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 purpose of a wound drain after surgery?

  1. ATo measure the temperature inside the wound
  2. BTo remove fluid or blood that could collect and delay healing
  3. CTo keep the wound edges apart until it heals
  4. DTo give antibiotics directly into the wound until it has fully healed
2.护理学基础困难

Which simple measure helps reduce the risk of delirium in an older inpatient?

  1. AMaking sure they have their glasses and hearing aids
  2. BKeeping the lights on all night
  3. CLimiting visits from family members
  4. DMoving them to a different bed every night to vary their surroundings
3.感染控制与患者安全中等

A patient with diabetes will use lancets and insulin needles at home. Which teaching about disposal is correct?

  1. APut them in a puncture-resistant container with a lid and follow local disposal rules
  2. BPut them loose in the household trash bag, as long as the bag is tied shut
  3. CRecap each needle with two hands before putting it in the kitchen trash
  4. DFlush the used lancets and needles down the toilet
4.感染控制与患者安全困难

A patient receiving chemotherapy has an absolute neutrophil count of 400/mm3 (0.4 × 109/L) and a new temperature of 38.3 °C (100.9 °F). What should the nurse do?

  1. ARecheck the temperature in four hours before calling anyone about it
  2. BEncourage oral fluids and record the result in the chart
  3. CGive an antipyretic and reassess at the next routine round
  4. DReport it at once, because fever with severe neutropenia is an emergency
5.优先排序与委派中等

A nursing assistant tells the RN that a patient’s IV pump is alarming. What is the best response?

  1. A“Turn the pump off and on again until it stops.”
  2. B“I will come and check the pump and the IV site now.”
  3. C“Increase the rate a little so the alarm clears.”
  4. D“Silence the alarm and I will check it at the end of the shift.”
6.优先排序与委派困难

一名患者正通过中心静脉导管接受肠外营养。哪项发现需要立即处理？

  1. A自昨天起体重增加 0.2 kg
  2. B输注意外中断后出现出汗、颤抖，血糖 62 mg/dL（3.4 mmol/L）
  3. C输注过程中血糖 150 mg/dL（8.3 mmol/L）
  4. D导管上的敷料干燥完整
7.临床护理中等

What should a patient starting oral iron tablets be told?

  1. ATheir urine will turn bright green
  2. BTheir stools may turn dark or black
  3. CThey must take the tablets with strong tea
  4. DThe tablets will cause weight loss
8.临床护理困难

Why can sepsis be missed in older adults?

  1. AThey may have no fever and present with confusion, falls or reduced mobility
  2. BBlood tests are not useful in older people
  3. COlder adults cannot develop sepsis because their immune system is weaker
  4. DOlder adults always have a very high fever
9.实验室检查值与电解质中等

Which blood collection practice helps prevent hemolysis of the sample?

  1. AForcing blood quickly through a needle into the tube
  2. BLeaving the tourniquet on for at least 3 minutes
  3. CUsing the smallest needle available for every patient
  4. DGently inverting the tubes instead of shaking them
10.实验室检查值与电解质困难

A patient with ongoing hemolytic anemia has an HbA1c of 4.6%, but home glucose readings are often 180–220 mg/dL (10–12 mmol/L). What best explains the gap?

  1. AShort red cell life span lowers the HbA1c falsely
  2. BThe home glucose meter is reading falsely high
  3. CHemolysis makes the HbA1c test read too high
  4. DThe patient has true, well-controlled diabetes
11.药理学中等

A patient takes isoniazid. Which advice is most important?

  1. ATake it with antacids to protect the stomach from irritation
  2. BStop the drug when the cough improves
  3. CAvoid alcohol and report jaundice, dark urine or poor appetite
  4. DExpect the urine to turn orange
12.药理学困难

A patient receiving a phenylephrine infusion has a rise in blood pressure and a fall in heart rate. What is the best explanation?

