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。

新题目返回课程

在打印窗口中选择“另存为 PDF”，即可在设备上保存一份副本。

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

Why should a patient wash and dry their hands before a fingerprick glucose test?

  1. AWet hands give a falsely high reading
  2. BIt is only needed if the hands look dirty
  3. CSugar on the skin can give a falsely high reading
  4. DClean hands make the finger bleed more slowly
2.护理学基础困难

During a handover the nurse notices a colleague is sharing patient details loudly in a busy corridor. What should the nurse do?

  1. ASuggest moving the handover to a private place
  2. BJoin in to finish the handover more quickly
  3. CReport the colleague to the police
  4. DIgnore it, as handover is part of care
3.感染控制与患者安全中等

A colleague has drawn up a medication and asks the nurse to give it to her patient. What should the nurse do?

  1. AGive it, because the colleague is experienced
  2. BGive it, as long as the syringe has a label with the drug name on it
  3. CDecline, and give only medications that the nurse prepared or checked personally
  4. DGive it, and document that the colleague prepared it
4.感染控制与患者安全困难

A patient with pulmonary tuberculosis has been on treatment. Which findings usually allow airborne isolation to end?

  1. AThe patient has been in hospital for one week and has taken every dose of medicine
  2. BThree negative sputum smears, clinical improvement and continued therapy
  3. CThe cough has stopped, even with no sputum tests
  4. DOne negative chest x-ray after starting treatment
5.优先排序与委派中等

哪种定时给药的药物时间要求最严格？

  1. A08:00 随早餐服用的每日降胆固醇他汀类药片
  2. B随已送到的早餐托盘一起给予的速效胰岛素
  3. C08:00 到期的每日复合维生素片
  4. D随早餐给予的每日大便软化剂
6.优先排序与委派困难

After handover on a medical unit, which patient should the nurse see first?

  1. ADeep vein thrombosis on a heparin infusion, aPTT in the target range
  2. BDay 2 after a hernia repair, pain 6/10, oral analgesic due in 20 minutes, wants it now
  3. CPneumonia on 2 L/min oxygen, SpO₂ 93%, talking in full sentences
  4. DNew atrial fibrillation, heart rate 150/min, blood pressure 86/50 mmHg, dizzy
7.临床护理中等

Which is the correct technique for using a metered-dose inhaler without a spacer?

  1. APress the canister and wait one minute before breathing in
  2. BBreathe in quickly through the nose while pressing the canister
  3. CPress the canister twice quickly, then breathe in fast and breathe straight out again
  4. DBreathe out, then breathe in slowly and deeply while pressing the canister, then hold
8.临床护理困难

A patient has a single hot, swollen, very painful knee and a fever. Why is urgent joint aspiration important?

  1. ATo measure the patient's cholesterol
  2. BTo rule out septic arthritis, which can rapidly destroy the joint
  3. CTo check for rheumatoid arthritis antibodies in the joint fluid
  4. DTo prevent osteoporosis
9.实验室检查值与电解质中等

A patient takes low-dose methotrexate weekly for rheumatoid arthritis. Which laboratory tests are monitored regularly?

  1. AComplete blood count, liver tests and kidney function
  2. BSerum amylase, lipase and blood ketones
  3. CSerum lithium, sodium and urine specific gravity
  4. DTroponin, creatine kinase and myoglobin
10.实验室检查值与电解质困难

A patient has eaten very little for 2 weeks and has received broad-spectrum antibiotics. The INR is now 2.3 without warfarin, and the platelets are normal. What is the most likely cause?

  1. AVitamin K deficiency
  2. BHemophilia A
  3. CImmune thrombocytopenia
  4. DIron-deficiency anemia
11.药理学中等

Which blood test is commonly used to monitor a continuous infusion of unfractionated heparin?

  1. AINR (international normalised ratio, prothrombin time)
  2. BSerum potassium
  3. CActivated partial thromboplastin time (aPTT)
  4. DHaemoglobin A1c
12.药理学困难

A patient on weekly methotrexate is prescribed trimethoprim for a urinary infection. What is the main risk?

