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 starts regular morphine. What is usually prescribed alongside it to prevent a common side effect?

  1. AA diuretic
  2. BAn antibiotic
  3. CAn antihistamine
  4. DA laxative
2.护理学基础困难

An older woman with severe arthritis has normal bladder control but wets herself because she cannot reach the toilet in time. Which type of incontinence is this?

  1. AOverflow incontinence
  2. BFunctional incontinence
  3. CUrge incontinence
  4. DStress incontinence
3.感染控制与患者安全中等

Why are blood cultures usually taken from two separate venipuncture sites?

  1. ATo make the results come back faster from the laboratory
  2. BTo help tell a true infection from skin contamination
  3. CTo reduce the total amount of blood taken
  4. DBecause each site tests a different antibiotic
4.感染控制与患者安全困难

A nurse calculates a child’s prescribed dose and finds it is ten times higher than the usual dose for the child’s weight. What should the nurse do?

  1. AHold the dose and verify it with the prescriber and pharmacist
  2. BGive it, because the prescriber must have a reason
  3. CGive one-tenth of the dose without telling anyone about it
  4. DGive half the dose and watch the child closely
5.优先排序与委派中等

A patient has a reddened area on the sacrum that does not blanch when pressed. What is the priority action?

  1. AKeep the patient lying on the back to protect the area
  2. BRelieve pressure on the area by changing position regularly
  3. CApply a heat pad to the area to increase circulation
  4. DMassage the area firmly to improve the blood flow to the skin
6.优先排序与委派困难

A nurse returns to the station to find four messages. Which one is answered first?

  1. AA family member wants an update on their father’s progress
  2. BThe laboratory is calling with a critical potassium result of 2.6 mEq/L
  3. CA colleague asks to swap shifts with them next week because of a family wedding
  4. DThe pharmacy asks when the next delivery should be scheduled
7.临床护理中等

输血开始几分钟内出现哪些表现提示输血反应？

  1. A面色好转、精力增加
  2. B发热、寒战、背痛和低血压
  3. C轻微饥饿
  4. D次日血红蛋白缓慢而稳定地上升
8.临床护理困难

Which nursing measure helps reduce raised intracranial pressure?

  1. ARaising the head of the bed to about 30° with the head kept midline
  2. BTilting the patient head-down
  3. CLying the patient flat with the neck flexed forward on two pillows
  4. DFrequent suctioning and encouraging strong coughing
9.实验室检查值与电解质中等

How often is the INR usually checked when warfarin is first started?

  1. AOnly if bleeding occurs at home
  2. BEvery hour, during the first week
  3. CEvery few days, until it is stable
  4. DOnce a year, at a routine visit
10.实验室检查值与电解质困难

A healthy woman at 10 weeks of pregnancy has a slightly low TSH with a normal free T4 and no symptoms. What is the most likely explanation?

  1. AShe has developed Graves disease in pregnancy
  2. BThe result shows severe primary hypothyroidism
  3. ChCG stimulates the thyroid in early pregnancy
  4. DShe has pituitary failure from the pregnancy
11.药理学中等

Long-term use of metformin can cause a deficiency of which vitamin?

  1. AVitamin D
  2. BVitamin B12
  3. CVitamin A
  4. DVitamin K
12.药理学困难

A patient on long-term lithium passes large amounts of dilute urine and is always thirsty. What is the most likely explanation?

  1. AThe patient is drinking too much and lithium is unrelated
  2. BLithium blocks the kidney's response to ADH (nephrogenic diabetes insipidus)
  3. CLithium causes type 1 diabetes by destroying the pancreatic beta cells
  4. DLithium increases ADH release from the pituitary
13.内外科护理：心血管与呼吸中等

A patient has exercise-induced asthma. Which advice is most appropriate?

  1. ATake a beta-blocker before exercise
  2. BExercise only in cold, dry air to toughen the airways
  3. CUse the reliever inhaler shortly before exercise and warm up
  4. DAvoid all forms of exercise permanently to prevent attacks
14.内外科护理：心血管与呼吸困难

As the defibrillator charges, a nurse sees a colleague still holding the patient's bed rail. What should the nurse do?

  1. ATurn off the defibrillator and start a new cycle of CPR
  2. BCall clearly for everyone to stand clear and check before the shock
  3. CDeliver the shock now, as the bed rail is not part of the patient
  4. DAsk the colleague to hold the patient's hand instead
15.内外科护理：神经、内分泌与肾脏中等

After a lumbar discectomy, which finding should the nurse report promptly?

