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

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

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

What is the effect of deflating the blood pressure cuff too quickly?

  1. AThe systolic may be read too low and the diastolic too high
  2. BThe reading becomes more accurate because it is faster
  3. CBoth the systolic and diastolic will be read too high
  4. DOnly the pulse rate is affected, not the blood pressure
3.感染控制与患者安全中等

How should a portable oxygen cylinder be kept in a patient’s room?

  1. APlaced next to a heater to keep it warm
  2. BSecured upright in a stand or holder
  3. CLaid on the bed next to the patient
  4. DLying loose on the floor beside the bed
4.感染控制与患者安全困难

A patient’s cardiac monitor alarms often because of artifact, and a colleague suggests turning the alarm off. What is the best response?

  1. AKeep the alarm on, fix the cause such as electrode placement, and adjust limits only per policy
  2. BTurn the alarm off and check the monitor screen at the nurses’ station every hour instead
  3. CTurn the alarm volume down as low as it will go
  4. DDisconnect the monitor overnight so the patient can sleep
5.优先排序与委派中等

一名护理助理拒绝一项被委派的任务，说他们没有接受过这项任务的培训。护士最好的回应是什么？

  1. A把任务留给下一班，到时有受过培训的人在
  2. B感谢助理，确保任务被安全完成，并安排培训
  3. C因拒绝任务而向经理举报该助理
  4. D告诉助理这在岗位说明里，必须完成
6.优先排序与委派困难

Several patients on a unit develop diarrhea within two days. What should the nurse do first?

  1. APlace affected patients on contact precautions and inform infection control
  2. BWait to see if more patients become unwell
  3. CMove the affected patients into shared rooms with other patients to free up beds
  4. DGive all patients antidiarrheal drugs without assessment
7.临床护理中等

A rising serum creatinine most often indicates:

  1. ADehydration of the skin only
  2. BImproved liver function
  3. CIncreased muscle strength
  4. DReduced kidney function
8.临床护理困难

A patient has a full-thickness burn all the way round the forearm. Which complication must be watched for closely?

  1. ALoss of circulation to the hand as swelling builds under tight burned skin
  2. BDelayed hair growth on the arm
  3. CHypoglycaemia caused by the body using glucose to heal the burn
  4. DExcessive bleeding from the burn surface needing an urgent blood transfusion
9.实验室检查值与电解质中等

Which instruction is correct for a patient starting oral iron tablets?

  1. AYour urine will turn bright orange while you take it
  2. BYour stools may turn dark green or black
  3. CTake the tablet with an antacid to improve absorption
  4. DTake each tablet with milk to protect the stomach
10.实验室检查值与电解质困难

A patient's results: sodium 140 mEq/L, chloride 100 mEq/L, bicarbonate 12 mEq/L. What is the anion gap, and what does it suggest?

  1. A52 mEq/L, a very high anion gap
  2. B12 mEq/L, a normal anion gap
  3. C28 mEq/L, a high anion gap
  4. D40 mEq/L, a high anion gap
11.药理学中等

哪类利尿剂作用于髓袢升支粗段？

  1. A袢利尿剂，如呋塞米
  2. B噻嗪类利尿剂
  3. C保钾利尿剂
  4. D渗透性利尿剂
12.药理学困难

A patient who takes propranolol has anaphylaxis and does not respond to repeated adrenaline doses. Which drug may help?

  1. AMore propranolol
  2. BGlucagon
  3. COral cetirizine alone
  4. DNaloxone
13.内外科护理：心血管与呼吸中等

植入永久起搏器后，最初几周通常会给予哪项指导？

  1. A用吊带将手臂完全固定六个月或更长时间
  2. B每天用力按摩伤口两次
  3. C避免将该侧手臂抬过肩高
  4. D六周内完全不能淋浴或清洗
14.内外科护理：心血管与呼吸困难

A patient with a valid, documented do-not-attempt-CPR decision (DNACPR in the UK, DNR or DNAR in the US) is found in cardiac arrest. What should the nurse do?

  1. ANot start CPR, call for support, and provide dignity and comfort
  2. BCall the arrest team and let them decide whether to resuscitate
  3. CStart full CPR because the patient's family is not present
  4. DStart CPR but use only chest compressions
15.内外科护理：神经、内分泌与肾脏中等

A patient with untreated hyperthyroidism is losing weight. Which diet is most appropriate until the condition is controlled?