  1. ASevere hypertension from the combination
  2. BLoss of antibiotic effect because methotrexate binds trimethoprim
  3. CBone marrow suppression, because both drugs inhibit folate metabolism
  4. DHypoglycaemia from reduced liver glucose output
13.内外科护理：心血管与呼吸中等

Why are patients with mitral stenosis at high risk of atrial fibrillation?

  1. AThe coronary arteries become blocked by the valve
  2. BThe right ventricle shrinks and stops contracting properly over time
  3. CThe narrow valve presses on the sinus node and slows it down directly
  4. DThe left atrium enlarges as it pushes blood through the narrow valve
14.内外科护理：心血管与呼吸困难

在严重哮喘发作期间，一名患者的 PaCO₂ 从偏低升至正常，同时看起来精疲力竭。这意味着什么？

  1. A发作正在缓解，可以减少治疗
  2. B标本很可能是静脉血，可以忽略
  3. C患者正在疲劳，随后可能发生呼吸衰竭
  4. D患者因焦虑而过度通气
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 it cannot be absorbed at night
  2. BBecause food doubles the strength of the dose
  3. CTo match the natural cortisol rhythm and protect the stomach
  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

一名服用丙戊酸盐的癫痫女性说她正计划怀孕。哪种回应最恰当？

  1. A安慰她丙戊酸盐在整个孕期都是安全的
  2. B建议将剂量加倍，以保护婴儿免受癫痫发作
  3. C告诉她从今天起完全停用丙戊酸盐
  4. D建议不要突然停药，并尽快进行专科评估
17.内外科护理：消化、围手术期与肿瘤中等

Which finding suggests a deep tissue pressure injury?

  1. AIntact skin that is purple or maroon over a bony area
  2. BDry, flaky skin on both shins
  3. CA small scratch on the skin with a little fresh red blood
  4. DPale pink skin that blanches quickly when pressed
18.内外科护理：消化、围手术期与肿瘤困难

一名使用阿片类药物 PCA 的患者经面罩吸氧。SpO₂ 97%，呼吸频率 11 次/分，但现在很难唤醒。护士应得出什么结论？

  1. A很可能是阿片类药物中毒；氧气可能掩盖了通气不足
  2. B患者只是睡得好，因为疼痛已得到控制
  3. C患者是安全的，因为血氧饱和度正常
  4. D应增加 PCA 剂量以保持患者舒适
19.产科护理中等

Which statement about the lactational amenorrhoea method (LAM) is correct?

  1. AIt works for as long as the mother breastfeeds at all
  2. BIt needs full breastfeeding, no periods and a baby under 6 months
  3. CIt becomes more reliable after the periods return
  4. DIt is reliable even when the baby is formula-fed at night
20.产科护理困难

A woman at 8 weeks takes valproate for epilepsy. She asks whether she should stop it. Which response is best?

  1. AContinue as usual because epilepsy drugs are all safe in pregnancy
  2. BDo not stop it suddenly; arrange urgent specialist review
  3. CHalve the dose herself to reduce the risk to the baby
  4. DStop the drug today because it causes birth defects
21.儿科护理中等

Which sign shows that a baby is ready to start solid foods?

  1. AHas cut a first tooth
  2. BHas reached 6 weeks of age
  3. CSits with support, holds the head steady and shows interest in food
  4. DStarts waking more often during the night and seems hungry after milk feeds
22.儿科护理困难

Several family members, including the children, have had headaches, nausea and drowsiness all winter. They feel better when away from home. What should the nurse suspect?

  1. AMigraine that runs in the family
  2. BCarbon monoxide poisoning
  3. CSeasonal influenza
  4. DFood poisoning
23.精神科护理中等

An 80-year-old man often talks about his life and his achievements. According to Erikson, which task is he working on?

  1. AIntegrity versus despair
  2. BIntimacy versus isolation
  3. CIdentity versus role confusion
  4. DGenerativity versus stagnation
24.精神科护理困难

A man whose wife died a month ago is rude and angry with the nurses about small things. What is the best understanding of his behaviour?