  1. AA dry, intact wound dressing
  2. BNew weakness or numbness in the legs
  3. CMild pain at the wound site
  4. DStiffness when getting out of bed
16.内外科护理：神经、内分泌与肾脏困难

On the first day after a kidney transplant, urine output suddenly falls from 200 mL/h to 10 mL/h. What should the nurse check first?

  1. AWhether the patient has eaten
  2. BThe patient's temperature and pulse
  3. CThe patient's blood glucose level
  4. DThat the catheter is not blocked or kinked
17.内外科护理：消化、围手术期与肿瘤中等

A patient with obstructive sleep apnoea is admitted for surgery. Which instruction is most appropriate?

  1. AAvoid sleeping at all on the night after surgery
  2. BBring their CPAP machine to use after surgery
  3. CLie flat on their back for the first night
  4. DStop all pain relief for the first three days
18.内外科护理：消化、围手术期与肿瘤困难

A patient with a severe flare of ulcerative colitis develops abdominal distension, fever and tachycardia, and the stool frequency has dropped. What should the nurse suspect?

  1. AThe flare is getting better
  2. BSimple constipation from low intake
  3. CToxic megacolon
  4. DHaemorrhoids caused by diarrhoea
19.产科护理中等

A woman at 39 weeks with a healthy pregnancy asks about walking in early labour. What is the best advice?

  1. AWalking will cause the cord to prolapse
  2. BUpright positions always make labour slower
  3. CWalking and upright positions can help progress
  4. DShe must stay in bed on her back for the whole labour
20.产科护理困难

A woman with a history of postnatal depression is pregnant again. What is the most appropriate plan?

  1. AAdvise her that it will not happen again
  2. BPlan early support and monitoring before and after birth
  3. CWait to see whether depression returns after birth
  4. DTell her that breastfeeding will prevent it
21.儿科护理中等

How are feeds usually restarted after a pyloromyotomy for pyloric stenosis?

  1. AOnly by nasogastric tube for the first month at home
  2. BNot until 10 days after surgery, when the wound has healed
  3. CWithin hours, increasing gradually as per protocol; some vomiting can be expected
  4. DWith large, full-volume feeds straight away to make up for the weight lost
22.儿科护理困难

一名 4 岁儿童高热、流口水、身体前倾、颈部伸展，看起来很焦虑。护士应首先做什么？

  1. A在呼救之前先置入静脉套管
  2. B采集咽拭子以确定病原体
  3. C让孩子平躺，用压舌板查看咽喉以确认肿胀
  4. D让孩子在父母陪伴下保持平静和直立，并呼叫擅长气道管理的团队
23.精神科护理中等

Which side effects are most common with quetiapine?

  1. AInsomnia and severe weight loss
  2. BA cough and swollen ankles
  3. CHigh prolactin with breast enlargement in almost every patient
  4. DSedation, dizziness when standing and weight gain
24.精神科护理困难

A mother with suspected postpartum psychosis says her newborn baby is "evil" and "must be stopped". What is the priority?

  1. AReassure her that all new mothers feel this way
  2. BKeep the baby safe, never alone with her, and arrange urgent assessment
  3. CEncourage her to spend more time alone with the baby so that they can bond
  4. DPlan a routine follow-up appointment with the health visitor in 2 weeks
25.护理数学与单位换算中等
10.5193 mL? mL取整到 0.1 mL

练习题（虚构数值，不作为临床指导）。 一次注射的剂量计算得到 10.5193 mL。 本练习的规则是：1 mL 或以上的体积取到最接近的十分之一 mL。你记录的数值x是多少？

10.5193 mL
x = mL
26.护理数学与单位换算困难
½ tsp · 2/天 · 14 d? × 150 mL1 tsp = 5 mL

练习题（虚构数值，不作为临床指导）。 一张处方写着口服混悬液½ tsp，每天两次，共 14 天。混悬液每瓶 150 mL。按1 tsp = 5 mL，必须提供多少整瓶N才能完成疗程？

