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 rectal suppository be inserted?

  1. AAfter the patient has stood up and bent forward
  2. BInto the middle of the stool in the rectum so it softens it
  3. CJust inside the anus, without passing the sphincter
  4. DPast the internal sphincter, against the rectal wall
2.护理学基础困难

According to the gate control theory, why can rubbing a bumped elbow ease the pain?

  1. ARubbing makes the elbow numb by stopping its blood supply
  2. BRubbing increases the release of pain chemicals so the nerves tire out
  3. CTouch signals reduce pain signals passing up the spinal cord
  4. DRubbing removes the damaged tissue from the elbow
3.感染控制与患者安全中等

A patient with a fentanyl skin patch wants to use a heating pad on the area. What should the nurse teach?

  1. AHeat makes the patch last longer, so fewer patches are needed each month
  2. BHeat is fine to use, because it helps the patch stick better to the skin
  3. CAvoid heat on or near the patch, because it increases how fast the drug is absorbed
  4. DHeat only matters if the patch is on the chest
4.感染控制与患者安全困难

In START triage, a casualty cannot walk and is breathing 36 times a minute. Which category applies?

  1. ABlack (expectant or dead)
  2. BYellow (delayed)
  3. CGreen (minor)
  4. DRed (immediate)
5.优先排序与委派中等

Two nursing assistants argue loudly at the station about their assignments. What is the charge nurse’s best first step?

  1. AChange both of their assignments without any discussion
  2. BIgnore it and hope they sort it out
  3. CReport them to human resources at once
  4. DMeet both of them privately to hear each side
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. AStop the oxytocin infusion
  2. BEncourage the patient to start pushing
  3. CIncrease the oxytocin rate
  4. DPlace the patient flat on her back
7.临床护理中等

A nurse suspects that an older patient is being financially abused by a relative. What should the nurse do?

  1. AConfront the relative directly at the bedside about it
  2. BRaise the concern through the local safeguarding (adult protection) procedure
  3. CKeep it secret because it is a family matter
  4. DWait until the patient has been discharged
8.临床护理困难

Why should chronic hypernatraemia be corrected gradually?

  1. ALowering the sodium too fast can cause cerebral oedema
  2. BFast correction causes severe hyperkalaemia
  3. CSlow correction is only needed in children
  4. DFast correction causes osmotic demyelination from swelling of the kidneys
9.实验室检查值与电解质中等

A patient takes high-dose furosemide. Besides potassium, which electrolyte is most commonly lowered?

  1. AMagnesium
  2. BSodium bicarbonate
  3. CPhosphate
  4. DUric acid
10.实验室检查值与电解质困难

一名服用噻嗪类利尿剂的患者钠 129 mEq/L，钾 3.2 mEq/L，感觉乏力。哪种解释最合适？

  1. A患者只是静脉输液导致水过多
  2. B这些结果是肾衰竭的典型表现
  3. C利尿剂导致钠和钾丢失
  4. D患者有原发性醛固酮增多症，钠高
11.药理学中等

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

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

A patient with Parkinson's disease has nausea. Why should metoclopramide be avoided?

  1. AIt blocks dopamine receptors in the brain and can worsen the parkinsonism
  2. BIt causes severe diarrhoea in Parkinson's disease
  3. CIt inhibits the absorption of all oral drugs
  4. DIt increases dopamine levels in the brain too much and causes psychosis
13.内外科护理：心血管与呼吸中等

A patient has pneumonia in the right lung only. In which side-lying position will oxygenation usually be best?

  1. ALying on the right side, with the affected lung down
  2. BFlat on the back with no pillows
  3. CProne with the head down
  4. DLying on the left side, with the healthy lung down
14.内外科护理：心血管与呼吸困难

Shortly after a thoracentesis, a patient becomes breathless with sharp chest pain and reduced breath sounds on the same side. What complication is most likely?

