepacia complex that can pass between patients and worsen outcomes. They are cared for in single rooms and kept apart, without sharing equipment or sessions.

答案

B · Nurse them in separate single rooms and keep them apart
15.内外科护理：神经、内分泌与肾脏

答案: A · A beta-blocker alone can cause a dangerous rise in BP

为什么是这个答案

Blocking beta receptors alone leaves catecholamines acting on alpha receptors, causing severe vasoconstriction and a hypertensive crisis. Alpha blockade, such as with phenoxybenzamine, comes first, and a beta-blocker may be added later for tachycardia.

答案

A · A beta-blocker alone can cause a dangerous rise in BP
16.内外科护理：神经、内分泌与肾脏

答案: D · Autonomic dysfunction, which needs continuous cardiac monitoring

为什么是这个答案

Guillain–Barré syndrome can involve autonomic nerves, causing labile blood pressure and dangerous arrhythmias. Patients need continuous ECG monitoring and close observation, often in a high-dependency setting.

答案

D · Autonomic dysfunction, which needs continuous cardiac monitoring
17.内外科护理：消化、围手术期与肿瘤

答案: C · They reduce the feeling of breathlessness

为什么是这个答案

In palliative care, low-dose opioids reduce the sensation of breathlessness and the anxiety it causes. Fans, positioning, relaxation and treating reversible causes are also used.

答案

C · They reduce the feeling of breathlessness
18.内外科护理：消化、围手术期与肿瘤

答案: B · Acute mesenteric ischaemia

为什么是这个答案

An embolus from AF can block the mesenteric artery, causing bowel ischaemia. Early signs are severe pain with few findings; raised lactate and peritonitis appear as the bowel dies. It needs urgent CT and surgery.

答案

B · Acute mesenteric ischaemia
19.产科护理

答案: B · Collect a urine sample for culture and inform the provider

为什么是这个答案

Dysuria suggests a urinary tract infection, which needs culture and treatment with a pregnancy-safe antibiotic. Untreated UTIs can progress to pyelonephritis and preterm labour.

答案

B · Collect a urine sample for culture and inform the provider
20.产科护理

答案: C · Diabetic ketoacidosis

为什么是这个答案

Diabetic ketoacidosis can develop quickly in pregnancy, even at moderately raised glucose, and carries a high risk of fetal death. Ketones and blood gases are checked urgently, and fluids and insulin are started.

答案

C · Diabetic ketoacidosis
21.儿科护理

答案: A · No added salt

为什么是这个答案

During the oedematous phase, salt is limited to reduce fluid retention, and fluids may be restricted if advised. Protein is not stopped; a normal, balanced intake for age is usually recommended.

答案

A · No added salt
22.儿科护理

答案: D · Contact the prescriber, because 750 mg a day is above the maximum of 600 mg

为什么是这个答案

Safe range = 12 × 25 to 12 × 50 = 300–600 mg/day. Prescribed = 250 × 3 = 750 mg/day, which is above the maximum. The nurse withholds the dose and clarifies with the prescriber, never adjusting it alone.

答案

D · Contact the prescriber, because 750 mg a day is above the maximum of 600 mg
23.精神科护理

答案: C · 发热、咽痛或其他感染征象

为什么是这个答案

发热、咽痛或流感样症状可能是粒细胞缺乏症的最初征象，需要紧急做血细胞计数。镇静和流涎过多是常见的副作用。

答案

C · 发热、咽痛或其他感染征象
24.精神科护理

答案: B · Brief psychotic disorder

为什么是这个答案

Brief psychotic disorder lasts at least 1 day but less than 1 month, followed by a full return to the previous level of functioning. It may follow a severe stressor.

答案

B · Brief psychotic disorder
25.护理数学与单位换算

答案: T = 35.4 °C

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。

减去 32

95.7 − 32 = 63.7

乘以 5/9

T = 63.7·5/9 = 35.39 ≈ 35.4 °C

答案

T = 35.4 °C
26.护理数学与单位换算

答案: c = 358 mg/dL

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。

转换

c = 19.9·18 = 358.2 ≈ 358 mg/dL

答案

c = 358 mg/dL
27.剂量计算

答案: D = 20 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

2·30 = 60 mg

每次剂量

D = 60/3 = 20 mg

答案

D = 20 mg
28.剂量计算

答案: R = 20 mL/h

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。

浓度

20000/500 = 40 件/mL

泵速

R = 800/40 = 20 mL/h

答案

R = 20 mL/h
29.静脉输液速度

答案: R = 21 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

8·60 = 480 min

滴速

R = 500·20/480 = 20.83 ≈ 21 gtt/min

答案

R = 21 gtt/min

床旁取最接近的整滴：21 滴/分。

30.静脉输液速度

答案: R = 15 mL/h

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

浓度

4000 mg/1000 mL = 4 mg/mL

每小时剂量

1·60 = 60 mg/h

泵速

R = 60/4 = 15 mL/h

答案

R = 15 mL/h
31.静脉输液与液体平衡

答案: I = 1720 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 + 200 + 120 = 520 mL
冰屑: 200/2 = 100 mL
静脉输液: 75·12 = 900 mL
静脉抗生素: 2·100 = 200 mL
I = 1720 mL

答案

I = 1720 mL
32.静脉输液与液体平衡

答案: V = 750 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

11:15 → 13:15 = 2 h

已输入体积

125·2 = 250 mL

剩余体积

V = 1000 − 250 = 750 mL

答案

V = 750 mL
33.临床评估评分

答案: 中度

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。

为每个方面评分

E: 呼唤时睁眼 → 3
V: 能说成句子但意识模糊 → 4
M: 把肢体从压迫处缩回（正常屈曲） → 4

相加

GCS = 3 + 4 + 4 = 11

严重程度

GCS 11 → 中度

答案

中度
34.临床评估评分

答案: DBP = 44 mmHg

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

变形

DBP = (3·MAP − SBP)/2

代入

DBP = (3·65 − 107)/2 = 88/2 = 44 mmHg

答案

DBP = 44 mmHg

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