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

Teaching a patient how to inject insulin mainly involves which domain of learning?

  1. AAffective
  2. BPsychomotor
  3. CSpiritual
  4. DCognitive
2.护理学基础困难

A patient taking furosemide has a serum potassium of 3.0 mmol/L (3.0 mEq/L). Why is this important?

  1. AThe level is normal and needs no action
  2. BLow potassium only causes mild thirst
  3. CFurosemide raises potassium, so this level is falsely low and can be ignored
  4. DLoop diuretics cause potassium loss, and low levels can cause arrhythmias
3.感染控制与患者安全中等

A small spill of blood is found on the floor. How should it be cleaned?

  1. ALeave it until housekeeping arrives the next morning
  2. BWipe it up quickly with a dry cloth using bare hands, then wash the hands well
  3. CCover it with a clean sheet and keep working
  4. DWear gloves, absorb the blood, then clean the area with an approved disinfectant
4.感染控制与患者安全困难

A nurse notices that the pharmacy has sent the wrong dose and corrects it before giving it. Should the event be reported?

  1. ANo, because reporting near misses only blames the pharmacy staff for nothing
  2. BYes, near misses are reported so system weaknesses can be fixed
  3. CNo, because the patient was not harmed
  4. DOnly if the same error happens three times
5.优先排序与委派中等

A nurse sees a nursing assistant leave a confused patient’s bed in the highest position after care. What should the nurse do?

  1. AAsk the family to lower the bed when they next visit
  2. BLower the bed now and remind the assistant why it matters
  3. CWrite it in the assistant’s yearly review only
  4. DLeave it because the patient is asleep
6.优先排序与委派困难

一名患者 45 分钟前突然说话困难。哪项行动优先级最高？

  1. A等神经科医生在早晨查房时评估患者
  2. B立即口服阿司匹林以限制血栓
  3. C给水，让患者服用平常的早晨药物
  4. D启动卒中团队进行紧急影像学检查，并记录最后已知正常的时间
7.临床护理中等

Which tool is commonly used at the bedside to screen for delirium?

  1. AThe Malnutrition Universal Screening Tool
  2. BThe Glasgow-Blatchford score
  3. CThe Braden scale
  4. DThe Confusion Assessment Method (CAM)
8.临床护理困难

A patient with a central venous catheter develops fever and rigors shortly after the line is flushed, with no other obvious source. What should be suspected?

  1. AA catheter-related bloodstream infection
  2. BNormal response to line use
  3. CA pulmonary embolism
  4. DAn allergic reaction to the saline flush
9.实验室检查值与电解质中等

A patient who is breathless during a transfusion has hypotension, fever and bilateral lung infiltrates, with no signs of fluid overload. Which complication is most likely?

  1. ATransfusion-related acute lung injury (TRALI)
  2. BA mild febrile nonhemolytic reaction
  3. CA simple allergic reaction with hives
  4. DTransfusion-associated circulatory overload
10.实验室检查值与电解质困难

A patient on warfarin with an INR of 3.6 fell and hit their head an hour ago. They now report a worsening headache and drowsiness. What is the priority?

  1. AReport urgently for imaging and possible reversal
  2. BGive acetaminophen (paracetamol) and recheck the INR tomorrow
  3. CHold warfarin for one dose and observe at home
  4. DEncourage rest in a dark room to settle the pain
11.药理学中等

Why is propranolol usually avoided in patients with asthma?

  1. AIt causes tolerance to inhaled corticosteroids
  2. BIt increases mucus production by blocking histamine
  3. CIt stimulates alpha-1 receptors in the airways and raises blood pressure
  4. DIt blocks beta-2 receptors in the airways and can cause bronchospasm
12.药理学困难

Why do infants absorb more of a topical corticosteroid than adults?

  1. ATheir skin contains no blood vessels
  2. BTheir liver changes the cream into a much stronger form
  3. CInfants do not absorb topical drugs at all
  4. DThey have more skin area per kilogram and thinner skin
13.内外科护理：心血管与呼吸中等

The telemetry monitor suddenly shows a chaotic waveform resembling ventricular fibrillation, but the patient is talking and brushing their teeth. What should the nurse do first?

