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 is getting up for the first time after several days in bed. What should the nurse do first?

  1. AAsk the patient to walk to the bathroom alone
  2. BHave the patient sit on the edge of the bed for a short time before standing
  3. CHelp the patient stand up quickly, so that the dizziness has less time to start
  4. DGive the patient a large drink of water while standing
2.护理学基础困难

ABO 血型不相容输血最常见的原因是什么？

  1. A输血速度太慢
  2. B对塑料血袋过敏
  3. C血液储存温度错误
  4. D患者或标本识别错误
3.感染控制与患者安全中等

A nurse’s hands are dry and cracked from frequent hand hygiene. What is the best approach?

  1. AWear gloves all day instead of cleaning the hands between patients
  2. BStop hand hygiene until the skin heals
  3. CUse any lotion from home, whatever its contents
  4. DUse the hand lotion approved by the facility to keep the skin intact
4.感染控制与患者安全困难

Before the wound is closed, the sponge count does not match the starting count. What should happen?

  1. AClose the wound to avoid a long anesthetic and recount the sponges after surgery
  2. BTell the surgeon and team, search for the item, and image the patient per policy if it is not found
  3. CChange the count on the record so that it matches, then close the wound as planned
  4. DAssume that the first count was wrong and continue
5.优先排序与委派中等

After a hip replacement using a posterior approach, which statement shows a need for further teaching?

  1. A“I will cross my legs when I sit, so I am more comfortable.”
  2. B“I will use a raised toilet seat at home.”
  3. C“I will not bend my hip past 90 degrees.”
  4. D“I will keep a pillow between my knees when I lie on my side in bed.”
6.优先排序与委派困难

A toddler with tetralogy of Fallot becomes very blue and breathless while crying. What should the nurse do first?

  1. AGive a large drink of water to calm the child
  2. BEncourage the child to keep crying to open the lungs
  3. CPlace the child in a knee-to-chest position
  4. DLay the child flat on their back
7.临床护理中等

A patient says they are "allergic" to codeine because it made them constipated. How should this be recorded?

  1. AAs a severe anaphylactic allergy to all opioids
  2. BIt should not be recorded at all
  3. CAs a side effect or intolerance, not a true allergy
  4. DAs an allergy to all painkillers
8.临床护理困难

Why should chronic hypernatraemia be corrected gradually?

  1. AFast correction causes osmotic demyelination from swelling of the kidneys
  2. BFast correction causes severe hyperkalaemia
  3. CLowering the sodium too fast can cause cerebral oedema
  4. DSlow correction is only needed in children
9.实验室检查值与电解质中等

一名服用呋塞米的患者钾为 2.9 mEq/L。护士预期会出现哪项发现？

  1. A心电图上 T 波高尖
  2. B口周麻刺感，Chvostek 征阳性
  3. C肌肉无力和腿部抽筋
  4. D肠道过度活跃引起的腹泻和腹部绞痛
10.实验室检查值与电解质困难

A patient with kidney stones and fatigue has a calcium of 11.6 mg/dL (2.9 mmol/L), a high parathyroid hormone (PTH) and a low phosphate. Which condition is most likely?

  1. APrimary hyperparathyroidism
  2. BVitamin D deficiency
  3. CHypoparathyroidism
  4. DCancer-related hypercalcemia
11.药理学中等

Which lab tests are monitored in a patient taking carbamazepine?

  1. AThyroid antibodies and cortisol
  2. BFull blood count and serum sodium
  3. CSerum amylase and lipase
  4. DINR and aPTT
12.药理学困难

A patient with latent tuberculosis feels well and is not infectious. Why is treatment such as isoniazid still offered?

  1. ATo cure an active lung infection
  2. BTo prevent progression to active TB later
  3. CTo stop the patient spreading TB at the moment
  4. DTo produce a negative skin test quickly
13.内外科护理：心血管与呼吸中等

How does digoxin help a patient with atrial fibrillation and heart failure?

