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

What is the main aim of "protected mealtimes" on hospital wards?

  1. ATo let patients eat without interruptions, with help where needed
  2. BTo give staff a fixed break while the patients are eating their meals
  3. CTo stop visitors from bringing any food into hospital
  4. DTo make sure all patients eat the same meal at once
2.护理学基础困难

A small fire starts in a patient's room. What is the first action?

  1. ATry to put out the fire with water
  2. BOpen the windows to let out the smoke
  3. CMove the patient away from immediate danger
  4. DGo and find the fire safety officer to ask what should be done
3.感染控制与患者安全中等

A patient with a severe latex allergy is booked for surgery. Which measure is commonly used?

  1. AGive the patient antihistamines before surgery and then use the normal supplies
  2. BUse latex-free supplies and schedule the patient as the first case of the day
  3. CWrap latex items in plastic before use
  4. DUse latex gloves only for short procedures
4.感染控制与患者安全困难

A patient was harmed by a medication error and asks the nurse what happened. Which approach is best?

  1. ATell the patient nothing happened to avoid worry
  2. BBlame the pharmacy for the error so that the nurse and the ward are not at fault
  3. CBe honest that an error occurred and involve the provider and team in disclosure per policy
  4. DTell the patient to make a formal complaint to find out
5.优先排序与委派中等

哪项发现是非预期的，需要及时跟进？

  1. A一名已知肝硬化的患者皮肤黄染，没有变化
  2. B一名腹腔镜胆囊手术后一天的患者出现右肩疼痛
  3. C一名使用肝素输注的患者出现新的黑色柏油样大便
  4. D一名长期 COPD 患者有桶状胸
6.优先排序与委派困难

A patient with raised intracranial pressure is being nursed on the ward. Which position is best?

  1. AHead of the bed at about 30 degrees with the neck straight
  2. BFlat on the back with the head turned well over to one side
  3. CHead down with the legs raised above the heart
  4. DSitting forward with the chin on the chest
7.临床护理中等

When should discharge planning usually begin?

  1. AOn the morning of discharge
  2. BAfter the patient has been home for a week
  3. COnly after the patient asks to go home
  4. DOn or soon after admission
8.临床护理困难

一名颅脑损伤患者的 GCS 从 14 分降至 10 分，一侧瞳孔变大且对光反应迟钝。护士应该怎么做？

  1. A鼓励患者睡觉
  2. B作为神经科急症立即上报
  3. C给予镇静剂使患者平静
  4. D在下一次常规观察时复查 GCS
9.实验室检查值与电解质中等

Why is a blood β-hydroxybutyrate level often preferred to a urine ketone dipstick in DKA?

  1. AIt is the only test that can measure glucose and ketones together
  2. BIt measures the main ketone in DKA, and the dipstick may miss it
  3. CThe urine dipstick only detects ketones in people without diabetes
  4. DIt shows the average ketone level over the past three months
10.实验室检查值与电解质困难

A patient's potassium is 7.2 mEq/L, and the monitor shows wide QRS complexes. Several treatments are prescribed. Which should be given first?

  1. AIV calcium gluconate (or chloride)
  2. BAn oral potassium binder dose
  3. CUrgent hemodialysis session
  4. DIV furosemide (a loop diuretic)
11.药理学中等

他汀类药物的哪种严重但罕见的不良反应需要患者立即报告？

  1. A干咳
  2. B口中有金属味
  3. C不明原因的肌肉疼痛或无力
  4. D踝部水肿
12.药理学困难

Why is strict aseptic technique and a limited hang time needed for propofol infusions?

  1. ALight exposure changes propofol into an opioid
  2. BIts lipid emulsion lets bacteria grow if it is contaminated
  3. CPropofol breaks down into a toxic gas after a few hours
  4. DPropofol becomes more potent the longer it hangs
13.内外科护理：心血管与呼吸中等

Why must inspired air be humidified for a patient with a tracheostomy?

  1. AHumidified air contains more oxygen than dry air at the same flow
  2. BThe nose and upper airway, which warm and moisten air, are bypassed
  3. CDry air is needed to stop secretions forming in the trachea
  4. DHumidification prevents the cuff from deflating
14.内外科护理：心血管与呼吸困难

A nurse reviews inhaler use with a patient who has asthma and uses a separate steroid preventer inhaler and a salbutamol reliever. Which statement shows a need for further teaching?

