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

When using a metered-dose inhaler without a spacer, what should the patient do straight after inhaling the dose?

1. AHold their breath for about 10 seconds
2. BTake another dose at once without pausing
3. CBreathe out hard through the mouthpiece
4. DRinse the mouth before breathing in

Why is heat usually avoided on a fresh soft-tissue injury during the first day?

1. AIt numbs the area so the patient cannot feel pain
2. BIt makes the muscles weaker for several weeks
3. CIt narrows blood vessels and reduces blood flow to the injury
4. DIt widens blood vessels and can increase swelling and bleeding

Before helping a patient from bed into a wheelchair, what should the nurse do with the wheelchair?

1. ALeave the brakes off so the chair can move along with the patient during the pivot
2. BPlace it at the foot of the bed, facing away
3. CLock the brakes and place it close to the bed on the patient’s stronger side
4. DPlace it on the patient’s weaker side so that side is supported

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

1. ATurn the alarm volume down as low as it will go
2. BKeep the alarm on, fix the cause such as electrode placement, and adjust limits only per policy
3. CDisconnect the monitor overnight so the patient can sleep
4. DTurn the alarm off and check the monitor screen at the nurses’ station every hour instead

Which action helps prevent a catheter-associated urinary tract infection?

1. AKeeping the drainage bag below the level of the bladder
2. BLeaving the catheter in place longer than needed
3. CRaising the drainage bag above the bladder when walking
4. DDisconnecting the bag every shift to empty it

Seorang pasien setelah operasi besar memiliki keluaran urine 15 mL/jam selama dua jam, denyut jantung 115/menit, dan tangan dingin. Apa yang pertama kali dilakukan perawat?

1. AMembilas kateter dan memeriksa keluaran besok pagi
2. BMenganjurkan pasien minum lebih banyak air dan memeriksa lagi nanti
3. CMenunggu dua jam lagi untuk melihat apakah keluaran membaik
4. DMengkaji tanda-tanda syok, seperti perdarahan, dan melakukan eskalasi

Which ECG change is typical of hypokalaemia?

1. ATall, peaked T waves
2. BST elevation in leads II, III and aVF
3. CFlattened T waves and prominent U waves
4. DA very short PR interval with a delta wave

Which route and site are recommended for the first dose of adrenaline (epinephrine) in anaphylaxis on a ward?

1. ASubcutaneous injection into the upper arm
2. BIntramuscular injection into the anterolateral thigh
3. CIntravenous bolus given by the nurse without monitoring
4. DOral tablet dissolved under the tongue

A patient with diabetes also takes propranolol. Why is regular glucose monitoring especially important?

1. AThe drug can mask warning signs of hypoglycemia
2. BThe drug stops the meter from reading correctly
3. CThe drug causes very high glucose in all patients
4. DThe drug blocks the insulin injection site

A patient taking an SGLT2 inhibitor has nausea and fast breathing. Glucose 190 mg/dL (10,5 mmol/L), pH 7,15, bicarbonate 10 mEq/L, blood ketones high. What is the most likely diagnosis?

1. ARespiratory acidosis from COPD
2. BSimple fasting ketosis only
3. CHyperosmolar hyperglycemic state
4. DEuglycemic diabetic ketoacidosis

Mengapa OAINS seperti ibuprofen meningkatkan risiko tukak lambung?

1. AMenaikkan pH asam lambung
2. BMelarutkan lapisan lendir secara langsung
3. CMenambah jumlah bakteri Helicobacter pylori di lambung
4. DMenurunkan prostaglandin pelindung di lapisan lambung

Why is adenosine used with caution in patients with asthma?

1. AIt can cause bronchospasm
2. BIt causes severe hypertension in asthma
3. CIt is broken down too slowly in asthma
4. DIt reduces the effect of inhaled steroids

A patient with bronchiectasis of the right lower lobe is taught postural drainage. How should they be positioned?

1. ASitting fully upright at all times
2. BWith the affected lobe uppermost so gravity drains it
3. CFlat on the back with the arms raised
4. DWith the affected lobe lowest so it fills with mucus

A 70-year-old man has a small abdominal aortic aneurysm found on screening and is placed under surveillance. Which advice is most important?

1. AStop smoking, control BP and seek help at once for sudden back pain
2. BAvoid all exercise and lifting for the rest of his life to protect the aorta
3. CHave the aneurysm repaired immediately, whatever its size or growth rate
4. DStop all blood pressure medicines to avoid low pressure

Which picture fits anterior cord syndrome?

1. AWeakness on one side and loss of pain sensation on the other side
2. BNormal movement but complete loss of position sense
3. CLoss of movement and pain sense, with position sense kept
4. DArms much weaker than legs after a neck injury

Four patients had a minor head injury with no loss of consciousness and a GCS of 15. Which one most needs a CT scan of the head?

