NCLEX-PN 风格练习题（LPN/LVN）：速成包

公式表、每个专题的关键方法步骤和 34 道练习题，完整解答附在最后。

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1公式与方法

感染控制与患者安全

方法

  1. 对每位患者都从标准预防开始：手卫生、针对预期暴露的个人防护装备、安全使用锐器。
  2. 按传播途径追加预防措施：接触传播（隔离衣、手套）、飞沫传播（外科口罩）、空气传播（N95、负压病房）。
  3. 保持无菌物品的无菌状态：如有疑问就视为不无菌；更换，绝不擦拭。
  4. 预防环境中的伤害：防跌倒措施，约束仅作为最后手段，火灾时用 RACE 和 PASS。
  5. 核对给药的正确原则、两个身份识别信息，以及对高警示药物的额外保障；报告差错和险兆事件。

优先排序与委派

方法

  1. 问自己：如果什么都不做，什么会最快伤害患者。
  2. 应用 ABC（心脏骤停时为 C-A-B），然后是 Maslow 需求层次：生理需要先于安全，安全先于心理需要。
  3. 比较各选项：急性先于慢性，不稳定先于稳定，意外先于预期，全身性先于局部，并将每项发现与患者的基线对照。
  4. 除非是紧急情况，否则先评估再行动；然后选择其他步骤所依赖的那一步。
  5. 委派时核对五项正确：任务、情境、人员、指示和监督。评估、宣教和评价仍由注册护士负责。

实验室检查值与电解质

方法

  1. 把数值与本实验室自己的参考范围比较，再与患者的基线和趋势比较。
  2. 检查标本：溶血、延迟，或在静脉输液附近采血都可能得出错误结果。
  3. 把数值与其典型体征以及引起它的药物和疾病联系起来。
  4. 注意相互作用：低钾或低镁会增加地高辛中毒的风险；脱水会使锂浓度升高。
  5. 对患者采取行动：评估，血药浓度不安全时暂停用药，复述危急值并通知开医嘱的医生。

内外科护理：心血管与呼吸

方法

  1. 说出问题所在：泵衰竭、动脉阻塞、节律、血栓、气道狭窄、感染或设备问题。
  2. 先检查危险征象：低氧、低血压、胸痛、新出现的意识模糊、冰冷无脉搏的肢体。
  3. 让氧疗与患者相匹配：大多数人为 94–98%，有 CO₂ 潴留风险者为 88–92%。
  4. 把每种药物与其检测和风险联系起来：华法林与 INR，肝素与 aPTT 和血小板，利尿剂与血钾。
  5. 选择安全的第一步措施，然后升级处理并重新评估。

内外科护理：神经、内分泌与肾脏

方法

  1. 对每位新出现意识模糊、乏力或癫痫发作的患者都检查血糖。
  2. 把意识水平作为脑部问题最早的警示；瞳孔变化和库欣三联征出现得较晚。
  3. 对于糖尿病急症，要区分 DKA（酮体、酸中毒）和 HHS（渗透压很高、脱水）；先补液。
  4. 对于钠和水，要判断是 ADH 过多（SIADH）还是缺乏（尿崩症），并缓慢纠正慢性变化。
  5. 对于肾脏问题，把原因分为肾前性、肾性或肾后性，并监测血钾和液体。

内外科护理：消化、围手术期与肿瘤

方法

  1. 想一想可能隐藏着什么：内出血、无发热的感染、SpO₂ 正常背后的通气不足。
  2. 利用术后的时间来缩小并发症的范围：出血在数小时内，胸部问题在数天内，伤口和吻合口漏出现得更晚。
  3. 对于疼痛，要评估、用多模式镇痛治疗、重新评估，并且在每次使用阿片类药物时监测镇静程度。
  4. 对于癌症患者，把低谷期的任何疾病都当作中性粒细胞减少性脓毒症处理，并了解肿瘤急症。
  5. 对于烧伤，只计算浅二度/深二度和三度的面积，从烧伤的时刻开始计算 Parkland 时间，并根据尿量调整。

