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 patient shouts at the nurse that nobody has told them when their operation will be. What is the best first response?

  1. ATell the patient to stop shouting or leave the ward
  2. BArgue back that the staff are very busy
  3. CWalk away until the patient calms down by themselves
  4. DStay calm, listen and acknowledge their frustration
2.护理学基础困难

The intact skin over a patient's heel is deep purple and feels boggy. What should be suspected?

  1. AA suspected deep tissue injury
  2. BA category 1 pressure ulcer that will heal by itself
  3. CA fungal skin infection
  4. DA normal bruise from a minor knock
3.感染控制与患者安全中等

Which patient has the highest risk of a burn from a heating pad?

  1. AA healthy young adult with a strained muscle
  2. BA patient with a sprained wrist who is fully alert
  3. CA patient with diabetic peripheral neuropathy
  4. DA patient recovering from a cold
4.感染控制与患者安全困难

The fire alarm sounds, but the nurse does not know where the fire is. What should the nurse do?

  1. AOpen all doors so patients can be seen easily
  2. BLeave the unit and the building to find out where the fire is
  3. CEvacuate all patients down the stairs at once, starting with those in bed
  4. DClose the doors to patient rooms, stay on the unit and wait for instructions
5.优先排序与委派中等

A patient with angina is taught to use sublingual nitroglycerin (GTN). Which statement shows a need for further teaching?

  1. A“I will sit or lie down when I take a tablet.”
  2. B“I will take five tablets one after the other before I call for help.”
  3. C“If the pain has not eased as my action plan says, I will call emergency services.”
  4. D“I will carry the tablets with me when I go out.”
6.优先排序与委派困难

A patient has a potassium of 7.0 mEq/L with peaked T waves. Several drugs are prescribed. Which one is usually given first to protect the heart?

  1. AIV calcium gluconate
  2. BIV furosemide
  3. COral potassium binder
  4. DOral sodium bicarbonate
7.临床护理中等

Which advice is important for a patient on long-term oral corticosteroids?

  1. ADo not stop them suddenly
  2. BTake them only when symptoms flare
  3. CTake them on an empty stomach at night
  4. DDouble the dose if a dose is missed
8.临床护理困难

A patient with small cell lung cancer has hyponatraemia, concentrated urine and no signs of dehydration. Which condition and first measure fit best?

  1. ACushing's syndrome, managed with potassium
  2. BSIADH, often managed first with fluid restriction
  3. CDehydration, managed with an IV fluid bolus
  4. DDiabetes insipidus, managed with extra fluids
9.实验室检查值与电解质中等

A patient with recurrent gout starts allopurinol. Which laboratory result shows that the treatment is achieving its goal?

  1. AA rising white cell count
  2. BA falling serum uric acid
  3. CA falling serum potassium
  4. DA rising serum calcium
10.实验室检查值与电解质困难

A patient's creatinine was 0.9 mg/dL (80 µmol/L) on admission and is 1.3 mg/dL (115 µmol/L) 36 hours later. Using the common KDIGO criteria, what does this show?

  1. ANo kidney injury, because the creatinine is still within the normal range
  2. BChronic kidney disease, because creatinine has risen above baseline
  3. CAcute kidney injury, because it rose by at least 0.3 mg/dL within 48 hours
  4. DA laboratory error, because creatinine cannot change within 2 days
11.药理学中等

A patient refuses a prescribed oral medicine. What should the nurse do?

  1. ARecord the medicine as given, so that the chart stays complete for the next shift
  2. BExplore the reason, respect the decision, document and inform the prescriber
  3. CHide the tablet in the patient's food
  4. DLeave the tablet on the bedside table for later
12.药理学困难

Why is strict aseptic technique and a limited hang time needed for propofol infusions?

  1. APropofol becomes more potent the longer it hangs
  2. BPropofol breaks down into a toxic gas after a few hours
  3. CLight exposure changes propofol into an opioid
  4. DIts lipid emulsion lets bacteria grow if it is contaminated
13.内外科护理：心血管与呼吸中等

A nurse measures blood pressure on a large upper arm using a cuff that is too small. What effect will this have?

  1. AOnly the pulse rate will be affected
  2. BThe reading will be falsely low
  3. CThe reading will be accurate but slower
  4. DThe reading will be falsely high
14.内外科护理：心血管与呼吸困难

A nurse teaches a patient who has a new permanent pacemaker. Which statement shows a need for further teaching?

  1. A"I will keep my follow-up appointments for device checks."
  2. B"I will tell staff about the device before any MRI scan."
  3. C"I will carry my pacemaker identification card with me at all times."
  4. D"I will keep my mobile phone in my shirt pocket over the device."
15.内外科护理：神经、内分泌与肾脏中等

A patient takes levodopa for Parkinson's disease. Which teaching point is correct?

