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

On the first step of the WHO analgesic ladder, which drugs are used?

1. AWeak opioids only, such as codeine
2. BStrong opioids such as morphine
3. CNon-opioids such as paracetamol (acetaminophen) or an NSAID
4. DGeneral anaesthetic drugs given in low doses

Two days after surgery a patient has a temperature of 37,9 °C and reduced breath sounds at the lung bases. What is the most helpful nursing action, alongside reporting it?

1. AEncourage deep breathing, coughing and getting out of bed
2. BKeep the patient lying flat in bed so they can rest and save energy
3. CStop all pain relief so the patient stays alert
4. DRestrict all fluids to dry the secretions

A patient needs to be moved up in bed and cannot help much. Which approach is safest?

1. ARaise the head of the bed fully and lift the patient up by the shoulders
2. BHave one nurse pull the patient up by the arms
3. CAsk the patient to push up with their heels alone
4. DUse a friction-reducing sheet with enough staff, with the bed flat if tolerated

Dua vial obat berbeda yang mirip disimpan berdampingan, dan seorang perawat nyaris mengambil yang salah. Respons mana yang paling mencerminkan budaya adil?

1. AMerahasiakan insiden demi menjaga reputasi unit
2. BMenyuruh perawat lebih berhati-hati dan tidak melakukan apa-apa lagi
3. CMendisiplinkan perawat yang nyaris mengambil vial yang salah
4. DMelaporkannya dan memperbaiki sistem, misalnya dengan memisahkan vial

Using the Emergency Severity Index, which level fits a 70-year-old with chest pressure that suggests a heart attack, but normal vital signs?

1. ALevel 5
2. BLevel 1
3. CLevel 4
4. DLevel 2

A dehydrated child is to receive IV fluids with added potassium. Which finding should the nurse confirm first?

1. AThat the child is passing urine
2. BThat the child can walk without help
3. CThat the child’s temperature is normal
4. DThat the child is hungry

A patient with dysphagia after a stroke has been cleared for a modified diet. How should they be positioned for meals?

1. ASitting fully upright, and staying upright for a time after eating
2. BLying on their side with the knees bent
3. CLying flat on their back with the head turned to one side
4. DSemi-reclined at about 20 degrees, with the head supported on pillows

Which drug group is first-line for a prolonged convulsive seizure?

1. ABenzodiazepines, such as buccal midazolam or IV lorazepam
2. BOpioids, such as morphine or diamorphine, given intravenously
3. CBeta-blockers, such as bisoprolol or atenolol
4. DAntihistamines, such as chlorphenamine

A patient's levothyroxine dose was changed today. When is the TSH usually rechecked?

1. AAfter about 24 hours
2. BAfter about 3 days
3. CAfter about 1 year
4. DAfter about 6–8 weeks

A patient taking isoniazid for latent TB reports nausea, loss of appetite and dark urine. The ALT is five times the upper limit of normal. What is the best action?

1. AContinue the isoniazid and give it with food to settle the stomach
2. BDouble the dose to finish the treatment course more quickly
3. CHold the isoniazid and report the findings to the prescriber at once
4. DReassure the patient that dark urine is a harmless drug effect

Which blood test is commonly used to monitor a continuous infusion of unfractionated heparin?

1. AHaemoglobin A1c
2. BActivated partial thromboplastin time (aPTT)
3. CSerum potassium
4. DINR (international normalised ratio, prothrombin time)

Why are tetracyclines usually avoided in pregnancy and in young children (under 8 years in US guidance, under 12 years in the UK)?

1. AThey cause grey baby syndrome in infants
2. BThey block the action of growth hormone and stunt the child's growth
3. CThey bind to growing teeth and bone and stain the teeth permanently
4. DThey cause severe hearing loss in children

Mengapa masker wajah sederhana tidak boleh digunakan dengan aliran oksigen di bawah sekitar 5 L/menit?

1. AOksigen tidak dapat dilembapkan pada aliran rendah
2. BTali elastis terlalu longgar pada aliran rendah
3. CMasker memberikan terlalu banyak oksigen pada aliran rendah
4. DCO₂ yang dihembuskan dapat terkumpul di masker dan terhirup kembali

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

A nurse is teaching a patient going home after a mild concussion. Which statement shows a need for further teaching?

1. A"I will return if my headache gets steadily worse."
2. B"A few drinks tonight will help me relax and sleep."
3. C"Someone will stay with me for the first night."
4. D"I will come back if I start vomiting again and again."

The nurse has four patients. Which one needs to be seen first?

1. AA patient with Parkinson's disease whose next dose is due in two hours
2. BA patient with stable CKD waiting for a renal diet review
3. CA patient with hypothyroidism asking when to take levothyroxine
4. DA patient on insulin for DKA whose potassium is now 2,9 mmol/L

Which advice helps a patient with haemorrhoids?

