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

Using the AVPU scale, a patient who opens their eyes and groans only when the nurse squeezes their shoulder is scored as:

  1. AV
  2. BA
  3. CU
  4. DP
2.护理学基础困难

For a patient at risk of pressure ulcers, why is the head of the bed usually kept at 30 degrees or less if their condition allows?

  1. AHigher angles always cause breathing problems in patients who are bedbound
  2. BLower angles stop the patient from getting out of bed
  3. CLower angles increase blood flow to the heels
  4. DHigher angles make the patient slide down, causing shear over the sacrum
3.感染控制与患者安全中等

Many intensive care units bathe patients daily with chlorhexidine. What is the main purpose?

  1. ATo reduce skin bacteria and bloodstream infections linked to central lines
  2. BTo lower the patient’s body temperature
  3. CTo treat existing wound infections without the need for antibiotics
  4. DTo moisturize dry skin in older patients
4.感染控制与患者安全困难

A patient with suspected sepsis has orders for blood cultures and an IV antibiotic. What is the correct order of actions?

  1. ADraw the blood cultures first, then give the antibiotic without delay
  2. BWait for the culture results before starting the antibiotic
  3. CGive the antibiotic first so that treatment starts, and take the cultures the next day
  4. DGive the antibiotic and take the cultures an hour later
5.优先排序与委派中等

RN 将哪项任务委派给 LPN/LVN 最为恰当？

  1. A对新开始使用胰岛素的患者进行出院教育
  2. B为病情稳定的患者置入留置导尿管
  3. C开始输注第一单位红细胞
  4. D对新患者进行入院评估
6.优先排序与委派困难

Four patients arrive at the emergency department at the same time. Who should be seen first?

  1. AAn adult with kidney stone pain of 9/10 and stable vital signs
  2. BA child with a temperature of 39 °C who is alert and drinking
  3. CA young adult with a swollen, painful ankle after a fall on the stairs
  4. DAn older adult with weakness on one side that began 40 minutes ago
7.临床护理中等

Which examination findings suggest a large pleural effusion on one side?

  1. ANormal breath sounds and normal percussion
  2. BWheeze heard over both lungs
  3. CDull percussion and reduced breath sounds over the lung base
  4. DA hyper-resonant chest with the trachea pulled towards that side
8.临床护理困难

After a head injury, a patient has clear fluid leaking from the nose. What does this most likely suggest?

  1. AA base-of-skull fracture with a cerebrospinal fluid leak
  2. BAllergic rhinitis triggered by the hospital environment
  3. CA normal and harmless response to head trauma
  4. DAcute sinusitis
9.实验室检查值与电解质中等

A pregnant woman's blood type is O Rh-negative, and her antibody screen (indirect Coombs test) is negative. What is usually offered at about 28 weeks?

  1. AAn IV dose of vitamin K given for the fetus
  2. BA transfusion of group O Rh-positive red cells
  3. CAnti-D immunoglobulin (Rho(D) immune globulin)
  4. DDaily oral iron and folic acid supplements only
10.实验室检查值与电解质困难

A patient with chronic kidney disease stage 4 has a high phosphate, a low-normal calcium and a very high parathyroid hormone (PTH). What does this show?

  1. APrimary hyperparathyroidism from a tumor
  2. BVitamin D toxicity from supplements
  3. CHypoparathyroidism after neck surgery
  4. DSecondary hyperparathyroidism from CKD
11.药理学中等

一名患者有严重肾功能损害。某药物主要以原形经尿排泄。通常如何调整？

  1. A改静脉给药为口服给药
  2. B增加剂量以弥补吸收不良
  3. C减少剂量或延长给药间隔
  4. D无须调整，因为肝脏会接管
12.药理学困难

有些受体即使没有激动剂也表现出活性。在这类受体上，反向激动剂与中性拮抗剂有何不同？

  1. A它永久破坏受体
  2. B单独给药时没有作用
  3. C它使活性降到基础水平以下
  4. D它使活性升高到基础水平以上
13.内外科护理：心血管与呼吸中等

Why should a long-acting beta-2 agonist (LABA) never be used alone in asthma?

  1. AIt works only when it is taken together with a course of antibiotics
  2. BIt always causes immediate severe bronchospasm when used on its own
  3. CIt cannot be inhaled without a nebuliser
  4. DWithout an inhaled steroid, it is linked with severe and fatal attacks
14.内外科护理：心血管与呼吸困难

A 74-year-old with atrial fibrillation, hypertension and diabetes asks why she needs an anticoagulant when she feels well. Which reply is best?