  1. ALarge high-protein meals can reduce how well the drug works
  2. BThe tablets work best taken with a large steak dinner
  3. CThe drug cures the disease if taken for a full year
  4. DStop the drug for a day each week to avoid tolerance
16.内外科护理：神经、内分泌与肾脏困难

A patient has erratic glucose readings. The nurse finds a soft, rubbery lump where they always inject. What is the most important teaching?

  1. AMassage the lump firmly after every injection
  2. BDouble the insulin dose because the lump blocks the insulin
  3. CUse healthy sites and check glucose often, as less insulin may be needed
  4. DKeep injecting into the lump, because it hurts less there
17.内外科护理：消化、围手术期与肿瘤中等

Aspirate from a nasogastric tube has a pH of 7. What should the nurse do?

  1. AFlush with 50 mL of air and start the feed
  2. BStart the feed slowly and watch the patient closely for coughing
  3. CGive the medicines but not the feed
  4. DDo not use it; re-test later or arrange an X-ray as per policy
18.内外科护理：消化、围手术期与肿瘤困难

A patient with facial burns from a house fire was talking normally on arrival. Two hours later, the voice is hoarse and there is stridor. What should the nurse do?

  1. AGive a warm drink to soothe the throat
  2. BEncourage the patient to rest the voice and reassess tomorrow
  3. CLay the patient flat to help them sleep
  4. DCall for urgent anaesthetic help, as the airway is swelling
19.产科护理中等

The fetus is in the left occiput anterior position. Where is the fetal heart usually heard best?

  1. ABelow the umbilicus on the mother's left side
  2. BAbove the umbilicus on the mother's right side
  3. CDirectly over the fundus
  4. DAbove the umbilicus on the mother's left side
20.产科护理困难

Routine screening at the booking visit shows asymptomatic bacteriuria. Why is treatment important even though the woman has no symptoms?

  1. AIt can progress to pyelonephritis and trigger preterm labour
  2. BTreatment is not needed because it will settle after birth
  3. CIt is treated only to prevent bladder stones
  4. DIt will cause gestational diabetes later in the pregnancy if left untreated
21.儿科护理中等

A child is receiving IV morphine. Which assessments are most important?

  1. ABlood glucose and urine ketones
  2. BPeak flow and inhaler technique
  3. CRespiratory rate and level of sedation
  4. DHead circumference and fontanelle tension
22.儿科护理困难

9 个月婴儿的哪项发现最需要尽快进行发育随访？

  1. A婴儿只用一只手，忽略另一只手
  2. B婴儿还不会走
  3. C婴儿还不会说清晰的词
  4. D婴儿对陌生人害羞
23.精神科护理中等

A patient with dependent personality disorder asks the nurse to choose her clothes and meals every day. What is an appropriate nursing goal?

  1. AThe patient will avoid contact with others until she feels more confident
  2. BThe patient will let staff make all her decisions while in hospital
  3. CThe patient will make small everyday decisions on her own
  4. DThe patient will move in with a relative who can make decisions for her
24.精神科护理困难

A community nurse visits an older woman with hoarding disorder whose home is so cluttered that the exits are blocked. What is the most appropriate approach?

  1. AArrange for the whole house to be cleared while she is out
  2. BWork with her to clear the exits first, then agree a gradual plan together
  3. CTell her that she will be evicted unless everything is thrown away today
  4. DIgnore the clutter, because it is her own home
25.护理数学与单位换算中等
94969810010210410635363738394041°F°C95.6 °F? °C

练习题（虚构数值，不作为临床指导）。 一位患者的体温为 95.6 °F。用 °C = (°F − 32) × 5/9 把它换算为摄氏度T。取到一位小数。

95.6 °F
T = °C
26.护理数学与单位换算困难
2 mcg/min? mg/h1 h = 60 min1 mg = 1000 mcg

练习题（虚构数值，不作为临床指导）。 一次输注的给药速率为 2 mcg/min。请把这个剂量速率D用 mg/h 表示。

2 mcg/min1 h = 60 min1 mg = 1000 mcg
D = mg/h
27.剂量计算中等
024681010 mL

一名体重 36 kg 的儿童按 5 mg/kg 处方用药。原液浓度为 50 mg/mL。请抽取剂量：应给多少体积 V？

36 kg5 mg/kg50 mg/mL
V = mL
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 2.5%（w/v）溶液。 必须向储备液中加入多少水 W？