½ tsp每天两次14 天150 mL1 tsp = 5 mL
N =
27.剂量计算中等
60 kg20 mg/kg/天4× 每天D = ? mg

某患者体重 60 kg。医嘱剂量为每天 20 mg/kg，分 4 次等量给药。每次给多少毫克 D？

60 kg20 mg/kg/天4× 每天
D = mg
28.剂量计算困难
200 mg/5 mLV = ? mL

一名体重 12 kg 的儿童，医嘱为口服混悬液每次 10 mg/kg，该混悬液每 5 mL 含 200 mg。你应给多少体积 V？

12 kg10 mg/kg200 mg/5 mL
V = mL
29.静脉输液速度中等
500 mL10 gtt/mL4 h? gtt/min

用滴系数为 10 滴/mL 的输液器在 4 小时内输入 500 mL。求滴速 R（滴/分）。 取整到最接近的整数。

500 mL4 h10 gtt/mL
R = gtt/min
30.静脉输液速度困难
2 g250 mL? mL/h4 mg/min

一袋中含有 2 g 药物，溶于 250 mL。医嘱为每分钟 4 mg。泵速 R 应设为多少 mL/h？

2 g/250 mL4 mg/min
R = mL/h
31.静脉输液与液体平衡中等
入量出量12 小时班次果汁120 mL汤180 mL冰屑120 mL静脉输液125 mL/h × 12 h静脉抗生素2 × 50 mL尿液250 mL尿液300 mL尿液275 mL尿液500 mL呕吐物250 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。求液体平衡 B = 入量 − 出量，以 mL 计（答案为负表示净丢失）。 冰屑按其体积的一半计。

果汁: 120 mL汤: 180 mL冰屑: 120 mL静脉输液: 125 mL/h × 12 h静脉抗生素: 2 × 50 mL尿液: 250 mL尿液: 300 mL尿液: 275 mL尿液: 500 mL呕吐物: 250 mL
B = mL
32.静脉输液与液体平衡困难
1000 mL800 mL 已输入125 mL/h16:30t = ? h

练习题（虚构数值，不作为临床指导）。 一袋 1000 mL 的液体用输液泵以 125 mL/h 输注。到 16:30 时已输入 800 mL。还要多少小时 t 袋子才会输完？ 保留一位小数。

1000 mL800 mL 已输入125 mL/h
t = h
33.临床评估评分中等
7441SBPDBPmmHgHR 57/min · SI = ?

练习题（虚构数值，不作为临床指导）。 一位患者的脉搏为 57 次/分，血压为 74/41 mmHg。求休克指数SI = HR/SBP。取到两位小数。

HR 57/minBP 74/41 mmHg
SI =
34.临床评估评分困难
120?SBPDBPmmHgMAP = 70

练习题（虚构数值，不作为临床指导）。 团队的目标是平均动脉压至少为 70 mmHg。一位患者的收缩压为 120 mmHg。使用 MAP = (SBP + 2·DBP)/3，仍能使 MAP 达到 70 mmHg 的最低舒张压DBP是多少？

MAP 70 mmHgSBP 120 mmHg
DBP = mmHg

3溶液

1.护理学基础

答案: D · A laxative

为什么是这个答案

Because opioid-induced constipation is so common, a regular laxative is usually prescribed with regular opioids, and bowel movements are monitored.

答案

D · A laxative
2.护理学基础

答案: B · Functional incontinence

为什么是这个答案

Functional incontinence is caused by problems outside the urinary tract, such as poor mobility or confusion. A commode near the bed, easy clothing and regular toileting help.

答案

B · Functional incontinence
3.感染控制与患者安全

答案: B · To help tell a true infection from skin contamination

为什么是这个答案

If the same organism grows from both sets, it is more likely to be a true bloodstream infection. Growth in only one set may be contamination from the skin.

答案

B · To help tell a true infection from skin contamination
4.感染控制与患者安全

答案: A · Hold the dose and verify it with the prescriber and pharmacist

为什么是这个答案

Tenfold errors are common in pediatrics, usually from decimal or unit mistakes. The nurse holds the dose and clarifies it, and never changes the dose on their own.

答案

A · Hold the dose and verify it with the prescriber and pharmacist
5.优先排序与委派

答案: B · Relieve pressure on the area by changing position regularly

为什么是这个答案

Non-blanching redness is a stage 1 pressure injury. Relieving pressure through repositioning and support surfaces is the priority; massage can damage tissue further.

答案

B · Relieve pressure on the area by changing position regularly
6.优先排序与委派

答案: B · The laboratory is calling with a critical potassium result of 2.6 mEq/L

为什么是这个答案

A critical potassium of 2.6 mEq/L can cause life-threatening arrhythmias, so it is acted on first: the nurse assesses the patient and informs the provider. The other calls can wait.

