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 student nurse is asked to carry out a procedure they have not been trained to do. What should they do?

  1. ADo it anyway, carefully, to avoid upsetting the team or delaying care
  2. BAsk the patient to talk them through it
  3. CWatch a video and then do it alone
  4. DExplain that they have not been trained and ask for supervision
2.护理学基础困难

Which statement by a visitor shows a need for further teaching about contact precautions?

  1. A"I'll take the gown off at home after I leave the hospital."
  2. B"I'll put on the gown and gloves before I go in."
  3. C"I'll clean my hands as I leave the room."
  4. D"I'll take off the gown and gloves before I leave the room."
3.感染控制与患者安全中等

为什么口服液体药物要用口服或肠内注射器，而不是普通静脉注射器抽取？

  1. A没有安全方面的原因；只是传统
  2. B口服注射器能更准确地量取静脉剂量
  3. C静脉注射器无法准确量取少量口服液体
  4. D口服注射器无法接入静脉管路，可防止给药途径错误
4.感染控制与患者安全困难

A patient weighs 180 kg and needs to be moved from bed to chair. The standard ceiling lift on the unit has a lower weight limit. What should the nurse do?

  1. AHave two staff lift the patient by hand
  2. BUse the standard lift, because limits include a safety margin
  3. CUse bariatric-rated equipment and enough trained staff
  4. DAsk the patient to stand and pivot without help
5.优先排序与委派中等

Straight after birth, what is the first priority for a healthy-looking newborn?

  1. AGive the vitamin K injection before anything else is done
  2. BWeigh and measure the baby on the scale
  3. CDry and warm the baby while checking that it is breathing
  4. DGive the first bath to remove the blood and vernix
6.优先排序与委派困难

一名心力衰竭患者气短，双肺有湿啰音。哪种行动顺序是正确的？

  1. A先给定时的口服药物，然后让患者坐起
  2. B坐起，按医嘱给氧，然后联系医疗人员
  3. C先称体重，4 小时后再重新评估呼吸
  4. D让患者平躺休息，然后开始静脉维持液体
7.临床护理中等

Which blood result often rises in an upper GI bleed because blood is digested in the gut?

  1. ASodium
  2. BUrea (blood urea nitrogen)
  3. CCalcium
  4. DGlucose
8.临床护理困难

An older patient has fallen several times since starting a new medicine. Which drug group is most likely to contribute?

  1. ALubricating eye drops
  2. BEmollient creams applied to the legs
  3. CBenzodiazepine sleeping tablets
  4. DVitamin D supplements
9.实验室检查值与电解质中等

A patient on a heparin infusion has an aPTT below the target range on the protocol. What should the nurse do?

  1. ASwitch the infusion to oral warfarin without a prescription
  2. BAdjust the rate as the protocol directs and recheck as scheduled
  3. CContinue the same rate and recheck the aPTT in a few days
  4. DStop the infusion and give protamine sulfate as quickly as possible
10.实验室检查值与电解质困难

Which set of results most strongly suggests hemolytic anemia?

  1. ALow hemoglobin, high MCV, low vitamin B12, normal bilirubin
  2. BLow hemoglobin, low reticulocytes, low MCV, low ferritin
  3. CLow hemoglobin, high reticulocytes, high unconjugated bilirubin, high LDH
  4. DLow hemoglobin, low platelets, low white cells, low reticulocytes
11.药理学中等

A parent will give a liquid medicine to a child at home. Which advice is safest?

  1. AUse the oral syringe or measuring cup supplied with it
  2. BMix the dose into a full bottle of milk
  3. CUse any kitchen teaspoon
  4. DEstimate the dose by pouring the liquid into a small cup
12.药理学困难

A man on long-term testosterone therapy has a rising haematocrit. Why is this important?

  1. AA high haematocrit shows that the testosterone is not being absorbed
  2. BIt means the testosterone dose is too low
  3. CIt is a sign of liver failure caused by testosterone
  4. DTestosterone raises red cell production, increasing clot risk
13.内外科护理：心血管与呼吸中等

Why should a long-acting beta-2 agonist (LABA) never be used alone in asthma?

