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

A patient's hearing aid keeps whistling. What is the most likely cause?

1. AThe patient's hearing has improved
2. BThe volume is turned right down
3. CIt is not fitted properly in the ear
4. DThe battery is completely flat

Eight hours after surgery a patient has not passed urine and has lower abdominal discomfort with a swelling above the pubic bone. What should the nurse do?

1. AGive a laxative to relieve the swelling
2. BCheck the bladder volume with a scanner and report the findings
3. CRecord it and check again the next morning
4. DEncourage the patient to drink two litres of water quickly

Which nursing care reduces the risk of ventilator-associated pneumonia?

1. AChanging the ventilator circuit every few hours
2. BLying the patient flat for most of the day
3. CRegular oral care to reduce bacteria in the mouth
4. DLeaving secretions in the mouth to protect the airway

A patient has signed a surgical consent form but tells the nurse, “I don’t really understand what they are going to do.” What should the nurse do?

1. AGive the preoperative sedative so the patient relaxes
2. BReassure the patient that the surgeon knows best and continue with the preparation
3. CInform the surgeon so the procedure can be explained again before any sedation
4. DExplain the risks and benefits in place of the surgeon

On the first day after abdominal surgery, a patient has a temperature of 37,9 °C and reduced breath sounds at the lung bases. Which nursing action is most helpful?

1. AEncourage deep breathing, coughing and use of the incentive spirometer
2. BGive a cough suppressant so that the incision is not strained
3. CKeep the patient lying flat in bed to rest the incision fully
4. DRestrict oral fluids so that the lungs do not fill up with extra fluid

A nurse returns to the station to find four messages. Which one is answered first?

1. AA colleague asks to swap shifts with them next week because of a family wedding
2. BThe laboratory is calling with a critical potassium result of 2,6 mEq/L
3. CA family member wants an update on their father’s progress
4. DThe pharmacy asks when the next delivery should be scheduled

A nurse finds a patient lying on the floor beside the bed. What should be done first?

1. APhone the patient's family
2. BCheck the patient for injuries before moving them
3. CLift the patient straight back into bed so they are comfortable
4. DComplete the incident report form

In a patient with a head injury, which is usually the earliest sign of rising intracranial pressure?

1. AA change in level of consciousness
2. BA slow pulse with high blood pressure
3. CA fixed, dilated pupil on both sides
4. DIrregular breathing pauses

Which instruction is correct for a patient taking an oral potassium chloride supplement?

1. AUse a salt substitute as well, so less of the tablet is needed each day
2. BTake it with food and a full glass of water, and do not crush extended-release tablets
3. CTake it on an empty stomach with only a small sip of water to speed absorption
4. DCrush the extended-release tablets and mix them with a little water if needed

A patient has a positive hepatitis C antibody (anti-HCV) test. What is the most appropriate next step?

1. ATell the patient they definitely have chronic hepatitis C
2. BGive hepatitis C vaccine to prevent further infection
3. CTest for HCV RNA to find out whether infection is current
4. DRepeat the antibody test, as a positive test is always false

Why is a spacer recommended with a metered-dose inhaler?

1. AMore drug reaches the lungs and less stays in the mouth
2. BIt doubles the dose of drug released by each puff of the inhaler
3. CIt removes the need to shake the inhaler
4. DIt turns the inhaler into a nebuliser

A patient taking furosemide has a serum potassium of 2,9 mmol/L (mEq/L). Which ECG change is typical of this level?

1. ATall, peaked T waves
2. BWidened QRS with a sine-wave pattern
3. CFlattened T waves and prominent U waves
4. DA short QT interval with high R waves

Which ECG pattern is typical of acute pericarditis?

1. AWidespread saddle-shaped ST elevation with PR depression
2. BST elevation only in leads II, III and aVF with Q waves
3. CA sawtooth baseline with a regular ventricular rate
4. DTall peaked T waves with a wide QRS

A nurse looked after a patient for a shift before smear-positive pulmonary TB was diagnosed, without wearing a respirator. What should happen?

1. AReport it so occupational health can arrange follow-up screening
2. BStart a full six-month course of TB drugs at once without any tests
3. CStay off work for six months in case symptoms develop
4. DTake no action, as healthcare workers are immune to TB

A patient with advanced CKD asks how to manage indigestion. Which option should they avoid?

1. ARaising the head of the bed at night
2. BEating smaller, more frequent meals
3. CMagnesium-containing antacids
4. DAvoiding large meals late in the evening

Six hours after a catheter is removed, a patient has not passed urine and feels uncomfortable. What should the nurse do?

1. APut the catheter back without assessing
2. BDo a bladder scan to check for retention
3. CTell the patient to drink two litres of water quickly
4. DWait until the next morning before checking

Which technique is correct when giving a prefilled low molecular weight heparin injection?