产科护理

方法

  1. 把产妇放在时间轴上定位：孕周、产程阶段或产后第几天，再判断此时什么是正常的。
  2. 找出处于危险中的对象：母亲、胎儿或新生儿，或者其中不止一个。
  3. 把发现与其原因联系起来：减速用 VEAL CHOP，出血用四个 T，产后用 BUBBLE-HE。
  4. 优先选择改善血流和氧合的措施（侧卧、停用缩宫素、宫底按摩），然后再升级处理。

儿科护理

方法

  1. 先记下患儿的年龄：它决定正常生命体征、发育里程碑和合适的疼痛量表。
  2. 评估气道、呼吸和循环，记住儿童代偿很久之后会迅速恶化。
  3. 让措施与发育阶段相匹配，并让家属参与。
  4. 检查答案对儿童是否安全：按体重计算，病毒感染不用阿司匹林，12 岁以下不用可待因。

精神科护理

方法

  1. 判断是否存在即时风险：自杀、暴力、药物急症或躯体疾病。
  2. 先保障安全：观察、移除危险物品、缓和局面、停用有害药物、寻求帮助。
  3. 选择治疗性回应：承认感受、陈述现实，避免虚假的安慰和“为什么”式提问。
  4. 尊重权利：采用限制最少的方案，知情同意，以及保密及其限度。

护理数学与单位换算

公制进位
1 kg = 1000 g, 1 g = 1000 mg, 1 mg = 1000 mcg, 1 L = 1000 mL
体重和长度
1 kg = 2.2 lb, 1 lb = 16 oz, 1 in = 2.54 cm, 1 ft = 12 in
家用计量
1 tsp = 5 mL, 1 tbsp = 15 mL, 1 fl oz = 30 mL, 1 cup = 8 fl oz = 240 mL
温度
°C = (°F − 32)·5/9, °F = °C·9/5 + 32
24 小时制
PM 1–11 点：加 12； 12 AM = 00:xx； 12 PM = 12:xx
给药速率
mcg/min × 60/1000 = mg/h
实验室换算系数
葡萄糖 1 mmol/L = 18 mg/dL； 肌酐 1 mg/dL = 88.4 µmol/L； Hb 1 g/dL = 10 g/L

方法

  1. 写出已知量及其单位，以及你想要的单位。
  2. 选定等量关系：kg、g、mg 和 mcg 之间，或 L 和 mL 之间为 1000；1 kg = 2.2 lb；1 tsp = 5 mL，1 tbsp = 15 mL，1 fl oz = 30 mL，1 cup = 240 mL。
  3. 写成分数，使不需要的单位相互约去；对于速率，每个变化的单位用一个分数。
  4. 检查方向：单位越小，数字越大。
  5. 只对最终答案取整，精度按题目所述。

剂量计算

由浓度计算剂量
体积 = 剂量 / 浓度
按体重给药
剂量 = mg/kg × 体重
片剂
片数 = 剂量 / 每片规格
单位
1 g = 1000 mg, 1 mg = 1000 mcg

方法

  1. 把医嘱剂量和药品规格换算为同一单位。
  2. 用“需要量除以现有量再乘以数量”：(D/H) × Q。
  3. 按体重给药时，先乘以以 kg 计的体重，再用日剂量除以给药次数。
  4. 先估算，再检查答案是否合理。

静脉输液速度

泵速
mL/h = volume (mL)/time (h)
滴速
drops/min = volume (mL) × drop factor / time (min)
输注时间
time (h) = volume (mL)/rate (mL/h)

方法

  1. 泵速 mL/h：体积除以以小时计的时间。
  2. 滴速 drops/min：体积 × 滴系数，再除以以分钟计的时间。
  3. 剩余时间：剩余体积除以速率。
  4. 按题目或设备的要求取整。

静脉输液与液体平衡

Holliday–Segar 每小时量
4 mL/kg（前 10 kg）+ 2 mL/kg（次 10 kg）+ 1 mL/kg（20 kg 以上每 kg）
Holliday–Segar 每日量
相同分段分别为 100 / 50 / 20 mL/kg
液体平衡
入量 − 出量
冰屑
按其体积的一半计算
尿量
mL/kg/h = mL / (kg × h)
输注时间
时间 (h) = 剩余体积 (mL) / 速率 (mL/h)
已输入体积
mL = 速率 × 时间