  1. AIt works only when it is taken together with a course of antibiotics
  2. BIt always causes immediate severe bronchospasm when used on its own
  3. CWithout an inhaled steroid, it is linked with severe and fatal attacks
  4. DIt cannot be inhaled without a nebuliser
14.内外科护理：心血管与呼吸困难

A nurse looked after a patient for a shift before smear-positive pulmonary TB was diagnosed, without wearing a respirator. What should happen?

  1. AStart a full six-month course of TB drugs at once without any tests
  2. BStay off work for six months in case symptoms develop
  3. CTake no action, as healthcare workers are immune to TB
  4. DReport it so occupational health can arrange follow-up screening
15.内外科护理：神经、内分泌与肾脏中等

Which statement about the PSA blood test is correct?

  1. AIt can be raised by benign problems as well as by cancer
  2. BA raised result always means prostate cancer
  3. CA normal result always rules out any prostate cancer
  4. DIt is only raised in women with bladder cancer
16.内外科护理：神经、内分泌与肾脏困难

A patient with an external ventricular drain sat up in bed without help. The drain stayed at its old height, and the drainage bag filled quickly. The patient now has a headache. What is the concern?

  1. AUnderdrainage, so the drain should be lowered further
  2. BNo concern, because more drainage always lowers the ICP safely
  3. CAn infected drain, so the dressing should be removed
  4. DOverdrainage of CSF, so act per protocol and inform the team
17.内外科护理：消化、围手术期与肿瘤中等

麻醉期间，恶性高热最早的征象通常是什么？

  1. A呼气末 CO₂ 无法解释地升高
  2. B皮肤潮红，同时 CO₂ 水平下降
  3. C体温持续下降
  4. D心率减慢、血压降低
18.内外科护理：消化、围手术期与肿瘤困难

一名高压电损伤的患者有小的入口和出口伤口。为什么需要密切监测？

  1. A隐匿的肌肉损伤：心律失常、横纹肌溶解、肾损伤
  2. B电损伤从不造成皮肤表面以下的损害
  3. C皮肤伤口小，说明内部损伤也一定很轻
  4. D唯一真正的风险是皮肤伤口的轻微感染
19.产科护理中等

A woman is 5 days after birth. She cries often, sleeps poorly when the baby sleeps and feels she is a bad mother. What should the nurse do?

  1. ATell her partner to take over all baby care
  2. BScreen further for depression and self-harm
  3. CTell her this is the baby blues and will pass
  4. DAdvise her to stop breastfeeding to rest
20.产科护理困难

A woman at 29 weeks is in preterm labour and is given magnesium sulfate. What is the main reason for giving it at this gestation?

  1. ATo prevent eclamptic seizures
  2. BTo reduce the baby's risk of cerebral palsy
  3. CTo treat a urinary tract infection
  4. DTo speed up fetal lung maturation
21.儿科护理中等

A 6-month-old's left eye turns inwards all the time. What should the nurse do?

  1. ACover the right eye with a patch at home without review
  2. BAdvise them to wait until the child can read letters
  3. CRefer the baby to an eye specialist
  4. DReassure the parents that this always resolves by school age
22.儿科护理困难

A child recovering from acute rheumatic fever with heart involvement asks why she needs regular penicillin for years. What is the best answer?

  1. ATo cure the heart valve damage that has already occurred and let the valves heal completely
  2. BTo reduce the joint pain that continues after the illness
  3. CTo prevent new strep infections that could cause further attacks and more valve damage
  4. DTo prevent common viral colds during the school year
23.精神科护理中等

A patient taking phenelzine, an MAOI, is being taught before discharge. Which statement shows a need for further teaching?

  1. A"I'll tell any new doctor or dentist that I take an MAOI."
  2. B"A sudden severe headache is a reason to get help straight away."
  3. C"I'll avoid aged cheese and cured meats."
  4. D"I can take any cold and flu remedy from the pharmacy."
24.精神科护理困难

A caller says she is a patient's sister and asks how he is doing. The patient has not given consent to share information. What should the nurse do?