  1. ACheck the patient and the electrodes, as this is likely artefact
  2. BStart chest compressions straight away and call the arrest team
  3. CDeliver an immediate defibrillation shock before checking anything
  4. DGive IV amiodarone as a bolus
14.内外科护理：心血管与呼吸困难

A patient with a tracheostomy suddenly becomes distressed, and a suction catheter will not pass down the tube. What should the nurse do first?

  1. AIncrease the oxygen and wait
  2. BRemove the inner cannula
  3. CInflate the cuff with more air
  4. DGive a nebulised bronchodilator
15.内外科护理：神经、内分泌与肾脏中等

How do DPP-4 inhibitors such as sitagliptin work?

  1. AThey block glucose reabsorption in the kidney
  2. BThey prolong the action of gut incretin hormones
  3. CThey stop the gut from absorbing fat
  4. DThey replace insulin that the pancreas cannot make
16.内外科护理：神经、内分泌与肾脏困难

A patient taking an SGLT2 inhibitor is booked for major surgery. Which statement is correct?

  1. ASurgery is not possible in patients taking this drug
  2. BThe dose is usually doubled on the morning of surgery
  3. CIt is usually paused in the days before surgery
  4. DThe drug must be taken right up until the operation starts
17.内外科护理：消化、围手术期与肿瘤中等

Which complication is more typical of Crohn's disease than of ulcerative colitis?

  1. AInflammation limited to the rectal lining
  2. BBleeding only from the rectum
  3. CFistulas between the bowel and other organs
  4. DDisease that is cured by removing the colon
18.内外科护理：消化、围手术期与肿瘤困难

Hours after an oesophageal dilatation, a patient has chest pain, fever and crackling swelling under the skin of the neck. What should the nurse suspect?

  1. AAn allergic reaction to the sedative
  2. BNormal discomfort after the procedure
  3. COesophageal perforation
  4. DSimple reflux after the dilatation
19.产科护理中等

A woman at 32 weeks has varicose veins in her legs. Which advice is most appropriate?

  1. AAvoid walking until after the birth
  2. BRaise the legs when resting and avoid long standing
  3. CWear tight elastic bands around the top of the thighs
  4. DSit with her legs crossed to support the veins
20.产科护理困难

A breastfeeding mother asks whether she can have a progestin-only implant before discharge. Which reply is best?

  1. AProgestin-only methods are compatible with breastfeeding
  2. BImplants contain oestrogen, which is safe in breastfeeding
  3. CAny hormonal contraception will stop her milk supply
  4. DShe should wait until she stops breastfeeding before using any method
21.儿科护理中等

Which stool pattern is typical of Hirschsprung disease in an older child?

  1. AChronic constipation with thin, ribbon-like, foul-smelling stools and distension
  2. BFrequent bloody diarrhoea with fever after eating chicken
  3. CPale, bulky, fatty stools that float and are hard to flush, with a large appetite
  4. DNormal stools with occasional itching around the anus at night
22.儿科护理困难

一名儿童正在静脉输注氯化钾。护士发现套管部位肿胀、苍白，孩子在哭。护士应首先做什么？

  1. A加快输注速度以便更快完成
  2. B安抚孩子并继续输注
  3. C在该部位紧紧包扎
  4. D停止输注并评估部位
23.精神科护理中等

Which measurement should be monitored regularly in a patient taking venlafaxine?

  1. ABlood pressure
  2. BVisual acuity
  3. CPeak expiratory flow
  4. DSerum lithium level
24.精神科护理困难

A child has been admitted several times with unexplained fevers that only happen when her mother is present. Staff see the mother tampering with the child's IV line. What is the priority action?

  1. ADocument the event carefully in the notes and wait to see whether it happens again before telling anyone else
  2. BDischarge the child home with the mother as soon as possible
  3. CDiscuss the matter with the mother alone and ask her to stop
  4. DEnsure the child's safety and follow child protection procedures
25.护理数学与单位换算中等
12345678910111214:00?1:00 PM2:00 PM2:00 AM4:00 PM

练习题（虚构数值，不作为临床指导）。 一个剂量记录在 14:00（24 小时制）。哪个条目是 12 小时制中的同一时间？点击它。

14:00
  1. 11:00 PM
  2. 22:00 PM
  3. 32:00 AM
  4. 44:00 PM
26.护理数学与单位换算困难
00:0017:1005:55t = ?