临床评估评分

格拉斯哥昏迷量表
GCS = E (1–4) + V (1–5) + M (1–6) = 3–15
Apgar
5 项体征 × 0–2 = 0–10； 7–10 令人放心， 4–6 中度异常， 0–3 低
Braden 量表
5 × (1–4) + 1 × (1–3) = 6–23； ≤ 18 有风险
Morse 跌倒评分
跌倒 25， 诊断 15， 辅助 15/30， 静脉输液 20， 步态 10/20， 精神状态 15
NEWS2 风险
0–4 低； 单项 3 分为中低； 5–6 中； ≥ 7 高
平均动脉压
MAP = (SBP + 2·DBP)/3 = DBP + PP/3
脉压和休克指数
PP = SBP − DBP, SI = HR/SBP
体质指数
BMI = kg/m² = 703·lb/in²

方法

  1. 找出题目使用的评分表及其范围（GCS 3–15，Apgar 0–10，Braden 6–23，Morse 0–125）。
  2. 分别为每个条目评分，将描述与其对应的等级匹配。
  3. 把各条目得分相加，并检查总分是否在范围内。
  4. 应用分界值：对于 NEWS2，还要查看是否有单项参数得 3 分。
  5. 对于导出的数值，使用 MAP = (SBP + 2·DBP)/3，PP = SBP − DBP，SI = HR/SBP，BMI = kg/m²。

2练习题

1.护理学基础中等

How should the opening of a stoma bag be cut?

  1. ATo fit closely around the stoma without pressing on it
  2. BIn any shape, as long as the bag sticks
  3. CMuch larger than the stoma so that the edge never rubs against it
  4. DSmaller than the stoma so it grips it tightly
2.护理学基础困难

What is the best way to check that a patient has learned to use an inhaler correctly?

  1. AAsk them to repeat the drug's name
  2. BAsk the patient to show how they use it
  3. CAsk whether they have any questions
  4. DAsk whether they have read the leaflet
3.感染控制与患者安全中等

A patient has orthostatic hypotension. Which teaching helps to prevent falls?

  1. AAvoid drinking fluids in the morning to reduce trips to the toilet
  2. BSit on the edge of the bed for a short time before standing up slowly
  3. CStand up straight after a hot shower to increase blood flow
  4. DGet out of bed quickly so the dizziness passes sooner
4.感染控制与患者安全困难

A patient refuses to wear an identification wristband. What should the nurse do?

  1. AForce the band onto the patient’s wrist
  2. BStop giving the patient any care until they agree to wear the band
  3. CAccept the refusal and identify the patient by room number and bed space instead
  4. DExplain why it is needed, use other ID methods per policy and document
5.优先排序与委派中等

Before giving a scheduled dose of metoprolol, which assessment is most important?

  1. ABowel sounds and urine color
  2. BApical pulse and blood pressure
  3. CTemperature and the latest pain score
  4. DBlood glucose and weight
6.优先排序与委派困难

A patient with a severe asthma attack had a PaCO₂ of 32 mmHg (4.3 kPa) on arrival. An hour later it is 46 mmHg (6.1 kPa), and the patient seems tired. What does this suggest?

  1. ARespiratory muscle fatigue with possible impending respiratory failure
  2. BThe patient is hyperventilating even more than before and needs calming
  3. CA laboratory error that should be ignored
  4. DThe asthma is improving, because the PaCO₂ is now near normal
7.临床护理中等

A patient receives IV furosemide for fluid overload. Which findings show the treatment is working?

  1. AIncreased urine output, less breathlessness and a falling weight
  2. BA rise in blood pressure and a new cough
  3. CFalling urine output, new ankle swelling and a rise in weight
  4. DA rise in weight and more lung crackles
8.临床护理困难

A patient with an epidural catheter develops new back pain and increasing leg weakness when the block should be wearing off. What should be suspected?