1. ATake a codeine-based painkiller every day
2. BSit on the toilet for long periods to empty fully
3. CEat less fibre so that stools are smaller
4. DEat more fibre, drink enough fluid and avoid straining

A patient on modified-release morphine for cancer pain has needed four breakthrough doses every day for several days. What should the nurse do?

1. ATell the patient to put up with the pain between doses
2. BReport it, as the regular background dose may need review
3. CStop the breakthrough doses to reduce opioid use
4. DGive all breakthrough doses at the same time

Why are pregnant women at increased risk of urinary tract infection and pyelonephritis?

1. AThe bladder empties more completely in pregnancy
2. BProgesterone dilates the ureters and slows the flow of urine
3. CPregnancy greatly reduces the production of urine
4. DThe urine becomes more acidic in pregnancy

Seorang perempuan hamil 10 minggu muntah selama berhari-hari, memiliki keton dalam urinenya, kehilangan 6% berat badannya, dan merasa pusing saat berdiri. Apa prioritasnya?

1. AMengoreksi dehidrasi dengan cairan IV dan elektrolit sesuai resep
2. BMenyarankannya makan tiga kali sehari dalam porsi besar
3. CMemulai diet penurunan berat badan
4. DMengatakan bahwa ini akan hilang sendiri setelah trimester pertama dan tidak perlu tindak lanjut

A toddler refuses a liquid medicine. Which approach is appropriate?

1. ATell the child it is a sweet so that he takes it happily
2. BMix it into a full bottle of milk or juice for the whole day
3. CMix it with a small spoonful of food, if the pharmacist says this is safe
4. DHold the child's nose firmly until he has to open his mouth to breathe

Seorang anak berusia 3 tahun yang sadar tersedak makanan dan tidak dapat batuk, menangis, atau berbicara. Apa yang harus dilakukan perawat?

1. AMenunggu untuk melihat apakah anak akan membatukkannya
2. BMemberi anak air untuk ditelan
3. CMengorek mulut dengan jari secara buta untuk mengait keluar potongan makanan
4. DMemberikan tepukan punggung lalu hentakan perut, dan memanggil bantuan

A patient in a manic episode makes repeated sexual comments to a nurse. What is the most appropriate response?

1. ARespond with similar comments to build rapport
2. BCalmly say that the comments are not acceptable and redirect him
3. CLaugh at the comments so he does not feel rejected
4. DAvoid the patient for the rest of the shift

A patient with borderline personality disorder and frequent self-harm says, "I'm going to kill myself tonight," after an argument on the phone. A colleague says, "She always says that." What should the nurse do?

1. ACarry out a full suicide risk assessment, as with any patient who expresses suicidal intent
2. BTell the patient she is only seeking attention
3. CWait until the next morning to see if she still feels the same once the argument has settled down
4. DAgree with the colleague and take no action at all

Latihan (nilai rekaan, bukan pedoman klinis). Seorang bayi baru lahir memiliki berat 6 lb 3 oz. Dengan 1 lb = 16 oz dan 1 kg = 2,2 lb, cari berat m dalam kilogram. Bulatkan ke dua tempat desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah infus memberikan 6 mcg/menit. Nyatakan laju dosis ini D dalam mg/jam.

Seorang anak dengan berat 35 kg diresepkan 2 mg/kg suatu obat. Larutan stok mengandung 10 mg/mL. Tarik dosisnya: berapa volume V yang Anda berikan?

Anda harus menyiapkan 1000 mL larutan 1% (b/v) dari larutan stok 10% (b/v). Berapa volume stok V₁ yang Anda perlukan?

Infuskan 500 mL selama 6 jam dengan set 10 tts/mL. Tentukan laju tetesan R dalam tetes per menit. Bulatkan ke bilangan bulat terdekat.

1000 mL diresepkan selama 6 jam. Setelah 4 jam Anda mendapati masih ada 390 mL di kantong, dan infus tetap harus selesai tepat waktu. Berapa persen Δ laju pompa awal harus dinaikkan?

Latihan (nilai rekaan, bukan pedoman klinis). Catatan menunjukkan asupan dan haluaran seorang pasien selama satu shift 8 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 1000 mL dijalankan dengan pompa pada 75 mL/h. Pada pukul 07:00, 750 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 Braden: persepsi sensorik: sedikit terbatas; kelembapan: kadang-kadang lembap; aktivitas: kadang-kadang berjalan; mobilitas: tanpa keterbatasan; nutrisi: kemungkinan tidak adekuat; gesekan dan geseran: berpotensi bermasalah. Cari total Braden B.

Latihan (nilai rekaan, bukan pedoman klinis). Pada menit ke-5 setelah lahir, seorang bayi baru lahir dalam latihan menunjukkan kulit biru atau pucat di seluruh tubuh, tidak ada denyut jantung, tidak ada respons terhadap rangsang, anggota gerak lunglai tanpa tonus otot, dan tidak bernapas. Hitung skor APGAR dan klik bagaimana skor itu diinterpretasikan.

1. 1menenangkan
2. 2abnormal sedang
3. 3rendah