C₁ = 50%C₂ = 2.5%V₂ = 1000 mL
W = mL
29.静脉输液速度中等
500 mL10 gtt/mL6 h? gtt/min

用滴系数为 10 滴/mL 的输液器在 6 小时内输入 500 mL。求滴速 R（滴/分）。 取整到最接近的整数。

500 mL6 h10 gtt/mL
R = gtt/min
30.静脉输液速度困难
200 mL20 gtt/mL50 gtt/mint = ? h

一组输液以 50 滴/分的速度经 20 滴/mL 的输液器滴注。袋中还剩 200 mL。还需多少小时 t 才会滴完？ 保留一位小数。

50 gtt/min20 gtt/mL200 mL
t = h
31.静脉输液与液体平衡中等
入量出量12 小时班次水150 mL汤200 mL静脉输液50 mL/h × 12 h静脉抗生素2 × 50 mL尿液400 mL尿液500 mL尿液175 mL尿液175 mL呕吐物100 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。

水: 150 mL汤: 200 mL静脉输液: 50 mL/h × 12 h静脉抗生素: 2 × 50 mL
I = mL
32.静脉输液与液体平衡困难
1000 mL→ 100 mL/h开始 19:00t总数​ = ? h150 mL/h × 4 h

练习题（虚构数值，不作为临床指导）。 一份 1000 mL 的输液于 19:00 开始以 150 mL/h 输注。4 小时后速率改为 100 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。

1000 mL150 mL/h · 4 h100 mL/h
t = h
33.临床评估评分中等
E2 / 4+V2 / 5+M? / 6GCS 8?

练习题（虚构数值，不作为临床指导）。 一张练习图表记录了 GCS 8，其中 E2 和 V2。记录的运动评分M是多少，它描述的是哪种反应？请给出数字。

GCS 8E2V2
M =
34.临床评估评分困难
无风险轻度风险中度风险高风险极高风险

练习题（虚构数值，不作为临床指导）。 用 Braden 量表评估一位练习患者：感觉知觉: 非常受限; 潮湿程度: 持续潮湿; 活动: 局限于椅子; 活动能力: 非常受限; 营养: 非常差; 摩擦力和剪切力: 有问题。使用的分级为：19–23 无风险，15–18 轻度，13–14 中度，10–12 高，9 或以下极高。点击风险等级。

  1. 1无风险
  2. 2轻度风险
  3. 3中度风险
  4. 4高风险
  5. 5极高风险

3溶液

1.护理学基础

答案: D · Stay calm, listen and acknowledge their frustration

为什么是这个答案

Listening calmly and acknowledging feelings often de-escalates anger. The nurse then finds out the answer or explains what will happen next. Staff safety is maintained throughout.

答案

D · Stay calm, listen and acknowledge their frustration
2.护理学基础

答案: A · A suspected deep tissue injury

为什么是这个答案

A purple or maroon area of intact skin, often firm or boggy, suggests deep tissue injury from pressure and shear. It can quickly become a deep open ulcer, so pressure must be removed at once.

答案

A · A suspected deep tissue injury
3.感染控制与患者安全

答案: C · A patient with diabetic peripheral neuropathy

为什么是这个答案

Reduced sensation, as in peripheral neuropathy, prevents a person from feeling heat damage. Patients with poor sensation, poor circulation or confusion need very close monitoring if heat is used at all.

答案

C · A patient with diabetic peripheral neuropathy
4.感染控制与患者安全

答案: D · Close the doors to patient rooms, stay on the unit and wait for instructions

为什么是这个答案

Closing doors limits the spread of smoke and fire. Staff follow the fire plan, keep corridors clear and prepare for evacuation, but do not evacuate until directed or the fire is in their area.

答案

D · Close the doors to patient rooms, stay on the unit and wait for instructions
5.优先排序与委派

答案: B · “I will take five tablets one after the other before I call for help.”

为什么是这个答案

Action plans differ slightly: US guidance says to call emergency services if pain is not better 5 minutes after the first dose, while UK guidance allows a second dose after 5 minutes and a 999 call if pain persists 5 minutes later. Taking many doses in a row delays care and can cause severe hypotension.

答案

B · “I will take five tablets one after the other before I call for help.”
6.优先排序与委派

答案: A · IV calcium gluconate

为什么是这个答案

IV calcium stabilizes the cardiac cell membranes within minutes and is given first when hyperkalemia changes the ECG. Insulin with glucose, binders and diuretics then lower the potassium.

答案

A · IV calcium gluconate
7.临床护理

答案: A · Do not stop them suddenly

为什么是这个答案

Long-term steroids suppress the adrenal glands, so stopping suddenly can cause adrenal crisis. Patients should carry a steroid alert card or medical ID and follow sick-day guidance.