  1. ATell her that he is on the ward but refuse to say anything else about his care or condition
  2. BNeither confirm nor deny that he is there, and offer to pass on a message
  3. CGive a full update, because she is a close family member
  4. DAsk her to prove she is his sister and then share the details
25.护理数学与单位换算中等
90.149 gtt/min? gtt/min取整到 1 gtt/min

练习题（虚构数值，不作为临床指导）。 一次滴速计算得到 90.149 gtt/min。 本练习的规则是：滴速取整到最接近的整滴。你记录的数值x是多少？

90.149 gtt/min
x = gtt/min
26.护理数学与单位换算困难
10 mg/h? mcg/min1 mg = 1000 mcg1 h = 60 min

练习题（虚构数值，不作为临床指导）。 一次输注的给药速率为 10 mg/h。请把这个剂量速率D用 mcg/min 表示。取到一位小数。

10 mg/h1 mg = 1000 mcg1 h = 60 min
D = mcg/min
27.剂量计算中等
25 kg2 mg/kgD = ? mg

某患者体重 25 kg，医嘱为单次给药 2 mg/kg。求剂量 D（mg）。

25 kg2 mg/kg
D = mg
28.剂量计算困难
50k 件1000 mL? mL/h1500 件/h

一袋输液在 1000 mL 中含 50000 单位药物。医嘱为每小时 1500 单位。泵速 R 应设为多少 mL/h？

50000 件/1000 mL1500 件/h
R = mL/h
29.静脉输液速度中等
870 mL剩余? mL/h3 h 剩余

医嘱要求在 6 小时内输入 1500 mL。3 小时后你发现袋中还剩 870 mL，而输液仍须按时完成。 必须把泵重新设定为多少 mL/h 的速率 R？

1500 mL / 6 h经过 3 h: 870 mL
R = mL/h
30.静脉输液速度困难
250 mg250 mL25 mL/h? mg/h

一袋液体在 250 mL 中含药 250 mg，以 25 mL/h 的速度输注。患者每小时获得多少毫克 D？

250 mg/250 mL25 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240 mL果汁150 mL冰屑200 mL静脉输液60 mL/h × 8 h静脉抗生素1 × 50 mL尿液275 mL尿液175 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。 冰屑按其体积的一半计。

牛奶: 240 mL果汁: 150 mL冰屑: 200 mL静脉输液: 60 mL/h × 8 h静脉抗生素: 1 × 50 mL
I = mL
32.静脉输液与液体平衡困难
500 mL→ 50 mL/h开始 10:30t总数​ = ? h100 mL/h × 2 h

练习题（虚构数值，不作为临床指导）。 一份 500 mL 的输液于 10:30 开始以 100 mL/h 输注。2 小时后速率改为 50 mL/h，之后不再改变。从开始算起多少小时 t 后袋子会输完？ 保留一位小数。

500 mL100 mL/h · 2 h50 mL/h
t = h
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仅对压迫（疼痛刺激）睁眼，只发出无法理解的声音，如呻吟，最佳运动反应表现为：手臂和腿伸直（异常伸展）。 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
体重过轻健康体重超重肥胖 I 级肥胖 II 级肥胖 III 级

练习题（虚构数值，不作为临床指导）。 一名成人体重 67 kg，身高 176 cm。计算 BMI 并点击 WHO 体重分类。

67 kg176 cm
  1. 1体重过轻
  2. 2健康体重
  3. 3超重
  4. 4肥胖 I 级
  5. 5肥胖 II 级
  6. 6肥胖 III 级

3溶液

1.护理学基础

答案: D · Explain that they have not been trained and ask for supervision

为什么是这个答案

Nurses and students must only practise within their competence. Saying so, and asking to observe or be supervised, protects the patient and the student.

答案

D · Explain that they have not been trained and ask for supervision
2.护理学基础

答案: A · "I'll take the gown off at home after I leave the hospital."

为什么是这个答案

PPE is removed in or at the door of the patient's room and disposed of there, followed by hand hygiene. Wearing it out of the room spreads the organism.