  1. AA high-calorie diet with enough protein
  2. BA strict low-protein diet
  3. CA low-calorie diet to protect the heart
  4. DA diet very high in caffeine for energy
16.内外科护理：神经、内分泌与肾脏困难

Which patient with a spinal cord injury is at risk of autonomic dysreflexia?

  1. AA patient with an injury at S2
  2. BA patient with an injury at T4
  3. CA patient with an injury at L5
  4. DA patient with an injury at L3
17.内外科护理：消化、围手术期与肿瘤中等

Why are accurate fluid balance charts kept after major surgery?

  1. ATo record when visitors come and go
  2. BTo detect dehydration, fluid overload or kidney problems early
  3. CTo decide which meal the patient will have next
  4. DTo check how far the patient has walked and how often they get out of bed
18.内外科护理：消化、围手术期与肿瘤困难

A patient's long-standing groin hernia has become tender, red and irreducible, and they are vomiting. What should the nurse do?

  1. AKeep them nil by mouth and arrange urgent surgical review
  2. BPush the hernia firmly back in, then discharge home
  3. CAdvise the patient to wear a tight truss and rest
  4. DApply a hot water bottle and give a laxative
19.产科护理中等

A newborn baby girl has a small amount of blood-tinged vaginal discharge on day 3. What should the nurse tell the parents?

  1. AIt shows a urinary tract infection
  2. BIt means the baby has a bleeding disorder
  3. CIt is caused by maternal hormones
  4. DIt is a sign of sexual abuse
20.产科护理困难

Which statement by a woman being discharged after birth shows a need for further teaching?

  1. A"I can use tampons for the bleeding as soon as I get home."
  2. B"I should report a painful, swollen calf straight away."
  3. C"I should change my pads regularly and wash my hands."
  4. D"I should call if my bleeding gets heavier or smells bad."
21.儿科护理中等

一名法洛四联症患儿在哭闹时突然变得非常青紫、呼吸急促。哪种体位有帮助？

  1. A膝胸卧位（或蹲踞）
  2. B头低位
  3. C坐位，双腿下垂
  4. D平躺仰卧
22.儿科护理困难

A 6-month-old has just learned to roll over. Which safety advice is most urgent now?

  1. ATeach her not to touch the hot oven door
  2. BTurn pan handles towards the back of the stove and fit a guard around the cooker
  3. CInstall locks on all kitchen cupboards and drawers
  4. DNever leave her alone on a changing table, bed or sofa
23.精神科护理中等

An older man has poor concentration, memory complaints and low mood that started after his wife died. Why is careful assessment important?

  1. ALow mood after the loss of a partner is always normal grief and never needs any assessment
  2. BDepression in older adults can look like dementia and is treatable
  3. CMemory complaints in older adults are always caused by dementia
  4. DOlder adults cannot be treated for depression
24.精神科护理困难

A nurse notices that a colleague smells of alcohol, has slurred speech and is about to give medicines. What should the nurse do?

  1. ASay nothing, because it is not her responsibility
  2. BGive the colleague some strong coffee and let her continue with the medicine round if she says she feels fine
  3. CWait until the end of the shift, then talk privately with the colleague
  4. DReport the concern immediately to the nurse in charge, following policy, to protect patients
25.护理数学与单位换算中等
1234567891011127:25 PM?19:2520:2507:2518:25

练习题（虚构数值，不作为临床指导）。 一个剂量记录在 7:25 PM。哪个条目是 24 小时制中的同一时间？点击它。

7:25 PM
  1. 119:25
  2. 220:25
  3. 307:25
  4. 418:25
26.护理数学与单位换算困难
25 mL/h? L/天1 天 = 24 h1 L = 1000 mL

练习题（虚构数值，不作为临床指导）。 一次维持输液以 25 mL/h 的速度不间断运行。24 小时内输注多少升V？

25 mL/h24 h
V = L
27.剂量计算中等
2 g+ 9.2 mLV = ? mL

一个药瓶中含有 2 g 的粉末。标签上写着：加入 9.2 mL 注射用水，得到总容量 10 mL。医嘱为 600 mg。你应给予复溶后溶液的多少容量 V？

2 g+ 9.2 mL → 10 mL600 mg
V = mL
28.剂量计算困难
25%储备液V₁ = ? mL

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

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

医嘱要求在 6 小时内输入 1500 mL。4 小时后你发现袋中还剩 650 mL，而输液仍须按时完成。 必须把泵重新设定为多少 mL/h 的速率 R？

1500 mL / 6 h经过 4 h: 650 mL
R = mL/h
30.静脉输液速度困难
1000 mg500 mL20 gtt/mL150 mg/h? gtt/min