  1. APulmonary embolism from the leg
  2. BRe-accumulation of the effusion
  3. CInfection at the puncture site
  4. DPneumothorax
15.内外科护理：神经、内分泌与肾脏中等

A patient with multiple sclerosis says their symptoms get worse after a hot bath. What should the nurse explain?

  1. AThey should take very cold baths to reverse the damage
  2. BHeat can briefly worsen MS symptoms, which settle when they cool down
  3. CThis shows that the disease has entered a new progressive stage
  4. DHot baths cause new areas of damage in the brain
16.内外科护理：神经、内分泌与肾脏困难

Which task can the registered nurse delegate to a trained healthcare assistant (nursing assistant)?

  1. ATeaching a new patient how to inject insulin
  2. BChecking pre-meal glucose and reporting results out of range
  3. CAssessing a confused patient whose glucose is 2.6 mmol/L (47 mg/dL)
  4. DDeciding the dose of correction insulin from the glucose result
17.内外科护理：消化、围手术期与肿瘤中等

Which monitoring is especially important for a patient receiving parenteral nutrition?

  1. ABlood glucose and signs of line infection
  2. BBowel sounds and stool colour only
  3. CPupil size and limb strength
  4. DPeak flow and visual acuity
18.内外科护理：消化、围手术期与肿瘤困难

Four hours after surgery, a catheterised patient's urine output has been 10 mL/h for two hours. Vital signs are stable. What should the nurse check first?

  1. AThat the catheter and tubing are not kinked or blocked
  2. BThe time the patient last ate
  3. CWhether the patient wants a cup of tea
  4. DYesterday's chest X-ray and blood gas results
19.产科护理中等

Why is a baby of a mother with poorly controlled diabetes often large?

  1. AFetal hyperinsulinaemia acts as a growth hormone
  2. BThe baby inherits a gene for large size
  3. CDiabetes always prolongs the pregnancy
  4. DThe mother's insulin crosses the placenta
20.产科护理困难

一名正在使用硫酸镁的女性的伴侣询问这种药是做什么用的。哪个回答是准确的？

  1. A它有助于预防子痫前期引起的抽搐
  2. B它加快产程
  3. C它防止婴儿长得过大
  4. D它是降低她血压的主要药物
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 cut a first tooth
  3. CStarts waking more often during the night and seems hungry after milk feeds
  4. DHas reached 6 weeks of age
22.儿科护理困难

An infant with heart failure is breathing fast and working hard. Which position helps most?

  1. ALying flat on the left side only
  2. BSemi-upright, with the head and chest raised
  3. CProne with the head turned to the side
  4. DFlat on the back with the legs raised
23.精神科护理中等

为什么不推荐把“不自杀协议”作为一种安全措施？

  1. A它们在所有地方都是非法的
  2. B没有证据表明它们能预防自杀，而且可能带来虚假的安心感
  3. C它们太长太复杂，大多数患者读不下去，所以很少有患者签署
  4. D它们只适用于儿童
24.精神科护理困难

A patient says, "I don't have a drinking problem. I only drink at weekends, like everyone else." He drinks heavily every weekend. Which approach fits his stage of change best?

  1. AHelp him set a quit date for next week
  2. BRefer him straight to a residential detox programme
  3. COffer non-judgemental information and explore how drinking affects his life
  4. DDiscuss detailed strategies to prevent a relapse after he has stopped drinking
25.护理数学与单位换算中等
12345678910111220:25?8:25 AM10:25 PM7:25 PM8:25 PM

练习题（虚构数值，不作为临床指导）。 一个剂量记录在 20:25（24 小时制）。哪个条目是 12 小时制中的同一时间？点击它。

20:25
  1. 18:25 AM
  2. 210:25 PM
  3. 37:25 PM
  4. 48:25 PM
26.护理数学与单位换算困难
00:0020:1505:05t = ?