答案

A · "I'll take the gown off at home after I leave the hospital."
3.感染控制与患者安全

答案: D · 口服注射器无法接入静脉管路，可防止给药途径错误

为什么是这个答案

口服和肠内注射器的接头与静脉接口不匹配，因此口服液体不会被误注入静脉。口服液体的给药途径错误曾导致死亡。

答案

D · 口服注射器无法接入静脉管路，可防止给药途径错误
4.感染控制与患者安全

答案: C · Use bariatric-rated equipment and enough trained staff

为什么是这个答案

Using equipment above its rated capacity can cause collapse and injury. Bariatric lifts, chairs and beds are used, with enough trained staff and a plan agreed in advance.

答案

C · Use bariatric-rated equipment and enough trained staff
5.优先排序与委派

答案: C · Dry and warm the baby while checking that it is breathing

为什么是这个答案

Breathing and keeping warm come first. Drying stimulates breathing and reduces heat loss; skin-to-skin contact helps. Weighing and routine injections can wait.

答案

C · Dry and warm the baby while checking that it is breathing
6.优先排序与委派

答案: B · 坐起，按医嘱给氧，然后联系医疗人员

为什么是这个答案

坐直可减少回心血量并缓解呼吸，氧气治疗缺氧。然后联系医疗人员并准备利尿剂。平躺或静脉补液会加重肺淤血。

答案

B · 坐起，按医嘱给氧，然后联系医疗人员
7.临床护理

答案: B · Urea (blood urea nitrogen)

为什么是这个答案

Blood proteins digested in the upper GI tract are absorbed and converted to urea, so urea rises out of proportion to creatinine. Urea is part of the Glasgow-Blatchford bleeding score.

答案

B · Urea (blood urea nitrogen)
8.临床护理

答案: C · Benzodiazepine sleeping tablets

为什么是这个答案

Sedatives, hypnotics, antipsychotics and drugs that lower blood pressure increase falls risk. A medication review is part of every falls assessment.

答案

C · Benzodiazepine sleeping tablets
9.实验室检查值与电解质

答案: B · Adjust the rate as the protocol directs and recheck as scheduled

为什么是这个答案

A subtherapeutic aPTT means the patient is not fully anticoagulated and is at risk of clot extension. Weight-based heparin protocols specify a bolus and/or rate increase and when to recheck. The nurse follows the protocol and documents the change.核对依据: Partial Thromboplastin Time (PTT) Test · MedlinePlus (NIH) (2026); Partial thromboplastin time (PTT) - Medical Encyclopedia · MedlinePlus (NIH) (2025)

答案

B · Adjust the rate as the protocol directs and recheck as scheduled
10.实验室检查值与电解质

答案: C · Low hemoglobin, high reticulocytes, high unconjugated bilirubin, high LDH

为什么是这个答案

When red cells break down early, hemoglobin is turned into unconjugated bilirubin and LDH is released, while the marrow increases reticulocytes. Option B fits iron deficiency, C fits B12 deficiency and D fits marrow failure.核对依据: Hemolytic anemia · MedlinePlus (NIH) (2026); Reticulocyte Count · MedlinePlus (NIH) (2024); Bilirubin Blood Test · MedlinePlus (NIH) (2024)

答案

C · Low hemoglobin, high reticulocytes, high unconjugated bilirubin, high LDH
11.药理学

答案: A · Use the oral syringe or measuring cup supplied with it

为什么是这个答案

Kitchen spoons are inaccurate and can cause under- or overdosing. Oral syringes in millilitres are the most accurate, and mixing doses into a whole bottle risks the child not getting the full dose.

答案

A · Use the oral syringe or measuring cup supplied with it
12.药理学

答案: D · Testosterone raises red cell production, increasing clot risk

为什么是这个答案

Testosterone increases erythropoiesis and can cause polycythaemia, which increases blood viscosity and thrombosis risk. Haematocrit is monitored, and the dose may be reduced or paused.