答案

B · The laboratory is calling with a critical potassium result of 2.6 mEq/L
7.临床护理

答案: B · 发热、寒战、背痛和低血压

为什么是这个答案

急性溶血性或发热性反应可引起发热、寒战、腰背痛、气促和低血压。应立即停止输血并呼救。

答案

B · 发热、寒战、背痛和低血压
8.临床护理

答案: A · Raising the head of the bed to about 30° with the head kept midline

为什么是这个答案

Head elevation and a midline neck position help venous drainage from the brain. Neck flexion, tight tube ties, coughing, straining and unnecessary suctioning can all raise intracranial pressure.

答案

A · Raising the head of the bed to about 30° with the head kept midline
9.实验室检查值与电解质

答案: C · Every few days, until it is stable

为什么是这个答案

When warfarin is started or its dose changes, the INR is checked frequently (often every few days) until it is stable in the target range. After that, the interval can be extended, often up to every 4 weeks or longer if very stable.

答案

C · Every few days, until it is stable
10.实验室检查值与电解质

答案: C · hCG stimulates the thyroid in early pregnancy

为什么是这个答案

hCG is structurally similar to TSH and stimulates the thyroid, peaking at the end of the first trimester, so TSH often falls slightly. With a normal free T4 and no symptoms, this is usually physiologic and is interpreted with pregnancy-specific ranges.

答案

C · hCG stimulates the thyroid in early pregnancy
11.药理学

答案: B · Vitamin B12

为什么是这个答案

Metformin reduces vitamin B12 absorption in the ileum. Deficiency can cause anaemia and neuropathy, so levels may be checked in long-term users.

答案

B · Vitamin B12
12.药理学

答案: B · Lithium blocks the kidney's response to ADH (nephrogenic diabetes insipidus)

为什么是这个答案

Lithium interferes with ADH action in the collecting duct, causing polyuria and polydipsia. Dehydration from this can raise lithium levels further, so fluid balance matters.

答案

B · Lithium blocks the kidney's response to ADH (nephrogenic diabetes insipidus)
13.内外科护理：心血管与呼吸

答案: C · Use the reliever inhaler shortly before exercise and warm up

为什么是这个答案

A short-acting bronchodilator taken shortly before exercise, a gradual warm-up and covering the mouth in cold air help prevent symptoms. Frequent exercise symptoms may mean asthma is poorly controlled and preventer treatment needs review.

答案

C · Use the reliever inhaler shortly before exercise and warm up
14.内外科护理：心血管与呼吸

答案: B · Call clearly for everyone to stand clear and check before the shock

为什么是这个答案

Before every shock, the operator states a clear warning, checks that nobody is touching the patient or bed and that oxygen is moved away from the chest. Compressions continue during charging in many protocols, then everyone stands clear for the shock. Touching the bed can conduct current to staff.

答案

B · Call clearly for everyone to stand clear and check before the shock
15.内外科护理：神经、内分泌与肾脏

答案: B · New weakness or numbness in the legs

为什么是这个答案

New or worsening leg weakness, numbness or problems passing urine may indicate a haematoma or nerve root compression and need urgent review. Mild wound pain and stiffness are expected.

答案

B · New weakness or numbness in the legs
16.内外科护理：神经、内分泌与肾脏

答案: D · That the catheter is not blocked or kinked

为什么是这个答案

A sudden drop in output after transplant may be caused by a blocked catheter, often from clots. The nurse checks the tubing and may flush the catheter per protocol, and then escalates urgently, because vascular thrombosis or rejection are also possible.

答案

D · That the catheter is not blocked or kinked
17.内外科护理：消化、围手术期与肿瘤

答案: B · Bring their CPAP machine to use after surgery

为什么是这个答案

OSA increases the risk of airway obstruction and respiratory depression after anaesthesia, especially with opioids. Using CPAP, careful opioid use, sitting up and close monitoring reduce this risk.

答案

B · Bring their CPAP machine to use after surgery
18.内外科护理：消化、围手术期与肿瘤

答案: C · Toxic megacolon

为什么是这个答案

Toxic megacolon is dilatation of the inflamed colon with systemic toxicity and a high risk of perforation. Antimotility drugs and opioids are avoided, an abdominal X-ray is done and the surgical team is involved.

答案

C · Toxic megacolon
19.产科护理

答案: C · Walking and upright positions can help progress

为什么是这个答案

Upright positions and mobility in the first stage can shorten labour and reduce the need for epidurals. She can choose positions that feel comfortable.