1. AInject into a vein in the back of the hand
2. BLeave the air bubble in and inject into a skin fold
3. CRub the site firmly afterwards to help absorption
4. DExpel the air bubble first and inject into the deltoid muscle

An 80 kg adult has 30% TBSA partial- and full-thickness burns. Using the Parkland formula, how much crystalloid is planned for the first 8 hours from the time of the burn?

1. A3200 mL
2. B9600 mL
3. C4800 mL
4. D2400 mL

A woman 4 hours after birth has severe perineal pain and pressure. Her fundus is firm, lochia is normal, and her heart rate is rising. What should the nurse suspect?

1. AA vulvar or vaginal haematoma
2. BA urinary tract infection
3. CNormal afterpains
4. DUterine atony

Temuan bayi baru lahir mana yang memerlukan tindak lanjut segera?

1. AMolase bentuk kepala setelah persalinan pervaginam cukup bulan
2. BMerintih, napas cuping hidung, dan retraksi dada pada jam ke-1
3. CBintik putih kecil (milia) di hidung
4. DAkrosianosis pada jam ke-2

Which finding at a 2-year check most needs a speech and language referral?

1. AThe child is not yet combining any two words
2. BThe child says "no" to most suggestions
3. CThe child uses about 50 words or more
4. DThe child prefers to play beside other toddlers

Which long-term problems should be monitored in a child with a repaired cleft palate?

1. AKidney function and blood pressure
2. BBone density and fracture risk in the teenage years
3. CGrowth hormone levels and puberty timing
4. DMiddle ear infections, hearing, speech and teeth

Seorang pasien berkata, "Saya tidak berharga. Tidak ada yang peduli pada saya." Respons mana yang paling terapeutik?

1. A"Anda merasa tidak ada yang peduli pada Anda. Ceritakan lebih banyak."
2. B"Itu tidak benar; semua orang di sini peduli pada Anda."
3. C"Mari kita bicarakan hal yang lebih menyenangkan."
4. D"Anda tidak seharusnya mengatakan hal seperti itu."

Pada hari ketiga pemberian makan kembali, seorang pasien anoreksia nervosa berat mengalami pergelangan kaki bengkak, fosfat rendah, dan nadi tidak teratur. Apa yang paling mungkin?

1. AKenaikan berat badan normal
2. BSindrom serotonin
3. CReaksi alergi terhadap makanan
4. DSindrom pemberian makan kembali (refeeding syndrome)

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah dosis dicatat pada 21:25 (jam 24 jam). Entri mana yang merupakan waktu yang sama pada jam 12 jam? Klik entri itu.

1. 19:25 PM
2. 28:25 PM
3. 311:25 PM
4. 49:25 AM

Latihan (nilai rekaan, bukan pedoman klinis). Selama satu shift seorang pasien mengonsumsi 1 tsp dari sirup batuk, ½ tbsp dari suplemen cair, 1½ fl oz dari jus. Dengan ekuivalen yang diberikan, cari total asupan oral V dalam mL.

Sebuah vial berisi 500 mg serbuk. Labelnya menyatakan: tambahkan 9,6 mL air untuk injeksi sehingga volume totalnya 10 mL. Resepnya 50 mg. Berapa volume V larutan hasil rekonstitusi yang Anda berikan?

Anda harus menyiapkan 100 mL larutan 0,5% (b/v) dari larutan stok 10% (b/v). Berapa volume stok V₁ yang Anda perlukan?

Infuskan 1000 mL selama 3 jam dengan set 10 tts/mL. Tentukan laju tetesan R dalam tetes per menit. Bulatkan ke bilangan bulat terdekat.

Infus menetes dengan laju 32 tts/menit melalui set 20 tts/mL. Tersisa 450 mL di kantong. Berapa jam t lagi hingga kosong? Bulatkan ke satu angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Catatan menunjukkan asupan dan haluaran seorang pasien selama satu shift 8 jam. Berat badan pasien 54 kg. Cari rata-rata haluaran urine U dalam mL/kg/jam. Bulatkan ke dua angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah kantong 500 mL dijalankan dengan pompa pada 125 mL/h. Pada pukul 20:30, 50 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: terbatas sepenuhnya; kelembapan: selalu lembap; aktivitas: sering berjalan; mobilitas: tanpa keterbatasan; nutrisi: sangat buruk; gesekan dan geseran: berpotensi bermasalah. Cari total Braden B.

Latihan (nilai rekaan, bukan pedoman klinis). Gunakan bagan NEWS2 (SpO₂ skala 1) untuk observasi berikut: frekuensi napas 11/menit, SpO₂ 96% dengan udara ruangan, tekanan darah 92/56 mmHg, nadi 132/menit, baru mengalami kebingungan, suhu 36,1 °C. Pasien termasuk kelompok risiko klinis yang mana? Klik kelompok itu.

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