将 1000 mg 药物稀释于 500 mL 中，通过滴系数为 20 gtt/mL 的输液器重力滴注。医嘱为每小时 150 mg。求滴速 R，以每分钟滴数表示。

1000 mg/500 mL150 mg/h20 gtt/mL
R = gtt/min
31.静脉输液与液体平衡中等
入量出量8 小时班次汤180 mL果冻100 mL静脉输液60 mL/h × 8 h静脉抗生素1 × 100 mL尿液500 mL尿液225 mL尿液475 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。求液体平衡 B = 入量 − 出量，以 mL 计（答案为负表示净丢失）。

汤: 180 mL果冻: 100 mL静脉输液: 60 mL/h × 8 h静脉抗生素: 1 × 100 mL尿液: 500 mL尿液: 225 mL尿液: 475 mL伤口引流: 90 mL
B = mL
32.静脉输液与液体平衡困难
500 mL150 mL 已输入75 mL/h16:00t = ? 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 75 mL/h 输注。到 16:00 时已输入 150 mL。还要多少小时 t 袋子才会输完？ 保留一位小数。

500 mL150 mL 已输入75 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 16 次/分，SpO₂ 96%正在补充吸氧，血压 96/58 mmHg，脉搏 76 次/分，清醒，体温 37.9 °C。NEWS2 总分是多少？

RR 16SpO₂ 96%O₂SBP 96HR 76AT 37.9 °C
NEWS2 =
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 60 kg，身高 187 cm。计算 BMI 并点击 WHO 体重分类。

60 kg187 cm
  1. 1体重过轻
  2. 2健康体重
  3. 3超重
  4. 4肥胖 I 级
  5. 5肥胖 II 级
  6. 6肥胖 III 级

3溶液

1.护理学基础

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

为什么是这个答案

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

答案

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

答案: A · The systolic may be read too low and the diastolic too high

为什么是这个答案

Fast deflation means the gauge drops past the first and last sounds before they are heard. The usual advice is to deflate at about 2–3 mmHg per second.

答案

A · The systolic may be read too low and the diastolic too high
3.感染控制与患者安全

答案: B · Secured upright in a stand or holder

为什么是这个答案

Oxygen cylinders are under high pressure and can be damaged or cause injury if they fall. They are kept upright in a holder or cart, away from heat and flames.

答案

B · Secured upright in a stand or holder
4.感染控制与患者安全

答案: A · Keep the alarm on, fix the cause such as electrode placement, and adjust limits only per policy

为什么是这个答案

Disabling alarms is a known cause of missed deterioration. Alarm fatigue is reduced by fixing causes such as poor skin preparation or old electrodes and by setting individual limits according to orders and policy.

答案

A · Keep the alarm on, fix the cause such as electrode placement, and adjust limits only per policy
5.优先排序与委派

答案: B · 感谢助理，确保任务被安全完成，并安排培训

为什么是这个答案

被委派者应拒绝自己没有能力完成的任务。护士要确保现在安全地完成任务，并为将来安排培训。强迫完成任务或搁置不做都会让患者处于风险之中。

答案

B · 感谢助理，确保任务被安全完成，并安排培训
6.优先排序与委派

答案: A · Place affected patients on contact precautions and inform infection control

为什么是这个答案

A cluster of diarrhea may be an outbreak, for example of C. difficile or norovirus. Contact precautions and early notification of infection control limit spread.

答案

A · Place affected patients on contact precautions and inform infection control
7.临床护理

答案: D · Reduced kidney function

为什么是这个答案

Creatinine is a muscle waste product filtered by the kidneys. A rise shows the glomerular filtration rate is falling, as in acute kidney injury.

答案

D · Reduced kidney function
8.临床护理

答案: A · Loss of circulation to the hand as swelling builds under tight burned skin

为什么是这个答案

Circumferential full-thickness burns form a tight eschar that acts like a tourniquet as oedema develops. Neurovascular checks are needed, and escharotomy may be required.

