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 a patient walk with a standard (non-wheeled) walking frame?

  1. AStep forward first, then pull the frame after
  2. BPush the frame along the floor while walking quickly
  3. CLift the frame forward, then step into it
  4. DLean forward on the frame and slide the feet
2.护理学基础困难

An 86-year-old has new confusion and a temperature of 37.1 °C. Why should infection still be considered?

  1. AConfusion is always caused by infection in older adults
  2. BOlder adults often have a weaker fever response to infection
  3. COlder adults normally have a higher body temperature
  4. DA temperature of 37.1 °C is a fever in older adults
3.感染控制与患者安全中等

A patient has a weak left leg. Which instruction about using a cane is correct?

  1. AHold the cane in the left hand, on the weaker side
  2. BKeep the cane well out to the side, away from the body
  3. CMove the cane and the right leg forward together
  4. DHold the cane in the right hand, on the stronger side
4.感染控制与患者安全困难

During flu season, a nurse wakes up with fever, cough and muscle aches. What is the best action?

  1. ATake an antipyretic so the fever does not show at work
  2. BGo to work but avoid caring for patients who have weak immune systems
  3. CGo to work but wear a surgical mask for the whole shift
  4. DStay home and inform the employer according to the illness policy
5.优先排序与委派中等

A patient receives hemodialysis this morning. Which type of medication is often held before dialysis, as prescribed?

  1. AEye drops for glaucoma
  2. BInhaled bronchodilators
  3. CAntihypertensive drugs
  4. DTopical skin creams
6.优先排序与委派困难

During birth, the baby’s head delivers but the shoulders do not follow. What should the nurse do first?

  1. AAsk the mother to stop pushing and wait an hour
  2. BHelp with the McRoberts position and give suprapubic pressure as directed
  3. CPull hard on the baby’s head and neck to free the trapped shoulders quickly
  4. DPush firmly on the top of the uterus (fundal pressure)
7.临床护理中等

Which of these is a non-drug measure that can help relieve pain?

  1. ARestricting visitors completely
  2. BTelling the patient that the pain is not real
  3. CKeeping the patient awake all night
  4. DRepositioning and distraction
8.临床护理困难

A patient with diabetes is found confused with slurred speech and weakness on one side. What should the nurse check first?

  1. ASerum cholesterol
  2. BUrine output for the last day
  3. CCapillary blood glucose
  4. DBody mass index
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. CTroponin, creatine kinase and myoglobin
  4. DSerum lithium, sodium and urine specific gravity
10.实验室检查值与电解质困难

A patient has a positive hepatitis C antibody (anti-HCV) test. What is the most appropriate next step?

  1. ARepeat the antibody test, as a positive test is always false
  2. BTest for HCV RNA to find out whether infection is current
  3. CTell the patient they definitely have chronic hepatitis C
  4. DGive hepatitis C vaccine to prevent further infection
11.药理学中等

A patient is starting olanzapine. Which monitoring is most important over the following months?

  1. AHearing tests and vision tests every month
  2. BINR and platelet count
  3. CWeight, blood glucose and blood lipids
  4. DPeak expiratory flow
12.药理学困难

A patient with type 2 diabetes starts a high dose of prednisolone for a flare of COPD. Which change should the nurse expect?

  1. ANo change in glucose, as steroids act only in the lungs
  2. BLower blood glucose, so the diabetes medicines should be stopped
  3. CHigher blood glucose, so more frequent glucose checks are needed
  4. DLower potassium only, with no effect on glucose
13.内外科护理：心血管与呼吸中等

关于定量吸入器的储雾罐，下列哪项说法正确？

  1. A它是为干粉吸入器设计的
  2. B所需的协调动作较少，更多药物到达肺部
  3. C它意味着可以完全停用类固醇预防型吸入器
  4. D它使每次喷出的药物比平时更强
14.内外科护理：心血管与呼吸困难

A ventilated patient with severe ARDS is to be turned prone. What is the main reason, and the key nursing risk?