  1. AMuscle strain from lying in the same position in bed for many hours
  2. BAn epidural haematoma or abscess compressing the spinal cord
  3. CMild hypokalaemia
  4. DThe normal expected effect of the local anaesthetic
9.实验室检查值与电解质中等

一名抗利尿激素分泌失调综合征（SIADH）患者的钠为 128 mEq/L。护士预期会有哪项处方措施？

  1. A限制液体
  2. B鼓励多饮水
  3. C大量静脉输注 5% 葡萄糖
  4. D低钠饮食
10.实验室检查值与电解质困难

A patient has fever, chills, flank pain and costovertebral angle tenderness. Urinalysis shows many white cells and white cell casts. Which condition is most likely?

  1. ASimple cystitis
  2. BGlomerulonephritis
  3. CNephrotic syndrome
  4. DAcute pyelonephritis
11.药理学中等

Why are many drugs started at lower doses in older adults?

  1. ALower doses are cheaper for older patients
  2. BOlder adults absorb no drugs from the stomach
  3. COlder adults always weigh more than younger adults, so drugs last longer
  4. DKidney and liver clearance often decline, and sensitivity to drugs increases
12.药理学困难

A nurse gave a patient ten times the prescribed dose of hydromorphone. The patient is currently alert. What is the most appropriate sequence of actions?

  1. ASay nothing because the patient is alert
  2. BGive another dose later to balance it out
  3. CMonitor closely, have naloxone ready, inform the prescriber and report
  4. DChange the chart so that it shows the correct dose, and continue to monitor
13.内外科护理：心血管与呼吸中等

A woman with hypertension who takes lisinopril says she is planning a pregnancy. What should the nurse advise?

  1. AStop all blood pressure treatment straight away without telling anyone
  2. BDiscuss switching medicine with the prescriber before trying to conceive
  3. CDouble the dose to protect the baby from high blood pressure
  4. DContinue lisinopril, as it is the safest blood pressure drug in pregnancy
14.内外科护理：心血管与呼吸困难

A patient with a confirmed type A aortic dissection is hypertensive and tachycardic while awaiting surgery. Which drug class is usually given first to lower the heart rate and blood pressure?

  1. AOral aspirin
  2. BAn intravenous beta-blocker
  3. CAn intravenous thrombolytic
  4. DAn intravenous fluid bolus
15.内外科护理：神经、内分泌与肾脏中等

Where is the zero point of an external ventricular drain usually levelled?

  1. AAt the mid-axillary line of the chest
  2. BAt the top of the head
  3. CAt the tragus of the ear
  4. DAt the level of the umbilicus
16.内外科护理：神经、内分泌与肾脏困难

Six hours after a catheter is removed, a patient has not passed urine and feels uncomfortable. What should the nurse do?

  1. ATell the patient to drink two litres of water quickly
  2. BDo a bladder scan to check for retention
  3. CWait until the next morning before checking
  4. DPut the catheter back without assessing
17.内外科护理：消化、围手术期与肿瘤中等

Which change suggests that a burn wound is becoming infected?

  1. ADry, healing skin with mild itching
  2. BThe wound becoming pink and a little smaller at each dressing change
  3. CA partial-thickness burn becoming deeper, with new discolouration
  4. DLess exudate on each dressing change
18.内外科护理：消化、围手术期与肿瘤困难

A nurse teaches a patient going home between chemotherapy cycles. Which statement shows a need for further teaching?

  1. A"I'll wash my hands often and avoid people with infections."
  2. B"I'll keep the emergency number and call if I feel shivery."
  3. C"I'll check my temperature whenever I feel hot, shivery or unwell."
  4. D"If I get a fever, I'll take paracetamol and see if it settles."
19.产科护理中等