练习题（虚构数值，不作为临床指导）。 一次输注从 20:15 开始，到次日早晨 05:05 结束（24 小时制）。它运行了多少分钟t？

20:1505:05
t = min
27.剂量计算中等
1:1000安瓿V = ? mL

一支肾上腺素安瓿标示为 1:1000（1 mg/mL）。医嘱为 0.5 mg 肌内注射（IM），用于严重过敏反应。你应抽取多少体积 V？

1:10000.5 mg
V = mL
28.剂量计算困难
125 mg/5 mLV = ? mL

一名患者体重 101.2 lb。医嘱为单次剂量 10 mg/kg，储备液为 5 mL 中含 125 mg。按 1 kg = 2.2 lb 计算，你应给予多少容量 V？

101.2 lb10 mg/kg125 mg/5 mL1 kg = 2.2 lb
V = mL
29.静脉输液速度中等
1500 mL10 gtt/mL5 h? gtt/min

用滴系数为 10 滴/mL 的输液器在 5 小时内输入 1500 mL。求滴速 R（滴/分）。

1500 mL5 h10 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 小时班次汤200 mL牛奶100 mL冰屑240 mL静脉输液125 mL/h × 12 h静脉抗生素2 × 100 mL尿液325 mL尿液450 mL尿液400 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 12 小时班次中的出入量。患者体重 81 kg。求平均尿量 U，以 mL/kg/h 计。 保留两位小数。

81 kg12 h尿液: 325 mL尿液: 450 mL尿液: 400 mL伤口引流: 120 mL
U = mL/kg/h
32.静脉输液与液体平衡困难
1000 mL100 mL/h开始 13:0018:30: ? mL

练习题（虚构数值，不作为临床指导）。 一袋 1000 mL 的液体于 13:00 开始用输液泵以 100 mL/h 输注。到 18:30 时袋中还剩多少 mL V？

1000 mL100 mL/h13:00 → 18:30
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自发睁眼，对人物、地点和时间定向正常，最佳运动反应表现为：把手移到受压部位（定位）。 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 79 kg，身高 158 cm。计算 BMI 并点击 WHO 体重分类。

79 kg158 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 · Past the internal sphincter, against the rectal wall

为什么是这个答案

The suppository is pushed past the internal anal sphincter and placed against the rectal wall, usually with the patient lying on the left side. Placing it in stool stops absorption.

答案

D · Past the internal sphincter, against the rectal wall
2.护理学基础

答案: C · Touch signals reduce pain signals passing up the spinal cord

为什么是这个答案

The gate control theory proposes that input from touch fibres "closes the gate" in the dorsal horn of the spinal cord, reducing pain transmission. This underlies massage and TENS.

答案

C · Touch signals reduce pain signals passing up the spinal cord
3.感染控制与患者安全

答案: C · Avoid heat on or near the patch, because it increases how fast the drug is absorbed

为什么是这个答案

Heat from heating pads, electric blankets, hot tubs or fever increases fentanyl absorption and can cause an overdose. Patients are taught to avoid heat over the patch.

答案

C · Avoid heat on or near the patch, because it increases how fast the drug is absorbed
4.感染控制与患者安全

答案: D · Red (immediate)

为什么是这个答案

In START, a non-walking casualty who is breathing more than 30 times a minute is tagged red, immediate. Fast breathing suggests a serious problem that needs urgent treatment.

答案

D · Red (immediate)
5.优先排序与委派

答案: D · Meet both of them privately to hear each side

为什么是这个答案

Talking with both staff members privately allows the charge nurse to understand the problem and look for a fair solution. Ignoring the conflict or acting without facts usually makes it worse.

答案

D · Meet both of them privately to hear each side
6.优先排序与委派

答案: A · 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

A · Stop the oxytocin infusion
7.临床护理

答案: B · Raise the concern through the local safeguarding (adult protection) procedure

为什么是这个答案

Financial abuse is a form of adult abuse. Nurses report concerns through safeguarding procedures, document facts accurately and involve the patient as appropriate.

