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 arrives back on the ward after surgery. What does the nurse assess first?

  1. AFluid balance chart
  2. BPain score
  3. CAirway and breathing
  4. DThe wound dressing
2.护理学基础困难

Before giving a PRN dose of oral morphine, which assessment is most important?

  1. AThe patient's blood glucose level
  2. BThe patient's last bowel movement
  3. CThe patient's weight and height, recorded on admission
  4. DThe respiratory rate and level of sedation
3.感染控制与患者安全中等

Which room lighting is safest at night for a patient at high risk of falls?

  1. ABright overhead lights left on all night in the room
  2. BOnly the light from the television screen
  3. CA low night light that lights the path to the bathroom
  4. DComplete darkness so the patient sleeps more deeply
4.感染控制与患者安全困难

A newly hired nurse has these hepatitis B results: HBsAg negative, anti-HBs positive, anti-HBc negative. What do they show?

  1. AA current hepatitis B infection
  2. BPast infection that has now cleared
  3. CNo immunity, so the vaccine is needed
  4. DImmunity from hepatitis B vaccination
5.优先排序与委派中等

During labor, the nurse sees the umbilical cord in the vagina after the membranes rupture. What is the first action?

  1. AWait for the next contraction before acting
  2. BRelieve pressure on the cord by lifting the presenting part with a gloved hand
  3. CAsk the patient to walk around the room to bring the baby lower and speed up labor
  4. DPush the cord back into the uterus
6.优先排序与委派困难

A patient suddenly has severe pain in one leg. The leg is pale and cold with no pedal pulse. What does this suggest?

  1. AA muscle cramp that will pass with stretching
  2. BAcute arterial occlusion, which is an emergency
  3. CChronic venous insufficiency that needs elevation
  4. DA deep vein thrombosis that can be treated next week
7.临床护理中等

After a needlestick injury from a patient known to have HIV, why must the nurse report it immediately?

  1. AThe needle must be sent for culture
  2. BThe patient will need antibiotics
  3. CThe nurse must be tested for HIV the same day to confirm infection
  4. DPost-exposure prophylaxis works best when started as soon as possible
8.临床护理困难

一名患者恶心呕吐三天，并在服用呋塞米。最可能出现哪种电解质问题？

  1. A仅高钠血症
  2. B高钙血症
  3. C低钾血症
  4. D高钾血症
9.实验室检查值与电解质中等

An older adult with chronic kidney disease takes glyburide (glibenclamide, a sulfonylurea) and has repeated low glucose readings. Why is this a concern?

  1. AThe drug causes high potassium that lowers the glucose
  2. BThe drug stops working entirely when the kidneys fail
  3. CThe drug makes the glucose meter read falsely low
  4. DThe drug and its metabolites build up and cause long lows
10.实验室检查值与电解质困难

A patient with acute kidney injury after severe dehydration has a rising creatinine. Which urine findings support a prerenal cause rather than acute tubular necrosis (ATN)?

  1. AHigh urine sodium and dilute urine with muddy brown granular casts
  2. BLow urine sodium and concentrated urine with a high specific gravity
  3. CRed cell casts with heavy protein loss in the urine
  4. DWhite cell casts with positive nitrites on the dipstick
11.药理学中等

按固定间隔给药，大约需要多长时间达到稳态？

  1. A10 个半衰期
  2. B只取决于剂量大小
  3. C1 个半衰期
  4. D4 到 5 个半衰期
12.药理学困难

Carboprost is a prostaglandin used for postpartum haemorrhage. In which woman should it be avoided?

  1. AA woman who had a vaginal birth
  2. BA woman with iron deficiency anaemia
  3. CA woman who is breastfeeding
  4. DA woman with asthma
13.内外科护理：心血管与呼吸中等

A patient on theophylline develops nausea, vomiting, a fast heart rate and restlessness. What should the nurse suspect?

  1. AAn expected sign that the drug is working
  2. BTheophylline toxicity
  3. CA theophylline allergy causing a rash
  4. DHypoglycaemia caused by the drug
14.内外科护理：心血管与呼吸困难

Seconds after an intramuscular injection, a patient becomes pale, sweaty and faint, with a heart rate of 48/min. There is no rash, wheeze or swelling, and they recover quickly when laid flat. What is the most likely cause?