  1. AIt improves oxygenation; risks are pressure injury and tube displacement
  2. BIt treats infection; the risk is fever
  3. CIt improves digestion and gut motility; the main risk is constipation
  4. DIt lowers the blood pressure; the main risk is rebound hypertension
15.内外科护理：神经、内分泌与肾脏中等

为什么每次血液透析前后都要给患者称体重？

  1. A计算未来一周每种药物的剂量
  2. B了解清除了多少液体，并指导确定干体重
  3. C因为没有体重数据机器无法启动
  4. D检查营养不良引起的体重减轻
16.内外科护理：神经、内分泌与肾脏困难

一名患者的慢性低钠血症在 24 小时内从 115 纠正到 132 mmol/L。两天后他们出现言语含糊、吞咽困难和肢体无力。最可能的原因是什么？

  1. A低钠血症的正常恢复
  2. B与血钠无关的新发卒中
  3. C摄入不足引起的低血糖
  4. D渗透性脱髓鞘综合征
17.内外科护理：消化、围手术期与肿瘤中等

A patient is starting regular oral morphine. Which bowel advice is most appropriate?

  1. AStop eating fibre completely
  2. BStart a regular laxative at the same time
  3. CWait until there has been no stool for a week
  4. DTake a bulk-forming laxative only with very little water
18.内外科护理：消化、围手术期与肿瘤困难

急性胰腺炎最初几小时，通常推荐哪种补液策略？

  1. A单用静脉白蛋白，不用任何晶体液
  2. B无论患者反应如何，都给予非常大量
  3. C以目标为导向的平衡晶体液，根据反应调整
  4. D完全不静脉补液，只喝少量口服水
19.产科护理中等

Which nursing measure is used during phototherapy?

  1. ARemove the eye shields while the lights are on
  2. BKeep the baby fully clothed under the lights
  3. CLimit feeds to reduce stooling
  4. DTurn the baby often and monitor hydration
20.产科护理困难

Just after the membranes rupture, there is painless vaginal bleeding and the fetal heart rate drops sharply. The mother's vital signs are normal. Which condition is most likely?

  1. ARuptured vasa praevia
  2. BUterine rupture
  3. CBloody show
  4. DPlacental abruption
21.儿科护理中等

A 12-year-old with type 1 diabetes will play a long football match. What should the nurse advise?

  1. AInject an extra dose of insulin into the thigh just before he starts running
  2. BAvoid sport, because exercise is unsafe with diabetes
  3. CCheck glucose before playing and keep fast-acting carbohydrate at hand
  4. DSkip the meal before the match to avoid high glucose
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停止输注并评估部位
  2. B安抚孩子并继续输注
  3. C在该部位紧紧包扎
  4. D加快输注速度以便更快完成
23.精神科护理中等

How does obsessive-compulsive personality disorder differ from obsessive-compulsive disorder?

  1. AIt always involves repeated hand washing and checking rituals
  2. BIt is a lasting pattern of perfectionism and control without true obsessions and compulsions
  3. CIt starts suddenly in later life after a stressful event and goes away on its own within a few months
  4. DPeople with it always feel that their behaviour is senseless and unwanted
24.精神科护理困难

While caring for a highly anxious patient, a nurse notices her own heart racing and her speech getting faster. What is most important?

  1. AIgnore her own reaction, because the nurse's feelings do not matter in patient care
  2. BLeave the patient immediately and not return
  3. CRecognise that anxiety spreads between people, and calm herself first
  4. DMatch the patient's level of anxiety to show empathy
25.护理数学与单位换算中等
8 lb 7 oz? kg1 lb = 16 oz1 kg = 2.2 lb

练习题（虚构数值，不作为临床指导）。 一名新生儿体重 8 lb 7 oz。按 1 lb = 16 oz 和 1 kg = 2.2 lb，求以千克表示的体重m。取到两位小数。

8 lb 7 oz1 lb = 16 oz1 kg = 2.2 lb
m = kg
26.护理数学与单位换算困难
00:0022:3505:55t = ?