练习题（虚构数值，不作为临床指导）。 一次输注从 17:10 开始，到次日早晨 05:55 结束（24 小时制）。它运行了多少分钟t？

17:1005:55
t = min
27.剂量计算中等
024681010 mL

一名体重 24 kg 的儿童按 3 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？

24 kg3 mg/kg10 mg/mL
V = mL
28.剂量计算困难
00.10.20.30.40.50.60.70.80.911 mL

处方剂量为 455 微克。安瓿浓度为 0.5 mg/mL。请用 1 mL 注射器抽取剂量：应给多少体积 V？

455 mcg0.5 mg/mL
V = mL
29.静脉输液速度中等
15 gtt/mL100 mL/h? gtt/min

医嘱要求以 100 mL/h 输液，但没有输液泵。改用滴系数为 15 gtt/mL 的输液器重力滴注。求滴速 R，以每分钟滴数表示。

100 mL/h15 gtt/mL
R = gtt/min
30.静脉输液速度困难
300 mL15 gtt/mL30 gtt/mint = ? h

一组输液以 30 滴/分的速度经 15 滴/mL 的输液器滴注。袋中还剩 300 mL。还需多少小时 t 才会滴完？

30 gtt/min15 gtt/mL300 mL
t = h
31.静脉输液与液体平衡中等
入量出量12 小时班次牛奶200 mL果汁120 mL茶150 mL冰屑120 mL静脉输液80 mL/h × 12 h静脉抗生素2 × 100 mL尿液475 mL尿液225 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 70 kg。求平均尿量 U，以 mL/kg/h 计。 保留两位小数。

70 kg12 h尿液: 475 mL尿液: 225 mL
U = mL/kg/h
32.静脉输液与液体平衡困难
1000 mL→ 200 mL/h开始 18:00t总数​ = ? h80 mL/h × 2 h

练习题（虚构数值，不作为临床指导）。 一份 1000 mL 的输液于 18:00 开始以 80 mL/h 输注。2 小时后速率改为 200 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 mL80 mL/h · 2 h200 mL/h
t = h
33.临床评估评分中等
9255SBPDBPmmHgHR 69/min · SI = ?

练习题（虚构数值，不作为临床指导）。 一位患者的脉搏为 69 次/分，血压为 92/55 mmHg。求休克指数SI = HR/SBP。取到两位小数。

HR 69/minBP 92/55 mmHg
SI =
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 122 kg，身高 195 cm。计算 BMI 并点击 WHO 体重分类。

122 kg195 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: B · Psychomotor

为什么是这个答案

The psychomotor domain covers physical skills, the cognitive domain covers knowledge and the affective domain covers attitudes and feelings. Skills are learned by demonstration and practice.

答案

B · Psychomotor
2.护理学基础

答案: D · Loop diuretics cause potassium loss, and low levels can cause arrhythmias

为什么是这个答案

Furosemide increases potassium loss in the urine. Hypokalaemia causes muscle weakness and cardiac arrhythmias, so the result is reported and replacement considered.

答案

D · Loop diuretics cause potassium loss, and low levels can cause arrhythmias
3.感染控制与患者安全

答案: D · Wear gloves, absorb the blood, then clean the area with an approved disinfectant

为什么是这个答案

Blood spills are cleaned promptly by staff wearing gloves. The blood is absorbed with disposable material, then the area is cleaned and disinfected with a hospital disinfectant, and waste goes into clinical waste.

答案

D · Wear gloves, absorb the blood, then clean the area with an approved disinfectant
4.感染控制与患者安全

答案: B · Yes, near misses are reported so system weaknesses can be fixed

为什么是这个答案

Near misses show where errors can slip through and are reported in the same way as errors that reach the patient. Learning from them prevents future harm.

答案

B · Yes, near misses are reported so system weaknesses can be fixed
5.优先排序与委派

答案: B · Lower the bed now and remind the assistant why it matters

为什么是这个答案

A high bed increases the risk of a serious fall, so the nurse corrects it at once and gives brief, clear feedback. Leaving it or delaying feedback leaves the patient at risk.