  1. AAnaphylaxis
  2. BA vasovagal reaction
  3. CA myocardial infarction
  4. DA tension pneumothorax
15.内外科护理：神经、内分泌与肾脏中等

Why is once-daily prednisolone usually taken in the morning with food?

  1. ABecause food doubles the strength of the dose
  2. BTo match the natural cortisol rhythm and protect the stomach
  3. CBecause it cannot be absorbed at night
  4. DBecause it causes drowsiness and is safer to take during the day
16.内外科护理：神经、内分泌与肾脏困难

一名使用呼吸机的患者有创伤性脑损伤。除非即将发生脑疝，通常的 PaCO₂ 目标是什么？

  1. A长时间过度通气造成的低 PaCO₂
  2. B正常的 PaCO₂（正常碳酸血症）
  3. C高 PaCO₂ 以扩张脑血管
  4. D任何 PaCO₂，因为它不影响颅内压
17.内外科护理：消化、围手术期与肿瘤中等

A patient had an upper GI endoscopy with a local anaesthetic throat spray. What must the nurse check before giving a drink?

  1. AThat swallowing and the gag reflex have returned
  2. BThat the patient's blood glucose is above normal
  3. CThat the patient has passed urine since the procedure
  4. DThat bowel sounds are present in all four quadrants
18.内外科护理：消化、围手术期与肿瘤困难

A patient with advanced cancer who has capacity decides to stop chemotherapy. The family insists that treatment must continue. What should the nurse do?

  1. ASupport the patient's decision and help the team talk with the family
  2. BContinue treatment because the family has asked for it
  3. CTell the patient that stopping is not allowed
  4. DAsk the family to sign a new consent form
19.产科护理中等

下列哪一组列出了生物物理评分的组成部分？

  1. AAPGAR 评分、脐血气、出生体重、身长和头围
  2. B宫高、胎位、先露位置、宫颈消退和扩张
  3. C无应激试验、胎儿呼吸、胎动、胎儿肌张力和羊水量
  4. D胎心率模式、母亲血压、血糖、体重和尿蛋白
20.产科护理困难

Monochorionic twins at 22 weeks show one twin with polyhydramnios and a large bladder and the other with almost no fluid. What condition is suspected?

  1. APlacenta praevia
  2. BRh isoimmunisation
  3. CTwin-to-twin transfusion syndrome
  4. DGestational diabetes in one twin
21.儿科护理中等

为什么儿童通常避免使用阿司匹林，而在川崎病中却使用它？

  1. A它仅用作皮疹和关节痛的镇痛药，热退后即停用
  2. B它预防瑞氏综合征
  3. C在专科医生监督下，它可减轻炎症并降低冠状动脉血栓的风险
  4. D它治愈引起该病的感染
22.儿科护理困难

A parent asks whether giving paracetamol (acetaminophen) at the first sign of fever will prevent another febrile seizure. What is the best answer?

  1. AYes; giving it every 4 hours during a fever will always prevent seizures
  2. BYes, but only if a cold bath is given at the same time
  3. CNo, because paracetamol can cause febrile seizures
  4. DNo; it may ease discomfort but does not prevent febrile seizures
23.精神科护理中等

According to Maslow's hierarchy of needs, which patient need should a nurse on a mental health ward address first?

  1. AA patient who wants to find a new hobby
  2. BA patient who has not eaten or drunk anything for two days
  3. CA patient who wants to improve her self-esteem
  4. DA patient who feels lonely and wants more visitors
24.精神科护理困难

A patient who had been abstinent from alcohol for 6 months has started drinking again. He says, "I've failed completely. There's no point in trying." What is the most helpful response?

  1. A"You'll have to start a completely new treatment from the beginning."
  2. B"You obviously weren't serious about stopping."
  3. C"Relapse is common in recovery. Let's look at what led to it and what you learned."
  4. D"Yes, I'm afraid you've wasted all of your hard work over the last six months."
25.护理数学与单位换算中等
94969810010210410635363738394041°F°C103 °F? °C

练习题（虚构数值，不作为临床指导）。 一位患者的体温为 103 °F。用 °C = (°F − 32) × 5/9 把它换算为摄氏度T。取到一位小数。

103 °F
T = °C
26.护理数学与单位换算困难
260 mg/dL? mmol/L1 mmol/L = 18 mg/dL

练习题（虚构数值，不作为临床指导）。 血糖结果为 260 mg/dL。按葡萄糖 1 mmol/L = 18 mg/dL，求以 mmol/L 表示的c。取到一位小数。