  1. AHis anger may be part of grief, displaced onto staff, so she should not take it personally
  2. BHe does not care about his wife's death and is using it as an excuse to be rude
  3. CHe has antisocial personality disorder that was not noticed before
  4. DHe should be told that his behaviour is unacceptable and that visits will be stopped
25.护理数学与单位换算中等
94969810010210410635363738394041°F°C? °F38.2 °C

练习题（虚构数值，不作为临床指导）。 一位患者的体温为 38.2 °C。用 °F = °C × 9/5 + 32 把它换算为华氏度T。取到一位小数。

38.2 °C
T = °F
26.护理数学与单位换算困难
½ tsp · 2/天 · 14 d? × 50 mL1 tsp = 5 mL

练习题（虚构数值，不作为临床指导）。 一张处方写着口服混悬液½ tsp，每 12 小时一次，共 14 天。混悬液每瓶 50 mL。按1 tsp = 5 mL，必须提供多少整瓶N才能完成疗程？

½ tsp每 12 小时一次14 天50 mL1 tsp = 5 mL
N =
27.剂量计算中等
22 kg2 mg/kg/天4× 每天D = ? mg

某患者体重 22 kg。医嘱剂量为每天 2 mg/kg，分 4 次等量给药。每次给多少毫克 D？

22 kg2 mg/kg/天4× 每天
D = mg
28.剂量计算困难
25%储备液V₁ = ? mL

你需要用 25%（w/v）储备液配制 500 mL 2.5%（w/v）溶液。 你需要多少容量的储备液 V₁？

C₁ = 25%C₂ = 2.5%V₂ = 500 mL
V₁ = mL
29.静脉输液速度中等
240 mL剩余? mL/h2 h 剩余

医嘱要求在 10 小时内输入 1000 mL。8 小时后你发现袋中还剩 240 mL，而输液仍须按时完成。 必须把泵重新设定为多少 mL/h 的速率 R？

1000 mL / 10 h经过 8 h: 240 mL
R = mL/h
30.静脉输液速度困难
1 g250 mL? mL/h4 mg/min

一袋中含有 1 g 药物，溶于 250 mL。医嘱为每分钟 4 mg。泵速 R 应设为多少 mL/h？

1 g/250 mL4 mg/min
R = mL/h
31.静脉输液与液体平衡中等
入量出量8 小时班次果冻120 mL牛奶100 mL果汁120 mL冰屑200 mL静脉输液75 mL/h × 8 h静脉抗生素1 × 50 mL尿液500 mL尿液325 mL伤口引流150 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。求液体平衡 B = 入量 − 出量，以 mL 计（答案为负表示净丢失）。 冰屑按其体积的一半计。

果冻: 120 mL牛奶: 100 mL果汁: 120 mL冰屑: 200 mL静脉输液: 75 mL/h × 8 h静脉抗生素: 1 × 50 mL尿液: 500 mL尿液: 325 mL伤口引流: 150 mL
B = mL
32.静脉输液与液体平衡困难
500 mL125 mL/h开始 12:4513:45: ? mL

练习题（虚构数值，不作为临床指导）。 一袋 500 mL 的液体于 12:45 开始用输液泵以 125 mL/h 输注。到 13:45 时袋中还剩多少 mL V？

500 mL125 mL/h12:45 → 13:45
V = mL
33.临床评估评分中等
H? / 25+D? / 15+Aid? / 30+IV? / 20+G? / 20+MS? / 15Σ?

练习题（虚构数值，不作为临床指导）。 用 Morse 跌倒评分评估一位练习患者：过去 3 个月内的跌倒史: 是; 次要诊断: 否; 行走辅助: 拐杖、手杖或助行器; 静脉输液或封管: 否; 步态: 受损; 精神状态: 了解自身局限。求 Morse 总分MFS。

0–125
MFS =
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 81 kg，身高 162 cm。计算 BMI 并点击 WHO 体重分类。

81 kg162 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: C · Sugar on the skin can give a falsely high reading

为什么是这个答案

Traces of food or drink on the finger can raise the reading. Washing with water and drying fully gives an accurate result; alcohol wipes can also affect some meters.

答案

C · Sugar on the skin can give a falsely high reading
2.护理学基础

答案: A · Suggest moving the handover to a private place

为什么是这个答案

Information shared for care must still be protected from people who do not need it. Moving to a private area or speaking quietly at the bedside protects patient confidentiality.