  1. APhenylephrine directly blocks beta-1 receptors in the heart's conduction system
  2. BPhenylephrine stimulates muscarinic receptors
  3. CThe fall in heart rate shows phenylephrine toxicity of the AV node
  4. DAlpha-1 vasoconstriction raises blood pressure and causes reflex bradycardia
13.内外科护理：心血管与呼吸中等

Septic shock belongs to which category of shock?

  1. ADistributive shock
  2. BObstructive shock
  3. CHypovolaemic shock
  4. DCardiogenic shock
14.内外科护理：心血管与呼吸困难

A patient with pneumonia has a temperature of 39 °C, pain and a sinus tachycardia of 122/min. BP is normal. What is the best way to manage the heart rate?

  1. AGive IV adenosine
  2. BTreat the fever, pain and possible dehydration, then reassess
  3. CGive a beta-blocker to bring the heart rate below 100/min
  4. DArrange urgent electrical cardioversion to restore a normal rate
15.内外科护理：神经、内分泌与肾脏中等

A patient takes levodopa for Parkinson's disease. Which teaching point is correct?

  1. AStop the drug for a day each week to avoid tolerance
  2. BThe tablets work best taken with a large steak dinner
  3. CLarge high-protein meals can reduce how well the drug works
  4. DThe drug cures the disease if taken for a full year
16.内外科护理：神经、内分泌与肾脏困难

血液透析期间，一名患者血压降至 80/50 mmHg，感到头晕恶心。最恰当的首要护理措施是什么？

  1. A立即给予患者平时的降压药剂量
  2. B提高超滤速度，使透析更早结束
  3. C让患者平躺，减少超滤，并寻求帮助
  4. D让患者坐直，并鼓励短距离行走
17.内外科护理：消化、围手术期与肿瘤中等

Which drug class is used to reduce the risk of a first variceal bleed in cirrhosis?

  1. AProton pump inhibitors
  2. BThiazide diuretics
  3. CCalcium supplements
  4. DNon-selective beta-blockers
18.内外科护理：消化、围手术期与肿瘤困难

During bowel preparation, an older patient becomes dizzy and confused. Blood tests show sodium 127 mmol/L. What should the nurse do?

  1. ARecord it and continue as planned, as this is expected
  2. BStop the preparation and escalate to the medical team
  3. CEncourage plain water only, as much as possible
  4. DGive the rest of the preparation more quickly
19.产科护理中等

Which feature suggests a newborn is preterm rather than term?

  1. ACreases covering the whole sole
  2. BPlantar creases only on the front of the sole
  3. CFirm ear cartilage that springs back
  4. DLabia majora covering the labia minora
20.产科护理困难

A deceleration lasts 3 minutes before the baseline recovers. How is this classified?

  1. AA change of baseline
  2. BA prolonged deceleration
  3. CAn early deceleration
  4. DA variable acceleration
21.儿科护理中等

护士应如何对一名 15 岁的青少年进行健康访谈？

  1. A只与家长交谈
  2. B在朋友陪同下访谈青少年以提供支持
  3. C就诊中留出一段时间单独与青少年交谈，并说明保密的限度
  4. D告诉青少年所说的一切都会告知父母，以便让他们知情
22.儿科护理困难

一名疑似阑尾炎的 10 岁儿童一直有剧烈腹痛，但疼痛突然明显缓解。这可能意味着什么？

  1. A止痛药治好了问题
  2. B阑尾炎已经缓解，孩子可以回家
  3. C阑尾可能已穿孔；应立即上报
  4. D这是正常的变化，无需随访
23.精神科护理中等

A young person who took LSD at a festival is frightened by what he is seeing. What is the most helpful nursing approach?

  1. AShine a bright light in his eyes every few minutes to check his pupils and keep him alert until it wears off
  2. BLeave him alone in a dark room so that he can sleep it off
  3. CArgue with him that what he sees is not real until he accepts it
  4. DStay with him in a calm, quiet place and reassure him that the effects are from the drug and will pass
24.精神科护理困难

A patient says, "I don't have a drinking problem. I only drink at weekends, like everyone else." He drinks heavily every weekend. Which approach fits his stage of change best?