  1. A"I use my steroid inhaler when I start to wheeze."
  2. B"I use my steroid inhaler every day, even when I feel well."
  3. C"I carry my blue reliever inhaler with me."
  4. D"I rinse my mouth after the steroid inhaler."
15.内外科护理：神经、内分泌与肾脏中等

哪项尿液表现最能区分尿崩症和 SIADH？

  1. A尿崩症为稀释尿；SIADH 为浓缩尿
  2. B尿崩症尿中有葡萄糖；SIADH 尿中有蛋白
  3. C尿崩症为浓缩尿；SIADH 为稀释尿
  4. D两种疾病都排出高度浓缩的尿
16.内外科护理：神经、内分泌与肾脏困难

A patient with Guillain–Barré syndrome has a blood pressure that swings between 80/50 and 190/100 mmHg and a heart rate that changes suddenly. What does this suggest?

  1. AAnxiety that will settle with reassurance alone
  2. BA faulty blood pressure cuff that should be replaced and the readings ignored
  3. CAutonomic dysfunction, which needs continuous cardiac monitoring
  4. DA drug reaction that means all medicines must stop
17.内外科护理：消化、围手术期与肿瘤中等

How should a patient use an incentive spirometer after surgery?

  1. ABreathe quickly in and out ten times in a row
  2. BUse it once a day, just before going to sleep at night
  3. CBreathe in slowly and deeply, then hold briefly
  4. DBlow out as hard and as fast as possible
18.内外科护理：消化、围手术期与肿瘤困难

Four hours after surgery, a catheterised patient's urine output has been 10 mL/h for two hours. Vital signs are stable. What should the nurse check first?

  1. AYesterday's chest X-ray and blood gas results
  2. BThat the catheter and tubing are not kinked or blocked
  3. CThe time the patient last ate
  4. DWhether the patient wants a cup of tea
19.产科护理中等

A woman at 28 weeks asks why her heart rate is higher than before pregnancy. Which response is accurate?

  1. AA rise of about 10 to 15 beats per minute is normal in pregnancy
  2. BA higher heart rate in pregnancy always points to heart disease
  3. CThe heart rate rises because blood pressure is much higher in pregnancy
  4. DHeart rate normally falls in pregnancy, so this needs urgent review
20.产科护理困难

Over the last hour, a labour tracing shows variable decelerations that are becoming deeper and longer, a baseline rising from 135 to 165 bpm and falling variability. How should the nurse interpret this?

  1. AA sign of fetal well-being; no action is needed
  2. BBenign head compression; continue routine monitoring
  3. CA normal fetal sleep cycle; recheck in an hour
  4. DEvolving fetal hypoxia; escalate for urgent obstetric review
21.儿科护理中等

A child with suspected appendicitis is waiting for surgery. Which action must the nurse avoid?

  1. APutting a heat pad on the abdomen
  2. BKeeping the child nil by mouth
  3. CRegular pain assessment
  4. DGiving IV fluids as prescribed
22.儿科护理困难

Which child is most appropriate to assign to a practical (enrolled) nurse?

  1. AA 9-year-old newly admitted with diabetic ketoacidosis on an insulin infusion
  2. BA 5-year-old just back from tonsillectomy who keeps swallowing
  3. CAn infant with bronchiolitis who needs more and more oxygen
  4. DA 7-year-old 2 days after an appendicectomy, stable on oral analgesia
23.精神科护理中等

A student avoids eating in the canteen and speaking in seminars because she fears others will judge her or see her blush. Which disorder does this suggest?

  1. AObsessive-compulsive disorder
  2. BSocial anxiety disorder
  3. CGeneralised anxiety disorder
  4. DAgoraphobia
24.精神科护理困难

An 81-year-old woman's memory has slowly worsened over 2 years. She repeats questions and gets lost in familiar places, but she is alert and her attention is normal. Which condition is most likely?

  1. ADelirium
  2. BBrief psychotic disorder in later life
  3. CA neurocognitive disorder such as Alzheimer's disease
  4. DNormal ageing with mild forgetfulness
25.护理数学与单位换算中等
0.48254 mL? mL取整到 0.01 mL

练习题（虚构数值，不作为临床指导）。 一次小剂量注射的计算得到 0.48254 mL。 本练习的规则是：低于 1 mL 的体积取到最接近的百分之一 mL。你记录的数值x是多少？

0.48254 mL
x = mL
26.护理数学与单位换算困难
00:0023:0005:00t = ?

