2025年NCLEX-PN 执业护士（LPN-LVN）备考题库及答案解析

2025年NCLEX-PN执业护士（LPN/LVN）备考题库及答案解析说明：NCLEX-PN为美国实用护士执照计算机自适应考试（NGN新一代NCLEX），本套题库严格参照NCSBN官方TestPlan编写，覆盖NCLEX-PN八大ClientNeeds考点，包含单选、SATA（SelectAllThatApply）、填空题，附详细Rationale解析，全文可直接复制粘贴进Word文档。

NCLEX-PN考试概况：题量85～150题，总时长5小时，含3套NGN病例题；八大模块：协调照护、安全与感染控制、健康促进维护、社会心理完整性、基础舒适照护、药理治疗、风险降低、生理适应。一、MultipleChoice单选题（每题只有1个最佳答案）Anursecaresforaclientwithleft-sidedheartfailure.Whichfindingshouldthenurseanticipate?

A.Jugularvenousdistention

B.Bilaterallungcrackles

C.Peripheralpittingedema

D.Abdominaldistention

Answer:B

Rationale：Leftheartfailureleadstobloodbackupintopulmonarycirculation,causingpulmonarycongestionandcrackles.JVD,peripheraledemaandascitesaretypicalmanifestationsofright-sidedheartfailure.Aclientdiagnosedwithdeepveinthrombosis(DVT)oftherightleg.Whichnursinginterventionisappropriate?

A.Massagetherightcalfeveryshift

B.Elevatetheaffectedlegaboveheartlevel

C.EncourageactivevigorousROMexercises

D.Applyhotcompresscontinuously

Answer:B

Rationale：Legelevationpromotesvenousreturnandreducesedema.Massagingthecalfiscontraindicated,whichmaydislodgethrombusandtriggerpulmonaryembolism.VigorousROMandcontinuoushotcompressincreasethrombusmigrationrisk.Aclientundergoesliverbiopsy.Whatistherecommendedpositionimmediatelyaftertheprocedure?

A.Leftlateral

B.Rightlateral

C.Supineflat

D.HighFowler

Answer:B

Rationale：Right-sidelyingpositionappliesdirectpressureonliverbiopsysitetopreventintra-abdominalbleeding.ACOPDpatientreceivesoxygenvianasalcannula.Administeringhigh-concentrationoxygenmaycausewhichcomplication?

A.Increasedsputumproduction

B.Tachypnea>30breaths/min

C.Suppressedrespiratorydrive,decreasedRR&depth

D.Severewheezingandagitation

Answer:C

Rationale：ChronicCO₂retainersrelyonhypoxicdriveforbreathing.Highoxygenreduceshypoxicstimulation,leadingtohypoventilationandCO₂narcosis.Low-flowoxygen(1–2L/min)isstandardforstableCOPD.Oliguriaisdefinedasurineoutputlessthan\\\\\\in24hours.

A.100mL

B.400mL

C.800mL

D.1000mL

Answer:B

Rationale：Oliguria:<400mL/24h;Anuria:<100mL/24h.Aclientwithchronickidneydiseaseisathighestriskofwhichelectrolytedisorder?

A.Hyperkalemia

B.Hypokalemia

C.Hyponatremia

D.Hypocalcemia

Answer:A

Rationale：Kidneysexcretepotassium.Renalimpairmentreducespotassiumexcretion;hyperkalemiamaytriggerfatalventriculararrhythmia.Aclientwithseverepreeclampsia.Whatistheprioritynursingintervention?

A.Turnclienttoleftlateralposition

B.AdministerIVmagnesiumsulfate

C.Checkdeeptendonreflexeshourly

D.Dimroomlightsandreducenoise

Answer:B

Rationale：Magnesiumsulfateisfirst-linemedicationtopreventeclampticseizure,thelife-threateningcomplicationofseverepreeclampsia.Othermeasuresaresupportivebutnotpriority.Thenursenoteshyporeflexiaandgeneralizedmuscleweaknessinalabresultreview.Whichlabvalueexplainsthispresentation?

A.Serumcalcium14mg/dL

B.Serumcalcium9.9mg/dL

C.Serumcalcium5mg/dL

D.Serumcalcium10.2mg/dL

Answer:A

Rationale：Normalcalcium:9–10.5mg/dL.Hypercalcemiadecreasesneuromuscularexcitability→muscleweakness,hyporeflexia.Hypocalcemiacausestetany,positiveChvostek/Trousseausign.Adiabeticclienthasbloodglucose55mg/dL.Whatisthepriorityaction?