  1. AOffer non-judgemental information and explore how drinking affects his life
  2. BDiscuss detailed strategies to prevent a relapse after he has stopped drinking
  3. CHelp him set a quit date for next week
  4. DRefer him straight to a residential detox programme
25.护理数学与单位换算中等
1234567891011128:00 AM?07:0009:0008:0020:00

练习题（虚构数值，不作为临床指导）。 一个剂量记录在 8:00 AM。哪个条目是 24 小时制中的同一时间？点击它。

8:00 AM
  1. 107:00
  2. 209:00
  3. 308:00
  4. 420:00
26.护理数学与单位换算困难
4 mcg/kg/min? mg/h77 kg1 h = 60 min1 mg = 1000 mcg

练习题（虚构数值，不作为临床指导）。 医嘱为 4 mcg/kg/min，患者体重 77 kg。请把剂量速率D用 mg/h 表示。取到两位小数。

4 mcg/kg/min77 kg
D = mg/h
27.剂量计算中等
024681010 mL

一名体重 6 kg 的儿童按 10 mg/kg 处方用药。原液浓度为 10 mg/mL。请抽取剂量：应给多少体积 V？

6 kg10 mg/kg10 mg/mL
V = mL
28.剂量计算困难
200 mg/5 mLV = ? mL

一名患者体重 173.8 lb。医嘱为单次剂量 1 mg/kg，储备液为 5 mL 中含 200 mg。按 1 kg = 2.2 lb 计算，你应给予多少容量 V？ 保留一位小数。

173.8 lb1 mg/kg200 mg/5 mL1 kg = 2.2 lb
V = mL
29.静脉输液速度中等
60 gtt/mL75 mL/h? gtt/min

医嘱要求以 75 mL/h 输液，但没有输液泵。改用滴系数为 60 gtt/mL 的输液器重力滴注。求滴速 R，以每分钟滴数表示。

75 mL/h60 gtt/mL
R = gtt/min
30.静脉输液速度困难
300 mL20 gtt/mL42 gtt/mint = ? h

一组输液以 42 滴/分的速度经 20 滴/mL 的输液器滴注。袋中还剩 300 mL。还需多少小时 t 才会滴完？ 保留一位小数。

42 gtt/min20 gtt/mL300 mL
t = h
31.静脉输液与液体平衡中等
入量出量12 小时班次果冻100 mL汤150 mL冰屑100 mL静脉输液75 mL/h × 12 h静脉抗生素1 × 100 mL尿液375 mL尿液150 mL尿液150 mL伤口引流60 mL

练习题（虚构数值，不作为临床指导）。 记录显示了一名患者在一个 12 小时班次中的出入量。静脉输液在整个班次中按所示速率输注。求液体平衡 B = 入量 − 出量，以 mL 计（答案为负表示净丢失）。 冰屑按其体积的一半计。

果冻: 100 mL汤: 150 mL冰屑: 100 mL静脉输液: 75 mL/h × 12 h静脉抗生素: 1 × 100 mL尿液: 375 mL尿液: 150 mL尿液: 150 mL伤口引流: 60 mL
B = mL
32.静脉输液与液体平衡困难
500 mL→ 75 mL/h开始 07:30t总数​ = ? h120 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 07:30 开始以 120 mL/h 输注。3 小时后速率改为 75 mL/h，之后不再改变。从开始算起多少小时 t 后袋子会输完？ 保留一位小数。

500 mL120 mL/h · 3 h75 mL/h
t = h
33.临床评估评分中等
S? / 4+M? / 4+A? / 4+Mob? / 4+N? / 4+F? / 3Σ?

