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

Seorang pasien bersuhu 38,6 °C, denyut jantung 118/menit, frekuensi napas 24/menit, dan baru mengalami kebingungan. Apa yang harus dicurigai pertama kali?

1. ASepsis
2. BHanya dehidrasi karena kurang minum
3. CHanya hipoglikemia
4. DPemulihan pascaoperasi yang normal

In an emergency a doctor gives a verbal order for a medicine. What should the nurse do?

1. ARefuse to give any medicine until a written prescription has been completed
2. BWrite it down, read it back and make sure it is signed later as per policy
3. CAsk another nurse to remember the order
4. DGive it and tell the doctor nothing more

An infant has had a cleft lip repair. Why are elbow restraints often used?

1. ATo keep the infant from rolling over in the crib
2. BTo prevent the infant from sucking a pacifier
3. CTo stop the infant’s hands reaching the mouth while still allowing arm movement
4. DTo hold the IV line in place during feeds and stop it being pulled out

The laboratory reports that a blood sample labeled with one patient’s name has a blood group different from that patient’s previous result. What is the most likely problem and response?

1. AA wrong-patient sample, so the test is repeated and the event reported
2. BA normal change in the patient’s blood group over the years since the last test
3. CA laboratory machine fault, so no action is needed
4. DThe previous result was wrong, so it is deleted

Which infant with gastroenteritis should the nurse see first?

1. AAlert, crying with tears, had a wet diaper an hour ago
2. BTwo loose stools today, feeding well
3. CMild diaper rash, otherwise playful
4. DLethargic, sunken fontanel, no wet diaper for 8 hours

An adult has burns over 40% of the body with no signs of airway injury. Which treatment is the priority during the first hours?

1. AGiving a high-protein meal to support healing
2. BApplying antibiotic cream to all the burns before anything else
3. CLarge-volume IV fluids with close monitoring of urine output
4. DStarting physiotherapy to prevent contractures straight away

A patient's low potassium does not improve despite potassium replacement. Which other electrolyte should be checked?

1. AMagnesium
2. BSodium
3. CChloride
4. DPhosphate

A patient rescued from a house fire has soot around the mouth, singed nasal hairs and a hoarse voice. What is the main concern?

1. AAirway swelling from inhalation injury
2. BHypothermia from the fire service water
3. CA minor throat infection
4. DDehydration from sweating

A patient with type 2 diabetes starts prednisone each morning. When is the glucose most likely to be highest?

1. AAt midnight only
2. BIn the afternoon and evening
3. CThe glucose will not change
4. DIn the early morning, before the dose

A patient's AST is about twice the ALT, both moderately raised, and the GGT is high. Which cause is most likely?

1. AAcute viral hepatitis A
2. BGallstone blocking the bile duct
3. CAcute myocardial infarction
4. DAlcohol-related liver disease

A patient is starting olanzapine. Which monitoring is most important over the following months?

1. AINR and platelet count
2. BPeak expiratory flow
3. CHearing tests and vision tests every month
4. DWeight, blood glucose and blood lipids

A woman has received a high-dose oxytocin infusion with large volumes of hypotonic fluid for many hours. She now has a headache, confusion and a low serum sodium. What is the most likely cause?

1. AAn allergic reaction to oxytocin causing brain swelling
2. BExcessive salt in the infusion fluid
3. CNormal tiredness after a long labour
4. DWater intoxication from the antidiuretic effect of oxytocin

Seorang pasien asma menggunakan inhaler pelega lebih dari tiga kali seminggu. Apa yang ditunjukkan hal ini?

1. AKontrol asma buruk dan pengobatan perlu ditinjau
2. BInhaler pencegah tidak lagi diperlukan
3. CAsma terkontrol baik dengan rencana saat ini
4. DPelega tidak lagi bekerja dan harus dihentikan

Drainase dada pasien tidak sengaja tercabut. Apa tindakan segera?

1. AMembiarkan lubang terbuka agar udara terperangkap dapat keluar
2. BMeminta pasien batuk kuat untuk mengembangkan paru
3. CMendorong drain kembali ke dada dan mengamankannya dengan plester
4. DMenutup lokasi dengan balutan oklusif steril dan meminta bantuan

Why must Parkinson's medicines be given on time in hospital?

1. ALate doses can soon cause stiffness, falls and poor swallowing
2. BGiving them on time prevents the disease from getting worse
3. CLate doses build up in the blood and cause an overdose
4. DLate doses cause the patient to develop high blood glucose

A patient with a new arm fistula says their hand on that side is cold, pale and painful, especially during dialysis. What is the concern?

1. ASteal syndrome, which needs urgent review
2. BFluid overload in the arm
3. CAn allergic reaction to the dressing on the arm
4. DNormal healing that needs no action

Pendekatan transfusi sel darah merah mana pada pasien stabil dengan perdarahan saluran cerna yang sesuai dengan bukti terkini?