  1. AIt slows AV node conduction and increases contractility
  2. BIt lowers potassium to stabilise the heart
  3. CIt dissolves clots that have formed in the left atrium
  4. DIt speeds conduction through the AV node to the ventricles
14.内外科护理：心血管与呼吸困难

一名因心房颤动服用华法林的患者被开具克拉霉素。哪项措施最恰当？

  1. A不作任何改变，因为抗生素不影响华法林
  2. B整个抗生素疗程期间停用华法林
  3. C询问是否应提前检查 INR，因为它可能升高
  4. D疗程期间将华法林剂量加倍
15.内外科护理：神经、内分泌与肾脏中等

Which nursing care is most important for a patient with diabetes insipidus?

  1. AStrict fluid balance, daily weight and free access to water
  2. BA strict fluid restriction to reduce the amount of urine passed
  3. CGiving a loop diuretic to clear extra fluid
  4. DWeighing the patient once a month
16.内外科护理：神经、内分泌与肾脏困难

A prescription reads "Insulin 10U". Why is this a safety problem?

  1. AThere is no problem as long as the nurse can read it
  2. B"U" can be misread as a zero, giving a tenfold dose
  3. C"U" means the insulin must be given intravenously
  4. DInsulin doses must always be written in millilitres
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 bowel sounds are present in all four quadrants
  3. CThat the patient has passed urine since the procedure
  4. DThat the patient's blood glucose is above normal
18.内外科护理：消化、围手术期与肿瘤困难

A patient on chemotherapy has white plaques on the tongue and cheeks that wipe off to leave red areas. What is most likely?

  1. AOral candidiasis
  2. BFood residue only
  3. CNormal mucositis healing
  4. DLeukoplakia from smoking
19.产科护理中等

A woman with hyperemesis gravidarum has been vomiting for weeks. Which vitamin is given before glucose-containing fluids to prevent Wernicke encephalopathy?

  1. AThiamine (vitamin B1)
  2. BVitamin D
  3. CPhytomenadione (vitamin K)
  4. DAscorbic acid (vitamin C)
20.产科护理困难

A woman at 12 weeks has light bleeding and mild cramping. The cervix is closed and fetal heart activity is seen on ultrasound. How is this classified?

  1. AThreatened miscarriage
  2. BMissed miscarriage
  3. CIncomplete miscarriage
  4. DInevitable miscarriage
21.儿科护理中等

一名儿童在咽痛两周后出现可乐色尿、眼睑浮肿和高血压。可能的诊断是什么？

  1. A尿路感染
  2. B肾病综合征
  3. CWilms 瘤
  4. D急性链球菌感染后肾小球肾炎
22.儿科护理困难

A 12-year-old with asthma has been prescribed a preventer inhaler (inhaled corticosteroid) to take every day. Which statement shows a need for further teaching?

  1. A"I stop taking my preventer inhaler whenever I've had a few good days."
  2. B"I rinse my mouth after using my preventer inhaler."
  3. C"I use my spacer with my inhaler, even at school."
  4. D"I carry my reliever inhaler with me everywhere I go."
23.精神科护理中等

How does memantine work in Alzheimer's disease?

  1. AIt inhibits the breakdown of acetylcholine
  2. BIt blocks NMDA glutamate receptors
  3. CIt blocks dopamine D2 receptors
  4. DIt increases serotonin by blocking its reuptake
24.精神科护理困难

A 6-month-old has a spiral fracture of the arm. The parents say he "rolled off the sofa". The nurse also notices bruises of different colours on his back. What is the most appropriate action?

  1. ATell the parents that the nurse knows they are abusing the child
  2. BDischarge the child quickly so that the parents do not become angry and stop bringing him for medical care
  3. CReport the concerns through child protection procedures and ensure the child's safety
  4. DAccept the parents' explanation, because babies often fall
25.护理数学与单位换算中等
94969810010210410635363738394041°F°C97.8 °F? °C