练习题（虚构数值，不作为临床指导）。 一次输注从 22:35 开始，到次日早晨 05:55 结束（24 小时制）。它运行了多少分钟t？

22:3505:55
t = min
27.剂量计算中等
22 kg7.5 mg/kg/天3× 每天D = ? mg

某患者体重 22 kg。医嘱剂量为每天 7.5 mg/kg，分 3 次等量给药。每次给多少毫克 D？

22 kg7.5 mg/kg/天3× 每天
D = mg
28.剂量计算困难
50%储备液水 = ? mL

你需要用 50%（w/v）储备液配制 200 mL 5%（w/v）溶液。 必须向储备液中加入多少水 W？

C₁ = 50%C₂ = 5%V₂ = 200 mL
W = mL
29.静脉输液速度中等
V = ?15 gtt/mL25 gtt/min12 h

滴注以 25 gtt/min 的速度通过滴系数为 15 gtt/mL 的输液器。患者在 12 小时内接受多少毫升 V？

25 gtt/min15 gtt/mL12 h
V = mL
30.静脉输液速度困难
490 mL剩余? mL/h4 h 剩余

医嘱要求在 10 小时内输入 1000 mL。6 小时后你发现袋中还剩 490 mL，而输液仍须按时完成。 原来的泵速必须提高百分之多少 Δ？

1000 mL / 10 h经过 6 h: 490 mL
Δ = %
31.静脉输液与液体平衡中等
入量出量8 小时班次果汁120 mL牛奶240 mL水200 mL冰屑120 mL静脉输液125 mL/h × 8 h静脉抗生素1 × 100 mL尿液225 mL尿液250 mL尿液300 mL尿液325 mL伤口引流40 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 8 小时班次中的出入量。患者体重 58 kg。求平均尿量 U，以 mL/kg/h 计。 保留两位小数。

58 kg8 h尿液: 225 mL尿液: 250 mL尿液: 300 mL尿液: 325 mL伤口引流: 40 mL呕吐物: 200 mL
U = mL/kg/h
32.静脉输液与液体平衡困难
500 mL50 mL 已输入125 mL/h08:30t = ? h

练习题（虚构数值，不作为临床指导）。 一袋 500 mL 的液体用输液泵以 125 mL/h 输注。到 08:30 时已输入 50 mL。还要多少小时 t 袋子才会输完？ 保留一位小数。

500 mL50 mL 已输入125 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: 完全受限; 潮湿程度: 很少潮湿; 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: 无明显问题。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 55 kg，身高 181 cm。计算 BMI 并点击 WHO 体重分类。

55 kg181 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 · Lift the frame forward, then step into it

为什么是这个答案

The frame is lifted a short step forward with all four feet placed down, then the patient steps into it, usually leading with the weaker leg.

答案

C · Lift the frame forward, then step into it
2.护理学基础

答案: B · Older adults often have a weaker fever response to infection

为什么是这个答案

Older adults may not mount a fever, and infection can show up as confusion, falls or reduced eating instead. A normal temperature does not rule out infection in this group.

答案

B · Older adults often have a weaker fever response to infection
3.感染控制与患者安全

答案: D · Hold the cane in the right hand, on the stronger side

为什么是这个答案

The cane is held on the strong side and moved forward with the weak leg, so it shares the weight that the weak leg cannot take. It is kept close to the body for stability.

答案

D · Hold the cane in the right hand, on the stronger side
4.感染控制与患者安全

答案: D · Stay home and inform the employer according to the illness policy

为什么是这个答案

Health care workers with signs of influenza should not work, because they can infect patients and colleagues. They follow the employer’s policy on when they may return.

答案

D · Stay home and inform the employer according to the illness policy
5.优先排序与委派

答案: C · Antihypertensive drugs

为什么是这个答案

Removing fluid during dialysis can cause hypotension, so blood pressure drugs are often held before treatment as prescribed. Some drugs are also removed by dialysis and given afterwards.

答案

C · Antihypertensive drugs
6.优先排序与委派

答案: B · Help with the McRoberts position and give suprapubic pressure as directed

为什么是这个答案

In shoulder dystocia, the McRoberts maneuver (flexing the mother’s thighs onto her abdomen) and suprapubic pressure help free the shoulder. Fundal pressure and pulling on the head can worsen the injury.