答案

D · Testosterone raises red cell production, increasing clot risk
13.内外科护理：心血管与呼吸

答案: C · Without an inhaled steroid, it is linked with severe and fatal attacks

为什么是这个答案

LABA monotherapy in asthma is linked with severe attacks and asthma deaths because it relieves symptoms while airway inflammation continues. In asthma, LABAs are always given with an inhaled corticosteroid, often in one combination inhaler.

答案

C · Without an inhaled steroid, it is linked with severe and fatal attacks
14.内外科护理：心血管与呼吸

答案: D · Report it so occupational health can arrange follow-up screening

为什么是这个答案

Contact tracing includes staff exposed without respiratory protection. Occupational health assesses the risk, checks for symptoms and arranges testing (for example IGRA) at suitable intervals. Treatment is offered for latent infection if found. Exposed people do not usually need to stop work unless they become unwell.

答案

D · Report it so occupational health can arrange follow-up screening
15.内外科护理：神经、内分泌与肾脏

答案: A · It can be raised by benign problems as well as by cancer

为什么是这个答案

PSA can rise with BPH, prostatitis, UTI, recent ejaculation or instrumentation, as well as cancer. A normal level does not exclude cancer. Results are interpreted with symptoms, examination and other tests.

答案

A · It can be raised by benign problems as well as by cancer
16.内外科护理：神经、内分泌与肾脏

答案: D · Overdrainage of CSF, so act per protocol and inform the team

为什么是这个答案

When the head rises above the drain level, CSF drains faster. Overdrainage can cause headache, collapse of the ventricles or a subdural bleed. The nurse follows the protocol (often clamping briefly and re-levelling) and informs the neurosurgical team.

答案

D · Overdrainage of CSF, so act per protocol and inform the team
17.内外科护理：消化、围手术期与肿瘤

答案: A · 呼气末 CO₂ 无法解释地升高

为什么是这个答案

恶性高热是对挥发性麻醉药和琥珀酰胆碱的遗传性反应。早期征象包括呼气末 CO₂ 升高、心动过速和肌肉强直（常为咬肌）；高热往往是晚期征象。治疗是停用触发药物并给予丹曲林。

答案

A · 呼气末 CO₂ 无法解释地升高
18.内外科护理：消化、围手术期与肿瘤

答案: A · 隐匿的肌肉损伤：心律失常、横纹肌溶解、肾损伤

为什么是这个答案

电流沿神经、血管和肌肉传导，在小的皮肤伤口下造成深部损伤。患者需要心电监护、评估骨筋膜室综合征，以及检查尿中肌红蛋白（尿色深），如存在肌红蛋白尿，则提高尿量目标。

答案

A · 隐匿的肌肉损伤：心律失常、横纹肌溶解、肾损伤
19.产科护理

答案: B · Screen further for depression and self-harm

为什么是这个答案

Insomnia even when the baby sleeps and feelings of worthlessness can point to depression. The nurse should screen further, including asking directly about self-harm, and arrange follow-up.

答案

B · Screen further for depression and self-harm
20.产科护理

答案: B · To reduce the baby's risk of cerebral palsy

为什么是这个答案

Before about 32 weeks, magnesium sulfate given when preterm birth is imminent reduces the risk of cerebral palsy. It is a neuroprotective use, separate from seizure prevention in pre-eclampsia.

答案

B · To reduce the baby's risk of cerebral palsy
21.儿科护理

答案: C · Refer the baby to an eye specialist

为什么是这个答案

An occasional squint is common in the first months, but a constant squint, or any squint after about 4–6 months, needs specialist assessment. Without treatment, the brain may suppress the image from the turning eye, causing amblyopia.

答案

C · Refer the baby to an eye specialist
22.儿科护理

答案: C · To prevent new strep infections that could cause further attacks and more valve damage

为什么是这个答案

Recurrent episodes of rheumatic fever follow new group A streptococcal infections and worsen rheumatic heart disease. Long-term secondary prophylaxis with penicillin prevents these infections; it does not reverse existing damage.

答案

C · To prevent new strep infections that could cause further attacks and more valve damage
23.精神科护理

答案: D · "I can take any cold and flu remedy from the pharmacy."