  1. AIt is given to lower her blood pressure
  2. BThe anticoagulant will stop the irregular heartbeat for good
  3. CIt is needed only while she has palpitations
  4. DHer risk of stroke is high, and an anticoagulant lowers it
15.内外科护理：神经、内分泌与肾脏中等

Why is IV calcium gluconate given in severe hyperkalaemia?

  1. AIt removes potassium through the kidneys
  2. BIt moves potassium into the cells
  3. CIt binds potassium in the gut
  4. DIt protects the heart from arrhythmias
16.内外科护理：神经、内分泌与肾脏困难

An adult stares blankly for about a minute, smacks their lips and fumbles with their clothes. Afterwards they are confused for ten minutes and remember nothing. Which seizure type fits best?

  1. AMyoclonic seizure
  2. BFocal impaired awareness seizure
  3. CAtonic (drop) seizure with a fall
  4. DAbsence seizure
17.内外科护理：消化、围手术期与肿瘤中等

Why is a pregnancy test often done before surgery in women who could be pregnant?

  1. AAnaesthesia, drugs and some tests may harm a fetus
  2. BPregnancy always makes surgery impossible
  3. CPregnant women cannot sign consent forms
  4. DIt is needed to calculate the anaesthetic drug dose
18.内外科护理：消化、围手术期与肿瘤困难

Just after extubation in recovery, a patient develops a high-pitched noise on breathing in, with falling SpO₂. What should the nurse do first?

  1. ASit the patient up and give a drink of water
  2. BCall for help, give 100% oxygen and use a jaw thrust
  3. CWait a few minutes to see if it passes
  4. DGive an opioid to calm the patient's breathing and reduce anxiety
19.产科护理中等

Why is mild anaemia common in the second trimester even in healthy women?

  1. AThe fetus breaks down maternal red blood cells
  2. BPlasma volume rises more than red cell mass
  3. CIron is lost in the urine because kidney filtration rises
  4. DThe bone marrow stops producing red cells during pregnancy
20.产科护理困难

A woman at 37 weeks has severe itching of the palms and soles, worse at night, without a rash. Which condition should be considered?

  1. AAn allergy to washing detergents
  2. BIntrahepatic cholestasis of pregnancy
  3. CNormal stretching of the abdominal skin
  4. DPre-eclampsia only
21.儿科护理中等

钳捏抓握（用拇指和食指捏起小物体）通常在大约多大时发育出来？

  1. A约 18 个月
  2. B约 9 至 10 个月
  3. C约 3 个月
  4. D约 2 岁
22.儿科护理困难

A baby born at 27 weeks has grunting, chest retractions and rising oxygen needs. Which treatment directly addresses the cause?

  1. AOral glucose gel rubbed into the gums
  2. BPhototherapy
  3. CIV antibiotics for 7 days
  4. DSurfactant given into the trachea
23.精神科护理中等

A patient who started lithium 2 weeks ago has a fine tremor of the hands and is passing more urine than usual. Her level is within the therapeutic range. How should the nurse interpret this?

  1. AThese are definite signs of severe lithium toxicity, so emergency dialysis is needed straight away
  2. BThese are signs of an allergic reaction, so she should never take lithium again
  3. CThese are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored
  4. DThese symptoms mean that the lithium is not working, so the dose should be stopped and a new drug chosen
24.精神科护理困难

Which intervention is most appropriate for an older patient with delirium?

  1. AProvide orientation cues, make sure glasses and hearing aids are used, and involve the family
  2. BUse physical restraints at night to prevent falls
  3. CMove the patient to a different room each day
  4. DKeep the lights on and the television loud all night to keep her alert and stop her from sleeping too much
25.护理数学与单位换算中等
4 ft 1 in1 ft = 12 in1 in = 2.54 cmh = ? cm

练习题（虚构数值，不作为临床指导）。 一位患者身高 4 ft 1 in。按 1 ft = 12 in 和 1 in = 2.54 cm，求以厘米表示的身高h，取到最接近的整厘米。

4 ft 1 in1 ft = 12 in1 in = 2.54 cm
h = cm
26.护理数学与单位换算困难
2 tsp · 4/天 · 14 d? × 100 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2 tsp，每天四次，共 14 天。混悬液每瓶 100 mL。按1 tsp = 5 mL，必须提供多少整瓶N才能完成疗程？