练习题（虚构数值，不作为临床指导）。 一位患者的体温为 97.8 °F。用 °C = (°F − 32) × 5/9 把它换算为摄氏度T。取到一位小数。

97.8 °F
T = °C
26.护理数学与单位换算困难
119 g/L? g/dL1 L = 10 dL

练习题（虚构数值，不作为临床指导）。 血红蛋白结果为 119 g/L。请用 g/dL 表示Hb。

119 g/L1 L = 10 dL
Hb = g/dL
27.剂量计算中等
2%w/vV = ? mL

需要从 2%（w/v）溶液中取 10 mg 的剂量。多少容量 V 含有这一剂量？

10 mg2% w/v
V = mL
28.剂量计算困难
00.10.20.30.40.50.60.70.80.911 mL

处方为 2800 单位的药物，药液规格为 10000 单位/mL。请用 1 mL 注射器抽取剂量：应给多少体积 V？

2800 units10000 units/mL
V = mL
29.静脉输液速度中等
250 mL10 gtt/mL5 h? gtt/min

用滴系数为 10 滴/mL 的输液器在 5 小时内输入 250 mL。求滴速 R（滴/分）。 取整到最接近的整数。

250 mL5 h10 gtt/mL
R = gtt/min
30.静脉输液速度困难
4 g500 mL? mL/h4 mg/min

一袋中含有 4 g 药物，溶于 500 mL。医嘱为每分钟 4 mg。泵速 R 应设为多少 mL/h？

4 g/500 mL4 mg/min
R = mL/h
31.静脉输液与液体平衡中等
入量出量12 小时班次汤180 mL牛奶100 mL水350 mL静脉输液80 mL/h × 12 h静脉抗生素2 × 100 mL尿液325 mL尿液175 mL尿液500 mL伤口引流110 mL呕吐物200 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）。

汤: 180 mL牛奶: 100 mL水: 350 mL静脉输液: 80 mL/h × 12 h静脉抗生素: 2 × 100 mL尿液: 325 mL尿液: 175 mL尿液: 500 mL伤口引流: 110 mL呕吐物: 200 mL
B = mL
32.静脉输液与液体平衡困难
500 mL→ 75 mL/h开始 14:00t总数​ = ? h100 mL/h × 3 h

练习题（虚构数值，不作为临床指导）。 一份 500 mL 的输液于 14:00 开始以 100 mL/h 输注。3 小时后速率改为 75 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。

500 mL100 mL/h · 3 h75 mL/h
t = h
33.临床评估评分中等
S? / 4+M? / 4+A? / 4+Mob? / 4+N? / 4+F? / 3Σ?

练习题（虚构数值，不作为临床指导）。 用 Braden 量表评估一位练习患者：感觉知觉: 轻度受限; 潮湿程度: 持续潮湿; 活动: 偶尔步行; 活动能力: 不受限制; 营养: 充足; 摩擦力和剪切力: 有问题。求 Braden 总分B。

6–23
B =
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 41 kg，身高 163 cm。计算 BMI 并点击 WHO 体重分类。

41 kg163 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 · Have the patient sit on the edge of the bed for a short time before standing

为什么是这个答案

After bed rest blood pressure may drop on standing. Sitting on the edge of the bed first, with the feet on the floor, lets the body adjust and lowers the risk of fainting and falls.

答案

B · Have the patient sit on the edge of the bed for a short time before standing
2.护理学基础

答案: D · 患者或标本识别错误

为什么是这个答案

大多数输错血事件源于识别错误，例如标本标签贴错或省略了床旁身份核对。在每一步都确认患者身份可以预防这类事件。

答案

D · 患者或标本识别错误
3.感染控制与患者安全

答案: D · Use the hand lotion approved by the facility to keep the skin intact

为什么是这个答案

Cracked skin is harder to clean and harbors more organisms. Facility-approved lotions help keep the skin healthy without reducing the effect of hand antiseptics such as chlorhexidine.

答案

D · Use the hand lotion approved by the facility to keep the skin intact
4.感染控制与患者安全

答案: B · Tell the surgeon and team, search for the item, and image the patient per policy if it is not found

为什么是这个答案

A count discrepancy is reported to the whole team at once. Closure waits while the field, wound and room are searched, and an x-ray is taken per policy if the item is still missing.

答案

B · Tell the surgeon and team, search for the item, and image the patient per policy if it is not found
5.优先排序与委派

答案: A · “I will cross my legs when I sit, so I am more comfortable.”

为什么是这个答案

After a posterior hip replacement, crossing the legs, bending the hip beyond 90 degrees and turning the leg inwards can cause dislocation. Raised seats and a pillow between the knees help prevent it.

答案

A · “I will cross my legs when I sit, so I am more comfortable.”
6.优先排序与委派

答案: C · Place the child in a knee-to-chest position

为什么是这个答案

In a hypercyanotic (“tet”) spell, the knee-chest position raises systemic vascular resistance and sends more blood to the lungs. Oxygen and prescribed medication follow.