练习题（虚构数值，不作为临床指导）。 一次输注从 23:00 开始，到次日早晨 05:00 结束（24 小时制）。它运行了多少分钟t？

23:0005:00
t = min
27.剂量计算中等
024681010 mL

一名体重 12 kg 的儿童按 2 mg/kg 处方用药。原液浓度为 20 mg/mL。请抽取剂量：应给多少体积 V？

12 kg2 mg/kg20 mg/mL
V = mL
28.剂量计算困难
00.10.20.30.40.50.60.70.80.911 mL

处方剂量为 0.35 mg。安瓿每 mL 含 1000 微克。请用 1 mL 注射器抽取剂量：应给多少体积 V？

0.35 mg1000 mcg/mL
V = mL
29.静脉输液速度中等
V = ?20 gtt/mL50 gtt/min8 h

滴注以 50 gtt/min 的速度通过滴系数为 20 gtt/mL 的输液器。患者在 8 小时内接受多少毫升 V？

50 gtt/min20 gtt/mL8 h
V = mL
30.静脉输液速度困难
100 mg250 mL20 mL/h? mg/h

一袋液体在 250 mL 中含药 100 mg，以 20 mL/h 的速度输注。患者每小时获得多少毫克 D？

100 mg/250 mL20 mL/h
D = mg/h
31.静脉输液与液体平衡中等
入量出量8 小时班次果冻100 mL牛奶200 mL茶200 mL静脉输液125 mL/h × 8 h静脉抗生素1 × 50 mL尿液175 mL尿液400 mL伤口引流70 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 66 kg。求平均尿量 U，以 mL/kg/h 计。 保留两位小数。

66 kg8 h尿液: 175 mL尿液: 400 mL伤口引流: 70 mL
U = mL/kg/h
32.静脉输液与液体平衡困难
500 mL→ 60 mL/h开始 18:30t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 18:30 开始以 100 mL/h 输注。3 小时后速率改为 60 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 h60 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: 非常潮湿; 活动: 偶尔步行; 活动能力: 轻度受限; 营养: 可能不足; 摩擦力和剪切力: 潜在问题。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 101 kg，身高 176 cm。计算 BMI 并点击 WHO 体重分类。

101 kg176 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: A · To let patients eat without interruptions, with help where needed

为什么是这个答案

Ward rounds and tests can interrupt meals, and patients then eat less. Protected mealtimes pause non-urgent activity so staff can focus on helping patients eat.

答案

A · To let patients eat without interruptions, with help where needed
2.护理学基础

答案: C · Move the patient away from immediate danger

为什么是这个答案

The first priority is to rescue anyone in immediate danger, then raise the alarm, contain the fire by closing doors and only then try to extinguish it if safe. Opening windows feeds a fire with oxygen.

答案

C · Move the patient away from immediate danger
3.感染控制与患者安全

答案: B · Use latex-free supplies and schedule the patient as the first case of the day

为什么是这个答案

Latex proteins can become airborne on glove powder and settle in the room. Using a latex-safe room and supplies and scheduling the patient first, when airborne latex is lowest, reduce the risk.

答案

B · Use latex-free supplies and schedule the patient as the first case of the day
4.感染控制与患者安全

答案: C · Be honest that an error occurred and involve the provider and team in disclosure per policy

为什么是这个答案

Open, honest disclosure of errors is an ethical duty and part of a safety culture. The nurse follows policy, which usually involves the provider and risk team, and does not hide or blame.

答案

C · Be honest that an error occurred and involve the provider and team in disclosure per policy
5.优先排序与委派

答案: C · 一名使用肝素输注的患者出现新的黑色柏油样大便

为什么是这个答案

黑色柏油样大便（黑便）提示上消化道出血，是抗凝治疗的危险并发症。腹腔镜手术后因使用的气体而出现肩痛很常见，COPD 的桶状胸和肝硬化稳定的黄疸是预期的。

答案

C · 一名使用肝素输注的患者出现新的黑色柏油样大便
6.优先排序与委派

答案: A · Head of the bed at about 30 degrees with the neck straight

为什么是这个答案

Raising the head to about 30 degrees and keeping the neck in line helps venous drainage and lowers intracranial pressure. Head-down positions and neck bending or turning can raise it.

答案

A · Head of the bed at about 30 degrees with the neck straight
7.临床护理

答案: D · On or soon after admission

为什么是这个答案

Discharge planning starts early so that needs such as equipment, care packages, medicines and follow-up are ready when the patient is fit to leave.