260 mg/dL1 mmol/L = 18 mg/dL
c = mmol/L
27.剂量计算中等
024681010 mL

一名体重 8 kg 的儿童按 10 mg/kg 处方用药。原液浓度为 10 mg/mL。请抽取剂量：应给多少体积 V？

8 kg10 mg/kg10 mg/mL
V = mL
28.剂量计算困难
20%储备液V₁ = ? mL

你需要用 20%（w/v）储备液配制 100 mL 2%（w/v）溶液。 你需要多少容量的储备液 V₁？

C₁ = 20%C₂ = 2%V₂ = 100 mL
V₁ = mL
29.静脉输液速度中等
60 gtt/mL125 mL/h? gtt/min

医嘱要求以 125 mL/h 输液，但没有输液泵。改用滴系数为 60 gtt/mL 的输液器重力滴注。求滴速 R，以每分钟滴数表示。

125 mL/h60 gtt/mL
R = gtt/min
30.静脉输液速度困难
450 mL15 gtt/mL28 gtt/mint = ? h

一组输液以 28 滴/分的速度经 15 滴/mL 的输液器滴注。袋中还剩 450 mL。还需多少小时 t 才会滴完？ 保留一位小数。

28 gtt/min15 gtt/mL450 mL
t = 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汤180 mL水240 mL冰屑200 mL静脉输液60 mL/h × 12 h静脉抗生素1 × 100 mL尿液225 mL尿液475 mL尿液175 mL尿液325 mL伤口引流60 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。 冰屑按其体积的一半计。

茶: 240 mL汤: 180 mL水: 240 mL冰屑: 200 mL静脉输液: 60 mL/h × 12 h静脉抗生素: 1 × 100 mL
I = mL
32.静脉输液与液体平衡困难
1000 mL75 mL/h开始 12:0013:00: ? mL

练习题（虚构数值，不作为临床指导）。 一袋 1000 mL 的液体于 12:00 开始用输液泵以 75 mL/h 输注。到 13:00 时袋中还剩多少 mL V？

1000 mL75 mL/h12:00 → 13:00
V = mL
33.临床评估评分中等
E4 / 4+V5 / 5+M? / 6GCS 15?

练习题（虚构数值，不作为临床指导）。 一张练习图表记录了 GCS 15，其中 E4 和 V5。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 15E4V5
M =
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 23 次/分，SpO₂ 99%吸室内空气，血压 118/70 mmHg，脉搏 58 次/分，清醒，体温 36.9 °C。患者属于哪个临床风险组？点击它。

RR 23SpO₂ 99%空气SBP 118HR 58AT 36.9 °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: C · Airway and breathing

为什么是这个答案

After anaesthesia the airway and breathing are checked first, then circulation, consciousness, pain, the wound, drains and fluids.

答案

C · Airway and breathing
2.护理学基础

答案: D · The respiratory rate and level of sedation

为什么是这个答案

Opioids can cause sedation and respiratory depression. Checking breathing and alertness before each dose, as well as the pain score, keeps the patient safe.

答案

D · The respiratory rate and level of sedation
3.感染控制与患者安全

答案: C · A low night light that lights the path to the bathroom

为什么是这个答案

A night light lets the patient see obstacles and the way to the bathroom without disturbing sleep. Many falls happen in the dark on the way to the toilet.

答案

C · A low night light that lights the path to the bathroom
4.感染控制与患者安全

答案: D · Immunity from hepatitis B vaccination

为什么是这个答案

The vaccine contains surface antigen, so it produces anti-HBs only. A negative anti-HBc shows there has been no natural infection, and a negative HBsAg rules out current infection.

答案

D · Immunity from hepatitis B vaccination
5.优先排序与委派

答案: B · Relieve pressure on the cord by lifting the presenting part with a gloved hand

为什么是这个答案

In cord prolapse, the presenting part can compress the cord and cut off fetal oxygen. The nurse lifts the presenting part off the cord, calls for help and positions the patient (for example knee-chest) while urgent birth is arranged.

答案

B · Relieve pressure on the cord by lifting the presenting part with a gloved hand
6.优先排序与委派

答案: B · Acute arterial occlusion, which is an emergency

为什么是这个答案

Sudden pain, pallor, coldness and loss of pulse suggest an embolus blocking an artery. The limb can be lost within hours, so the nurse escalates immediately.