答案

B · Help with the McRoberts position and give suprapubic pressure as directed
7.临床护理

答案: D · Repositioning and distraction

为什么是这个答案

Positioning, heat or cold where safe, relaxation, distraction and explanation can all reduce pain alongside analgesics.

答案

D · Repositioning and distraction
8.临床护理

答案: C · Capillary blood glucose

为什么是这个答案

Hypoglycaemia can cause focal neurological signs that mimic stroke. A bedside glucose check is quick and should be done in any patient with sudden neurological symptoms.

答案

C · Capillary blood glucose
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: B · Test for HCV RNA to find out whether infection is current

为什么是这个答案

Anti-HCV shows exposure, but some people clear the virus and keep antibodies. An HCV RNA test shows whether the infection is current. There is no vaccine for hepatitis C, but antiviral treatment can cure most infections.核对依据: Hepatitis C · MedlinePlus (NIH) (2025)

答案

B · Test for HCV RNA to find out whether infection is current
11.药理学

答案: C · Weight, blood glucose and blood lipids

为什么是这个答案

Olanzapine and several other atypical antipsychotics cause weight gain, insulin resistance and dyslipidaemia. Weight, waist size, glucose and lipids are checked regularly.

答案

C · Weight, blood glucose and blood lipids
12.药理学

答案: C · Higher blood glucose, so more frequent glucose checks are needed

为什么是这个答案

Glucocorticoids raise blood glucose by increasing liver glucose production and insulin resistance. Glucose is monitored more often, and diabetes treatment may need to be increased during the course.

答案

C · Higher blood glucose, so more frequent glucose checks are needed
13.内外科护理：心血管与呼吸

答案: B · 所需的协调动作较少，更多药物到达肺部

为什么是这个答案

储雾罐使气雾减速并将其留存，让患者可以缓慢呼吸吸入。更多药物到达肺部，沉积在口腔的减少。它与加压定量吸入器配合使用，而不用于干粉装置。

答案

B · 所需的协调动作较少，更多药物到达肺部
14.内外科护理：心血管与呼吸

答案: A · It improves oxygenation; risks are pressure injury and tube displacement

为什么是这个答案

Prone positioning improves ventilation–perfusion matching and oxygenation and improves survival in severe ARDS. Turning needs a trained team. Risks include accidental extubation or line removal and pressure damage to the face, chest and knees, so careful positioning and skin checks are essential.

答案

A · It improves oxygenation; risks are pressure injury and tube displacement
15.内外科护理：神经、内分泌与肾脏

答案: B · 了解清除了多少液体，并指导确定干体重

为什么是这个答案

透析前后体重之差显示清除了多少液体。透析间期体重增加过多说明液体摄入过量，并增加透析期间发生高血压、呼吸困难和痉挛的风险。

答案

B · 了解清除了多少液体，并指导确定干体重
16.内外科护理：神经、内分泌与肾脏

答案: D · 渗透性脱髓鞘综合征

为什么是这个答案

慢性低钠血症的快速纠正会使脑细胞皱缩，并可损伤脑桥和其他区域的髓鞘。症状（构音障碍、吞咽困难、四肢轻瘫、“闭锁”状态）在数天后出现。这就是为什么要限制纠正速度并密切监测血钠。

答案

D · 渗透性脱髓鞘综合征
17.内外科护理：消化、围手术期与肿瘤

答案: B · Start a regular laxative at the same time

为什么是这个答案

Opioids slow gut movement, and tolerance to constipation does not develop. A regular laxative, often a stimulant with a softener, is started with the opioid, alongside fluids and mobility where possible.