答案

C · Place the child in a knee-to-chest position
7.临床护理

答案: C · As a side effect or intolerance, not a true allergy

为什么是这个答案

Constipation is a predictable side effect of opioids, not an immune response. Recording it accurately avoids withholding useful medicines while still noting the patient's experience.

答案

C · As a side effect or intolerance, not a true allergy
8.临床护理

答案: C · Lowering the sodium too fast can cause cerebral oedema

为什么是这个答案

In chronic hypernatraemia, brain cells adapt by holding extra solutes. If sodium falls too quickly, water moves into brain cells and causes cerebral oedema, so correction is controlled.

答案

C · Lowering the sodium too fast can cause cerebral oedema
9.实验室检查值与电解质

答案: C · 肌肉无力和腿部抽筋

为什么是这个答案

低钾引起肌肉无力、抽筋、肠蠕动减弱（便秘，甚至肠麻痹）和心律失常。T 波高尖见于高钾血症，口周麻刺感提示低钙。核对依据: Heart failure - fluids and diuretics · MedlinePlus (NIH); Low blood potassium · MedlinePlus (NIH) (2025)

答案

C · 肌肉无力和腿部抽筋
10.实验室检查值与电解质

答案: A · Primary hyperparathyroidism

为什么是这个答案

In primary hyperparathyroidism, usually from an adenoma, PTH is high despite high calcium, and phosphate is low because PTH increases its excretion. Cancer-related hypercalcemia typically has a suppressed PTH.核对依据: Parathyroid Hormone (PTH) Test · MedlinePlus (NIH) (2023); Hyperparathyroidism · MedlinePlus (NIH) (2026)

答案

A · Primary hyperparathyroidism
11.药理学

答案: B · Full blood count and serum sodium

为什么是这个答案

Carbamazepine can rarely cause bone marrow suppression and commonly lowers serum sodium. Blood counts, sodium and liver tests are checked, especially early in treatment.

答案

B · Full blood count and serum sodium
12.药理学

答案: B · To prevent progression to active TB later

为什么是这个答案

People with latent TB carry dormant bacteria that can reactivate, especially if immunity weakens. Treatment reduces the risk of active disease, which would be infectious.

答案

B · To prevent progression to active TB later
13.内外科护理：心血管与呼吸

答案: A · It slows AV node conduction and increases contractility

为什么是这个答案

Digoxin inhibits the Na⁺/K⁺-ATPase, raising intracellular calcium and contractility, and increases vagal tone, slowing AV conduction and the ventricular rate. It controls symptoms but does not reduce stroke risk, so anticoagulation is still needed in AF.

答案

A · It slows AV node conduction and increases contractility
14.内外科护理：心血管与呼吸

答案: C · 询问是否应提前检查 INR，因为它可能升高

为什么是这个答案

包括克拉霉素等大环内酯类、某些氟喹诺酮类和复方磺胺甲噁唑在内的几种抗生素，可使 INR 升高并增加出血风险。需要更密切地监测 INR，并可能需要调整剂量。未经建议停用或加倍华法林是不安全的。

答案

C · 询问是否应提前检查 INR，因为它可能升高
15.内外科护理：神经、内分泌与肾脏

答案: A · Strict fluid balance, daily weight and free access to water

为什么是这个答案

Patients with DI can become dehydrated and hypernatraemic quickly. Strict input and output, daily weights, sodium monitoring and access to water are essential. Desmopressin replaces the missing ADH in cranial DI.

答案

A · Strict fluid balance, daily weight and free access to water
16.内外科护理：神经、内分泌与肾脏

答案: B · "U" can be misread as a zero, giving a tenfold dose

为什么是这个答案

A handwritten "U" can look like a 0, turning 10 units into 100. The word "units" must be written in full. Insulin errors are a well-known cause of serious harm.

答案

B · "U" can be misread as a zero, giving a tenfold dose
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 · Oral candidiasis

为什么是这个答案

Oral thrush is common during chemotherapy, especially with steroids or antibiotics. It is reported so that antifungal treatment can be prescribed, and good oral care continues.