答案

A · Do not stop them suddenly
8.临床护理

答案: B · SIADH, often managed first with fluid restriction

为什么是这个答案

In SIADH, excess ADH makes the kidneys retain water, so blood sodium is diluted while urine is concentrated. Small cell lung cancer is a classic cause; fluid restriction is a common first step.

答案

B · SIADH, often managed first with fluid restriction
9.实验室检查值与电解质

答案: B · A falling serum uric acid

为什么是这个答案

Allopurinol reduces uric acid production by blocking xanthine oxidase. Over time, a lower serum uric acid reduces gout attacks and dissolves urate crystals. Kidney function is checked, and a rash must be reported because of rare severe skin reactions.核对依据: Gout · StatPearls (NCBI Bookshelf) (2026)

答案

B · A falling serum uric acid
10.实验室检查值与电解质

答案: C · Acute kidney injury, because it rose by at least 0.3 mg/dL within 48 hours

为什么是这个答案

KDIGO defines AKI as a creatinine rise of at least 0.3 mg/dL (26.5 µmol/L) within 48 hours, a rise to 1.5 times baseline within 7 days, or urine output below 0.5 mL/kg/h for 6 hours. A result inside the reference range can still be a significant rise.

答案

C · Acute kidney injury, because it rose by at least 0.3 mg/dL within 48 hours
11.药理学

答案: B · Explore the reason, respect the decision, document and inform the prescriber

为什么是这个答案

Competent patients may refuse treatment. The nurse explores concerns, explains the purpose and risks, documents the refusal and informs the prescriber; covert administration needs formal legal and clinical procedures.

答案

B · Explore the reason, respect the decision, document and inform the prescriber
12.药理学

答案: D · Its lipid emulsion lets bacteria grow if it is contaminated

为什么是这个答案

Propofol is formulated in a soybean oil emulsion, which is a good growth medium for bacteria. Contaminated propofol has caused sepsis, so it is handled aseptically and tubing and containers are changed at set intervals.

答案

D · Its lipid emulsion lets bacteria grow if it is contaminated
13.内外科护理：心血管与呼吸

答案: D · The reading will be falsely high

为什么是这个答案

A cuff that is too small needs a higher pressure to compress the brachial artery, giving a falsely high reading. A cuff that is too large can give a falsely low reading. The bladder should encircle most of the arm, so cuff size is chosen by arm circumference.

答案

D · The reading will be falsely high
14.内外科护理：心血管与呼吸

答案: D · "I will keep my mobile phone in my shirt pocket over the device."

为什么是这个答案

Patients are advised to keep mobile phones at least about 15 cm from the device and to hold them to the opposite ear. They carry a device card, tell staff before MRI or surgery (diathermy) and attend follow-up checks. Normal household appliances are generally safe.

答案

D · "I will keep my mobile phone in my shirt pocket over the device."
15.内外科护理：神经、内分泌与肾脏

答案: A · Large high-protein meals can reduce how well the drug works

为什么是这个答案

Protein-rich meals can compete with levodopa for absorption and entry into the brain, which reduces its effect. Patients are often advised to take doses at consistent times relative to meals. Levodopa controls symptoms but does not stop the disease.

答案

A · Large high-protein meals can reduce how well the drug works
16.内外科护理：神经、内分泌与肾脏

答案: C · Use healthy sites and check glucose often, as less insulin may be needed

为什么是这个答案

Lipohypertrophy causes poor and unpredictable absorption. When the patient switches to healthy tissue, more insulin is absorbed, so hypos can occur. Glucose is monitored closely, and doses may need to be reduced.

答案

C · Use healthy sites and check glucose often, as less insulin may be needed
17.内外科护理：消化、围手术期与肿瘤

答案: D · Do not use it; re-test later or arrange an X-ray as per policy

为什么是这个答案

A pH above 5.5 may mean the tube is in the lung or oesophagus, or the stomach acid is reduced by drugs or feed. Nothing is given until position is confirmed according to local policy.

答案

D · Do not use it; re-test later or arrange an X-ray as per policy
18.内外科护理：消化、围手术期与肿瘤

答案: D · Call for urgent anaesthetic help, as the airway is swelling

为什么是这个答案

Progressive hoarseness and stridor after a facial or inhalation burn mean the airway is narrowing. Early intubation by an experienced anaesthetist is needed before swelling makes it impossible. The patient is sat up and given oxygen.

答案

D · Call for urgent anaesthetic help, as the airway is swelling
19.产科护理

答案: A · Below the umbilicus on the mother's left side

为什么是这个答案

The fetal heart is heard most clearly through the fetal back. In a cephalic LOA position, that is in the lower left quadrant. In breech presentations, it is usually heard above the umbilicus.