练习题（虚构数值，不作为临床指导）。 用 Braden 量表评估一位练习患者：感觉知觉: 轻度受限; 潮湿程度: 非常潮湿; 活动: 卧床不起; 活动能力: 不受限制; 营养: 非常差; 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
107?SBPDBPmmHgMAP = 65

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 65 mmHg。一位患者的收缩压为 107 mmHg。使用 MAP = (SBP + 2·DBP)/3，仍能使 MAP 达到 65 mmHg 的最低舒张压DBP是多少？

MAP 65 mmHgSBP 107 mmHg
DBP = mmHg

3溶液

1.护理学基础

答案: B · To remove fluid or blood that could collect and delay healing

为什么是这个答案

Drains let blood, serous fluid or pus escape, preventing collections such as seromas and haematomas. The nurse records the amount and type of drainage.

答案

B · To remove fluid or blood that could collect and delay healing
2.护理学基础

答案: A · Making sure they have their glasses and hearing aids

为什么是这个答案

Sensory aids, orientation, good sleep, hydration, mobility and family involvement all help prevent delirium. Frequent moves and poor sleep make it more likely.

答案

A · Making sure they have their glasses and hearing aids
3.感染控制与患者安全

答案: A · Put them in a puncture-resistant container with a lid and follow local disposal rules

为什么是这个答案

Home sharps go into a puncture-resistant container, such as an approved sharps container or a rigid plastic bottle if local rules allow, which is closed and disposed of according to local guidance.

答案

A · Put them in a puncture-resistant container with a lid and follow local disposal rules
4.感染控制与患者安全

答案: D · Report it at once, because fever with severe neutropenia is an emergency

为什么是这个答案

Febrile neutropenia can progress to sepsis quickly. The nurse reports it immediately so cultures can be taken and antibiotics started without delay.

答案

D · Report it at once, because fever with severe neutropenia is an emergency
5.优先排序与委派

答案: B · “I will come and check the pump and the IV site now.”

为什么是这个答案

An alarm may mean an occlusion, air in the line or infiltration. The nurse checks the pump and site; the assistant should not adjust the pump or silence alarms.

答案

B · “I will come and check the pump and the IV site now.”
6.优先排序与委派

答案: B · 输注意外中断后出现出汗、颤抖，血糖 62 mg/dL（3.4 mmol/L）

为什么是这个答案

肠外营养含有大量葡萄糖，身体会以高胰岛素水平作出反应。如果输注突然中断，可能随后出现反跳性低血糖。护士应按规程处理低血糖，通知医疗人员，并遵循输注中断的政策。血糖轻度升高、敷料完整和体重小幅变化是预期的或轻微的。

答案

B · 输注意外中断后出现出汗、颤抖，血糖 62 mg/dL（3.4 mmol/L）
7.临床护理

答案: B · Their stools may turn dark or black

为什么是这个答案

Oral iron commonly darkens the stool and can cause constipation or stomach upset. Tea and antacids reduce absorption, while vitamin C may increase it.

答案

B · Their stools may turn dark or black
8.临床护理

答案: A · They may have no fever and present with confusion, falls or reduced mobility

为什么是这个答案

Older people may have a normal or low temperature and present with delirium, falls or general decline. Early warning scores and a high index of suspicion are important.

答案

A · They may have no fever and present with confusion, falls or reduced mobility
9.实验室检查值与电解质

答案: D · Gently inverting the tubes instead of shaking them

为什么是这个答案

Hemolysis falsely raises potassium and affects other results. It is reduced by gentle inversion of tubes, avoiding very small needles, avoiding strong suction or forcing blood through a needle, and keeping tourniquet time short.

答案

D · Gently inverting the tubes instead of shaking them
10.实验室检查值与电解质

答案: A · Short red cell life span lowers the HbA1c falsely

为什么是这个答案

HbA1c reflects glucose attached to hemoglobin over the red cell life span. In hemolysis, red cells are younger and have less time to bind glucose, so HbA1c is falsely low. Glucose monitoring or other markers are used instead.核对依据: The A1C Test & Diabetes · NIDDK (NIH) (2018); Hemoglobin A1C (HbA1c) Test · MedlinePlus (NIH) (2025)

答案

A · Short red cell life span lowers the HbA1c falsely
11.药理学

答案: C · Avoid alcohol and report jaundice, dark urine or poor appetite

为什么是这个答案

Isoniazid can cause hepatitis, and alcohol increases the risk. Signs of liver injury are reported at once, and liver tests may be checked.