答案

B · Acute arterial occlusion, which is an emergency
7.临床护理

答案: D · Post-exposure prophylaxis works best when started as soon as possible

为什么是这个答案

HIV post-exposure prophylaxis should be started as soon as possible after exposure, ideally within hours. Occupational health or the emergency department will assess the risk and arrange follow-up testing.

答案

D · Post-exposure prophylaxis works best when started as soon as possible
8.临床护理

答案: C · 低钾血症

为什么是这个答案

呕吐和袢利尿剂都会导致失钾。低钾血症会引起乏力、肌肉痉挛和心律失常，需要监测和补充。

答案

C · 低钾血症
9.实验室检查值与电解质

答案: D · The drug and its metabolites build up and cause long lows

为什么是这个答案

Glyburide and its active metabolites are cleared by the kidneys, so they accumulate in CKD and can cause severe, prolonged hypoglycemia. Older adults are at greater risk. The prescriber is informed, and a different drug is usually chosen.

答案

D · The drug and its metabolites build up and cause long lows
10.实验室检查值与电解质

答案: B · Low urine sodium and concentrated urine with a high specific gravity

为什么是这个答案

In prerenal AKI the tubules are intact, so they keep sodium and water, giving a low urine sodium and concentrated urine. In ATN the damaged tubules cannot do this, so urine sodium is high, the urine is dilute and muddy brown casts appear.核对依据: Urine specific gravity test · MedlinePlus (NIH) (2025)

答案

B · Low urine sodium and concentrated urine with a high specific gravity
11.药理学

答案: D · 4 到 5 个半衰期

为什么是这个答案

重复给药时，无论剂量多少，血药浓度约在 4–5 个半衰期后接近稳态。使用负荷剂量可以更快达到。

答案

D · 4 到 5 个半衰期
12.药理学

答案: D · A woman with asthma

为什么是这个答案

Carboprost is a PGF2-alpha analogue that can cause bronchospasm. Oxytocin is first-line, and carboprost is avoided in asthma.

答案

D · A woman with asthma
13.内外科护理：心血管与呼吸

答案: B · Theophylline toxicity

为什么是这个答案

Theophylline has a narrow therapeutic window. Toxicity causes nausea, vomiting, tachycardia, arrhythmias, agitation and seizures. Levels are monitored, and many drugs and smoking status change its clearance. The nurse should hold the dose and report.

答案

B · Theophylline toxicity
14.内外科护理：心血管与呼吸

答案: B · A vasovagal reaction

为什么是这个答案

Vasovagal reactions cause bradycardia, pallor, sweating and fainting, and resolve quickly when lying flat. Anaphylaxis usually causes tachycardia, airway or breathing problems and often skin changes, and does not settle on its own. If in doubt, treat as anaphylaxis.

答案

B · A vasovagal reaction
15.内外科护理：神经、内分泌与肾脏

答案: B · To match the natural cortisol rhythm and protect the stomach

为什么是这个答案

Morning dosing mimics the normal early-morning cortisol peak, causes less adrenal suppression and less sleep disturbance. Taking it with food reduces gastric irritation.

答案

B · To match the natural cortisol rhythm and protect the stomach
16.内外科护理：神经、内分泌与肾脏

答案: B · 正常的 PaCO₂（正常碳酸血症）

为什么是这个答案

高 CO₂ 使脑血管扩张并升高颅内压，而过度通气使其收缩，可引起脑缺血。通常以正常碳酸血症（约 4.7–5.3 kPa，即 35–40 mmHg）为目标；仅在出现即将脑疝的征象时短暂过度通气，作为确定性治疗前的过渡。

答案

B · 正常的 PaCO₂（正常碳酸血症）
17.内外科护理：消化、围手术期与肿瘤

答案: A · That swallowing and the gag reflex have returned

为什么是这个答案

Throat spray numbs the pharynx, so drinking too early risks aspiration. Fluids are given once the gag reflex and swallowing have returned, usually after about an hour, starting with sips of water.

答案

A · That swallowing and the gag reflex have returned
18.内外科护理：消化、围手术期与肿瘤

答案: A · Support the patient's decision and help the team talk with the family

为什么是这个答案

A competent adult can refuse treatment. The nurse advocates for the patient, supports communication with the family and team, and helps plan symptom control and palliative care.