1. AA 78-year-old who takes warfarin for atrial fibrillation
2. BA 30-year-old who bumped their head on a cupboard door
3. CA 40-year-old with a mild headache that is improving
4. DA 25-year-old with a small scalp graze after a fall

Which nerve is at risk if the arm is poorly padded at the elbow during surgery?

1. ASciatic nerve
2. BFemoral nerve
3. CFacial nerve
4. DUlnar nerve

A 76-year-old with a past peptic ulcer needs long-term anti-inflammatory treatment for arthritis. Which plan best reduces GI bleeding risk?

1. AUse the highest NSAID dose to shorten the course
2. BCombine two different NSAIDs at lower doses
3. CConsider an alternative; if an NSAID is needed, add a PPI
4. DTake the NSAID with a glass of milk instead of food

A pregnant woman asks why she needs a whooping cough (pertussis) vaccine in pregnancy. Which answer is correct?

1. AIt protects her from pre-eclampsia
2. BIt prevents the baby from developing rubella
3. CIt is a live vaccine that gives the baby lifelong immunity to whooping cough
4. DHer antibodies cross the placenta and protect the newborn

At a booking visit, a woman says she drinks heavily most weekends. Which nursing response is most appropriate?

1. AReassure her that weekend drinking is safe if she avoids weekdays
2. BAdvise her to change to beer, which has less alcohol
3. CTell her the damage is done, so stopping will not help
4. DExplain the risks and refer her for support to stop

Kewaspadaan keperawatan mana yang berlaku untuk anak dengan dugaan tumor Wilms (nefroblastoma)?

1. AMemberikan enema setiap hari
2. BMenjaga anak berbaring datar di tempat tidur selama 2 minggu
3. CMenganjurkan pemijatan abdomen yang kuat
4. DMenghindari palpasi abdomen

A 9-year-old with Down syndrome has new neck pain, clumsy walking and changes in bladder control. What should the nurse suspect?

1. AAtlantoaxial instability with spinal cord compression
2. BA simple urinary infection causing tiredness
3. CThe normal low muscle tone of Down syndrome getting worse with age
4. DGrowing pains in the legs

What is the main advantage of a long-acting injectable antipsychotic?

1. AIt cures schizophrenia after a fixed course of injections
2. BIt works faster than any oral antipsychotic in an acute crisis
3. CIt improves adherence because the patient does not need to take daily tablets
4. DIt has no side effects, unlike the oral forms of the same antipsychotic drugs

A patient taking venlafaxine has started a second serotonergic medicine. She is restless, sweating, has a fast pulse and twitching muscles. What should the nurse do first?

1. AGive the next dose of venlafaxine as planned
2. BEncourage her to walk or exercise in the garden to relieve the restlessness and muscle twitching
3. CGive paracetamol (acetaminophen) and check her again tomorrow
4. DHold the serotonergic medicines and inform the prescriber urgently

Latihan (nilai rekaan, bukan pedoman klinis). Suhu seorang pasien adalah 38,7 °C. Konversikan ke derajat Fahrenheit T dengan °F = °C × 9/5 + 32. Bulatkan ke satu tempat desimal.

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

Sebuah spuit prefilled epinefrin (adrenalin) berlabel 1:10 000 (0,1 mg/mL). Resepnya 1 mg IV pada henti jantung. Berapa volume V yang Anda berikan?

Seorang pasien memiliki tinggi 165 cm dan berat 59 kg. Resepnya 60 mg/m². Dengan rumus Mosteller BSA = √(tinggi (cm) × berat (kg)/3600), tentukan dosis D dalam mg.

Infuskan 500 mL selama 4 jam dengan set 10 tts/mL. Tentukan laju tetesan R dalam tetes per menit. Bulatkan ke bilangan bulat terdekat.

1000 mL diresepkan selama 10 jam. Setelah 4 jam Anda mendapati masih ada 760 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 500 mL dijalankan dengan pompa pada 60 mL/h. Pada pukul 13:00, 100 mL sudah diinfuskan. Berapa jam t lagi sampai kantong kosong? Bulatkan ke satu angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Seorang pasien latihan setelah cedera kepala membuka mata secara spontan, mengucapkan kata-kata yang tidak sesuai dan acak, dan menunjukkan respons motorik terbaik: menarik anggota gerak dari tekanan (fleksi normal). Hitung GCS dan klasifikasikan cedera kepala berdasarkan GCS tersebut. Klik jawaban Anda.

1. 1ringan
2. 2sedang
3. 3berat

Latihan (nilai rekaan, bukan pedoman klinis). Pada menit ke-1 setelah lahir, seorang bayi baru lahir latihan memiliki kulit merah muda di seluruh tubuh, denyut jantung 75/menit, menangis, batuk, atau bersin saat dirangsang, gerakan aktif, dan napas lambat dan tidak teratur dengan tangis lemah. Hitung skor APGAR dan klik bagaimana skor itu diinterpretasikan.

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