答案

A · Oral candidiasis
19.产科护理

答案: A · Thiamine (vitamin B1)

为什么是这个答案

Prolonged vomiting depletes thiamine. Giving glucose without thiamine can trigger Wernicke encephalopathy, with confusion, ataxia and eye movement problems.

答案

A · Thiamine (vitamin B1)
20.产科护理

答案: A · Threatened miscarriage

为什么是这个答案

Bleeding with a closed cervix and a viable pregnancy is a threatened miscarriage; many continue normally. An open cervix means an inevitable or incomplete miscarriage, and a missed miscarriage has no fetal heart activity.

答案

A · Threatened miscarriage
21.儿科护理

答案: D · 急性链球菌感染后肾小球肾炎

为什么是这个答案

链球菌感染后肾小球肾炎出现在咽部感染后约 1–3 周（皮肤感染后则更晚），引起血尿、水肿和高血压。需监测血压、液体平衡和体重。

答案

D · 急性链球菌感染后肾小球肾炎
22.儿科护理

答案: A · "I stop taking my preventer inhaler whenever I've had a few good days."

为什么是这个答案

Preventer (inhaled corticosteroid) inhalers reduce airway inflammation and must be taken daily as prescribed, even when the child feels well. Carrying a reliever, rinsing the mouth and using a spacer are correct.

答案

A · "I stop taking my preventer inhaler whenever I've had a few good days."
23.精神科护理

答案: B · It blocks NMDA glutamate receptors

为什么是这个答案

Memantine is an NMDA receptor antagonist used in moderate to severe Alzheimer's disease. It may be combined with a cholinesterase inhibitor.

答案

B · It blocks NMDA glutamate receptors
24.精神科护理

答案: C · Report the concerns through child protection procedures and ensure the child's safety

为什么是这个答案

Injuries that do not fit the child's developmental stage or the history, and bruises of different ages, are warning signs of abuse. The nurse documents objectively and reports through safeguarding procedures.

答案

C · Report the concerns through child protection procedures and ensure the child's safety
25.护理数学与单位换算

答案: T = 36.6 °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

97.8 − 32 = 65.8

乘以 5/9

T = 65.8·5/9 = 36.56 ≈ 36.6 °C

答案

T = 36.6 °C
26.护理数学与单位换算

答案: Hb = 11.9 g/dL

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

Hb = 119 g/L × (1 L/10 dL) = 11.9 g/dL

答案

Hb = 11.9 g/dL
27.剂量计算

答案: V = 0.5 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.

浓度

2% = 20 mg/mL

体积

V = 10/20 = 0.5 mL

答案

V = 0.5 mL
28.剂量计算

答案: V = 0.28 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。

体积

V = 2800/10000 = 0.28 mL

在注射器上

在这支 1 mL 的注射器上，每条小刻度线代表 0.01 mL。

答案

V = 0.28 mL
29.静脉输液速度

答案: R = 8 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

5·60 = 300 min

滴速

R = 250·10/300 = 8.333 ≈ 8 gtt/min

答案

R = 8 gtt/min

床旁取最接近的整滴：8 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

4000 mg/500 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 = 480 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: 180 + 100 + 350 = 630 mL
静脉输液: 80·12 = 960 mL
静脉抗生素: 2·100 = 200 mL
总入量 = 1790 mL

总出量

325 + 175 + 500 + 110 + 200 = 1310 mL

平衡

B = 1790 − 1310 = 480 mL

答案

B = 480 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 = 5.7 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

100·3 = 300 mL
500 − 300 = 200 mL 剩余

第二部分

200/75 = 2.667 h

总时间

t = 3 + 2.667 = 5.667 ≈ 5.7 h

答案

t = 5.7 h

约为 5 h 40 min，所以袋子大约在 19:40 输完。

33.临床评估评分

答案: B = 15

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

为每个分项评分

感觉知觉: 轻度受限 → 3
潮湿程度: 持续潮湿 → 1
活动: 偶尔步行 → 3
活动能力: 不受限制 → 4
营养: 充足 → 3
摩擦力和剪切力: 有问题 → 1

相加

Braden 总分 = 3 + 1 + 3 + 4 + 3 + 1 = 15

答案

B = 15
34.临床评估评分

答案: 体重过轻

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 = 41/1.63² = 15.43

分类

体重过轻

答案

体重过轻

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