一名子痫前期的女性主诉剧烈头痛并看到闪光。这提示什么？

  1. A低血糖
  2. B紧张性头痛，在妊娠晚期常见且无害
  3. C伴有严重表现的子痫前期，有发生子痫的风险
  4. D硫酸镁的正常作用
20.产科护理困难

一名妊娠 30 周的女性每 5 分钟出现一次规律的疼痛性宫缩，并伴有宫颈改变。如果发生分娩，预期使用哪种治疗来保护婴儿的肺？

  1. A抗 D 免疫球蛋白
  2. B甲麦角新碱
  3. C产前皮质类固醇
  4. D缩宫素
21.儿科护理中等

一名儿童在同一次就诊时需要接种几种不同的疫苗。一般原则是什么？

  1. A应将每种疫苗分半剂，分散在几周内接种
  2. B可以在同一次就诊时接种，选择不同的注射部位
  3. C所有疫苗应混在同一支注射器里
  4. D每月只能接种一种疫苗
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. ANo; it may ease discomfort but does not prevent febrile seizures
  2. BNo, because paracetamol can cause febrile seizures
  3. CYes; giving it every 4 hours during a fever will always prevent seizures
  4. DYes, but only if a cold bath is given at the same time
23.精神科护理中等

According to DSM-5, how long must signs of the disturbance last before schizophrenia can be diagnosed?

  1. AAt least 2 weeks of continuous symptoms
  2. BAt least 6 months, including at least 1 month of active symptoms
  3. CAt least 1 month, with no further time required
  4. DAt least 2 years, including 6 months of active symptoms
24.精神科护理困难

ECT 治疗后即刻，一名患者在恢复区昏昏欲睡。护理的优先事项是什么？

  1. A立即给一顿丰盛的早餐
  2. B让患者独自走回病房
  3. C维持气道，让患者侧卧，并监测生命体征
  4. D详细测试患者的长期记忆，以检查是否有持久损害
25.护理数学与单位换算中等
94969810010210410635363738394041°F°C? °F38.8 °C

练习题（虚构数值，不作为临床指导）。 一位患者的体温为 38.8 °C。用 °F = °C × 9/5 + 32 把它换算为华氏度T。取到一位小数。

38.8 °C
T = °F
26.护理数学与单位换算困难
4 tbsp? mL2 fl oz? mL2 杯? mL½ tsp? mLΣ = ? mL

练习题（虚构数值，不作为临床指导）。 一个班次中，患者摄入了4 tbsp / 液体营养补充剂, 2 fl oz / 果汁, 2 杯 / 茶, ½ tsp / 止咳糖浆。按给出的等量关系，求以 mL 表示的口服总摄入量V。

1 tbsp = 15 mL1 fl oz = 30 mL1 杯 = 8 fl oz = 240 mL1 tsp = 5 mL
V = mL
27.剂量计算中等
2 g+ 9.2 mLV = ? mL

一个药瓶中含有 2 g 的粉末。标签上写着：加入 9.2 mL 注射用水，得到总容量 10 mL。医嘱为 600 mg。你应给予复溶后溶液的多少容量 V？

2 g+ 9.2 mL → 10 mL600 mg
V = mL
28.剂量计算困难
10%储备液V₁ = ? mL

你需要用 10%（w/v）储备液配制 200 mL 5%（w/v）溶液。 你需要多少容量的储备液 V₁？

C₁ = 10%C₂ = 5%V₂ = 200 mL
V₁ = mL
29.静脉输液速度中等
V = ?20 gtt/mL35 gtt/min6 h

滴注以 35 gtt/min 的速度通过滴系数为 20 gtt/mL 的输液器。患者在 6 小时内接受多少毫升 V？

35 gtt/min20 gtt/mL6 h
V = mL
30.静脉输液速度困难
500 mg50 mL8 mL/h? mg/h

一袋液体在 50 mL 中含药 500 mg，以 8 mL/h 的速度输注。患者每小时获得多少毫克 D？

500 mg/50 mL8 mL/h
D = mg/h
31.静脉输液与液体平衡中等
入量出量8 小时班次汤200 mL果冻100 mL茶240 mL冰屑240 mL静脉输液50 mL/h × 8 h静脉抗生素1 × 50 mL尿液375 mL尿液175 mL尿液175 mL伤口引流50 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 8 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。

汤: 200 mL果冻: 100 mL茶: 240 mL冰屑: 240 mL静脉输液: 50 mL/h × 8 h静脉抗生素: 1 × 50 mL
I = mL
32.静脉输液与液体平衡困难
500 mL50 mL/h开始 11:0013:00: ? mL

练习题（虚构数值，不作为临床指导）。 一袋 500 mL 的液体于 11:00 开始用输液泵以 50 mL/h 输注。到 13:00 时袋中还剩多少 mL V？

500 mL50 mL/h11:00 → 13:00
V = mL
33.临床评估评分中等
10166SBPDBPmmHgHR 129/min · SI = ?

