Soal latihan bergaya NCLEX-PN (LPN/LVN): paket kilat

When are non-sterile gloves needed?

1. AWhen contact with blood, body fluids or broken skin is expected
2. BFor every patient contact, including taking a pulse or blood pressure
3. COnly when the patient is known to have an infection
4. DOnly when handling medicines

A nurse uses SBAR to call a doctor about a breathless patient. Which item belongs under "Background"?

1. AThe patient has COPD and was admitted two days ago with pneumonia
2. B"Please come and review him within the next 10 minutes."
3. CHis respiratory rate is 30 and his SpO₂ is 86% on 2 L of oxygen
4. D"I am calling about Mr Smith in bed 4, who is very breathless."

Which patient has the highest risk of a burn from a heating pad?

1. AA patient with a sprained wrist who is fully alert
2. BA patient with diabetic peripheral neuropathy
3. CA patient recovering from a cold
4. DA healthy young adult with a strained muscle

Which position is especially dangerous for a patient in physical restraints?

1. ALying face down (prone)
2. BSitting upright in bed
3. CLying on the back with the head raised
4. DLying on the side

Setelah serah terima, pasien mana yang harus ditemui perawat lebih dulu?

1. APasien diabetes dengan glukosa sebelum sarapan 160 mg/dL (8,9 mmol/L)
2. BPasien pneumonia, suhu 38,2 °C, yang mendapat antipiretik 30 menit yang lalu
3. CPasien asma yang menggunakan otot bantu napas dan SpO₂ 88%
4. DPasien dua hari setelah penggantian sendi panggul dengan nyeri 5/10

An RN sees an LPN/LVN crushing an extended-release metoprolol tablet to mix with applesauce. What should the RN do?

1. ATell the LPN/LVN to give half of the crushed tablet now and the other half at lunchtime
2. BLet the LPN/LVN continue, since crushing makes the tablet easier to swallow
3. CStop the LPN/LVN and contact the prescriber or pharmacist about another form
4. DReport the LPN/LVN at the end of the month without saying anything now

Why is blood pressure monitored closely in a patient with an epidural infusion?

1. AEpidurals always cause severe hypertension that needs regular treatment
2. BThe epidural pump uses the blood pressure to set the rate
3. CThe local anaesthetic can block sympathetic nerves and cause hypotension
4. DBlood pressure readings show whether the catheter is infected

Why can sepsis be missed in older adults?

1. AOlder adults always have a very high fever
2. BOlder adults cannot develop sepsis because their immune system is weaker
3. CBlood tests are not useful in older people
4. DThey may have no fever and present with confusion, falls or reduced mobility

A patient takes high-dose biotin supplements for hair and nails. Why should the nurse report this before blood tests?

1. ABiotin can distort some immunoassays, such as troponin or TSH
2. BBiotin causes a true rise in blood glucose in all patients
3. CBiotin makes the blood clot in the tube before testing
4. DBiotin lowers the hemoglobin by destroying the red cells

Weeks after neck surgery, a patient has muscle cramps and tingling. Calcium is low, phosphate is high and parathyroid hormone (PTH) is low. Which condition fits best?

1. APrimary hyperparathyroidism
2. BChronic kidney disease
3. CVitamin D toxicity
4. DHypoparathyroidism

Digoxin 0,25 mg is ordered. The tablets available are 0,125 mg. How many tablets should be given?

1. A4 tablets
2. B2 tablets
3. C1 tablet
4. D0,5 tablet

Why is pethidine (meperidine) avoided in older people and in kidney impairment?

1. AIt causes severe hypoglycaemia in these groups
2. BIt has no pain-relieving effect in older people
3. CIt is not absorbed from the gut when kidney function is poor
4. DIts metabolite norpethidine builds up and can cause seizures

The telemetry monitor suddenly shows a chaotic waveform resembling ventricular fibrillation, but the patient is talking and brushing their teeth. What should the nurse do first?

1. ACheck the patient and the electrodes, as this is likely artefact
2. BDeliver an immediate defibrillation shock before checking anything
3. CStart chest compressions straight away and call the arrest team
4. DGive IV amiodarone as a bolus

A ventilated patient suddenly desaturates to 82%. The cause is not obvious and the ventilator alarms are sounding. What should the nurse do first?

1. ADisconnect and hand-ventilate with 100% oxygen while calling for help
2. BSilence the alarm and wait for the result of the next routine blood gas
3. CChange the ventilator settings to a higher rate
4. DIncrease the sedation and watch the monitor for the next half hour

A patient with migraine takes painkillers or triptans on most days and now has a headache almost every day. What is the likely problem?

1. AA brain tumour, which is almost certain
2. BAn allergy to the painkillers
3. CMedication overuse headache
4. DNormal progress of migraine

The night after hip surgery, an 84-year-old becomes suddenly confused and tries to pull out their IV line. What is the most appropriate first step?

1. ATell the family that this is the start of dementia
2. BApply wrist restraints to protect the IV line
3. CAsk for a strong sedative so that the patient can sleep
4. DLook for causes such as low oxygen, pain, retention or infection

In the SBAR communication tool, what belongs under "A"?