答案

C · Walking and upright positions can help progress
20.产科护理

答案: B · Plan early support and monitoring before and after birth

为什么是这个答案

A past episode increases the risk of recurrence. Early identification, a care plan with mental health services, support and monitoring during pregnancy and after birth are recommended.

答案

B · Plan early support and monitoring before and after birth
21.儿科护理

答案: C · Within hours, increasing gradually as per protocol; some vomiting can be expected

为什么是这个答案

After pyloromyotomy, feeding normally restarts within hours and is increased to full feeds as tolerated. Mild vomiting in the first day is common; the nurse monitors intake, weight and the wound.

答案

C · Within hours, increasing gradually as per protocol; some vomiting can be expected
22.儿科护理

答案: D · 让孩子在父母陪伴下保持平静和直立，并呼叫擅长气道管理的团队

为什么是这个答案

这些征象提示会厌炎或其他上气道急症。应避免令孩子痛苦的干预，让孩子保持舒适体位，并立即获得专家的气道援助。

答案

D · 让孩子在父母陪伴下保持平静和直立，并呼叫擅长气道管理的团队
23.精神科护理

答案: D · Sedation, dizziness when standing and weight gain

为什么是这个答案

Quetiapine commonly causes drowsiness, orthostatic hypotension and metabolic effects. It has a lower risk of extrapyramidal effects and raised prolactin than many other antipsychotics.

答案

D · Sedation, dizziness when standing and weight gain
24.精神科护理

答案: B · Keep the baby safe, never alone with her, and arrange urgent assessment

为什么是这个答案

Postpartum psychosis with delusions about the baby carries a risk of harm to the infant and to the mother. The baby must be kept safe and the mother assessed urgently, usually with admission.

答案

B · Keep the baby safe, never alone with her, and arrange urgent assessment
25.护理数学与单位换算

答案: x = 10.5 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。

十分位位上的数字

10.5193 → 5

只看下一位数字

10.5193 → 1
1 小于或等于 4，所以 5 不变。
后面的数字（93）不考虑：只取整一次，不要逐位取整。

取整

x = 10.5 mL

答案

x = 10.5 mL
26.护理数学与单位换算

答案: N = 1

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。

总体积

2.5 mL × 2 × 14 = 70 mL

瓶数

70/150 = 0.4667 → N = 1

答案

N = 1
27.剂量计算

答案: D = 300 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

20·60 = 1200 mg

每次剂量

D = 1200/4 = 300 mg

答案

D = 300 mg
28.剂量计算

答案: V = 3 mL

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。

按体重计算剂量

10·12 = 120 mg

体积

V = (120/200)·5 = 3 mL

答案

V = 3 mL
29.静脉输液速度

答案: R = 21 gtt/min

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

以分钟计的时间

4·60 = 240 min

滴速

R = 500·10/240 = 20.83 ≈ 21 gtt/min

答案

R = 21 gtt/min

床旁取最接近的整滴：21 滴/分。

30.静脉输液速度

答案: R = 30 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

2000 mg/250 mL = 8 mg/mL

每小时剂量

4·60 = 240 mg/h

泵速

R = 240/8 = 30 mL/h

答案

R = 30 mL/h
31.静脉输液与液体平衡

答案: B = 385 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。

总入量

口服: 120 + 180 = 300 mL
冰屑: 120/2 = 60 mL
静脉输液: 125·12 = 1500 mL
静脉抗生素: 2·50 = 100 mL
总入量 = 1960 mL

总出量

250 + 300 + 275 + 500 + 250 = 1575 mL

平衡

B = 1960 − 1575 = 385 mL

答案

B = 385 mL

为正：摄入的液体多于排出的液体。

32.静脉输液与液体平衡

答案: t = 1.6 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。

剩余体积

1000 − 800 = 200 mL

时间

t = 200/125 = 1.6 h

答案

t = 1.6 h

约为 1 h 36 min，所以袋子大约在 18:06 输完。

33.临床评估评分

答案: SI = 0.77

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

休克指数

SI = 57/74 = 0.7703 ≈ 0.77

答案

SI = 0.77

高于通常的 0.5–0.7。

34.临床评估评分

答案: DBP = 45 mmHg

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

变形

DBP = (3·MAP − SBP)/2

代入

DBP = (3·70 − 120)/2 = 90/2 = 45 mmHg

答案

DBP = 45 mmHg

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