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

Where in the eye should eye drops be placed?

  1. AInto the pocket of the lower eyelid
  2. BOnto the upper eyelid while the eye is shut
  3. CInto the inner corner of the eye only
  4. DDirectly onto the centre of the cornea
2.护理学基础困难

A patient with a new colostomy has been taught stoma care. Which statement shows a need for further teaching?

  1. A"I'll cut the opening much bigger than my stoma so it doesn't rub."
  2. B"I'll dry the skin well before putting on a new bag."
  3. C"I'll check the skin around my stoma when I change the bag."
  4. D"I'll measure the stoma again as it shrinks over the next weeks."
3.感染控制与患者安全中等

A peripheral IV site is red, warm and tender along the vein. What should the nurse do?

  1. AApply a warm pack and keep using the same site
  2. BFlush the catheter harder to clear the vein and keep using the same site
  3. CIncrease the infusion rate to finish the bag sooner
  4. DRemove the catheter and insert a new one at another site if still needed
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. CAsk the patient to stand and pivot without help
  4. DUse bariatric-rated equipment and enough trained staff
5.优先排序与委派中等

Which practice makes a shift handover safest?

  1. ALeaving a sticky note on the computer screen for the next nurse
  2. BA structured format, such as SBAR, with time for questions
  3. CHanding over only the patients who had problems during the shift
  4. DA quick chat in the corridor with no notes taken
6.优先排序与委派困难

护士应首先看哪名儿童？

  1. A一名腿上打石膏、要求喝水的学龄儿童
  2. B一名 RSV 感染的婴儿，有鼻翼扇动、胸壁凹陷和 89% 的 SpO₂
  3. C一名哮喘的青少年，呼气峰流速为个人最佳值的 90%
  4. D一名体温 38.4 °C、正在玩玩具的幼儿
7.临床护理中等

A patient with anaphylaxis is hypotensive but has no breathing difficulty. How should they be positioned?

  1. AStanding up and walking around
  2. BLying face down
  3. CLying flat, with the legs raised
  4. DSitting upright with the legs dangling
8.临床护理困难

A drowsy patient in recovery is making snoring sounds and the SpO2 is falling. What is the first action?

  1. AWait for the patient to wake up fully
  2. BLie the patient face down
  3. COpen the airway with a head tilt–chin lift or jaw thrust
  4. DGive sips of oral fluid to clear the throat and wake them
9.实验室检查值与电解质中等

Which instruction is correct for a patient taking an oral potassium chloride supplement?

  1. ACrush the extended-release tablets and mix them with a little water if needed
  2. BUse a salt substitute as well, so less of the tablet is needed each day
  3. CTake it on an empty stomach with only a small sip of water to speed absorption
  4. DTake it with food and a full glass of water, and do not crush extended-release tablets
10.实验室检查值与电解质困难

Four results arrive at the same time. Which patient should the nurse see first?

  1. AINR 2.6 in a patient on warfarin for atrial fibrillation
  2. BWhite cell count 12.0 × 10³/µL on the first day after surgery
  3. CHemoglobin 10.4 g/dL (104 g/L) in a patient with stable chronic kidney disease
  4. DGlucose 48 mg/dL (2.7 mmol/L) in a patient who had insulin an hour ago
11.药理学中等

服用甲硝唑的患者通常被建议避免：

  1. A乳制品
  2. B日晒
  3. C西柚汁
  4. D饮酒
12.药理学困难

Why is adenosine used with caution in patients with asthma?

  1. AIt is broken down too slowly in asthma
  2. BIt causes severe hypertension in asthma
  3. CIt can cause bronchospasm
  4. DIt reduces the effect of inhaled steroids
13.内外科护理：心血管与呼吸中等

Why must intravenous potassium chloride never be given as a rapid push or undiluted?

  1. AIt works only when given by mouth
  2. BA sudden high potassium level can cause cardiac arrest
  3. CIt turns into solid crystals inside the vein and blocks it
  4. DIt immediately lowers the blood glucose to dangerous levels
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. APut them in the same bay so they can support each other
  2. BLet them share physiotherapy sessions and equipment
  3. CUse standard precautions only, as CF is not infectious
  4. DNurse them in separate single rooms and keep them apart
15.内外科护理：神经、内分泌与肾脏中等

一名服用达格列净（一种 SGLT2 抑制剂）的患者呕吐，血酮 4.5 mmol/L，但血糖只有 11 mmol/L。应怀疑什么？

  1. A正常血糖性糖尿病酮症酸中毒
  2. B不需要处理的正常副作用
  3. C高渗高血糖状态
  4. D呕吐引起的低血糖
16.内外科护理：神经、内分泌与肾脏困难

Near the end of a haemodialysis session, a patient has painful leg cramps and a falling blood pressure. What is the most likely cause?

