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

Why should insulin injection sites be rotated?

1. ATo prevent lumpy fatty swelling that affects absorption
2. BTo stop the patient getting used to the needle
3. CBecause each site can only be used once
4. DTo make the insulin work more quickly with each injection

A patient with heart failure weighs 2 kg more than yesterday on the same scales. What does this most likely show?

1. AThe patient is becoming dehydrated
2. BThe scales must have been faulty
3. CThe patient has gained 2 kg of body fat
4. DAbout 2 litres of fluid has been retained

A peripheral IV site is red, warm and tender along the vein. What should the nurse do?

1. ARemove the catheter and insert a new one at another site if still needed
2. BFlush the catheter harder to clear the vein and keep using the same site
3. CIncrease the infusion rate to finish the bag sooner
4. DApply a warm pack and keep using the same site

Seorang pasien dengan kewaspadaan udara membutuhkan CT scan segera. Rencana mana yang benar?

1. APemindaian ditunda sampai pasien tidak lagi menular
2. BPasien bermasker, CT diberi tahu lebih dulu, petugas memakai respirator
3. CPasien memakai respirator N95, sehingga petugas tidak memerlukan perlindungan
4. DPasien pergi tanpa masker, dan ruang CT dibersihkan keesokan harinya

On day 3 after hip surgery, a patient suddenly becomes short of breath with sharp chest pain and an SpO₂ of 88%. What should the nurse do first?

1. AMassage the patient’s calves to ease any muscle cramp
2. BGive the next dose of oral analgesia and reassess the patient in an hour
3. CEncourage the patient to walk to improve the circulation
4. DRaise the head of the bed, give oxygen and call for urgent help

A patient on a cardiac monitor suddenly becomes unresponsive, and the monitor shows ventricular fibrillation. What is the priority once help has been called?

1. AGive an oral antiarrhythmic tablet and recheck the rhythm in five minutes
2. BRecord a full 12-lead ECG to confirm the rhythm before doing anything else at all
3. CCheck the blood potassium level before any shock is considered
4. DDefibrillate as soon as the defibrillator is available, with CPR until then

Compared with a colostomy, a patient with an ileostomy is at greater risk of:

1. AHard stools, straining and constipation from slow transit
2. BDehydration and electrolyte loss from liquid output
3. CLow blood glucose after meals
4. DUrinary retention

A patient taking dapagliflozin is vomiting and unwell, with high blood ketones and a blood glucose of only 11 mmol/L (198 mg/dL). What should be suspected?

1. AHypoglycaemia
2. BEuglycaemic diabetic ketoacidosis
3. CSimple gastroenteritis with no further concern
4. DHyperosmolar hyperglycaemic state

A patient on a heparin infusion has an aPTT below the target range on the protocol. What should the nurse do?

1. AAdjust the rate as the protocol directs and recheck as scheduled
2. BStop the infusion and give protamine sulfate as quickly as possible
3. CSwitch the infusion to oral warfarin without a prescription
4. DContinue the same rate and recheck the aPTT in a few days

A patient with long-term heavy alcohol use is admitted with alcohol withdrawal. Which group of electrolyte problems is most common?

1. AHigh sodium, high calcium and high glucose
2. BHigh magnesium, high phosphate and high potassium
3. CLow chloride, high bicarbonate and high calcium
4. DLow magnesium, low phosphate and low potassium

Why is testing for HLA-B*15:02 recommended before carbamazepine in people of some Asian ancestries?

1. AThis gene variant causes carbamazepine to raise blood glucose
2. BThis gene variant makes carbamazepine ineffective
3. CThis gene variant speeds up the kidney excretion of carbamazepine
4. DIt greatly raises the risk of Stevens–Johnson syndrome

Why are oral liquid medicines drawn up in dedicated oral or enteral syringes that do not fit IV connectors?

1. ABecause IV syringes cannot hold liquids
2. BTo keep the medicine sterile for injection
3. CTo prevent oral liquids being given intravenously by mistake
4. DTo make the oral dose more accurate than a dose given through an IV syringe

A patient is starting long-term amiodarone. Which teaching and monitoring are most important?

1. AEat extra salt and stop the drug as soon as the pulse is regular
2. BProtect skin from sunlight and have thyroid, liver and lung checks
3. CExpect orange urine and no need for blood tests
4. DAvoid dairy products and have the INR checked once at the start

Seorang pasien yang mengonsumsi dabigatran mengalami perdarahan saluran cerna serius. Agen pembalik spesifik mana yang dapat digunakan?

1. AFitomenadion (vitamin K)
2. BProtamin sulfat
3. CIdarusizumab
4. DAsam traneksamat saja

A patient takes levodopa for Parkinson's disease. Which teaching point is correct?