答案

A · Suggest moving the handover to a private place
3.感染控制与患者安全

答案: C · Decline, and give only medications that the nurse prepared or checked personally

为什么是这个答案

Nurses give only medicines they prepared themselves or verified fully, because they are accountable for what they give. A drug prepared by someone else may be wrong in ways the nurse cannot see.

答案

C · Decline, and give only medications that the nurse prepared or checked personally
4.感染控制与患者安全

答案: B · Three negative sputum smears, clinical improvement and continued therapy

为什么是这个答案

Airborne precautions usually continue until the patient is on effective therapy, is improving clinically and has three negative sputum smears for acid-fast bacilli, according to policy.

答案

B · Three negative sputum smears, clinical improvement and continued therapy
5.优先排序与委派

答案: B · 随已送到的早餐托盘一起给予的速效胰岛素

为什么是这个答案

速效胰岛素随餐给药；给得晚或不进食可导致血糖过高或过低。其他每日用药稍晚一点给予也无妨。

答案

B · 随已送到的早餐托盘一起给予的速效胰岛素
6.优先排序与委派

答案: D · New atrial fibrillation, heart rate 150/min, blood pressure 86/50 mmHg, dizzy

为什么是这个答案

Rapid atrial fibrillation with hypotension and dizziness means the heart is not pumping enough blood; the patient is unstable. The other patients are within target or have predictable needs.

答案

D · New atrial fibrillation, heart rate 150/min, blood pressure 86/50 mmHg, dizzy
7.临床护理

答案: D · Breathe out, then breathe in slowly and deeply while pressing the canister, then hold

为什么是这个答案

The patient breathes out, seals the lips around the mouthpiece, starts breathing in slowly, presses the canister and continues a deep breath, then holds it for about 10 seconds. Spacers make coordination easier.

答案

D · Breathe out, then breathe in slowly and deeply while pressing the canister, then hold
8.临床护理

答案: B · To rule out septic arthritis, which can rapidly destroy the joint

为什么是这个答案

Septic arthritis can destroy cartilage within days. Aspiration allows microscopy and culture, and helps distinguish infection from crystal arthritis such as gout.

答案

B · To rule out septic arthritis, which can rapidly destroy the joint
9.实验室检查值与电解质

答案: A · Complete blood count, liver tests and kidney function

为什么是这个答案

Methotrexate can cause bone marrow suppression, liver toxicity and, as it is cleared by the kidneys, toxicity when kidney function falls. The CBC, liver tests and creatinine are checked regularly, and folic acid is usually given to reduce adverse effects.核对依据: Methotrexate · StatPearls (NCBI Bookshelf) (2024)

答案

A · Complete blood count, liver tests and kidney function
10.实验室检查值与电解质

答案: A · Vitamin K deficiency

为什么是这个答案

Vitamin K comes from the diet and from gut bacteria. Poor intake plus antibiotics can cause vitamin K deficiency, which lowers factors II, VII, IX and X and prolongs the PT/INR. Vitamin K replacement corrects it.核对依据: Vitamin K Deficiency in Neonates and Adults (StatPearls) · StatPearls (NCBI Bookshelf) (2026); Prothrombin time (PT) · MedlinePlus (NIH) (2025)

答案

A · Vitamin K deficiency
11.药理学

答案: C · Activated partial thromboplastin time (aPTT)

为什么是这个答案

Unfractionated heparin is often monitored with the aPTT, and the infusion rate is adjusted according to a protocol. Low-molecular-weight heparins usually do not need routine aPTT checks.

答案

C · Activated partial thromboplastin time (aPTT)
12.药理学

答案: C · Bone marrow suppression, because both drugs inhibit folate metabolism

为什么是这个答案

Trimethoprim and methotrexate both inhibit dihydrofolate reductase, and trimethoprim also reduces methotrexate excretion. The combination can cause severe pancytopenia, so another antibiotic is chosen.