  1. AThe dialysate is too cold
  2. BFluid is being removed too quickly
  3. CNot enough fluid is being removed
  4. DAn allergic reaction to the needles
17.内外科护理：消化、围手术期与肿瘤中等

Which is correct when caring for a patient with a PICC line?

  1. ALeave the external length unchecked once it is placed
  2. BFlush the line only when it blocks
  3. CUse the PICC arm for heavy lifting to keep it flexible
  4. DAvoid taking blood pressure on the arm with the line
18.内外科护理：消化、围手术期与肿瘤困难

Two days after a PEG insertion, a patient reports pain on feeding, and feed is leaking around the site. What should the nurse do?

  1. AStop the feed at once and seek urgent medical advice
  2. BGive the next medicines through the tube as usual
  3. CContinue feeding and apply a thicker dressing
  4. DIncrease the feed rate to improve nutrition
19.产科护理中等

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

  1. ACaesarean birth
  2. BBreastfeeding
  3. CNormal blood loss
  4. DEarly walking after birth
20.产科护理困难

A large for gestational age newborn of a mother with diabetes is also very red and has a high haematocrit. Which complication of this finding should the nurse watch for?

  1. ADehydration caused by vomiting
  2. BJaundice
  3. CNeural tube defects
  4. DHypothermia caused by sweating
21.儿科护理中等

A child has tinea capitis (ringworm of the scalp). Which treatment is usually needed?

  1. AAn oral antifungal medicine
  2. BShaving the head, with no medicine
  3. CA topical antifungal cream alone
  4. DOral antibiotics such as amoxicillin
22.儿科护理困难

A 2-year-old has swallowed several of his mother's iron tablets. Why is this treated as an emergency even if he looks well?

  1. AIron poisoning can cause gut bleeding, shock and liver failure hours later
  2. BIron poisoning causes only constipation, which needs an enema
  3. CIron tablets cause an immediate allergic reaction in young children
  4. DIron tablets dissolve to form a gas that blocks the airway
23.精神科护理中等

Which information is essential when documenting the use of physical restraint?

  1. AOnly the time the restraint started and the name of the nurse in charge of the shift
  2. BThe reason for it, alternatives tried, start and end times, and the observations made
  3. CThe nurse's personal opinion of the patient's character and attitude
  4. DThe full names of the other patients who saw the incident
24.精神科护理困难

一名服用氯氮平的患者体温 38.5 °C，咽痛。优先事项是什么？

  1. A紧急上报，以便在下一次给药前检查包括中性粒细胞在内的全血细胞计数
  2. B等到下一次常规血液检查
  3. C给予对乙酰氨基酚，并照常继续使用氯氮平
  4. D告诉患者这可能只是普通感冒，鼓励多喝水，并照常继续使用氯氮平
25.护理数学与单位换算中等
0.35455 mL? mL取整到 0.01 mL

练习题（虚构数值，不作为临床指导）。 一次小剂量注射的计算得到 0.35455 mL。 本练习的规则是：低于 1 mL 的体积取到最接近的百分之一 mL。你记录的数值x是多少？

0.35455 mL
x = mL
26.护理数学与单位换算困难
00:0020:1008:40t = ?

练习题（虚构数值，不作为临床指导）。 一次输注从 20:10 开始，到次日早晨 08:40 结束（24 小时制）。它运行了多少分钟t？

20:1008:40
t = min
27.剂量计算中等
12 kg5 mg/kg/天3× 每天D = ? mg

某患者体重 12 kg。医嘱剂量为每天 5 mg/kg，分 3 次等量给药。每次给多少毫克 D？

12 kg5 mg/kg/天3× 每天
D = mg
28.剂量计算困难
50%储备液水 = ? mL

你需要用 50%（w/v）储备液配制 1000 mL 2%（w/v）溶液。 必须向储备液中加入多少水 W？

C₁ = 50%C₂ = 2%V₂ = 1000 mL
W = mL
29.静脉输液速度中等
1000 mL10 gtt/mL12 h? gtt/min

用滴系数为 10 滴/mL 的输液器在 12 小时内输入 1000 mL。求滴速 R（滴/分）。 取整到最接近的整数。

1000 mL12 h10 gtt/mL
R = gtt/min
30.静脉输液速度困难
100 mg100 mL20 mL/h? mg/h

一袋液体在 100 mL 中含药 100 mg，以 20 mL/h 的速度输注。患者每小时获得多少毫克 D？

100 mg/100 mL20 mL/h
D = mg/h
31.静脉输液与液体平衡中等
入量出量12 小时班次茶240 mL果汁100 mL汤150 mL静脉输液50 mL/h × 12 h静脉抗生素1 × 50 mL尿液200 mL尿液200 mL尿液200 mL尿液325 mL伤口引流80 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。患者体重 95 kg。求平均尿量 U，以 mL/kg/h 计。 保留两位小数。