答案

B · Raise the concern through the local safeguarding (adult protection) procedure
8.临床护理

答案: A · Lowering the sodium too fast can cause cerebral oedema

为什么是这个答案

In chronic hypernatraemia, brain cells adapt by holding extra solutes. If sodium falls too quickly, water moves into brain cells and causes cerebral oedema, so correction is controlled.

答案

A · Lowering the sodium too fast can cause cerebral oedema
9.实验室检查值与电解质

答案: A · Magnesium

为什么是这个答案

Loop diuretics block the Na-K-2Cl transporter in the loop of Henle, where much magnesium and calcium are also reabsorbed. They therefore commonly cause hypokalemia and hypomagnesemia, and they can raise uric acid and bicarbonate.核对依据: Magnesium Blood Test · MedlinePlus (NIH) (2023)

答案

A · Magnesium
10.实验室检查值与电解质

答案: C · 利尿剂导致钠和钾丢失

为什么是这个答案

噻嗪类利尿剂常引起低钠血症和低钾血症，尤其是在老年人中。护士应报告结果，开医嘱者会复核药物和电解质补充。核对依据: Thiazide Diuretics · StatPearls (NCBI Bookshelf) (2025)

答案

C · 利尿剂导致钠和钾丢失
11.药理学

答案: D · 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

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

答案: A · It blocks dopamine receptors in the brain and can worsen the parkinsonism

为什么是这个答案

Metoclopramide crosses the blood–brain barrier and antagonises D2 receptors. In Parkinson's disease this worsens rigidity and bradykinesia, so antiemetics that do not block central dopamine receptors are preferred.

答案

A · It blocks dopamine receptors in the brain and can worsen the parkinsonism
13.内外科护理：心血管与呼吸

答案: D · Lying on the left side, with the healthy lung down

为什么是这个答案

Blood flow goes preferentially to the dependent lung. Placing the healthy lung down matches more blood to the well-ventilated lung, improving oxygenation ("good lung down"). Exceptions include a lung abscess or bleeding, when the affected lung is placed down to protect the healthy one.

答案

D · Lying on the left side, with the healthy lung down
14.内外科护理：心血管与呼吸

答案: D · Pneumothorax

为什么是这个答案

Pneumothorax is a common complication of thoracentesis, caused by the needle puncturing the lung or air entering the chest. The nurse assesses the patient, gives oxygen and informs the team, who will arrange a chest X-ray. An effusion re-accumulates over days, and infection appears later.

答案

D · Pneumothorax
15.内外科护理：神经、内分泌与肾脏

答案: B · Heat can briefly worsen MS symptoms, which settle when they cool down

为什么是这个答案

Heat sensitivity (Uhthoff's phenomenon) is common in MS. A rise in body temperature slows conduction in demyelinated nerves and temporarily worsens symptoms. It is not a relapse, and the symptoms settle with cooling.

答案

B · Heat can briefly worsen MS symptoms, which settle when they cool down
16.内外科护理：神经、内分泌与肾脏

答案: B · Checking pre-meal glucose and reporting results out of range

为什么是这个答案

Trained assistants can measure and record glucose and report abnormal results. Dose decisions, teaching and the assessment of an unstable patient need the registered nurse.

答案

B · Checking pre-meal glucose and reporting results out of range
17.内外科护理：消化、围手术期与肿瘤

答案: A · Blood glucose and signs of line infection

为什么是这个答案

PN can cause hyperglycaemia and electrolyte disturbance, and the central line is a route for bloodstream infection. Glucose, electrolytes, fluid balance, weight and temperature are monitored closely.

答案

A · Blood glucose and signs of line infection
18.内外科护理：消化、围手术期与肿瘤

答案: A · That the catheter and tubing are not kinked or blocked

为什么是这个答案

A sudden low output may be due to a kinked tube or blocked catheter. If drainage is normal, hypovolaemia or kidney injury is considered and the team is informed, with a fluid assessment.