练习题（虚构数值，不作为临床指导）。 一位患者的脉搏为 129 次/分，血压为 101/66 mmHg。求休克指数SI = HR/SBP。取到两位小数。

HR 129/minBP 101/66 mmHg
SI =
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 18 次/分，SpO₂ 88%吸室内空气，血压 112/68 mmHg，脉搏 126 次/分，清醒，体温 35.8 °C。患者属于哪个临床风险组？点击它。

RR 18SpO₂ 88%空气SBP 112HR 126AT 35.8 °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: A · To fit closely around the stoma without pressing on it

为什么是这个答案

The opening should fit snugly so stoma output does not reach the skin, but not so tight that it damages the stoma. Stomas shrink in the weeks after surgery, so the size is re-measured.

答案

A · To fit closely around the stoma without pressing on it
2.护理学基础

答案: B · Ask the patient to show how they use it

为什么是这个答案

A return demonstration shows whether a psychomotor skill has been learned and lets the nurse correct mistakes. Saying "yes, I understand" does not prove the technique is right.

答案

B · Ask the patient to show how they use it
3.感染控制与患者安全

答案: B · Sit on the edge of the bed for a short time before standing up slowly

为什么是这个答案

Changing position slowly, dangling the legs first and getting up with help give the circulation time to adjust. Rapid standing, heat and dehydration make orthostatic hypotension worse.

答案

B · Sit on the edge of the bed for a short time before standing up slowly
4.感染控制与患者安全

答案: D · Explain why it is needed, use other ID methods per policy and document

为什么是这个答案

The nurse explains how the band prevents errors. If the patient still refuses, the nurse follows policy for alternative identification using two identifiers, informs the team and documents it.

答案

D · Explain why it is needed, use other ID methods per policy and document
5.优先排序与委派

答案: B · Apical pulse and blood pressure

为什么是这个答案

Metoprolol can cause bradycardia and hypotension, so the nurse checks the apical pulse and blood pressure first. The dose is held and reported according to the prescribed parameters.

答案

B · Apical pulse and blood pressure
6.优先排序与委派

答案: A · Respiratory muscle fatigue with possible impending respiratory failure

为什么是这个答案

Early in an asthma attack, fast breathing lowers the PaCO₂. A rising, “normal” value in a tiring patient means they can no longer move enough air, which is a warning sign of respiratory failure.

答案

A · Respiratory muscle fatigue with possible impending respiratory failure
7.临床护理

答案: A · Increased urine output, less breathlessness and a falling weight

为什么是这个答案

Effective diuresis increases urine output and reduces congestion, so breathing improves and weight falls. Electrolytes, renal function and blood pressure are also monitored.

答案

A · Increased urine output, less breathlessness and a falling weight
8.临床护理

答案: B · An epidural haematoma or abscess compressing the spinal cord

为什么是这个答案

Increasing motor block, back pain or new weakness after an epidural can mean a haematoma or abscess compressing the cord. This is a surgical emergency: stop the infusion and get urgent medical review.