答案

A · Loss of circulation to the hand as swelling builds under tight burned skin
9.实验室检查值与电解质

答案: B · Your stools may turn dark green or black

为什么是这个答案

Oral iron commonly darkens the stools, which is harmless, but black tarry stools with abdominal pain should be reported. Milk, antacids and tea reduce absorption; vitamin C or orange juice can improve it.核对依据: Ferrograd C patient information leaflet (ferrous sulfate + vitamin C) · electronic medicines compendium (eMC), UK (2018)

答案

B · Your stools may turn dark green or black
10.实验室检查值与电解质

答案: C · 28 mEq/L, a high anion gap

为什么是这个答案

The anion gap is 140 − (100 + 12) = 28 mEq/L; a typical normal value is about 8–12 mEq/L when potassium is not included. A high anion gap metabolic acidosis suggests unmeasured acids, for example ketones in DKA or lactate in shock.核对依据: Anion Gap Blood Test · MedlinePlus (NIH) (2024)

答案

C · 28 mEq/L, a high anion gap
11.药理学

答案: A · 袢利尿剂，如呋塞米

为什么是这个答案

袢利尿剂阻断升支粗段的 Na⁺/K⁺/2Cl⁻ 同向转运体，是作用最强的利尿剂。

答案

A · 袢利尿剂，如呋塞米
12.药理学

答案: B · Glucagon

为什么是这个答案

Beta blockers can make anaphylaxis more severe and resistant to adrenaline. Glucagon acts through its own receptor to increase heart rate and contractility, bypassing the blocked beta receptors.

答案

B · Glucagon
13.内外科护理：心血管与呼吸

答案: C · 避免将该侧手臂抬过肩高

为什么是这个答案

在最初几周内限制装置侧的手臂活动，可降低电极导线移位的风险。还应教导患者观察伤口有无感染、随身携带装置卡，并遵循有关磁铁和某些医学扫描的建议。

答案

C · 避免将该侧手臂抬过肩高
14.内外科护理：心血管与呼吸

答案: A · Not start CPR, call for support, and provide dignity and comfort

为什么是这个答案

A valid do-not-attempt-CPR decision means CPR is not attempted. Other appropriate care continues, the senior team and family are informed and the patient is cared for with dignity. Nurses should check that the decision is valid and applies to the situation.

答案

A · Not start CPR, call for support, and provide dignity and comfort
15.内外科护理：神经、内分泌与肾脏

答案: A · A high-calorie diet with enough protein

为什么是这个答案

Excess thyroid hormone raises metabolism, so patients need more calories and protein to prevent weight loss. Caffeine is limited because it worsens palpitations, tremor and anxiety.

答案

A · A high-calorie diet with enough protein
16.内外科护理：神经、内分泌与肾脏

答案: B · A patient with an injury at T4

为什么是这个答案

Autonomic dysreflexia usually occurs with injuries at T6 or above. Below this level, the body can still control the sympathetic response to stimuli such as a full bladder. Lumbar and sacral injuries do not usually cause it.

答案

B · A patient with an injury at T4
17.内外科护理：消化、围手术期与肿瘤

答案: B · To detect dehydration, fluid overload or kidney problems early

为什么是这个答案

Fluid balance charts record IV and oral intake against urine, drains, vomit and NG losses. Trends help detect hypovolaemia, overload and acute kidney injury.

答案

B · To detect dehydration, fluid overload or kidney problems early
18.内外科护理：消化、围手术期与肿瘤

答案: A · Keep them nil by mouth and arrange urgent surgical review

为什么是这个答案

A tender, red, irreducible hernia with vomiting suggests strangulation and bowel obstruction. It needs emergency surgery; the nurse keeps the patient nil by mouth, gives analgesia, and starts IV access and fluids as prescribed.

答案

A · Keep them nil by mouth and arrange urgent surgical review
19.产科护理

答案: C · It is caused by maternal hormones

为什么是这个答案

Pseudomenstruation is caused by withdrawal of maternal hormones after birth and resolves within days. Swollen breasts in either sex have the same cause.

答案

C · It is caused by maternal hormones
20.产科护理

答案: A · "I can use tampons for the bleeding as soon as I get home."