答案

B · Lower the bed now and remind the assistant why it matters
6.优先排序与委派

答案: D · 启动卒中团队进行紧急影像学检查，并记录最后已知正常的时间

为什么是这个答案

溶栓治疗与时间有关，且需要先做影像学检查以排除出血。最后已知正常的时间决定是否符合条件。影像学检查前不给阿司匹林，在吞咽筛查之前不经口给予任何东西。

答案

D · 启动卒中团队进行紧急影像学检查，并记录最后已知正常的时间
7.临床护理

答案: D · The Confusion Assessment Method (CAM)

为什么是这个答案

The CAM, and similar tools such as the 4AT, check for an acute onset or fluctuating course, inattention and disorganised thinking or altered consciousness. Early detection allows causes to be treated.

答案

D · The Confusion Assessment Method (CAM)
8.临床护理

答案: A · A catheter-related bloodstream infection

为什么是这个答案

Rigors after flushing suggest bacteria colonising the catheter. Blood cultures are taken (often from the line and a peripheral vein) and the team decides whether to remove the line.

答案

A · A catheter-related bloodstream infection
9.实验室检查值与电解质

答案: A · Transfusion-related acute lung injury (TRALI)

为什么是这个答案

TRALI is acute lung injury within 6 hours of transfusion, caused by donor antibodies activating neutrophils in the lungs. It causes hypoxia, bilateral infiltrates and often hypotension and fever. TACO, in contrast, causes hypertension and signs of fluid overload.

答案

A · Transfusion-related acute lung injury (TRALI)
10.实验室检查值与电解质

答案: A · Report urgently for imaging and possible reversal

为什么是这个答案

A head injury in an anticoagulated patient, with worsening headache and drowsiness, suggests intracranial bleeding. The provider is told at once, neurological checks are done often, urgent imaging is arranged, and warfarin reversal (vitamin K and a prothrombin complex concentrate) may be prescribed.核对依据: Taking warfarin (Coumadin, Jantoven) - what to ask your doctor · MedlinePlus (NIH) (2025); Prothrombin Time Test and INR (PT/INR) · MedlinePlus (NIH) (2024)

答案

A · Report urgently for imaging and possible reversal
11.药理学

答案: D · It blocks beta-2 receptors in the airways and can cause bronchospasm

为什么是这个答案

Non-selective beta blockers block both beta-1 and beta-2 receptors. Blocking beta-2 receptors in the bronchi removes their relaxing effect and can trigger severe bronchospasm.

答案

D · It blocks beta-2 receptors in the airways and can cause bronchospasm
12.药理学

答案: D · They have more skin area per kilogram and thinner skin

为什么是这个答案

Infants have a high surface area-to-weight ratio and a thinner skin barrier, so topical drugs reach higher systemic levels. Nappies can act as an occlusive dressing and increase absorption further.

答案

D · They have more skin area per kilogram and thinner skin
13.内外科护理：心血管与呼吸

答案: A · Check the patient and the electrodes, as this is likely artefact

为什么是这个答案

Movement, loose electrodes and muscle activity can create artefact that looks like VF. A conscious, talking patient cannot be in VF. The nurse assesses the patient and checks the leads and electrodes, then reattaches them if needed.

答案

A · Check the patient and the electrodes, as this is likely artefact
14.内外科护理：心血管与呼吸

答案: B · Remove the inner cannula

为什么是这个答案

Tracheostomy emergency guidance is to remove the inner cannula first, because it may be blocked with secretions. If the patient does not improve, the cuff is deflated and the tube may need to be removed. Oxygen is applied to the face and the stoma, and emergency help is called.

答案

B · Remove the inner cannula
15.内外科护理：神经、内分泌与肾脏

答案: B · They prolong the action of gut incretin hormones

为什么是这个答案

DPP-4 inhibitors slow the breakdown of incretins such as GLP-1, so more insulin is released and less glucagon after meals. They rarely cause hypoglycaemia on their own and are weight-neutral.

答案

B · They prolong the action of gut incretin hormones
16.内外科护理：神经、内分泌与肾脏

答案: C · It is usually paused in the days before surgery

为什么是这个答案

Fasting, surgery and dehydration increase the risk of euglycaemic DKA with SGLT2 inhibitors. Guidance usually advises stopping them in the days before major surgery and restarting when the patient is eating and drinking normally.

答案

C · It is usually paused in the days before surgery
17.内外科护理：消化、围手术期与肿瘤

答案: C · Fistulas between the bowel and other organs

为什么是这个答案

Transmural inflammation in Crohn's disease can create fistulas, abscesses and strictures. Ulcerative colitis is mucosal, and removing the colon and rectum is curative.