答案

B · An epidural haematoma or abscess compressing the spinal cord
9.实验室检查值与电解质

答案: A · 限制液体

为什么是这个答案

在 SIADH 中，过多的抗利尿激素使肾脏潴留水分，稀释了钠。限制液体是首要措施。低渗液体或额外的水会使钠进一步降低。核对依据: Syndrome of inappropriate antidiuretic hormone secretion · MedlinePlus (NIH) (2025)

答案

A · 限制液体
10.实验室检查值与电解质

答案: D · Acute pyelonephritis

为什么是这个答案

White cell casts show that the inflammation is in the kidney itself, not just the bladder. With fever and flank pain this indicates pyelonephritis. Glomerulonephritis typically causes red cell casts, and nephrotic syndrome causes heavy protein loss.核对依据: Urinary casts · MedlinePlus (NIH) (2025); Glomerulonephritis · MedlinePlus (NIH) (2025)

答案

D · Acute pyelonephritis
11.药理学

答案: D · Kidney and liver clearance often decline, and sensitivity to drugs increases

为什么是这个答案

Ageing reduces kidney function, changes body composition and often slows liver metabolism. Many drugs also have stronger effects on the ageing brain, so doses are started low and increased slowly.

答案

D · Kidney and liver clearance often decline, and sensitivity to drugs increases
12.药理学

答案: C · Monitor closely, have naloxone ready, inform the prescriber and report

为什么是这个答案

The patient may become sedated and develop respiratory depression later, so close monitoring and a ready antidote are needed. The prescriber is informed, the patient is told honestly, and the error is reported to improve the system.

答案

C · Monitor closely, have naloxone ready, inform the prescriber and report
13.内外科护理：心血管与呼吸

答案: B · Discuss switching medicine with the prescriber before trying to conceive

为什么是这个答案

ACE inhibitors and ARBs are contraindicated in pregnancy because they can damage fetal kidneys and cause other harm. Women of childbearing age should be counselled and switched to a suitable alternative, such as labetalol or nifedipine, before conception or as soon as pregnancy is confirmed.

答案

B · Discuss switching medicine with the prescriber before trying to conceive
14.内外科护理：心血管与呼吸

答案: B · An intravenous beta-blocker

为什么是这个答案

In acute dissection, IV beta-blockers are usually given first to reduce heart rate and the rate of rise of pressure, limiting extension of the tear. Vasodilators may follow once the heart rate is controlled. Antiplatelets, anticoagulants and thrombolytics are avoided. Type A dissection needs urgent surgery.

答案

B · An intravenous beta-blocker
15.内外科护理：神经、内分泌与肾脏

答案: C · At the tragus of the ear

为什么是这个答案

The EVD is levelled at the tragus, which approximates the foramen of Monro. If the head of the bed is changed, the drain must be re-levelled, because its height decides how much CSF drains.

答案

C · At the tragus of the ear
16.内外科护理：神经、内分泌与肾脏

答案: B · Do a bladder scan to check for retention

为什么是这个答案

After catheter removal, the patient is monitored for voiding. Discomfort without voiding suggests retention. A bladder scan shows the volume, and the team decides whether to re-catheterise or use intermittent catheterisation.

答案

B · Do a bladder scan to check for retention
17.内外科护理：消化、围手术期与肿瘤

答案: C · A partial-thickness burn becoming deeper, with new discolouration

为什么是这个答案

Signs of burn wound infection include conversion to a deeper burn, new dark or green discolouration, increasing pain, offensive exudate, spreading redness and systemic signs such as fever or tachycardia.

答案

C · A partial-thickness burn becoming deeper, with new discolouration
18.内外科护理：消化、围手术期与肿瘤

答案: D · "If I get a fever, I'll take paracetamol and see if it settles."

为什么是这个答案

Fever or feeling unwell during the nadir may mean neutropenic sepsis, which needs urgent assessment and antibiotics within an hour. Patients must call the emergency line straight away, not wait at home.