答案

A · Support the patient's decision and help the team talk with the family
19.产科护理

答案: C · 无应激试验、胎儿呼吸、胎动、胎儿肌张力和羊水量

为什么是这个答案

五个组成部分各计 0 分或 2 分。总分 8–10 分令人放心；分数更低则需要进一步评估或制订分娩计划。

答案

C · 无应激试验、胎儿呼吸、胎动、胎儿肌张力和羊水量
20.产科护理

答案: C · Twin-to-twin transfusion syndrome

为什么是这个答案

In monochorionic twins, unbalanced vascular connections can shunt blood from one twin to the other. The recipient becomes overloaded with polyhydramnios, while the donor has low fluid and growth restriction.

答案

C · Twin-to-twin transfusion syndrome
21.儿科护理

答案: C · 在专科医生监督下，它可减轻炎症并降低冠状动脉血栓的风险

为什么是这个答案

川崎病是一种血管炎，可导致冠状动脉瘤。在专科医生监督下，用静脉注射免疫球蛋白和阿司匹林治疗，并通过超声心动图检查冠状动脉。

答案

C · 在专科医生监督下，它可减轻炎症并降低冠状动脉血栓的风险
22.儿科护理

答案: D · No; it may ease discomfort but does not prevent febrile seizures

为什么是这个答案

Antipyretics relieve discomfort but have not been shown to prevent febrile seizure recurrence. Parents are taught seizure first aid, when to call for help and that most febrile seizures are harmless.

答案

D · No; it may ease discomfort but does not prevent febrile seizures
23.精神科护理

答案: B · A patient who has not eaten or drunk anything for two days

为什么是这个答案

Maslow places physiological needs, such as food and fluids, before safety, love and belonging, esteem and self-actualisation. A patient who is not eating or drinking has the most basic unmet need.

答案

B · A patient who has not eaten or drunk anything for two days
24.精神科护理

答案: C · "Relapse is common in recovery. Let's look at what led to it and what you learned."

为什么是这个答案

Relapse is common and does not mean failure. Treating it as a learning opportunity, reviewing triggers and coping strategies and returning to the plan supports the person's motivation.

答案

C · "Relapse is common in recovery. Let's look at what led to it and what you learned."
25.护理数学与单位换算

答案: T = 39.4 °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

103 − 32 = 71

乘以 5/9

T = 71·5/9 = 39.44 ≈ 39.4 °C

答案

T = 39.4 °C
26.护理数学与单位换算

答案: c = 14.4 mmol/L

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。

转换

c = 260/18 = 14.44 ≈ 14.4 mmol/L

答案

c = 14.4 mmol/L
27.剂量计算

答案: V = 8 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 = 10·8 = 80 mg

体积

V = 80/10 = 8 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 = 8 mL
28.剂量计算

答案: V₁ = 10 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 = 2·100/20 = 10 mL

答案

V₁ = 10 mL
29.静脉输液速度

答案: R = 125 gtt/min

Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.

每分钟毫升数

125/60 = 2.083 mL/min

滴速

R = 2.083·60 = 125 gtt/min

答案

R = 125 gtt/min

使用微滴输液器（60 gtt/mL）时，gtt/min 等于 mL/h。

30.静脉输液速度

答案: t = 4 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）

28·60/15 = 112 mL/h

剩余时间

t = 450/112 = 4.018 ≈ 4 h

答案

t = 4 h
31.静脉输液与液体平衡

答案: I = 1580 mL

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

计算入量

口服: 240 + 180 + 240 = 660 mL
冰屑: 200/2 = 100 mL
静脉输液: 60·12 = 720 mL
静脉抗生素: 1·100 = 100 mL
I = 1580 mL

答案

I = 1580 mL
32.静脉输液与液体平衡

答案: V = 925 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

12:00 → 13:00 = 1 h

已输入体积

75·1 = 75 mL

剩余体积

V = 1000 − 75 = 925 mL

答案

V = 925 mL
33.临床评估评分

答案: M = 6

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 = 15 − 4 − 5 = 6
M6: 遵嘱动作

答案

M = 6
34.临床评估评分

答案: 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 23/min → 2
SpO₂ 99% → 0
吸空气 → 0
SBP 118 mmHg → 0
HR 58/min → 0
清醒 (A) → 0
T 36.9 °C → 0

总分和红色分值

NEWS2 = 2 + 0 + 0 + 0 + 0 + 0 + 0 = 2
没有参数得 3 分。

风险组

低

答案

低

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