答案

B · Start a regular laxative at the same time
18.内外科护理：消化、围手术期与肿瘤

答案: C · 以目标为导向的平衡晶体液，根据反应调整

为什么是这个答案

胰腺炎使液体丢失到组织中，所以早期静脉补液很重要。最新指南倾向于使用哈特曼液或乳酸林格液等平衡晶体液进行适度、以目标为导向的复苏，并根据心率、血压和尿量调整，因为过于积极的补液只会增加负荷而没有益处。

答案

C · 以目标为导向的平衡晶体液，根据反应调整
19.产科护理

答案: D · Turn the baby often and monitor hydration

为什么是这个答案

The baby is undressed except for a small nappy, eyes are shielded, position is changed and temperature and hydration are monitored. Frequent feeds help excrete bilirubin through stools.

答案

D · Turn the baby often and monitor hydration
20.产科护理

答案: A · Ruptured vasa praevia

为什么是这个答案

Rupture of the membranes can tear unprotected fetal vessels in vasa praevia. Fetal blood loss causes rapid bradycardia while the mother stays stable. An emergency caesarean is needed.

答案

A · Ruptured vasa praevia
21.儿科护理

答案: C · Check glucose before playing and keep fast-acting carbohydrate at hand

为什么是这个答案

Exercise increases glucose uptake by muscles, so hypoglycaemia can occur during or after sport, even overnight. Checking glucose, having extra carbohydrate and adjusting insulin as advised make sport safe and beneficial.

答案

C · Check glucose before playing and keep fast-acting carbohydrate at hand
22.儿科护理

答案: A · 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

A · 停止输注并评估部位
23.精神科护理

答案: B · It is a lasting pattern of perfectionism and control without true obsessions and compulsions

为什么是这个答案

In OCPD, rigid perfectionism, orderliness and control are part of the personality and usually feel right to the person. In OCD, the person has intrusive obsessions and compulsions that they usually find distressing.

答案

B · It is a lasting pattern of perfectionism and control without true obsessions and compulsions
24.精神科护理

答案: C · Recognise that anxiety spreads between people, and calm herself first

为什么是这个答案

Anxiety can be communicated between people. A nurse who notices and manages her own anxiety can provide a calm, steady presence that helps reduce the patient's anxiety.

答案

C · Recognise that anxiety spreads between people, and calm herself first
25.护理数学与单位换算

答案: m = 3.84 kg

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。

盎司换算为磅

7 oz/16 = 0.4375 lb
8 + 0.4375 = 8.438 lb

磅换算为千克

m = 8.438/2.2 = 3.835 ≈ 3.84 kg

答案

m = 3.84 kg
26.护理数学与单位换算

答案: t = 440 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

22:35 → 24:00 = 85 min

午夜之后

00:00 → 05:55 = 355 min

合计

t = 85 + 355 = 440 min

答案

t = 440 min
27.剂量计算

答案: D = 55 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

7.5·22 = 165 mg

每次剂量

D = 165/3 = 55 mg

答案

D = 55 mg
28.剂量计算

答案: W = 180 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 = 5·200/50 = 20 mL

需加水量

W = 200 − 20 = 180 mL

答案

W = 180 mL
29.静脉输液速度

答案: V = 1200 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）

25·60/15 = 100 mL/h

体积

V = 100·12 = 1200 mL

答案

V = 1200 mL
30.静脉输液速度

答案: Δ = 22.5 %

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 = 490/4 = 122.5 mL/h

变化百分比

Δ = (122.5 − 100)/100·100% = 22.5%

答案

Δ = 22.5%

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。

31.静脉输液与液体平衡

答案: U = 2.37 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

225 + 250 + 300 + 325 = 1100 mL

每千克每小时

U = 1100/(58·8) = 2.371 ≈ 2.37 mL/kg/h

答案

U = 2.37 mL/kg/h
32.静脉输液与液体平衡

答案: t = 3.6 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。

剩余体积

500 − 50 = 450 mL

时间

t = 450/125 = 3.6 h

答案

t = 3.6 h

约为 3 h 36 min，所以袋子大约在 12:06 输完。

33.临床评估评分

答案: B = 18

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: 完全受限 → 1
潮湿程度: 很少潮湿 → 4
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: 无明显问题 → 3

相加

Braden 总分 = 1 + 4 + 3 + 4 + 3 + 3 = 18

答案

B = 18
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 = 55/1.81² = 16.79

分类

体重过轻

答案

体重过轻

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