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

A goal states: "The patient will report pain of 3/10 or less within one hour of analgesia." After one hour the patient reports 6/10. What should the nurse do?

1. AChange the goal to 6/10 or less so that it counts as met
2. BRecord the goal as met, as the pain has gone down
3. CWait until the next day to evaluate again
4. DRecord the goal as not met and review the plan

Sebuah luka tekan menunjukkan kehilangan kulit seluruh ketebalan dengan lemak terlihat, tetapi tidak ada tulang, tendon, atau otot yang terpapar. Kategori berapakah ini?

1. AKategori 2
2. BKategori 3
3. CKategori 4
4. DKategori 1

A patient with diabetes will use lancets and insulin needles at home. Which teaching about disposal is correct?

1. ARecap each needle with two hands before putting it in the kitchen trash
2. BPut them loose in the household trash bag, as long as the bag is tied shut
3. CFlush the used lancets and needles down the toilet
4. DPut them in a puncture-resistant container with a lid and follow local disposal rules

In a mass-casualty incident with limited resources, why may a critically injured patient with little chance of survival receive care after others?

1. ACritical patients are always treated last in every situation, even outside disasters
2. BPatients are treated in the order they arrive
3. CResources go first to those most likely to survive with treatment
4. DThe most severely injured are never given comfort care

A nurse sees a nursing assistant leave a confused patient’s bed in the highest position after care. What should the nurse do?

1. AWrite it in the assistant’s yearly review only
2. BLower the bed now and remind the assistant why it matters
3. CAsk the family to lower the bed when they next visit
4. DLeave it because the patient is asleep

Which finding most suggests a tension pneumothorax rather than a simple pneumothorax?

1. AA small air leak seen on a routine chest X-ray
2. BSharp chest pain that is worse on deep breathing
3. CTrachea shifted away from the affected side, with low blood pressure
4. DMild breathlessness with reduced breath sounds on one side of the chest only

Which technique is correct when suctioning through a tracheostomy?

1. AKeep suctioning for at least a minute each time to clear all the secretions
2. BSuction every 15 minutes whether or not secretions are present
3. CApply suction continuously while inserting the catheter as far as it will go
4. DApply suction only while withdrawing the catheter, for no more than about 10–15 seconds

A patient due a blood transfusion is not wearing an identity band. What should the nurse do?

1. AAsk another patient to confirm who the patient is
2. BCheck the name on the bed and proceed
3. CNot start until a correct identity band is in place and identity is confirmed
4. DAsk the patient to state their name and date of birth, then start straight away

A patient with an upper gastrointestinal bleed has a BUN of 48 mg/dL (urea 17 mmol/L) and a normal creatinine. What is the most likely explanation?

1. ASkeletal muscle is breaking down because of the blood loss
2. BThe liver has stopped making urea because of the bleeding
3. CDigested blood adds protein, which the liver turns into urea
4. DThe kidneys have suddenly lost most of their function

Which cerebrospinal fluid (CSF) pattern most strongly suggests bacterial meningitis?

1. AClear fluid, normal glucose, mildly raised protein, lymphocytes
2. BClear fluid, high glucose, low protein, many red cells
3. CCloudy fluid, low glucose, high protein, many neutrophils
4. DClear fluid, normal glucose, normal protein, no white cells

An adult patient is due to receive digoxin. The apical pulse, counted for a full minute, is 52 beats per minute. What should the nurse do?

1. AGive half the dose and document the pulse
2. BGive the dose with food to slow absorption
3. CWithhold the dose and notify the prescriber
4. DGive the dose and recheck the pulse in one hour

Lithium taken in the first trimester of pregnancy has been linked to which type of birth defect?

1. ANeural tube defects such as spina bifida
2. BCleft lip and palate only
3. CHeart malformations, such as Ebstein's anomaly
4. DLimb defects similar to thalidomide

What is the main problem in heart failure with preserved ejection fraction?

1. AA leaking aortic valve
2. BA blocked pulmonary artery
3. CA dilated ventricle that cannot contract strongly
4. DA stiff ventricle that fills poorly in diastole

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. CDisconnect and hand-ventilate with 100% oxygen while calling for help
4. DSilence the alarm and wait for the result of the next routine blood gas

A patient with diabetic neuropathy has an ulcer on the ball of the foot. Which measure is most important for healing?

1. ATaking pressure off the ulcer
2. BWalking more to improve blood flow
3. CCovering it and checking it in a month
4. DSoaking the foot in hot water daily

A patient with hypopituitarism needs both hydrocortisone and levothyroxine. Which is usually started first?

