护士英语四级试题及答案

护士英语四级试题及答案PartIListeningComprehension(30marks,25min)SectionANewsReports(1–7)Directions:Inthissectionyouwillhearthreenewsreports.Attheendofeachreportyouwillheartwoorthreequestions.BoththereportandthequestionswillbespokenONCEONLY.Aftereachquestionyouwillbegiven15secondstochoosethebestanswerfromthefourchoicesmarkedA,B,CandD.NewsReport11.WhatcausedthetemporaryclosureofSt.Mary’sPediatricWardlastTuesday?A.AnorovirusoutbreakamongnursingstaffB.FailureofthenegativepressureventilationsystemC.FirecodeviolationdiscoveredduringamockdrillD.ShortageofIVpotassiumchloride2.Accordingtothehospitalspokesperson,howmanyextrashiftswerecoveredbyfloatnurses?A.38B.57C.72D.91NewsReport23.WhydidtheWHOreviseitsguidelineontransfusiontriggers?A.MetaanalysisshowedincreasedmortalitywithliberalstrategyB.RedcellunitswerefoundcontaminatedwithBabesiamicrotiC.Lowincomecountriesreported40%wastageofbloodproductsD.Nurses’unionslobbiedforstricterconsentprocedures4.Whichhemoglobinthresholdisnowrecommendedforstableadults?A.60g/LB.70g/LC.80g/LD.90g/LNewsReport35.WhatnewdevicedidthebiomedicalteamatKing’sCollegeHospitaltrial?A.BluetoothenabledsmartbedrailthatpredictspatientfallsB.Wearabledefibrillatorvestforneonatesunder1500gC.UltrasoundguidedglassesthatlocateperipheralveinsD.AIpoweredpilldispensingdroneforruralhospicecare6.Howdidthepilotstudyreducenighttimefallsby32%?A.Byincreasinghourlyroundingfrequencytoq30minB.Bydimmingcorridorlightsto50luxafter22:00C.ByissuingvibratingwristbandstopatientsatriskD.Byinstallingbedexitsensorswithnursestationalerts7.WhenwillthehospitalpresentitsdatatotheNationalPatientSafetyCongress?A.ThisSeptemberB.NextMarchC.IntwoweeksD.AfterpeerreviewSectionBLongConversation(8–15)Directions:Inthissectionyouwillhearonelongconversation.Attheendoftheconversationfivequestionswillbeasked.BoththeconversationandthequestionswillbespokenONCEONLY.Conversation:NurseManagerInterviewon“QuietICU”Initiative8.Whatwastheprimarymotivationforlaunchingthe“QuietICU”project?A.ReduceincidenceofICUdeliriumB.ComplywithJointCommissionacousticalstandardsC.Lowerenergyconsumptionby20%D.ImproveHCAHPSscoresfor“quietness”domain9.Whichdecibellevelistargetedatnightbythenewpolicy?A.≤35dBB.≤40dBC.≤45dBD.≤50dB10.Howdidstaffrespondtothebanonoverheadpaging?A.78%favoreditaftertwoweektrialB.PhysiciansthreatenedtounionizeC.RespiratorytherapistsreporteddelaysD.Nightshiftsickcallsrose15%11.Whichtechnologicalupgradereceivedthelargestbudgetallocation?A.SoundabsorbingceilingtilesB.SmartphonebasedsecuremessagingC.NoisecancellingheadsetsforpatientsD.Vibrationalarmsoninfusionpumps12.Whatoutcomeindicatorshowedthegreatestimprovementpostintervention?A.Averagelengthofstaydecreased0.8daysB.Benzodiazepineusedropped22%C.Staffturnoverfellto8%annuallyD.Patientsatisfactionwithpaincontrolrose12%SectionCPassageListening(13–20)Directions:Youwillhearalectureon“SodiumGlucoseCotransporter2InhibitorsinHeartFailure:NursingImplications