答案

D · On or soon after admission
8.临床护理

答案: B · 作为神经科急症立即上报

为什么是这个答案

GCS 下降伴单侧瞳孔散大提示颅内压升高、可能发生脑疝。需要紧急医疗评估和影像学检查。

答案

B · 作为神经科急症立即上报
9.实验室检查值与电解质

答案: B · It measures the main ketone in DKA, and the dipstick may miss it

为什么是这个答案

In DKA, β-hydroxybutyrate is the main ketone, but most urine dipsticks detect acetoacetate, so they can underestimate ketosis. Blood β-hydroxybutyrate gives a current value that is also useful to monitor recovery.核对依据: Diabetic ketoacidosis - Medical Encyclopedia · MedlinePlus (NIH) (2025)

答案

B · It measures the main ketone in DKA, and the dipstick may miss it
10.实验室检查值与电解质

答案: A · IV calcium gluconate (or chloride)

为什么是这个答案

With ECG changes, IV calcium is given first to stabilize the cardiac membrane within minutes. It does not lower potassium, so insulin with glucose (and sometimes albuterol/salbutamol) follows to shift potassium into cells, then binders, diuretics or dialysis remove it.核对依据: High potassium level - Medical Encyclopedia · MedlinePlus (NIH) (2025)

答案

A · IV calcium gluconate (or chloride)
11.药理学

答案: C · 不明原因的肌肉疼痛或无力

为什么是这个答案

他汀类可引起肌病，极少数会进展为伴肾损伤的横纹肌溶解。不明原因的肌痛应进行检查，例如测定肌酸激酶。

答案

C · 不明原因的肌肉疼痛或无力
12.药理学

答案: B · Its lipid emulsion lets bacteria grow if it is contaminated

为什么是这个答案

Propofol is formulated in a soybean oil emulsion, which is a good growth medium for bacteria. Contaminated propofol has caused sepsis, so it is handled aseptically and tubing and containers are changed at set intervals.

答案

B · Its lipid emulsion lets bacteria grow if it is contaminated
13.内外科护理：心血管与呼吸

答案: B · The nose and upper airway, which warm and moisten air, are bypassed

为什么是这个答案

The tracheostomy bypasses the nose, mouth and pharynx, which warm, filter and humidify air. Without humidification, secretions become thick and can block the tube. Heat and moisture exchangers, humidified oxygen and nebulised saline are used.

答案

B · The nose and upper airway, which warm and moisten air, are bypassed
14.内外科护理：心血管与呼吸

答案: A · "I use my steroid inhaler when I start to wheeze."

为什么是这个答案

Inhaled corticosteroids are preventers that reduce airway inflammation over days to weeks and must be taken regularly. They do not relieve an acute wheeze. Unless the patient has a combined reliever and maintenance regimen, a short-acting bronchodilator is used for symptoms.

答案

A · "I use my steroid inhaler when I start to wheeze."
15.内外科护理：神经、内分泌与肾脏

答案: A · 尿崩症为稀释尿；SIADH 为浓缩尿

为什么是这个答案

在尿崩症中，缺乏 ADH 作用导致大量稀释尿（比重常低于 1.005）和血清钠升高。在 SIADH 中，ADH 过多导致尿量少、尿液浓缩和血清钠降低。

答案

A · 尿崩症为稀释尿；SIADH 为浓缩尿
16.内外科护理：神经、内分泌与肾脏

答案: C · Autonomic dysfunction, which needs continuous cardiac monitoring

为什么是这个答案

Guillain–Barré syndrome can involve autonomic nerves, causing labile blood pressure and dangerous arrhythmias. Patients need continuous ECG monitoring and close observation, often in a high-dependency setting.

答案

C · Autonomic dysfunction, which needs continuous cardiac monitoring
17.内外科护理：消化、围手术期与肿瘤

答案: C · Breathe in slowly and deeply, then hold briefly

为什么是这个答案

Slow, deep inspiration with a short hold expands the alveoli and helps prevent atelectasis. It is repeated regularly while awake, together with coughing and good pain control.

答案

C · Breathe in slowly and deeply, then hold briefly
18.内外科护理：消化、围手术期与肿瘤

答案: B · That the catheter and tubing are not kinked or blocked

为什么是这个答案

A sudden low output may be due to a kinked tube or blocked catheter. If drainage is normal, hypovolaemia or kidney injury is considered and the team is informed, with a fluid assessment.

答案

B · That the catheter and tubing are not kinked or blocked
19.产科护理

答案: A · A rise of about 10 to 15 beats per minute is normal in pregnancy

为什么是这个答案

Blood volume and cardiac output rise in pregnancy, and the resting heart rate typically increases by 10 to 15 beats per minute. Blood pressure usually falls slightly in the second trimester.