95 kg12 h尿液: 200 mL尿液: 200 mL尿液: 200 mL尿液: 325 mL伤口引流: 80 mL
U = mL/kg/h
32.静脉输液与液体平衡困难
500 mL100 mL/h开始 10:4514:15: ? mL

练习题（虚构数值，不作为临床指导）。 一袋 500 mL 的液体于 10:45 开始用输液泵以 100 mL/h 输注。到 14:15 时袋中还剩多少 mL V？

500 mL100 mL/h10:45 → 14:15
V = mL
33.临床评估评分中等
H? / 25+D? / 15+Aid? / 30+IV? / 20+G? / 20+MS? / 15Σ?

练习题（虚构数值，不作为临床指导）。 用 Morse 跌倒评分评估一位练习患者：过去 3 个月内的跌倒史: 否; 次要诊断: 是; 行走辅助: 无、卧床休息或由护士协助; 静脉输液或封管: 否; 步态: 受损; 精神状态: 了解自身局限。求 Morse 总分MFS。

0–125
MFS =
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 30 次/分，SpO₂ 99%吸室内空气，血压 130/78 mmHg，脉搏 58 次/分，清醒，体温 38.0 °C。患者属于哪个临床风险组？点击它。

RR 30SpO₂ 99%空气SBP 130HR 58AT 38.0 °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 · Into the pocket of the lower eyelid

为什么是这个答案

Drops go into the lower conjunctival sac, which is less sensitive than the cornea. Pressing gently on the inner corner afterwards reduces drainage into the nose.

答案

A · Into the pocket of the lower eyelid
2.护理学基础

答案: A · "I'll cut the opening much bigger than my stoma so it doesn't rub."

为什么是这个答案

An opening that is too large leaves skin exposed to output, causing soreness and leaks. Checking the skin, re-measuring and drying the skin are correct.

答案

A · "I'll cut the opening much bigger than my stoma so it doesn't rub."
3.感染控制与患者安全

答案: D · Remove the catheter and insert a new one at another site if still needed

为什么是这个答案

Redness, warmth and tenderness along the vein indicate phlebitis, which can lead to infection. The catheter is removed and, if IV access is still needed, a new one is placed at a different site.

答案

D · Remove the catheter and insert a new one at another site if still needed
4.感染控制与患者安全

答案: D · 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

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

答案: B · A structured format, such as SBAR, with time for questions

为什么是这个答案

Handover is a high-risk moment for errors. A structured format and the chance to ask questions help the next nurse understand each patient’s condition and priorities.

答案

B · A structured format, such as SBAR, with time for questions
6.优先排序与委派

答案: B · 一名 RSV 感染的婴儿，有鼻翼扇动、胸壁凹陷和 89% 的 SpO₂

为什么是这个答案

鼻翼扇动、凹陷和低 SpO₂ 显示呼吸窘迫，婴儿可能迅速恶化。正在玩耍的发热儿童、口渴的儿童以及峰流速接近正常的青少年都是稳定的。

答案

B · 一名 RSV 感染的婴儿，有鼻翼扇动、胸壁凹陷和 89% 的 SpO₂
7.临床护理

答案: C · Lying flat, with the legs raised

为什么是这个答案

Lying flat with the legs raised supports circulation in anaphylactic shock. Patients with breathing difficulty may prefer to sit up, but should not stand or walk, as this can cause collapse.

答案

C · Lying flat, with the legs raised
8.临床护理

答案: C · Open the airway with a head tilt–chin lift or jaw thrust

为什么是这个答案

In a drowsy patient the tongue can fall back and obstruct the airway, causing snoring. Simple airway manoeuvres, oxygen and, if needed, an airway adjunct are used while help is called.

答案

C · Open the airway with a head tilt–chin lift or jaw thrust
9.实验室检查值与电解质

答案: D · Take it with food and a full glass of water, and do not crush extended-release tablets

为什么是这个答案

Oral potassium can irritate the esophagus and stomach, so it is taken with food and plenty of fluid, and extended-release forms are swallowed whole. Most salt substitutes contain potassium chloride and can add to the risk of hyperkalemia.