A.Administersubcutaneousregularinsulin

B.Give15gfast-actingcarbohydrate

C.Recheckglucosein60minutes

D.NotifyHCPimmediatelywithoutintervention

Answer:B

Rationale：Hypoglycemia(BG<70mg/dL)ruleof15:give15gsimplecarb,recheckglucoseafter15mins.Insulinworsenshypoglycemia.Afterchesttubeaccidentaldislodgement,whatistheimmediateintervention?

A.Callhealthcareproviderandwaitatbedside

B.Applysterileocclusivegauze,tapethreesides

C.Applysterilegauzeandtapeallfoursides

D.Assistpatienttosupinepositionandperformdeepbreath

Answer:B

Rationale：Three-sidedocclusivedressingallowsairescapeduringexhalationandpreventsnewairentryintopleuralspace;fullysealedfour-sidedressingcancausetensionpneumothorax.二、SATA(SelectAllThatApply)多选（选全部正确项，部分得分NGN计分）WhichclinicalmanifestationsbelongtoBell’spalsy?(Selectallthatapply)

A.Asymmetricsmile

B.Frequentblinkingofaffectedeye

C.Shock-likefacialpainonlipandgum

D.Lossofforeheadandeyebrowmovement

E.Decreasedlacrimationonaffectedside

Answer:A,D,E

Rationale：Bellpalsy=CNVIIperipheralfacialparalysis.Features:asymmetricsmile,cannotcloseeyefully,lossforeheadwrinkle,reducedtearproduction.B&Cbelongtotrigeminalneuralgia(CNV).ApostupperGIbleedingclientisstartedonclearliquiddiet.Whichselectionsareappropriate?(Selectallthatapply)

A.Applejuice(noreddye)

B.Chickenbroth

C.Unsweetenedtea

D.Creamofchickensoup

E.Vanillaicecream

Answer:A,B,C

Rationale：Clearliquid:transparent,nopulp/milk/cream.Icecreamandcreamsouparefullliquiddiet.ReddyedrinksareavoidedinGIbleedingpatients,whichcanmaskbloodinstool.WhichtaskscanbedelegatedbyPNtoUAP(unlicensedassistivepersonnel)?(Selectallthatapply)

A.RecordI&Ototalatshiftend

B.Reinforcepatientteachingoninsulininjection

C.Measurevitalsignsofstablepostoperativepatients

D.Completeadmissionfocusedassessment

E.Assiststableclientwithbathingandoralhygiene

Answer:A,C,E

Rationale：Assessment,initialpatientteaching,medicationadministrationcannotbedelegatedtoUAP.UAPcanperformroutinestablepatientcare,measureVS,recordintakeoutput,assistADLs.Standardairborneinfectionprecautionsarerequiredforwhichconditions?(Selectallthatapply)

A.Tuberculosis

B.Measles

C.Varicella

D.Influenza

E.MRSAwoundinfection

Answer:A,B,C

Rationale：Airborne:TB,measles,varicella(N95respiratorrequired).Influenza=dropletprecautions;MRSAwound=contactprecautions.三、Fillinblank计算题（药剂量计算，保留指定小数）Prescribecefuroxime30mg/kg/dayPOdividedinto2doses.Clientweightis15.9kg.Available:cefuroxime250mg/5mL.CalculatemLpersingledose.Keep1decimalplace.

Answer:4.8mL

Rationale

Dailydose=30mg/kg×15.9kg=477mg/day

Singledose=477÷2=238.5mgperdose

250mg/5mL=50mg/mL

Volume=238.5÷50=4.77≈4.8mL四、CaseStudy病例简答题（NGN临床判断题型）Case1A28-year-oldprimigravidaat36weeksgestation,BP168/112mmHg,3+proteinuria,complainssevereheadacheandepigastricpain.DTR4+,clonuspositive.

Questions:Whatistheprioritydiagnosis?Identifyprioritynursinginterventionandmonitoringitems.

Answer&RationaleSeverepreeclampsia,highriskforeclampsiaseizure.Priority:InitiateIVmagnesiumsulfateinfusion.

Monitor:Vitalsigns,DTR,respiratoryrate,urineoutput,serummagnesiumlevel.Watchformagnesiumtoxicity:RR<12/min,lossofDTR,oliguria.Antidote:calciumgluconate.Maintainseizureprecaution,quietdimenvironment.Case2AclientreceivingTPNviacentralline.Suddenlyreportsdyspnea,chestpain,hypotensionaftertubingdisconnection.Suspectairembolism.

Question:Whatimmediatepositionandnursingaction?

Answer&Ration