答案

C · Bone marrow suppression, because both drugs inhibit folate metabolism
13.内外科护理：心血管与呼吸

答案: D · The left atrium enlarges as it pushes blood through the narrow valve

为什么是这个答案

A narrowed mitral valve raises pressure in the left atrium, which dilates. A stretched atrium is prone to atrial fibrillation, and blood stasis there carries a high risk of clots and stroke. Anticoagulation is therefore essential in mitral stenosis with AF.

答案

D · The left atrium enlarges as it pushes blood through the narrow valve
14.内外科护理：心血管与呼吸

答案: C · 患者正在疲劳，随后可能发生呼吸衰竭

为什么是这个答案

发作早期，过度通气会使 PaCO₂ 降低。呼吸困难且正在疲劳的患者 PaCO₂ 正常或升高，意味着通气功能衰竭，是危及生命的特征。需要紧急的高级医师和重症监护评估。

答案

C · 患者正在疲劳，随后可能发生呼吸衰竭
15.内外科护理：神经、内分泌与肾脏

答案: C · 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

C · 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: D · 建议不要突然停药，并尽快进行专科评估

为什么是这个答案

丙戊酸盐具有高度致畸性（神经管缺陷和神经发育问题），在可能怀孕者中的使用受到严格限制。然而，突然停用抗癫痫药物有发生癫痫持续状态的风险。需要紧急的专科评估以规划更安全的替代方案，并补充叶酸。

答案

D · 建议不要突然停药，并尽快进行专科评估
17.内外科护理：消化、围手术期与肿瘤

答案: A · Intact skin that is purple or maroon over a bony area

为什么是这个答案

A deep tissue injury appears as persistent purple, maroon or dark discolouration, or a blood-filled blister, from pressure and shear on underlying tissue. It may quickly turn into a deep wound.

答案

A · Intact skin that is purple or maroon over a bony area
18.内外科护理：消化、围手术期与肿瘤

答案: A · 很可能是阿片类药物中毒；氧气可能掩盖了通气不足

为什么是这个答案

补充氧气可使 SpO₂ 保持正常，而 CO₂ 却因通气不足而升高。镇静加深是阿片类药物中毒的早期征象。护士应停止 PCA，刺激患者，呼叫援助并遵循纳洛酮方案，密切监测呼吸频率、深度和镇静程度。

答案

A · 很可能是阿片类药物中毒；氧气可能掩盖了通气不足
19.产科护理

答案: B · It needs full breastfeeding, no periods and a baby under 6 months

为什么是这个答案

LAM is effective only if the mother is fully or nearly fully breastfeeding day and night, her periods have not returned and the baby is under 6 months. Ovulation can occur before the first period.

答案

B · It needs full breastfeeding, no periods and a baby under 6 months
20.产科护理

答案: B · Do not stop it suddenly; arrange urgent specialist review

为什么是这个答案

Valproate is strongly teratogenic, but stopping antiepileptics suddenly can cause seizures that harm mother and fetus. She needs urgent specialist review to change treatment safely, ideally before conception.

答案

B · Do not stop it suddenly; arrange urgent specialist review
21.儿科护理

答案: C · Sits with support, holds the head steady and shows interest in food

为什么是这个答案

Readiness for solids, usually around 6 months, includes good head control, sitting with support, interest in food and loss of the tongue-thrust reflex. Night waking and teething are not signs of readiness.

答案

C · Sits with support, holds the head steady and shows interest in food
22.儿科护理

答案: B · Carbon monoxide poisoning

为什么是这个答案

Carbon monoxide from faulty heaters or boilers causes headache, nausea, dizziness and drowsiness that improve away from the source. Pulse oximetry can look falsely normal. Treatment is removal from the source and high-flow oxygen; the appliance must be checked.

答案

B · Carbon monoxide poisoning
23.精神科护理

答案: A · Integrity versus despair

为什么是这个答案

In later life, the task is to look back and find meaning in one's life. Reminiscence supports a sense of integrity; failure leads to regret and despair.

答案

A · Integrity versus despair
24.精神科护理

答案: A · His anger may be part of grief, displaced onto staff, so she should not take it personally

为什么是这个答案

Anger is a common part of grief and may be directed at staff who are safer targets. The nurse responds calmly, sets limits if needed and invites him to talk about his loss.