答案

D · Take it with food and a full glass of water, and do not crush extended-release tablets
10.实验室检查值与电解质

答案: D · Glucose 48 mg/dL (2.7 mmol/L) in a patient who had insulin an hour ago

为什么是这个答案

Hypoglycemia after insulin can quickly cause seizures and loss of consciousness, so it is treated first. Mild anemia in CKD is expected, an INR of 2.6 is within the target range, and a slightly raised white count is common after surgery.

答案

D · Glucose 48 mg/dL (2.7 mmol/L) in a patient who had insulin an hour ago
11.药理学

答案: D · 饮酒

为什么是这个答案

甲硝唑与酒精合用可引起双硫仑样反应，表现为潮红、恶心和心悸。治疗期间及停药后短期内应避免饮酒。

答案

D · 饮酒
12.药理学

答案: C · It can cause bronchospasm

为什么是这个答案

Adenosine can trigger bronchospasm in people with asthma or COPD. Other treatment options, such as verapamil, may be chosen.

答案

C · It can cause bronchospasm
13.内外科护理：心血管与呼吸

答案: B · A sudden high potassium level can cause cardiac arrest

为什么是这个答案

Rapid or concentrated IV potassium can cause cardiac arrest. It is given diluted, by infusion, at controlled rates (often with a pump and ECG monitoring for higher rates). Concentrated ampoules are tightly controlled in hospitals because of fatal errors.

答案

B · A sudden high potassium level can cause cardiac arrest
14.内外科护理：心血管与呼吸

答案: D · 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

D · 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 · 正常血糖性糖尿病酮症酸中毒

为什么是这个答案

SGLT2 抑制剂通过增加尿糖排出来降低血糖，因此血糖仅中度升高时也可发生 DKA。任何服用这类药物且感觉不适的患者都应检查酮体，急性疾病期间应停药（病日规则）。

答案

A · 正常血糖性糖尿病酮症酸中毒
16.内外科护理：神经、内分泌与肾脏

答案: B · Fluid is being removed too quickly

为什么是这个答案

Muscle cramps and hypotension during dialysis are often due to rapid or excessive fluid removal. Staff may reduce the ultrafiltration rate and give saline per protocol. The dry weight may need to be reviewed.

答案

B · Fluid is being removed too quickly
17.内外科护理：消化、围手术期与肿瘤

答案: D · Avoid taking blood pressure on the arm with the line

为什么是这个答案

BP cuffs and tourniquets on the PICC arm can damage the line. The external length and site are checked, the dressing is kept intact, and the line is flushed and used with aseptic technique according to policy.

答案

D · Avoid taking blood pressure on the arm with the line
18.内外科护理：消化、围手术期与肿瘤

答案: A · Stop the feed at once and seek urgent medical advice

为什么是这个答案

Pain on feeding, external leakage or new bleeding soon after PEG insertion may mean feed is leaking into the peritoneum. Feeding and medicines are stopped immediately and senior review is arranged to exclude peritonitis.

答案

A · Stop the feed at once and seek urgent medical advice
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: B · Jaundice

为什么是这个答案

Polycythaemia is common in infants of diabetic mothers and SGA babies. Breakdown of the extra red cells raises bilirubin, and high viscosity can cause poor feeding, lethargy or thrombosis.

答案

B · Jaundice
21.儿科护理

答案: A · An oral antifungal medicine

为什么是这个答案

Topical creams cannot reach the fungus in the hair shafts and follicles, so tinea capitis needs an oral antifungal for several weeks, sometimes with an antifungal shampoo to reduce spread.

答案

A · An oral antifungal medicine
22.儿科护理

答案: A · Iron poisoning can cause gut bleeding, shock and liver failure hours later

为什么是这个答案

Iron overdose damages the gut lining and disrupts cell metabolism, leading to vomiting, bleeding, shock, acidosis and liver failure, sometimes after a period when the child seems better. Urgent assessment is needed; deferoxamine is used for serious poisoning.

答案

A · Iron poisoning can cause gut bleeding, shock and liver failure hours later
23.精神科护理

答案: B · The reason for it, alternatives tried, start and end times, and the observations made

为什么是这个答案

Documentation records the reason, alternatives tried, who authorised and carried out the restraint, when it started and ended, the observations made and any injuries. This supports safety and accountability.