答案

C · Avoid alcohol and report jaundice, dark urine or poor appetite
12.药理学

答案: D · Alpha-1 vasoconstriction raises blood pressure and causes reflex bradycardia

为什么是这个答案

Phenylephrine is a pure alpha-1 agonist with little direct cardiac action. The higher blood pressure activates baroreceptors, which increase vagal tone and slow the heart.

答案

D · Alpha-1 vasoconstriction raises blood pressure and causes reflex bradycardia
13.内外科护理：心血管与呼吸

答案: A · Distributive shock

为什么是这个答案

In distributive shock (septic, anaphylactic, neurogenic), vessels dilate and leak, so blood is maldistributed and pressure falls. Obstructive shock includes PE, tamponade and tension pneumothorax; cardiogenic shock is pump failure; hypovolaemic shock is volume loss.

答案

A · Distributive shock
14.内外科护理：心血管与呼吸

答案: B · Treat the fever, pain and possible dehydration, then reassess

为什么是这个答案

Sinus tachycardia is usually a physiological response to fever, pain, hypovolaemia, anxiety, hypoxia or sepsis. Treating the cause (antipyretics, analgesia, fluids, oxygen if needed) is appropriate, while watching for sepsis. Rate-slowing drugs can be harmful by masking compensation.

答案

B · Treat the fever, pain and possible dehydration, then reassess
15.内外科护理：神经、内分泌与肾脏

答案: C · Large high-protein meals can reduce how well the drug works

为什么是这个答案

Protein-rich meals can compete with levodopa for absorption and entry into the brain, which reduces its effect. Patients are often advised to take doses at consistent times relative to meals. Levodopa controls symptoms but does not stop the disease.

答案

C · Large high-protein meals can reduce how well the drug works
16.内外科护理：神经、内分泌与肾脏

答案: C · 让患者平躺，减少超滤，并寻求帮助

为什么是这个答案

透析中低血压很常见。调整体位、减少或暂停超滤，并按方案给予少量生理盐水推注，通常可恢复血压。对易发生低血压的患者，降压药常按医嘱在透析前暂停。

答案

C · 让患者平躺，减少超滤，并寻求帮助
17.内外科护理：消化、围手术期与肿瘤

答案: D · Non-selective beta-blockers

为什么是这个答案

Non-selective beta-blockers such as propranolol or carvedilol reduce portal pressure and the risk of variceal bleeding. Endoscopic band ligation is an alternative or addition.

答案

D · Non-selective beta-blockers
18.内外科护理：消化、围手术期与肿瘤

答案: B · Stop the preparation and escalate to the medical team

为什么是这个答案

Bowel preparation can cause dehydration and electrolyte disturbance, including hyponatraemia, especially in older people. Confusion with low sodium needs prompt medical review, and further prep is withheld until assessed.

答案

B · Stop the preparation and escalate to the medical team
19.产科护理

答案: B · Plantar creases only on the front of the sole

为什么是这个答案

Preterm babies have few plantar creases, abundant lanugo, flat areolae, soft ears, prominent labia minora and an extended posture. Creases over the whole sole suggest a term baby.

答案

B · Plantar creases only on the front of the sole
20.产科护理

答案: B · A prolonged deceleration

为什么是这个答案

A prolonged deceleration lasts at least 2 minutes but less than 10. A decrease of 10 minutes or more is a baseline change. The cause, such as hypotension or tachysystole, should be found and corrected.