答案

A · His anger may be part of grief, displaced onto staff, so she should not take it personally
25.护理数学与单位换算

答案: T = 100.8 °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

38.2·9/5 = 68.76

加 32

T = 68.76 + 32 = 100.8 °F

答案

T = 100.8 °F
26.护理数学与单位换算

答案: N = 2

量纲分析：先写出已知量，再乘以写成分数形式的换算系数（例如 60 min/1 h 或 1 mg/1000 mcg），使每个不需要的单位在分子和分母各出现一次并相互约去。只剩下所求单位时再计算。使用题目给出的等量关系，只对最终答案取整。

总体积

2.5 mL × 2 × 14 = 70 mL

瓶数

70/50 = 1.4 → N = 2

答案

N = 2
27.剂量计算

答案: D = 11 mg

剂量计算：给药量等于医嘱剂量除以现有药物的规格，再乘以该规格对应的量：给药量 = (医嘱剂量/储备规格) × 储备体积。始终统一单位（先把 g 换成 mg，mg 换成 mcg），并检查答案是否合理。

每日总量

2·22 = 44 mg

每次剂量

D = 44/4 = 11 mg

答案

D = 11 mg
28.剂量计算

答案: V₁ = 50 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 = 2.5·500/25 = 50 mL

答案

V₁ = 50 mL
29.静脉输液速度

答案: R = 120 mL/h

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.

原速率

1000/10 = 100 mL/h

新速率

R = 240/2 = 120 mL/h

答案

R = 120 mL/h

许多医院允许在不重开医嘱的情况下进行不超过 25% 的此类调整；请查阅本院规定。

30.静脉输液速度

答案: R = 60 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

1000 mg/250 mL = 4 mg/mL

每小时剂量

4·60 = 240 mg/h

泵速

R = 240/4 = 60 mL/h

答案

R = 60 mL/h
31.静脉输液与液体平衡

答案: B = 115 mL

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

总入量

口服: 120 + 100 + 120 = 340 mL
冰屑: 200/2 = 100 mL
静脉输液: 75·8 = 600 mL
静脉抗生素: 1·50 = 50 mL
总入量 = 1090 mL

总出量

500 + 325 + 150 = 975 mL

平衡

B = 1090 − 975 = 115 mL

答案

B = 115 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: V = 375 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

12:45 → 13:45 = 1 h

已输入体积

125·1 = 125 mL

剩余体积

V = 500 − 125 = 375 mL

答案

V = 375 mL
33.临床评估评分

答案: MFS = 60

Morse 跌倒评分：六个条目。跌倒史：否 0 分，是 25 分。次要诊断：否 0 分，是 15 分。行走辅助：无、卧床休息或护士协助 0 分；拐杖、手杖或助行器 15 分；扶着家具 30 分。静脉输液或封管：否 0 分，是 20 分。步态：正常、卧床休息或轮椅 0 分；虚弱 10 分；受损 20 分。精神状态：了解自身局限 0 分；高估或忘记自身局限 15 分。总分为 0 至 125。各医院的风险分界值不同；常用的一套是 0–24 低风险，25–44 中度风险，45 及以上为高风险。

为每个条目评分

过去 3 个月内的跌倒史: 是 → 25
次要诊断: 否 → 0
行走辅助: 拐杖、手杖或助行器 → 15
静脉输液或封管: 否 → 0
步态: 受损 → 20
精神状态: 了解自身局限 → 0

相加

Morse 总分 = 25 + 0 + 15 + 0 + 20 + 0 = 60

答案

MFS = 60
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 = 81/1.62² = 30.86

分类

肥胖 I 级

答案

肥胖 I 级

本内容为独立练习材料。ExamProblems 与该考试的主办机构没有隶属关系，也未获其认可，考试名称仅用于描述内容。 NCLEX®, NCLEX-RN® and NCLEX-PN® 是 the National Council of State Boards of Nursing, Inc. (NCSBN) 的商标，该机构与 ExamProblems 无关，不为其背书，也不保证其准确性。

ExamProblems · examproblems.com/courses/nclex-pn-practice-questions