答案

C · Fistulas between the bowel and other organs
18.内外科护理：消化、围手术期与肿瘤

答案: C · Oesophageal perforation

为什么是这个答案

Chest pain, fever and surgical (subcutaneous) emphysema after instrumentation suggest oesophageal perforation, which can cause mediastinitis. The patient is kept nil by mouth and reviewed urgently; CT confirms it.

答案

C · Oesophageal perforation
19.产科护理

答案: B · Raise the legs when resting and avoid long standing

为什么是这个答案

Leg elevation, regular walking, avoiding long standing and graduated compression stockings improve venous return. Crossing the legs and tight bands at the thigh restrict venous flow.

答案

B · Raise the legs when resting and avoid long standing
20.产科护理

答案: A · Progestin-only methods are compatible with breastfeeding

为什么是这个答案

Progestin-only methods such as implants, injections and pills do not have a clinically important effect on milk supply. Oestrogen-containing methods are usually avoided in the first weeks.

答案

A · Progestin-only methods are compatible with breastfeeding
21.儿科护理

答案: A · Chronic constipation with thin, ribbon-like, foul-smelling stools and distension

为什么是这个答案

In children diagnosed later, Hirschsprung disease causes chronic constipation, abdominal distension, poor growth and thin, ribbon-like, foul-smelling stools. Most cases are found in the newborn period with delayed meconium.

答案

A · Chronic constipation with thin, ribbon-like, foul-smelling stools and distension
22.儿科护理

答案: D · 停止输注并评估部位

为什么是这个答案

肿胀、苍白和疼痛提示药液外渗或渗漏。应停止输注，评估部位，遵循当地的外渗处理规程，并通知开医嘱者。刺激性输液可损伤组织。

答案

D · 停止输注并评估部位
23.精神科护理

答案: A · Blood pressure

为什么是这个答案

Venlafaxine is an SNRI. By increasing noradrenaline, it can raise blood pressure, particularly at higher doses, so blood pressure is checked regularly.

答案

A · Blood pressure
24.精神科护理

答案: D · Ensure the child's safety and follow child protection procedures

为什么是这个答案

This suggests factitious disorder imposed on another, which is a form of child abuse. The nurse protects the child and reports through safeguarding procedures. Confronting the parent alone can increase the risk to the child.

答案

D · Ensure the child's safety and follow child protection procedures
25.护理数学与单位换算

答案: 2:00 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

14 − 12 = 2 → PM

答案

2:00 PM

答案

2:00 PM
26.护理数学与单位换算

答案: t = 765 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

17:10 → 24:00 = 410 min

午夜之后

00:00 → 05:55 = 355 min

合计

t = 410 + 355 = 765 min

答案

t = 765 min
27.剂量计算

答案: V = 7.2 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 = 3·24 = 72 mg

体积

V = 72/10 = 7.2 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 = 7.2 mL
28.剂量计算

答案: V = 0.91 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。

单位相同

0.5 mg/mL = 500 mcg/mL

体积

V = 455/500 = 0.91 mL

答案

V = 0.91 mL
29.静脉输液速度

答案: R = 25 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

100/60 = 1.667 mL/min

滴速

R = 1.667·15 = 25 gtt/min

答案

R = 25 gtt/min
30.静脉输液速度

答案: t = 2.5 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）

30·60/15 = 120 mL/h

剩余时间

t = 300/120 = 2.5 h

答案

t = 2.5 h
31.静脉输液与液体平衡

答案: U = 0.83 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

475 + 225 = 700 mL

每千克每小时

U = 700/(70·12) = 0.8333 ≈ 0.83 mL/kg/h

答案

U = 0.83 mL/kg/h
32.静脉输液与液体平衡

答案: t = 6.2 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

80·2 = 160 mL
1000 − 160 = 840 mL 剩余

第二部分

840/200 = 4.2 h

总时间

t = 2 + 4.2 = 6.2 h

答案

t = 6.2 h

约为 6 h 12 min，所以袋子大约在 00:12 输完。

33.临床评估评分

答案: SI = 0.75

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 = 69/92 = 0.75

答案

SI = 0.75

高于通常的 0.5–0.7。

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 = 122/1.95² = 32.08

分类

肥胖 I 级

答案

肥胖 I 级

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