2 tsp每天四次14 天100 mL1 tsp = 5 mL
N =
27.剂量计算中等
024681010 mL

一名体重 7 kg 的儿童按 10 mg/kg 处方用药。原液浓度为 25 mg/mL。请抽取剂量：应给多少体积 V？

7 kg10 mg/kg25 mg/mL
V = mL
28.剂量计算困难
100 mg/5 mLV = ? mL

一名体重 18 kg 的儿童，医嘱为口服混悬液每次 10 mg/kg，该混悬液每 5 mL 含 100 mg。你应给多少体积 V？

18 kg10 mg/kg100 mg/5 mL
V = mL
29.静脉输液速度中等
V = ?20 gtt/mL35 gtt/min2 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 2 小时内接受多少毫升 V？

35 gtt/min20 gtt/mL2 h
V = mL
30.静脉输液速度困难
25 mg250 mL15 mL/h? mcg/min

25 mg 药物溶于 250 mL 的输液以 15 mL/h 运行。患者每分钟接受多少微克 D？

25 mg/250 mL15 mL/h
D = mcg/min
31.静脉输液与液体平衡中等
入量出量8 小时班次牛奶100 mL汤200 mL静脉输液50 mL/h × 8 h静脉抗生素1 × 100 mL尿液475 mL尿液350 mL尿液200 mL尿液400 mL伤口引流90 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。

牛奶: 100 mL汤: 200 mL静脉输液: 50 mL/h × 8 h静脉抗生素: 1 × 100 mL
I = mL
32.静脉输液与液体平衡困难
500 mL100 mL 已输入150 mL/h11:30t = ? 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 150 mL/h 输注。到 11:30 时已输入 100 mL。还要多少小时 t 袋子才会输完？ 保留一位小数。

500 mL100 mL 已输入150 mL/h
t = h
33.临床评估评分中等
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

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 20 次/分，SpO₂ 96%吸室内空气，血压 118/70 mmHg，脉搏 58 次/分，清醒，体温 38.1 °C。NEWS2 总分是多少？

RR 20SpO₂ 96%空气SBP 118HR 58AT 38.1 °C
NEWS2 =
34.临床评估评分困难
116?SBPDBPmmHgMAP = 70

练习题（虚构数值，不作为临床指导）。 团队的目标是平均动脉压至少为 70 mmHg。一位患者的收缩压为 116 mmHg。使用 MAP = (SBP + 2·DBP)/3，仍能使 MAP 达到 70 mmHg 的最低舒张压DBP是多少？

MAP 70 mmHgSBP 116 mmHg
DBP = mmHg

3溶液

1.护理学基础

答案: D · P

为什么是这个答案

AVPU stands for Alert, responds to Voice, responds to Pain, Unresponsive. A response only to a painful stimulus is "P", a serious sign that needs urgent review.

答案

D · P
2.护理学基础

答案: D · Higher angles make the patient slide down, causing shear over the sacrum

为什么是这个答案

When the head is raised high, the body tends to slide while the skin stays still, distorting the tissues over the sacrum. Keeping the angle low, where safe, reduces this shear.

答案

D · Higher angles make the patient slide down, causing shear over the sacrum
3.感染控制与患者安全

答案: A · To reduce skin bacteria and bloodstream infections linked to central lines

为什么是这个答案

Daily chlorhexidine bathing lowers the number of organisms on the skin, reducing central line-associated bloodstream infections and the spread of resistant bacteria in ICUs.

答案

A · To reduce skin bacteria and bloodstream infections linked to central lines
4.感染控制与患者安全

答案: A · Draw the blood cultures first, then give the antibiotic without delay

为什么是这个答案

Cultures are drawn before the first antibiotic dose so the organism can still be grown and identified. The antibiotic is then given promptly, because delay increases the risk of death in sepsis.

答案

A · Draw the blood cultures first, then give the antibiotic without delay
5.优先排序与委派

答案: B · 为病情稳定的患者置入留置导尿管

为什么是这个答案

为病情稳定的患者置入导尿管是常在 LPN/LVN 范围内的技能。入院评估、初次教育和开始输血通常仍由 RN 负责。具体范围因州和国家而异。

答案

B · 为病情稳定的患者置入留置导尿管
6.优先排序与委派

答案: D · An older adult with weakness on one side that began 40 minutes ago

为什么是这个答案

Sudden one-sided weakness suggests a stroke, and treatment depends on how quickly it starts. Severe kidney stone pain needs prompt pain relief, but the patient is stable.

答案

D · An older adult with weakness on one side that began 40 minutes ago
7.临床护理

答案: C · Dull percussion and reduced breath sounds over the lung base

为什么是这个答案

Fluid in the pleural space muffles breath sounds and makes percussion stony dull. A large effusion may push the trachea away from the affected side.