答案

A · A rise of about 10 to 15 beats per minute is normal in pregnancy
20.产科护理

答案: D · Evolving fetal hypoxia; escalate for urgent obstetric review

为什么是这个答案

Deepening decelerations with a rising baseline and falling variability show that the fetus is losing its ability to compensate. Intrauterine resuscitation (position change, stopping any oxytocin, treating hypotension) starts and the obstetrician is called urgently, because expedited birth may be needed.

答案

D · Evolving fetal hypoxia; escalate for urgent obstetric review
21.儿科护理

答案: A · Putting a heat pad on the abdomen

为什么是这个答案

Heat on the abdomen and laxatives or enemas are avoided in suspected appendicitis because they can increase the risk of perforation. Nil by mouth, IV fluids, analgesia and close monitoring are appropriate.

答案

A · Putting a heat pad on the abdomen
22.儿科护理

答案: D · A 7-year-old 2 days after an appendicectomy, stable on oral analgesia

为什么是这个答案

Practical or enrolled nurses usually care for stable children with predictable outcomes. Children who are unstable, newly admitted with a complex condition or showing signs of deterioration need a registered nurse's assessment.

答案

D · A 7-year-old 2 days after an appendicectomy, stable on oral analgesia
23.精神科护理

答案: B · Social anxiety disorder

为什么是这个答案

Social anxiety disorder is a marked fear of social situations in which the person may be scrutinised, with fear of embarrassment or negative judgement, leading to avoidance or intense distress.

答案

B · Social anxiety disorder
24.精神科护理

答案: C · A neurocognitive disorder such as Alzheimer's disease

为什么是这个答案

Gradual, progressive memory loss with impaired daily functioning and normal alertness suggests dementia, most commonly Alzheimer's disease. Delirium is acute and fluctuating with impaired attention.

答案

C · A neurocognitive disorder such as Alzheimer's disease
25.护理数学与单位换算

答案: x = 0.48 mL

取整：看舍入位后面的那个数字：5 或更大则进位，4 或更小则保持原数字不变。只对最终答案取整，绝不对中间步骤取整。典型的考试规则：1 mL 或以上的体积取到十分位，低于 1 mL 的体积取到百分位，滴速取整到整滴，体重取到一位小数；务必遵循题目所规定的规则。

百分位位上的数字

0.48254 → 8

只看下一位数字

0.48254 → 2
2 小于或等于 4，所以 8 不变。
后面的数字（54）不考虑：只取整一次，不要逐位取整。

取整

x = 0.48 mL

答案

x = 0.48 mL
26.护理数学与单位换算

答案: t = 360 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

23:00 → 24:00 = 60 min

午夜之后

00:00 → 05:00 = 300 min

合计

t = 60 + 300 = 360 min

答案

t = 360 min
27.剂量计算

答案: V = 1.2 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 = 2·12 = 24 mg

体积

V = 24/20 = 1.2 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 = 1.2 mL
28.剂量计算

答案: V = 0.35 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。

单位相同

0.35 mg = 350 mcg

体积

V = 350/1000 = 0.35 mL

答案

V = 0.35 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）

50·60/20 = 150 mL/h

体积

V = 150·8 = 1200 mL

答案

V = 1200 mL
30.静脉输液速度

答案: D = 8 mg/h

输注速率：输液泵按 mL/h = 体积/时间（小时）设定。重力滴注按每分钟滴数计：gtt/min = 体积 (mL) × 滴系数 (gtt/mL)/时间 (min)。 滴系数印在输液器包装上：普通输液器为 10、15 或 20 gtt/mL（输血器在美国常为 10 gtt/mL，在英国为 15），微量输液器为 60 gtt/mL。务必使用题目或包装给出的滴系数。

浓度

100/250 = 0.4 mg/mL

给药速率

D = 0.4·20 = 8 mg/h

答案

D = 8 mg/h
31.静脉输液与液体平衡

答案: U = 1.09 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

175 + 400 = 575 mL

每千克每小时

U = 575/(66·8) = 1.089 ≈ 1.09 mL/kg/h

答案

U = 1.09 mL/kg/h
32.静脉输液与液体平衡

答案: t = 6.3 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

200/60 = 3.333 h

总时间

t = 3 + 3.333 = 6.333 ≈ 6.3 h

答案

t = 6.3 h

约为 6 h 20 min，所以袋子大约在 00:50 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: 非常潮湿 → 2
活动: 偶尔步行 → 3
活动能力: 轻度受限 → 3
营养: 可能不足 → 2
摩擦力和剪切力: 潜在问题 → 2

相加

Braden 总分 = 3 + 2 + 3 + 3 + 2 + 2 = 15

答案

B = 15
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 = 101/1.76² = 32.61

分类

肥胖 I 级

答案

肥胖 I 级

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