.”Answerquestions13–20.13.WhichSGLT2inhibitoriscurrentlyapprovedforheartfailureregardlessofdiabetesstatus?A.CanagliflozinB.EmpagliflozinC.DapagliflozinD.Ertugliflozin14.Thenurseshouldinstructthepatienttosuspendthedrugif:A.Fastingforsurgery>4hB.Urinaryketones≥moderateC.SystolicBP<100mmHgD.Heartrate>100bpm15.WhatisthemostcommonadverseeffectleadingtodiscontinuationintheEMPERORReducedtrial?A.GenitalmycoticinfectionB.PolyuriacausingsleepdisruptionC.AcutekidneyinjuryD.Orthostatichypotension16.Whichlaboratorymonitoringscheduledoesthespeakerrecommend?A.eGFRandK+at1,3,6monthsB.HbA1cq3monthsonlyifdiabeticC.BNPweeklyfor4weeksD.Liverpanelevery14days17.ThelectureadvisesholdingthedrugwheneGFRfallsbelow:A.60mL/min/1.73m²B.45mL/min/1.73m²C.30mL/min/1.73m²D.15mL/min/1.73m²18.Patientsshouldbecounseledtoexpectaweightreductionaveraging:A.0.5–1kgB.1–1.5kgC.2–3kgD.4–5kg19.Whichcardiacbiomarkershowedtheearliestimprovementintrials?A.NTproBNPB.Galectin3C.ST2D.hscTnT20.Whatnursingdiagnosisisprioritizedwheneducatingapatientstartingdapagliflozin?A.RiskforinfectionrelatedtoglucosuriaB.ImpairedgasexchangerelatedtometabolicacidosisC.ActivityintolerancerelatedtohypoglycemiaD.ExcessfluidvolumerelatedtosodiumretentionPartIIVocabulary&Structure(20marks,15min)Directions:ForeachofthefollowingsentencestherearefourchoicesmarkedA,B,CandD.ChoosetheONEthatbestcompletesthesentence.21.Therapidresponseteamwas______tothebedsidewithin90secondsofthebradycardiaalarm.A.summonedB.surmisedC.subsumedD.sublimated22.Becausethepatient’sINRexceeded4.5,thephysicianelectedto______theeveningdoseofwarfarin.A.omitB.diluteC.taperD.augment23.Thenursenoteda______smellemanatingfromthediabeticfootulcer,promptingurgentsurgicalreview.A.fetidB.fragrantC.mustyD.acrid24.Postmortemcarewasperformedwithculturalsensitivity,ensuringthedeceased’sbodywaspositioned______toMecca.A.parallelB.perpendicularC.lateralD.supine25.Thepharmacistcautionedthatconcurrentuseofazithromycincould______theQTinterval.A.prolongB.shortenC.invertD.segment26.Afterthoracentesis,thenurseinstructedthepatienttoreportany______ofbreath,whichmightindicatereaccumulation.A.orthopneaB.paroxysmC.eupneaD.dyspnea27.Theunitimplementedbedsideshiftreportto______theriskofinformationomission.A.accentuateB.mitigateC.extrapolateD.interrogate28.A34weekparturientwithpreeclampsiareceivedbetamethasoneto______fetallungmaturity.A.impedeB.potentiateC.attenuateD.desiccate29.Thenursepracticed______handhygieneafterremovinggloves,awarethat30%ofglovesurfacesharbormicroperforations.A.asepticB.surgicalC.socialD.substandard30.Duringacodeblue,theteamleadercalledfor“highqualityCPR”withacompressionfraction______80%.A.exceedingB.beneathC.approximatingD.circumventingPartIIICloze(20marks,15min)Directions:ReadthefollowingpassageandchoosetheBESTwordforeachnumberedblank.TheWorldHealthOrganizationestimatesthat1in10hospitalizedpatientswillacquireatleastoneinfection,astatisticthatunderscoresthepivotalroleofnursing__31__ininfectionprevention.Centrallineassociatedbloodstreaminfections(CLABSIs)aloneprolonghospitalizationbyamedianof10daysandincreasemortality__32__12%.Alandmarkmulticenterstudydemonstratedthatstrict__33__toafiveitemchecklist—handhygiene,fullbarrierprecautions,chlorhexidineskinantisepsis,optimalcathetersiteselection,anddailyreviewforlinenecessity—reducedCLABSIrates__34__zeroin103ICUsacrossMichigan.Yetcomplianceremains__35__;observationalauditsrevealthatnursesomithandcleansingin25%ofopportunities,oftencitinghighworkloadorinaccessiblesanitizerdispensers.Emergingevidencesuggeststhat__36__behavioralpsychologycanclosethisgap.Byrelocatingdispenserstoeyelevelandaddingauditoryreminderstriggeredbyroomentry,investigatorsachieveda47%__37__inhandhygieneadherencewithoutincreasingstaffing.Similarly,theinsertionofurinarycathetersisfrequently__38__bynursesinresponsetopatientrequestratherthanclinicalindication.AqualityimprovementprojectatJohnsHopkinsintroduceda“nurseempowerment”protocolallowinganybedsideRNto__39__anonindicatedcatheterorderwithoutphysicianapproval.Over6months,catheterutilizationratiosfellfrom0.42to0.28andsymptomaticcatheterassociatedurinarytractinfectionsdecreasedby62%.Theparadigmisshiftingfromblamingindividualclinicianstoredesigningsystemsthat__40__humanfactors.AsFlorenceNightingaleasserted,“Itmayseemastrangeprincipletoenunciateastheveryfirstrequirementofahospitalthatitshoulddothesicknoharm.”Modernnursingmustoperationalizethisprinciplethroughrelentlesssurveillance,educationandculturaltransformation.31.A.inferenceB.surveillanceC.complianceD.negligence32.A.byB.toC.fromD.with33.A.adhesionB.adherenceC.cohesionD.coherence34.A.toB.atC.towardD.against35.A.optimalB.suboptimalC.maximalD.infinitesimal36.A.principlesofB.detrimentstoC.dogmasofD.anomaliesin37.A.reductionB.inductionC.influxD.plateau38.A.omittedB.commissionedC.initiatedD.eradicated39.A.refuteB.rebuffC.revokeD.requisition40.A.accommodateB.exacerbateC.complicateD.invalidatePartIVReadingComprehension(40marks,35min)SectionACareorientedPassages(41–55)Passage1Inthepreanestheticholdingarea,a68yearoldmalewithsevereaorticstenosisawaitsvalvereplacement.HispreopECGshowsnewLBBB.TheanesthetistrequeststhenursetoinitiateahighdosestatinprotocolbasedontheDECREASEIIItrial.Thenursehesitates,recallingthatthetrial’ssubgroupanalysisexcludedpatientswithLVEF<30%.41.Whichethicalprincipleismostapplicablewhenthenursequestionstheorder?A.BeneficenceB.NonmaleficenceC.JusticeD.Fidelity42.Thenurse’sactionbestillustrateswhichprovisionoftheANACodeofEthics?A.3.4B.4.1C.5.2D.9.3Passage2AtertiaryNICUintroduced“kangaroocare”forventilatedneonatesweighing<1200g.Outcomestrackedincludedventilatordays,nosocomialsepsis,andmaternalstressmeasuredbytheParentalStressorScale.43.Whattypeofstudydesignisdescribed?A.RandomizedcontrolledtrialB.QuasiexperimentalC.MetaanalysisD.Casecontrol44.Whichconfoundingvariableismostdifficulttocontrol