答案

C · Dull percussion and reduced breath sounds over the lung base
8.临床护理

答案: A · A base-of-skull fracture with a cerebrospinal fluid leak

为什么是这个答案

Clear fluid from the nose or ear after head injury suggests a CSF leak from a skull base fracture, with a risk of meningitis. Nasal tubes and nose-blowing should be avoided and the patient reviewed urgently.

答案

A · A base-of-skull fracture with a cerebrospinal fluid leak
9.实验室检查值与电解质

答案: C · Anti-D immunoglobulin (Rho(D) immune globulin)

为什么是这个答案

An Rh-negative mother can form anti-D antibodies if Rh-positive fetal blood enters her circulation, which can cause hemolytic disease in a later pregnancy. Anti-D immunoglobulin at about 28 weeks and after delivery of an Rh-positive baby prevents this sensitization.核对依据: Red Blood Cell Antibody Screen · MedlinePlus (NIH) (2025); Hemolytic disease of the newborn · MedlinePlus (NIH) (2025)

答案

C · Anti-D immunoglobulin (Rho(D) immune globulin)
10.实验室检查值与电解质

答案: D · Secondary hyperparathyroidism from CKD

为什么是这个答案

In CKD, phosphate retention and reduced activation of vitamin D lower calcium, which stimulates the parathyroid glands. The result is high PTH with high phosphate, causing bone disease. Phosphate binders, diet and active vitamin D are used.核对依据: Parathyroid Hormone (PTH) Test · MedlinePlus (NIH) (2023)

答案

D · Secondary hyperparathyroidism from CKD
11.药理学

答案: C · 减少剂量或延长给药间隔

为什么是这个答案

肾清除率下降时，经肾排泄的药物会蓄积。应根据肾功能并尽可能根据血药浓度降低剂量或减少给药频次。

答案

C · 减少剂量或延长给药间隔
12.药理学

答案: C · 它使活性降到基础水平以下

为什么是这个答案

中性拮抗剂只是阻断激动剂，基础活性不变。反向激动剂稳定受体的非活性状态，因此组成性活性降到基础水平以下。

答案

C · 它使活性降到基础水平以下
13.内外科护理：心血管与呼吸

答案: D · Without an inhaled steroid, it is linked with severe and fatal attacks

为什么是这个答案

LABA monotherapy in asthma is linked with severe attacks and asthma deaths because it relieves symptoms while airway inflammation continues. In asthma, LABAs are always given with an inhaled corticosteroid, often in one combination inhaler.

答案

D · Without an inhaled steroid, it is linked with severe and fatal attacks
14.内外科护理：心血管与呼吸

答案: D · Her risk of stroke is high, and an anticoagulant lowers it

为什么是这个答案

In AF, blood stasis in the left atrium causes clots that can travel to the brain. Scores such as CHA₂DS₂-VASc (age, hypertension, diabetes, female sex and others) estimate stroke risk; her score is high. Anticoagulation reduces stroke risk but does not change the rhythm.

答案

D · Her risk of stroke is high, and an anticoagulant lowers it
15.内外科护理：神经、内分泌与肾脏

答案: D · It protects the heart from arrhythmias

为什么是这个答案

Calcium stabilises the cardiac cell membrane and reduces the risk of arrhythmias within minutes. It does not change the potassium level, so other treatments are needed to shift and remove potassium.

答案

D · It protects the heart from arrhythmias
16.内外科护理：神经、内分泌与肾脏

答案: B · Focal impaired awareness seizure

为什么是这个答案

Focal impaired awareness seizures often come from the temporal lobe. They last about a minute or two, with automatisms such as lip smacking and fumbling, and are followed by confusion. Absence seizures are shorter and have no postictal phase.

答案

B · Focal impaired awareness seizure
17.内外科护理：消化、围手术期与肿瘤

答案: A · Anaesthesia, drugs and some tests may harm a fetus

为什么是这个答案

Unknown pregnancy can change the decision to operate, the timing, and the choice of drugs and X-rays. Testing is offered with consent, according to local policy.

答案

A · Anaesthesia, drugs and some tests may harm a fetus
18.内外科护理：消化、围手术期与肿瘤

答案: B · Call for help, give 100% oxygen and use a jaw thrust

为什么是这个答案

Stridor after extubation suggests laryngospasm or another upper airway obstruction. The nurse calls for help, applies high-flow oxygen and airway manoeuvres, and the anaesthetist may give drugs or reintubate.