为什么是这个答案

Decongestants such as pseudoephedrine are sympathomimetics and can cause a hypertensive crisis with MAOIs. Patients should check any new medicine, including over-the-counter remedies, with a pharmacist or prescriber.

答案

D · "I can take any cold and flu remedy from the pharmacy."
24.精神科护理

答案: B · Neither confirm nor deny that he is there, and offer to pass on a message

为什么是这个答案

Without the patient's consent, the nurse should not disclose that a person is receiving mental health care. Offering to pass on a message respects confidentiality while allowing the patient to decide.

答案

B · Neither confirm nor deny that he is there, and offer to pass on a message
25.护理数学与单位换算

答案: x = 90 gtt/min

取整：看舍入位后面的那个数字：5 或更大则进位，4 或更小则保持原数字不变。只对最终答案取整，绝不对中间步骤取整。典型的考试规则：1 mL 或以上的体积取到十分位，低于 1 mL 的体积取到百分位，滴速取整到整滴，体重取到一位小数；务必遵循题目所规定的规则。

1 位位上的数字

90.149 → 0

只看下一位数字

90.149 → 1
1 小于或等于 4，所以 0 不变。
后面的数字（49）不考虑：只取整一次，不要逐位取整。

取整

x = 90 gtt/min

答案

x = 90 gtt/min
26.护理数学与单位换算

答案: D = 166.7 mcg/min

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。

列出换算链

D = 10 mg/h × (1000 mcg/1 mg) × (1 h/60 min)

计算

D = 10000/60 = 166.7 mcg/min

答案

D = 166.7 mcg/min
27.剂量计算

答案: D = 50 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

2·25 = 50 mg

答案

D = 50 mg
28.剂量计算

答案: R = 30 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

50000/1000 = 50 件/mL

泵速

R = 1500/50 = 30 mL/h

答案

R = 30 mL/h
29.静脉输液速度

答案: R = 290 mL/h

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

1500/6 = 250 mL/h

新速率

R = 870/3 = 290 mL/h

答案

R = 290 mL/h

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。

30.静脉输液速度

答案: D = 25 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

250/250 = 1 mg/mL

给药速率

D = 1·25 = 25 mg/h

答案

D = 25 mg/h
31.静脉输液与液体平衡

答案: I = 1020 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: 240 + 150 = 390 mL
冰屑: 200/2 = 100 mL
静脉输液: 60·8 = 480 mL
静脉抗生素: 1·50 = 50 mL
I = 1020 mL

答案

I = 1020 mL
32.静脉输液与液体平衡

答案: t = 8 h

输液时间：时间 (h) = 待输体积 (mL)/速率 (mL/h)；使用袋中剩余的体积，而不是袋的容量。已输入体积 = 速率 × 时间。把小数小时换算为小时和分钟时，用小数部分 × 60（0.5 h = 30 min，而不是 50 min）。 这些数字仅供练习；在临床工作中务必遵循当地规程，高危剂量须经双人核对。

第一部分

100·2 = 200 mL
500 − 200 = 300 mL 剩余

第二部分

300/50 = 6 h

总时间

t = 2 + 6 = 8 h

答案

t = 8 h

约为 8 h 00 min，所以袋子大约在 18:30 输完。

33.临床评估评分

答案: 重度

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: 仅对压迫（疼痛刺激）睁眼 → 2
V: 只发出无法理解的声音，如呻吟 → 2
M: 手臂和腿伸直（异常伸展） → 2

相加

GCS = 2 + 2 + 2 = 6

严重程度

GCS 6 → 重度

答案

重度
34.临床评估评分

答案: 健康体重

体质指数：BMI = 体重（kg）/身高（m）²，身高要先换算为米。使用磅和英寸时，BMI = 703 × 体重（lb）/身高（in）²。WHO 成人分类：低于 18.5 为体重过轻，18.5–24.9 为健康体重，25.0–29.9 为超重，30.0–34.9 为肥胖 I 级，35.0–39.9 为肥胖 II 级，40 及以上为肥胖 III 级。

BMI

BMI = 67/1.76² = 21.63

分类

健康体重

答案

健康体重

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