为什么是这个答案

Tampons are avoided until lochia has stopped and the postnatal check is done, because they increase the risk of infection. The other statements are correct.

答案

A · "I can use tampons for the bleeding as soon as I get home."
21.儿科护理

答案: A · 膝胸卧位（或蹲踞）

为什么是这个答案

屈膝贴胸可提高体循环血管阻力，使右向左分流减少，更多血液流向肺部。应保持孩子平静，给氧并呼叫援助。

答案

A · 膝胸卧位（或蹲踞）
22.儿科护理

答案: D · Never leave her alone on a changing table, bed or sofa

为什么是这个答案

Rolling makes falls from raised surfaces the main immediate risk, so a hand should always stay on the baby on any raised surface. Cupboard locks and kitchen safety become important as she starts to crawl and pull to stand.

答案

D · Never leave her alone on a changing table, bed or sofa
23.精神科护理

答案: B · Depression in older adults can look like dementia and is treatable

为什么是这个答案

Depression can cause slowed thinking and poor concentration that resemble dementia, sometimes called pseudodementia. Unlike dementia, the cognitive problems usually improve when the depression is treated.

答案

B · Depression in older adults can look like dementia and is treatable
24.精神科护理

答案: D · Report the concern immediately to the nurse in charge, following policy, to protect patients

为什么是这个答案

An impaired nurse is a risk to patients. The concern is reported at once through the proper channel so the colleague can be removed from patient care and offered support through the organisation's procedures.

答案

D · Report the concern immediately to the nurse in charge, following policy, to protect patients
25.护理数学与单位换算

答案: 19:25

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

7 PM → 7 + 12 = 19

答案

19:25

答案

19:25
26.护理数学与单位换算

答案: V = 0.6 L

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。

一天的体积

25 mL/h × 24 h = 600 mL

以升计

V = 600/1000 = 0.6 L

答案

V = 0.6 L
27.剂量计算

答案: V = 3 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.

混合后的浓度

2000 mg/10 mL = 200 mg/mL

体积

V = 600/200 = 3 mL

答案

V = 3 mL
28.剂量计算

答案: V₁ = 50 mL

Solution strengths: a percentage strength is grams per 100 mL, so 1% = 1 g/100 mL = 10 mg/mL. A ratio strength 1:1000 means 1 g in 1000 mL = 1 mg/mL; 1:10 000 is 0.1 mg/mL. For a dilution the amount of drug stays the same: C₁·V₁ = C₂·V₂.

储备液的容量

V₁ = 2.5·500/25 = 50 mL

答案

V₁ = 50 mL
29.静脉输液速度

答案: R = 325 mL/h

Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.

原速率

1500/6 = 250 mL/h

新速率

R = 650/2 = 325 mL/h

答案

R = 325 mL/h

这超过了 25% 的增幅：大多数医院要求你联系开医嘱者，而不是加快补输，并评估患者是否存在液体过多。

30.静脉输液速度

答案: R = 25 gtt/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

1000/500 = 2 mg/mL

每小时容量

150/2 = 75 mL/h

滴速

R = 75·20/60 = 25 gtt/min

答案

R = 25 gtt/min
31.静脉输液与液体平衡

答案: B = −430 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: 180 + 100 = 280 mL
静脉输液: 60·8 = 480 mL
静脉抗生素: 1·100 = 100 mL
总入量 = 860 mL

总出量

500 + 225 + 475 + 90 = 1290 mL

平衡

B = 860 − 1290 = −430 mL

答案

B = −430 mL

为负：患者丢失的液体多于摄入的液体。

32.静脉输液与液体平衡

答案: t = 4.7 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 − 150 = 350 mL

时间

t = 350/75 = 4.667 ≈ 4.7 h

答案

t = 4.7 h

约为 4 h 40 min，所以袋子大约在 20:40 输完。

33.临床评估评分

答案: NEWS2 = 4

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 16/min → 0
SpO₂ 96% → 0
吸氧 → 2
SBP 96 mmHg → 2
HR 76/min → 0
清醒 (A) → 0
T 37.9 °C → 0

相加

NEWS2 = 0 + 0 + 2 + 2 + 0 + 0 + 0 = 4

答案

NEWS2 = 4
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 = 60/1.87² = 17.16

分类

体重过轻

答案

体重过轻

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