答案

D · "If I get a fever, I'll take paracetamol and see if it settles."
19.产科护理

答案: C · 伴有严重表现的子痫前期，有发生子痫的风险

为什么是这个答案

新出现的剧烈头痛和视觉障碍是重度子痫前期的脑部征象，可能先于抽搐出现。需要紧急上报。

答案

C · 伴有严重表现的子痫前期，有发生子痫的风险
20.产科护理

答案: C · 产前皮质类固醇

为什么是这个答案

产前皮质类固醇可减少早产儿的呼吸窘迫。可使用宫缩抑制剂争取时间，当可能在约 32 周前分娩时，可给予硫酸镁以保护胎儿神经。

答案

C · 产前皮质类固醇
21.儿科护理

答案: B · 可以在同一次就诊时接种，选择不同的注射部位

为什么是这个答案

一次就诊接种几种疫苗是安全有效的，并可避免延误。应使用不同的注射器和部位，如在同一肢体，至少相距约 2.5 cm。除非产品是专门设计的，否则切勿混合疫苗。

答案

B · 可以在同一次就诊时接种，选择不同的注射部位
22.儿科护理

答案: A · 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

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

答案: B · At least 6 months, including at least 1 month of active symptoms

为什么是这个答案

Schizophrenia needs continuous signs for at least 6 months, with at least 1 month of active-phase symptoms such as delusions or hallucinations. An episode of 1 to 6 months is schizophreniform disorder.

答案

B · At least 6 months, including at least 1 month of active symptoms
24.精神科护理

答案: C · 维持气道，让患者侧卧，并监测生命体征

为什么是这个答案

ECT 后，在患者完全清醒之前，优先事项是气道和呼吸，同时监测生命体征和定向力。进食和行走要等患者清醒且吞咽安全之后。

答案

C · 维持气道，让患者侧卧，并监测生命体征
25.护理数学与单位换算

答案: T = 101.8 °F

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。

乘以 9/5

38.8·9/5 = 69.84

加 32

T = 69.84 + 32 = 101.8 °F

答案

T = 101.8 °F
26.护理数学与单位换算

答案: V = 602.5 mL

家用计量和体重：护理考试使用取整的等量关系：1 茶匙（tsp）= 5 mL，1 汤匙（tbsp）= 15 mL = 3 tsp，1 液量盎司（fl oz）= 30 mL = 2 tbsp，1 杯 = 8 fl oz = 240 mL。体重方面，1 kg = 2.2 lb，1 lb = 16 oz；长度方面，1 英寸 = 2.54 cm。设置换算时，要让你不需要的单位相互约去。

每一项的 mL 数

4 tbsp = 4·15 = 60 mL
2 fl oz = 2·30 = 60 mL
2 杯 = 2·240 = 480 mL
½ tsp = 0.5·5 = 2.5 mL

相加

V = 60 + 60 + 480 + 2.5 = 602.5 mL

答案

V = 602.5 mL
27.剂量计算

答案: V = 3 mL

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

混合后的浓度

2000 mg/10 mL = 200 mg/mL

体积

V = 600/200 = 3 mL

答案

V = 3 mL
28.剂量计算

答案: V₁ = 100 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 = 5·200/10 = 100 mL

答案

V₁ = 100 mL
29.静脉输液速度

答案: V = 630 mL

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.

速度（mL/h）

35·60/20 = 105 mL/h

体积

V = 105·6 = 630 mL

答案

V = 630 mL
30.静脉输液速度

答案: D = 80 mg/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。

浓度

500/50 = 10 mg/mL

给药速率

D = 10·8 = 80 mg/h

答案

D = 80 mg/h
31.静脉输液与液体平衡

答案: I = 1110 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: 200 + 100 + 240 = 540 mL
冰屑: 240/2 = 120 mL
静脉输液: 50·8 = 400 mL
静脉抗生素: 1·50 = 50 mL
I = 1110 mL

答案

I = 1110 mL
32.静脉输液与液体平衡

答案: V = 400 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

11:00 → 13:00 = 2 h

已输入体积

50·2 = 100 mL

剩余体积

V = 500 − 100 = 400 mL

答案

V = 400 mL
33.临床评估评分

答案: SI = 1.28

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 = 129/101 = 1.277 ≈ 1.28

答案

SI = 1.28

1 或更高：在这个练习病例中是休克的警示信号。

34.临床评估评分

答案: 中

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 18/min → 0
SpO₂ 88% → 3
吸空气 → 0
SBP 112 mmHg → 0
HR 126/min → 2
清醒 (A) → 0
T 35.8 °C → 1

总分和红色分值

NEWS2 = 0 + 3 + 0 + 0 + 2 + 0 + 1 = 6
至少有一个参数得 3 分。

风险组

中

答案

中

总分 5 或以上需要紧急的临床响应。

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