1. AThe tablets work best taken with a large steak dinner
2. BThe drug cures the disease if taken for a full year
3. CLarge high-protein meals can reduce how well the drug works
4. DStop the drug for a day each week to avoid tolerance

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

1. AA patient with hypothyroidism who has been constipated for three days
2. BA patient with Graves' disease asking about radioactive iodine
3. CA patient with hyperthyroidism who is confused, with a temperature of 39,5 °C (103,1 °F)
4. DA patient after thyroidectomy with mild pain on swallowing

Which advice is appropriate for a patient with a very low platelet count?

1. AUse a soft toothbrush and an electric razor
2. BUse a razor blade for shaving every day
3. CTake aspirin regularly for headaches
4. DFloss hard every day to prevent gum disease

A nurse teaches a patient about a fentanyl skin patch. Which statement shows a need for further teaching?

1. A"I'll fold used patches sticky sides together before disposal."
2. B"I won't put a hot water bottle over the patch."
3. C"I'll put the new patch on a different area of skin."
4. D"I can cut the patch in half if I need less."

Why is mild anaemia common in the second trimester even in healthy women?

1. AThe bone marrow stops producing red cells during pregnancy
2. BThe fetus breaks down maternal red blood cells
3. CPlasma volume rises more than red cell mass
4. DIron is lost in the urine because kidney filtration rises

A newborn in the first hours sneezes, has a high-pitched cry, tremors and loose stools. The mother took opioids throughout pregnancy. Which intervention is most appropriate first?

1. AA quiet, dim room, swaddling and small, frequent feeds
2. BGiving naloxone to reverse the opioids
3. CBright lights and frequent handling to keep the baby awake
4. DWithholding feeds until the symptoms settle

When is airway clearance (chest physiotherapy) best done for a child with cystic fibrosis?

1. ABefore meals, or well after eating
2. BOnly at bedtime, lying flat after the evening meal
3. CStraight after a large meal, when the child has more energy
4. DOnly on days when the child has a fever

A 4-year-old says it is wrong to hit his sister "because then I get a time-out". Which level of Kohlberg's moral development does this reflect?

1. APostconventional level
2. BFormal operational level
3. CPreconventional level
4. DConventional level

A patient says, "I'm going to be a famous singer, and I'll buy this whole hospital." Which response best uses the technique of voicing doubt?

1. A"Why do you want to buy the hospital?"
2. B"You know that isn't true at all."
3. C"That sounds hard to believe."
4. D"That's wonderful. When will you start?"

A man with gambling disorder has lost his savings and has large debts. He tells the nurse, "My family would be better off without me." What should the nurse do?

1. AAsk directly about suicidal thoughts and plans, and assess his risk
2. BFocus only on helping him create a budget
3. CReassure him that his family will forgive him
4. DChange the subject to his gambling triggers and how to avoid the betting shop

Latihan (nilai rekaan, bukan pedoman klinis). Seorang bayi baru lahir memiliki berat 8 lb 8 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 8 mg/jam. Nyatakan laju dosis ini D dalam mcg/menit. Bulatkan ke satu tempat desimal.

Seorang anak dengan berat 20 kg diresepkan 5 mg/kg suatu obat. Larutan stok mengandung 25 mg/mL. Tarik dosisnya: berapa volume V yang Anda berikan?

Seorang pasien memiliki berat 156,2 lb. Resepnya 5 mg/kg sebagai dosis tunggal, dan stoknya berisi 40 mg dalam 1 mL. Dengan 1 kg = 2,2 lb, berapa volume V yang Anda berikan? Bulatkan ke satu angka desimal.

Infuskan 1500 mL selama 12 jam dengan set 20 tts/mL. Tentukan laju tetesan R dalam tetes per menit. Bulatkan ke bilangan bulat terdekat.

Infus berisi 100 mg dalam 250 mL berjalan pada 12 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. Berat badan pasien 91 kg. Cari rata-rata haluaran urine U dalam mL/kg/jam. Bulatkan ke dua angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah kantong 1000 mL dijalankan dengan pompa pada 60 mL/h. Pada pukul 19:00, 550 mL sudah diinfuskan. Berapa jam t lagi sampai kantong kosong? Bulatkan ke satu angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Gunakan bagan NEWS2 (SpO₂ skala 1) untuk observasi berikut: frekuensi napas 7/menit, SpO₂ 99% dengan oksigen tambahan, tekanan darah 124/74 mmHg, nadi 82/menit, sadar penuh, suhu 37,1 °C. Berapa total skor NEWS2?

Latihan (nilai rekaan, bukan pedoman klinis). Gunakan bagan NEWS2 (SpO₂ skala 1) untuk observasi berikut: frekuensi napas 18/menit, SpO₂ 96% dengan udara ruangan, tekanan darah 84/50 mmHg, nadi 104/menit, sadar penuh, suhu 38,4 °C. Pasien termasuk kelompok risiko klinis yang mana? Klik kelompok itu.

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