答案

A · Below the umbilicus on the mother's left side
20.产科护理

答案: A · It can progress to pyelonephritis and trigger preterm labour

为什么是这个答案

Urinary stasis in pregnancy lets bacteria ascend, so untreated bacteriuria often progresses to pyelonephritis, which is linked with preterm labour. A pregnancy-safe antibiotic and a repeat culture are standard.

答案

A · It can progress to pyelonephritis and trigger preterm labour
21.儿科护理

答案: C · Respiratory rate and level of sedation

为什么是这个答案

Opioids can cause respiratory depression, usually preceded by increasing sedation. Respiratory rate, sedation score, oxygen saturation and pain are monitored regularly, and naloxone is kept available.

答案

C · Respiratory rate and level of sedation
22.儿科护理

答案: A · 婴儿只用一只手，忽略另一只手

为什么是这个答案

约 18 个月之前出现明显的利手偏好，可能提示另一侧无力，例如脑瘫。不会走、怕生和没有清晰的词是 9 个月时的典型表现。

答案

A · 婴儿只用一只手，忽略另一只手
23.精神科护理

答案: C · The patient will make small everyday decisions on her own

为什么是这个答案

People with dependent personality disorder have an excessive need to be cared for and difficulty making decisions. Nursing care encourages and praises small independent decisions to build confidence.

答案

C · The patient will make small everyday decisions on her own
24.精神科护理

答案: B · Work with her to clear the exits first, then agree a gradual plan together

为什么是这个答案

Forced clear-outs cause great distress and the clutter usually returns. Collaborative, gradual work focusing first on safety, such as fire exits and fall risks, with involvement of relevant services, is more effective.

答案

B · Work with her to clear the exits first, then agree a gradual plan together
25.护理数学与单位换算

答案: T = 35.3 °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

95.6 − 32 = 63.6

乘以 5/9

T = 63.6·5/9 = 35.33 ≈ 35.3 °C

答案

T = 35.3 °C
26.护理数学与单位换算

答案: D = 0.12 mg/h

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 = 2 mcg/min × (60 min/1 h) × (1 mg/1000 mcg)

计算

D = 2·60/1000 = 0.12 mg/h

答案

D = 0.12 mg/h
27.剂量计算

答案: V = 3.6 mL

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

按体重计算剂量

D = 5·36 = 180 mg

体积

V = 180/50 = 3.6 mL

在注射器上

在这支 10 mL 的注射器上，每条小刻度线代表 0.2 mL。

答案

V = 3.6 mL
28.剂量计算

答案: W = 950 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 = 2.5·1000/50 = 50 mL

需加水量

W = 1000 − 50 = 950 mL

答案

W = 950 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

6·60 = 360 min

滴速

R = 500·10/360 = 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: t = 1.3 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。

速度（mL/h）

50·60/20 = 150 mL/h

剩余时间

t = 200/150 = 1.333 ≈ 1.3 h

答案

t = 1.3 h
31.静脉输液与液体平衡

答案: I = 1050 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: 150 + 200 = 350 mL
静脉输液: 50·12 = 600 mL
静脉抗生素: 2·50 = 100 mL
I = 1050 mL

答案

I = 1050 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

150·4 = 600 mL
1000 − 600 = 400 mL 剩余

第二部分

400/100 = 4 h

总时间

t = 4 + 4 = 8 h

答案

t = 8 h

约为 8 h 00 min，所以袋子大约在 03:00 输完。

33.临床评估评分

答案: M = 4

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。

运动评分

M = 8 − 2 − 2 = 4
M4: 把肢体从压迫处缩回（正常屈曲）

答案

M = 4
34.临床评估评分

答案: 极高风险

Braden 量表：评估压力性损伤风险的六个分项。感觉知觉、潮湿程度、活动、活动能力和营养各评 1 至 4 分，从最差水平（1）到无问题（4）；摩擦力和剪切力评 1 至 3 分。总分为 6 至 23，总分越低风险越高。常用分级：19–23 无风险，15–18 轻度风险，13–14 中度风险，10–12 高风险，9 分及以下为极高风险。

为每个分项评分

感觉知觉: 非常受限 → 2
潮湿程度: 持续潮湿 → 1
活动: 局限于椅子 → 2
活动能力: 非常受限 → 2
营养: 非常差 → 1
摩擦力和剪切力: 有问题 → 1

相加

Braden 总分 = 2 + 1 + 2 + 2 + 1 + 1 = 9

风险等级

9 → 极高风险

答案

极高风险

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