答案

B · A prolonged deceleration
21.儿科护理

答案: C · 就诊中留出一段时间单独与青少年交谈，并说明保密的限度

为什么是这个答案

青少年单独接受访谈时更坦率。应说明，除非存在严重伤害的风险，否则他们所说的内容是保密的。HEADSSS 等框架涵盖家庭、教育、活动、药物、性、自杀和安全。

答案

C · 就诊中留出一段时间单独与青少年交谈，并说明保密的限度
22.儿科护理

答案: C · 阑尾可能已穿孔；应立即上报

为什么是这个答案

阑尾炎患者疼痛突然缓解可能提示穿孔，随后出现腹膜炎，疼痛加重、发热和腹肌强直。需要紧急上报。

答案

C · 阑尾可能已穿孔；应立即上报
23.精神科护理

答案: D · Stay with him in a calm, quiet place and reassure him that the effects are from the drug and will pass

为什么是这个答案

For a frightening hallucinogen experience, a calm setting, a supportive person and simple reassurance usually help. The nurse also monitors vital signs and watches for injury or other substances.

答案

D · Stay with him in a calm, quiet place and reassure him that the effects are from the drug and will pass
24.精神科护理

答案: A · Offer non-judgemental information and explore how drinking affects his life

为什么是这个答案

In precontemplation, the aim is to raise awareness without confrontation, for example by giving personalised feedback and exploring the pros and cons. Action-focused plans fit later stages.

答案

A · Offer non-judgemental information and explore how drinking affects his life
25.护理数学与单位换算

答案: 08:00

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。

换算小时

8 AM → 08

答案

08:00

答案

08:00
26.护理数学与单位换算

答案: D = 18.48 mg/h

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。

列出换算链

D = 4 mcg/kg/min × 77 kg × (60 min/1 h) × (1 mg/1000 mcg)

计算

D = 4·77·60/1000 = 18.48 mg/h

答案

D = 18.48 mg/h
27.剂量计算

答案: V = 6 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 = 10·6 = 60 mg

体积

V = 60/10 = 6 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 = 6 mL
28.剂量计算

答案: V = 2 mL

Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.

体重 (kg)

173.8/2.2 = 79 kg

剂量

1·79 = 79 mg

体积

V = (79/200)·5 = 1.975 ≈ 2 mL

答案

V = 2 mL
29.静脉输液速度

答案: R = 75 gtt/min

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.

每分钟毫升数

75/60 = 1.25 mL/min

滴速

R = 1.25·60 = 75 gtt/min

答案

R = 75 gtt/min

使用微滴输液器（60 gtt/mL）时，gtt/min 等于 mL/h。

30.静脉输液速度

答案: t = 2.4 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。

速度（mL/h）

42·60/20 = 126 mL/h

剩余时间

t = 300/126 = 2.381 ≈ 2.4 h

答案

t = 2.4 h
31.静脉输液与液体平衡

答案: B = 565 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: 100 + 150 = 250 mL
冰屑: 100/2 = 50 mL
静脉输液: 75·12 = 900 mL
静脉抗生素: 1·100 = 100 mL
总入量 = 1300 mL

总出量

375 + 150 + 150 + 60 = 735 mL

平衡

B = 1300 − 735 = 565 mL

答案

B = 565 mL

为正：摄入的液体多于排出的液体。

32.静脉输液与液体平衡

答案: t = 4.9 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

120·3 = 360 mL
500 − 360 = 140 mL 剩余

第二部分

140/75 = 1.867 h

总时间

t = 3 + 1.867 = 4.867 ≈ 4.9 h

答案

t = 4.9 h

约为 4 h 52 min，所以袋子大约在 12:22 输完。

33.临床评估评分

答案: B = 14

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: 卧床不起 → 1
活动能力: 不受限制 → 4
营养: 非常差 → 1
摩擦力和剪切力: 无明显问题 → 3

相加

Braden 总分 = 3 + 2 + 1 + 4 + 1 + 3 = 14

答案

B = 14
34.临床评估评分

答案: DBP = 44 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 = (3·65 − 107)/2 = 88/2 = 44 mmHg

答案

DBP = 44 mmHg

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