答案

B · Call for help, give 100% oxygen and use a jaw thrust
19.产科护理

答案: B · Plasma volume rises more than red cell mass

为什么是这个答案

Plasma volume increases more than red cell mass, so haemoglobin concentration falls (physiological or dilutional anaemia). Iron deficiency can add to this and should still be checked.

答案

B · Plasma volume rises more than red cell mass
20.产科护理

答案: B · Intrahepatic cholestasis of pregnancy

为什么是这个答案

Itching of the hands and feet without a rash suggests intrahepatic cholestasis of pregnancy. Raised bile acids are linked with stillbirth, so liver function and bile acids are checked and timing of birth may be planned.

答案

B · Intrahepatic cholestasis of pregnancy
21.儿科护理

答案: B · 约 9 至 10 个月

为什么是这个答案

钳捏抓握通常在约 9–10 个月时出现，到约 12 个月时变得灵巧精细。这也是这个年龄小物体成为窒息风险的原因。

答案

B · 约 9 至 10 个月
22.儿科护理

答案: D · Surfactant given into the trachea

为什么是这个答案

Respiratory distress syndrome in preterm babies is caused by surfactant deficiency. Exogenous surfactant given via the airway, with respiratory support such as CPAP, improves lung compliance. Antibiotics are often started too, because infection can look similar.

答案

D · Surfactant given into the trachea
23.精神科护理

答案: C · These are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored

为什么是这个答案

Fine tremor, thirst, polyuria and mild nausea are common early effects of lithium. A coarse tremor, vomiting, diarrhoea, confusion or unsteadiness suggest toxicity.

答案

C · These are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored
24.精神科护理

答案: A · Provide orientation cues, make sure glasses and hearing aids are used, and involve the family

为什么是这个答案

Non-drug measures, such as clocks and calendars, sensory aids, a normal sleep-wake cycle, mobility, hydration and familiar people, help while the underlying cause is treated. Restraints and frequent moves worsen delirium.

答案

A · Provide orientation cues, make sure glasses and hearing aids are used, and involve the family
25.护理数学与单位换算

答案: h = 124 cm

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。

以英寸表示的身高

4·12 + 1 = 49 in

英寸换算为厘米

h = 49·2.54 = 124.5 ≈ 124 cm

答案

h = 124 cm
26.护理数学与单位换算

答案: N = 6

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

10 mL × 4 × 14 = 560 mL

瓶数

560/100 = 5.6 → N = 6

答案

N = 6
27.剂量计算

答案: V = 2.8 mL

抽取剂量：体积 = (处方剂量/药物浓度) × 药物体积。先换算成相同的单位，再检查该体积是否适合注射器，并落在它的某一个刻度上。

按体重计算剂量

D = 10·7 = 70 mg

体积

V = 70/25 = 2.8 mL

在注射器上

在这支 10 mL 的注射器上，每条小刻度线代表 0.2 mL。

答案

V = 2.8 mL
28.剂量计算

答案: V = 9 mL

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。

按体重计算剂量

10·18 = 180 mg

体积

V = (180/100)·5 = 9 mL

答案

V = 9 mL
29.静脉输液速度

答案: V = 210 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 = 105·2 = 210 mL

答案

V = 210 mL
30.静脉输液速度

答案: D = 25 mcg/min

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

25000 mcg/250 mL = 100 mcg/mL

每小时剂量

15·100 = 1500 mcg/h

每分钟剂量

D = 1500/60 = 25 mcg/min

答案

D = 25 mcg/min
31.静脉输液与液体平衡

答案: I = 800 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: 100 + 200 = 300 mL
静脉输液: 50·8 = 400 mL
静脉抗生素: 1·100 = 100 mL
I = 800 mL

答案

I = 800 mL
32.静脉输液与液体平衡

答案: t = 2.7 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。

剩余体积

500 − 100 = 400 mL

时间

t = 400/150 = 2.667 ≈ 2.7 h

答案

t = 2.7 h

约为 2 h 40 min，所以袋子大约在 14:10 输完。

33.临床评估评分

答案: NEWS2 = 1

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 20/min → 0
SpO₂ 96% → 0
吸空气 → 0
SBP 118 mmHg → 0
HR 58/min → 0
清醒 (A) → 0
T 38.1 °C → 1

相加

NEWS2 = 0 + 0 + 0 + 0 + 0 + 0 + 1 = 1

答案

NEWS2 = 1
34.临床评估评分

答案: DBP = 47 mmHg

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。

变形

DBP = (3·MAP − SBP)/2

代入

DBP = (3·70 − 116)/2 = 94/2 = 47 mmHg

答案

DBP = 47 mmHg

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