答案

B · The reason for it, alternatives tried, start and end times, and the observations made
24.精神科护理

答案: A · 紧急上报，以便在下一次给药前检查包括中性粒细胞在内的全血细胞计数

为什么是这个答案

服用氯氮平的患者出现发热和咽痛可能提示中性粒细胞减少或粒细胞缺乏症。需要紧急做血细胞计数，由开医嘱者决定是否暂停该药。

答案

A · 紧急上报，以便在下一次给药前检查包括中性粒细胞在内的全血细胞计数
25.护理数学与单位换算

答案: x = 0.35 mL

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。

百分位位上的数字

0.35455 → 5

只看下一位数字

0.35455 → 4
4 小于或等于 4，所以 5 不变。
后面的数字（55）不考虑：只取整一次，不要逐位取整。

取整

x = 0.35 mL

答案

x = 0.35 mL
26.护理数学与单位换算

答案: t = 750 min

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。

午夜之前

20:10 → 24:00 = 230 min

午夜之后

00:00 → 08:40 = 520 min

合计

t = 230 + 520 = 750 min

答案

t = 750 min
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

5·12 = 60 mg

每次剂量

D = 60/3 = 20 mg

答案

D = 20 mg
28.剂量计算

答案: W = 960 mL

Solution strengths: a percentage strength is grams per 100 mL, so 1% = 1 g/100 mL = 10 mg/mL. A ratio strength 1:1000 means 1 g in 1000 mL = 1 mg/mL; 1:10 000 is 0.1 mg/mL. For a dilution the amount of drug stays the same: C₁·V₁ = C₂·V₂.

储备液的容量

V₁ = 2·1000/50 = 40 mL

需加水量

W = 1000 − 40 = 960 mL

答案

W = 960 mL
29.静脉输液速度

答案: R = 14 gtt/min

输注速率：输液泵按 mL/h = 体积/时间（小时）设定。重力滴注按每分钟滴数计：gtt/min = 体积 (mL) × 滴系数 (gtt/mL)/时间 (min)。 滴系数印在输液器包装上：普通输液器为 10、15 或 20 gtt/mL（输血器在美国常为 10 gtt/mL，在英国为 15），微量输液器为 60 gtt/mL。务必使用题目或包装给出的滴系数。

以分钟计的时间

12·60 = 720 min

滴速

R = 1000·10/720 = 13.89 ≈ 14 gtt/min

答案

R = 14 gtt/min

床旁取最接近的整滴：14 滴/分。

30.静脉输液速度

答案: D = 20 mg/h

输注速率：输液泵按 mL/h = 体积/时间（小时）设定。重力滴注按每分钟滴数计：gtt/min = 体积 (mL) × 滴系数 (gtt/mL)/时间 (min)。 滴系数印在输液器包装上：普通输液器为 10、15 或 20 gtt/mL（输血器在美国常为 10 gtt/mL，在英国为 15），微量输液器为 60 gtt/mL。务必使用题目或包装给出的滴系数。

浓度

100/100 = 1 mg/mL

给药速率

D = 1·20 = 20 mg/h

答案

D = 20 mg/h
31.静脉输液与液体平衡

答案: U = 0.81 mL/kg/h

出入量：入量计入所有进入体内的液体（口服液体、静脉输液、静脉用药及冲管液、管饲）；冰屑按其体积的一半计。出量计入尿液、引流液、呕吐物和其他丢失。平衡 = 总入量 − 总出量；平衡为负表示净丢失。 这些数字仅供练习；在临床工作中务必遵循当地规程，高危剂量须经双人核对。

总尿量

200 + 200 + 200 + 325 = 925 mL

每千克每小时

U = 925/(95·12) = 0.8114 ≈ 0.81 mL/kg/h

答案

U = 0.81 mL/kg/h
32.静脉输液与液体平衡

答案: V = 150 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

10:45 → 14:15 = 3.5 h

已输入体积

100·3.5 = 350 mL

剩余体积

V = 500 − 350 = 150 mL

答案

V = 150 mL
33.临床评估评分

答案: MFS = 35

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

为每个条目评分

过去 3 个月内的跌倒史: 否 → 0
次要诊断: 是 → 15
行走辅助: 无、卧床休息或由护士协助 → 0
静脉输液或封管: 否 → 0
步态: 受损 → 20
精神状态: 了解自身局限 → 0

相加

Morse 总分 = 0 + 15 + 0 + 0 + 20 + 0 = 35

答案

MFS = 35
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 30/min → 3
SpO₂ 99% → 0
吸空气 → 0
SBP 130 mmHg → 0
HR 58/min → 0
清醒 (A) → 0
T 38.0 °C → 0

总分和红色分值

NEWS2 = 3 + 0 + 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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