1. AThe nurse's assessment of what the problem is
2. BA list of the patient's allergies only
3. CThe address and phone number of the patient's next of kin
4. DThe patient's admission date only

Just after extubation in recovery, a patient develops a high-pitched noise on breathing in, with falling SpO₂. What should the nurse do first?

1. ASit the patient up and give a drink of water
2. BWait a few minutes to see if it passes
3. CGive an opioid to calm the patient's breathing and reduce anxiety
4. DCall for help, give 100% oxygen and use a jaw thrust

Why do newborns become cold so easily?

1. AThey sweat more than adults
2. BThey have a large surface area and little fat
3. CTheir blood is thicker than adult blood
4. DThey cannot produce heat at all

A woman at 30 weeks is in a minor car accident. She feels fine and has no bleeding. What should the nurse advise?

1. AStay at home because there is no bleeding
2. BCome in for fetal monitoring even without symptoms
3. CTake a warm bath and rest
4. DCome in only if she bleeds within a week

A child with type 1 diabetes has a stomach bug and is eating very little. What is the correct advice about insulin?

1. AStop all insulin until the child is eating normally again, then restart at the usual dose
2. BGive insulin only if the child is vomiting
3. CKeep giving insulin, check glucose and ketones more often and follow the sick-day plan
4. DGive double the usual insulin to prevent ketones

After hypospadias repair, a toddler has a urinary catheter. Which nursing action has priority?

1. AKeep the catheter draining freely and check for kinks or blockage
2. BLimit fluids for the first days so that less urine passes over the repair
3. CRemove the dressing on the first day to check the wound
4. DClamp the catheter for a few hours to train the bladder

Which US legal case is associated with the duty of mental health professionals to protect people who are threatened by a patient?

1. ABrown v Board of Education
2. BMiranda v Arizona
3. CTarasoff v Regents of the University of California
4. DRoe v Wade

A patient asks, "Do you think I should divorce my husband?" Which response best supports the patient's autonomy?

1. A"What are your thoughts about the options you have?"
2. B"No, divorce would only make things worse for you."
3. C"You should ask your doctor what to do about it."
4. D"Yes, I think you'd be happier without him."

Latihan (nilai rekaan, bukan pedoman klinis). Perhitungan dosis untuk suatu suntikan menghasilkan 7,3891 mL. Aturan dalam latihan ini adalah volume 1 mL atau lebih dibulatkan ke persepuluhan mL terdekat. Nilai x berapa yang Anda catat?

Latihan (nilai rekaan, bukan pedoman klinis). Selama satu shift seorang pasien mengonsumsi 2 tsp dari sirup batuk, 2 fl oz dari jus, ½ cangkir dari teh, 1½ tbsp dari suplemen cair. Dengan ekuivalen yang diberikan, cari total asupan oral V dalam mL.

Seorang pasien berbobot 18 kg. Dosis yang diresepkan 10 mg/kg per hari, diberikan dalam 2 dosis yang sama. Berapa miligram D yang diberikan per dosis?

Resepnya 3440 mikrogram. Ampul mengandung 4 mg/mL. Tarik dosis dalam alat suntik 1 mL: berapa volume V yang Anda berikan?

Infuskan 250 mL selama 2 jam dengan set 15 tts/mL. Tentukan laju tetesan R dalam tetes per menit. Bulatkan ke bilangan bulat terdekat.

Infus berisi 50 mg dalam 250 mL berjalan pada 10 mL/h. Berapa mikrogram per menit D yang diterima pasien?

Latihan (nilai rekaan, bukan pedoman klinis). Catatan menunjukkan asupan dan haluaran seorang pasien selama satu shift 12 jam. Infus IV berjalan dengan laju yang ditunjukkan selama seluruh shift. Cari keseimbangan cairan B = asupan − haluaran dalam mL (jawaban negatif berarti kehilangan bersih).

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah kantong 500 mL dijalankan dengan pompa pada 150 mL/h. Pada pukul 07:30, 200 mL sudah diinfuskan. Berapa jam t lagi sampai kantong kosong? Bulatkan ke satu angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Seorang pasien latihan dinilai dengan skala jatuh Morse: riwayat jatuh dalam 3 bulan terakhir: tidak; diagnosis sekunder: ya; alat bantu jalan: kruk, tongkat, atau walker; terapi IV atau saline lock: ya; cara berjalan: lemah; status mental: melebih-lebihkan atau melupakan batas kemampuannya. Cari total Morse MFS.

Latihan (nilai rekaan, bukan pedoman klinis). Gunakan bagan NEWS2 (SpO₂ skala 1) untuk observasi berikut: frekuensi napas 20/menit, SpO₂ 88% dengan udara ruangan, tekanan darah 112/68 mmHg, nadi 88/menit, sadar penuh, suhu 35,8 °C. Pasien termasuk kelompok risiko klinis yang mana? Klik kelompok itu.

1. 1rendah
2. 2rendah–sedang
3. 3sedang
4. 4tinggi