?A.GestationalageB.AntenatalsteroidexposureC.MaternaleducationD.NursingexpertisePassage3A2019crosssectionalsurveyof2847RNsinsixcountriesfoundthateachadditionalpatientaddedtoanurse’sworkloadincreasedtheoddsofjobdissatisfactionby23%andintentiontoleaveby15%.45.Thestudy’sprimaryindependentvariableis:A.NursetopatientratioB.YearsofexperienceC.EducationallevelD.Overtimehours46.Whichstatisticaltestismostappropriateforthereportedassociations?A.ChisquareB.PearsonrC.LogisticregressionD.ANOVAPassage4AhomecareagencyadoptedtelemonitoringforCHFpatients.Dailyweight,BPandO₂satweretransmittedtoanurseledcallcenter.At30days,readmissionratesfellfrom22%to14%,savingUSD1.9million.47.Theeconomicevaluationdescribedisbesttermed:A.CostbenefitanalysisB.CosteffectivenessanalysisC.CostminimizationanalysisD.Costutilityanalysis48.WhichQoLinstrumentismostappropriatetocapturetelemonitoringimpact?A.EQ5DB.APGARC.BarthelIndexD.MorseFallScalePassage5A2022scopingreviewsynthesized47qualitativestudiesonmoraldistressamongICUnurses.Fourrecurrentthemesemerged:futilecare,resourcescarcity,hierarchicalconstraints,andwitnessingpatientsuffering.49.Whichphilosophicalframeworkunderpinstheconceptofmoraldistress?A.UtilitarianismB.DeontologyC.VirtueethicsD.Feministethics50.Thereview’smethodologyischaracterizedby:A.MetaethnographyB.MetaaggregationC.ThematicsynthesisD.GroundedtheorySectionBMatching(51–55)Directions:Matchthenursingtheoristwiththecoreconceptdescribed.51.“Unitaryhumanbeingsincontinuousmutualprocesswiththeenvironment.”52.“Selfcaredeficitdeterminesneedfornursing.”53.“Nursesexpandadaptivemodestoachieveoptimaladaptation.”54.“Humantohumanrelationshipfacilitatesfreedomofchoice.”55.“Nursingisacaringhealingarttopromoteharmony.”A.DorotheaOremB.MarthaRogersC.JeanWatsonD.CallistaRoyE.JoyceTravelbeePartVTranslation(20marks,25min)SectionAChinesetoEnglish(56–60)56.护士在交接班时发现患者股静脉置管穿刺点有脓性分泌物，立即留取标本送培养，并依据机构政策启动中心静脉导管相关血流感染（CLABSI）处理流程。57.最新循证指南建议，对机械通气成人实施4小时一次的口腔护理，含0.12%氯己定溶液，可显著降低呼吸机相关肺炎（VAP）发生率。58.夜班护士长使用SBAR模式向值班医生汇报：一名78岁COPD患者突发躁动，SpO₂降至86%，已上调氧流量至6L/min并准备动脉血气分析。59.儿科肿瘤病房引入“化疗护照”，由责任护士记录每次用药剂量、外周神经毒性评分及家长教育内容，实现化疗全程可追溯。60.社区护士通过“同伴支持小组”干预，使糖尿病患者的糖化血红蛋白（HbA1c）在三个月内平均下降0.8%，自我管理能力得分提高25%。SectionBEnglishtoChinese(61–65)61.Thenursepractitionertitratedthefentanylinfusionby25mcg/hevery15minutesuntilthepatient’sRichmondAgitationSedationScalereached−2.62.Amultidisciplinaryhuddlewasconvenedatthebedsidetoclarifygoalsofcareafterthefamilyexpressedhesitationaboutcontinuingdialysis.63.ThenewlypublishedINSstandardsrecommendusingapassivedisinfectioncaponeveryneedlelessconnectoraftereachaccesstoreduceintraluminalcontamination.64.DuringtheEbolaoutbreak,theCDCmandatedatrainedobservertosuperviseeverystepofpersonalprotectiveequipmentdonninganddoffing.65.Thelactationconsultanttaughttheprimiparahowtoachieveanasymmetricallatch,ensuringthattheinfant’slowerlipflangedoutwardandthechinindentedthebreast.PartVIWriting(20marks,30min