1. ALevothyroxine
2. BHydrocortisone
3. CBoth on the same day, in any order
4. DNeither, until symptoms appear

What does "neoadjuvant" treatment mean?

1. ATreatment that is given instead of any surgery
2. BTreatment given only for pain relief
3. CTreatment before the main treatment, often to shrink the tumour
4. DTreatment that is given only after the cancer has already spread

On the day after a Hartmann's procedure, the end colostomy is dark purple to black. What should the nurse do?

1. ACut a smaller hole in the pouch
2. BRub the stoma to improve its colour
3. CRecord it as normal postoperative bruising and recheck it next week
4. DReport it urgently, as the stoma may be necrotic

Seorang ibu pascapersalinan yang tidak imun terhadap rubela menerima vaksin sebelum pulang. Nasihat apa yang penting?

1. AMenghindari kehamilan setidaknya selama 4 minggu
2. BMenjauhi bayi barunya selama 2 hari
3. CMengulang vaksin dalam 6 bulan
4. DBerhenti menyusui selama 4 minggu

A newborn boy's scrotum is empty on one side and the testis cannot be felt in the groin. What is appropriate?

1. AMassage the groin daily to push it down
2. BTell the parents it will never descend
3. CRecord it and arrange follow-up; many descend later
4. DArrange emergency surgery on the testis today

Which advice best prevents dog bites in young children?

1. ANever leave a young child alone with a dog, even the family pet
2. BLet the child hug the dog while it eats so it gets used to children
3. CChoose a small breed, as small dogs never bite
4. DTeach the child to stare into the dog's eyes to show who is in charge

Only one negative-pressure room is available. Which child should be placed in it?

1. AA child with RSV bronchiolitis
2. BA child with suspected measles
3. CA child with impetigo
4. DA child with norovirus gastroenteritis and vomiting

Which treatment is recommended first-line for chronic insomnia in adults?

1. AStaying in bed for longer each morning
2. BCognitive behavioural therapy for insomnia (CBT-I)
3. CLong-term daily benzodiazepines
4. DDrinking alcohol in the evening to fall asleep

A patient with anorexia nervosa is found doing sit-ups in her room after every meal. What is the best nursing response?

1. ACalmly follow the agreed care plan on activity and observation, without arguing or punishing
2. BTell her she will be tube-fed if she does it again
3. CIgnore it, because exercise is always healthy
4. DPraise her for being so active and motivated, because it shows she is taking care of her health

Latihan (nilai rekaan, bukan pedoman klinis). Suhu seorang pasien adalah 96,7 °F. Konversikan ke derajat Celsius T dengan °C = (°F − 32) × 5/9. Bulatkan ke satu tempat desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah resep tertulis 1 tsp suspensi oral setiap 6 jam selama 14 hari. Suspensi tersedia dalam botol 50 mL. Dengan 1 tsp = 5 mL, berapa botol utuh N yang harus disediakan agar pengobatan lengkap?

Sebuah vial berisi 500 mg serbuk. Labelnya menyatakan: tambahkan 9,6 mL air untuk injeksi sehingga volume totalnya 10 mL. Resepnya 120 mg. Berapa volume V larutan hasil rekonstitusi yang Anda berikan?

Resepnya 455 mikrogram. Ampul mengandung 0,5 mg/mL. Tarik dosis dalam alat suntik 1 mL: berapa volume V yang Anda berikan?

Infus diresepkan pada 40 mL/h, tetapi tidak ada pompa. Infus berjalan dengan gravitasi melalui set infus 60 gtt/mL. Tentukan laju tetes R dalam tetes per menit.

1000 mL diresepkan selama 10 jam. Setelah 6 jam Anda mendapati masih ada 430 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 total asupan I dalam mL. Hitung serpihan es setengah volumenya.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah kantong 1000 mL dijalankan dengan pompa pada 150 mL/h. Pada pukul 11:30, 150 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: menggerakkan tangan ke tempat tekanan (melokalisasi). Hitung GCS dan klasifikasikan cedera kepala berdasarkan GCS tersebut. Klik jawaban Anda.

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

Latihan (nilai rekaan, bukan pedoman klinis). Tim menargetkan tekanan arteri rata-rata minimal 60 mmHg. Tekanan sistolik seorang pasien adalah 110 mmHg. Dengan MAP = (SBP + 2·DBP)/3, berapa tekanan diastolik terendah DBP yang masih memberi MAP 60 mmHg?