答案

A · That the catheter and tubing are not kinked or blocked
19.产科护理

答案: A · Fetal hyperinsulinaemia acts as a growth hormone

为什么是这个答案

Maternal glucose crosses the placenta, so the fetal pancreas makes extra insulin, which promotes growth and fat storage. After birth this extra insulin continues and can cause neonatal hypoglycaemia.

答案

A · Fetal hyperinsulinaemia acts as a growth hormone
20.产科护理

答案: A · 它有助于预防子痫前期引起的抽搐

为什么是这个答案

硫酸镁用于预防和治疗子痫抽搐。它不是有效的降压药，因此重度高血压需要另用药物。

答案

A · 它有助于预防子痫前期引起的抽搐
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: B · Semi-upright, with the head and chest raised

为什么是这个答案

A semi-upright position lowers the pressure of abdominal organs on the diaphragm and eases breathing. Raising the legs would increase venous return and may worsen pulmonary congestion.

答案

B · Semi-upright, with the head and chest raised
23.精神科护理

答案: B · 没有证据表明它们能预防自杀，而且可能带来虚假的安心感

为什么是这个答案

不自杀协议不能代替评估。推荐采用协作式安全计划、减少获得手段的途径以及必要时的密切观察。

答案

B · 没有证据表明它们能预防自杀，而且可能带来虚假的安心感
24.精神科护理

答案: C · Offer non-judgemental information and explore how drinking affects his life

为什么是这个答案

In precontemplation, the aim is to raise awareness without confrontation, for example by giving personalised feedback and exploring the pros and cons. Action-focused plans fit later stages.

答案

C · Offer non-judgemental information and explore how drinking affects his life
25.护理数学与单位换算

答案: 8:25 PM

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

换算小时

20 − 12 = 8 → PM

答案

8:25 PM

答案

8:25 PM
26.护理数学与单位换算

答案: t = 530 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

20:15 → 24:00 = 225 min

午夜之后

00:00 → 05:05 = 305 min

合计

t = 225 + 305 = 530 min

答案

t = 530 min
27.剂量计算

答案: V = 0.5 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.

浓度

1:1000 = 1 g/1000 mL = 1 mg/mL

体积

V = 0.5/1 = 0.5 mL

答案

V = 0.5 mL

美国的标签现在标示 mg/mL（1 mg/mL = 1:1000；0.1 mg/mL = 1:10 000）。切勿静脉推注 1 mg/mL 的肾上腺素。

28.剂量计算

答案: V = 18.4 mL

Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.

体重 (kg)

101.2/2.2 = 46 kg

剂量

10·46 = 460 mg

体积

V = (460/125)·5 = 18.4 mL

答案

V = 18.4 mL
29.静脉输液速度

答案: R = 50 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

5·60 = 300 min

滴速

R = 1500·10/300 = 50 gtt/min

答案

R = 50 gtt/min
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: U = 1.21 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

325 + 450 + 400 = 1175 mL

每千克每小时

U = 1175/(81·12) = 1.209 ≈ 1.21 mL/kg/h

答案

U = 1.21 mL/kg/h
32.静脉输液与液体平衡

答案: V = 450 mL

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

经过的时间

13:00 → 18:30 = 5.5 h

已输入体积

100·5.5 = 550 mL

剩余体积

V = 1000 − 550 = 450 mL

答案

V = 450 mL
33.临床评估评分

答案: 轻度

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: 自发睁眼 → 4
V: 对人物、地点和时间定向正常 → 5
M: 把手移到受压部位（定位） → 5

相加

GCS = 4 + 5 + 5 = 14

严重程度

GCS 14 → 轻度

答案

轻度
34.临床评估评分

答案: 肥胖 I 级

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 = 79/1.58² = 31.65

分类

肥胖 I 级

答案

肥胖 I 级

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