1. ATidak pernah mentransfusi, berapa pun hemoglobin atau gejalanya
2. BMentransfusi semua orang agar hemoglobin selalu di atas 150 g/L
3. CMentransfusi dua unit secara rutin sebelum setiap endoskopi
4. DAmbang restriktif, sering sekitar 70 g/L, pada sebagian besar pasien stabil

A nurse teaches a carer about overnight tube feeding at home. Which statement shows a need for further teaching?

1. A"I'll check the external length mark on the tube every day."
2. B"I'll stop the feed and call if he coughs or struggles to breathe."
3. C"I'll flush the tube with water before and after his medicines."
4. D"I'll let him lie flat so he sleeps better while the feed runs."

When should an Rh-negative woman with no anti-D antibodies routinely receive antenatal anti-D immunoglobulin?

1. AOnly at the first antenatal visit
2. BOnly if the baby is known to be Rh-negative
3. CAt about 28 weeks of pregnancy
4. DAfter she has formed anti-D antibodies

Empat hari setelah melahirkan, seorang ibu berkata mendengar suara-suara yang mengatakan bayinya jahat. Apa prioritasnya?

1. AMenyarankannya tidur lebih banyak dan menilai ulang dalam seminggu
2. BMenenangkannya bahwa ini hanya baby blues dan akan berlalu
3. CMemastikan ibu dan bayi tidak ditinggal sendirian dan mengatur pemeriksaan psikiatri segera
4. DMeminta pasangan membawa bayi pulang semalam dan membiarkannya beristirahat sendirian di ruangan yang tenang

Mengapa kodein dan tramadol tidak direkomendasikan untuk anak di bawah 12 tahun?

1. AKeduanya hanya dapat diberikan secara intravena
2. BKeduanya terlalu lemah untuk meredakan nyeri sedang, sehingga opioid yang lebih kuat selalu lebih disukai
3. CSebagian anak memetabolismenya sangat cepat, menyebabkan depresi napas yang berbahaya
4. DKeduanya selalu menyebabkan alergi

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

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

Which statement about benzodiazepines in anxiety disorders is correct?

1. AThey take 4–6 weeks to have any effect on anxiety, like antidepressants
2. BThey are safe to stop suddenly after many months of daily use
3. CThey are the preferred long-term treatment for generalised anxiety disorder
4. DThey give rapid relief but are generally used only short-term because of tolerance and dependence

A patient asks the nurse to pray with her before her ECT. The nurse does not share her religion. What is the most appropriate response?

1. ARespect the request, join in if comfortable, and offer to call the chaplain
2. BTry to persuade her to adopt the nurse's own beliefs
3. CIgnore the request politely and change the subject to the procedure itself
4. DTell her that religion has no place in hospital care

Latihan (nilai rekaan, bukan pedoman klinis). Seorang pasien memiliki tinggi 6 ft 10 in. Dengan 1 ft = 12 in dan 1 in = 2,54 cm, cari tinggi h dalam sentimeter, ke sentimeter bulat terdekat.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah infus dimulai pada 23:00 dan selesai pada 03:15 keesokan paginya (jam 24 jam). Berapa menit t infus itu berjalan?

Seorang pasien berbobot 18 kg. Dosis yang diresepkan 2 mg/kg per hari, diberikan dalam 2 dosis yang sama. Berapa miligram D yang diberikan per dosis?

Resepnya 105 mikrogram. Ampul mengandung 0,5 mg/mL. Tarik dosis dalam alat suntik 1 mL: berapa volume V yang Anda berikan?

Infus diresepkan pada 80 mL/h, tetapi tidak ada pompa. Infus berjalan dengan gravitasi melalui set infus 60 gtt/mL. Tentukan laju tetes R dalam tetes per menit.

Sebuah kantong berisi 2 g obat dalam 500 mL. Resepnya 0,5 mg per menit. Pada laju berapa R Anda mengatur pompa, dalam mL/h?

Latihan (nilai rekaan, bukan pedoman klinis). Catatan menunjukkan asupan dan haluaran seorang pasien selama satu shift 12 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 75 mL/h. Pada pukul 19:00, 50 mL sudah diinfuskan. Berapa jam t lagi sampai kantong kosong? Bulatkan ke satu angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Seorang pasien memiliki nadi 111/menit dan tekanan darah 156/94 mmHg. Cari indeks syok SI = HR/SBP. Bulatkan ke dua tempat desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Seorang pasien latihan dinilai dengan skala jatuh Morse: riwayat jatuh dalam 3 bulan terakhir: ya; diagnosis sekunder: tidak; alat bantu jalan: tidak ada, tirah baring, atau dibantu perawat; terapi IV atau saline lock: tidak; cara berjalan: normal, tirah baring, atau kursi roda; status mental: mengetahui batas kemampuannya. Dengan batas 0–24 rendah, 25–44 sedang, dan 45 atau lebih tinggi, klik tingkat risiko jatuhnya.

1. 1risiko rendah
2. 2risiko sedang
3. 3risiko tinggi