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

A patient has just finished a glass of iced water. How should this affect taking an oral temperature?

1. ATake it straight away, as cold drinks do not affect the mouth
2. BWait about 15–30 minutes, as the reading may be falsely low
3. CUse the reading but only if the patient says they feel warm
4. DAdd half a degree to the reading to correct for the drink

A patient with type 1 diabetes is vomiting and not eating. Which advice is correct?

1. ADrink only sugar-free fluids and stop testing for ketones until better
2. BKeep taking basal insulin and check glucose and ketones more often
3. CStop all insulin until eating normally again
4. DHalve every dose and stop testing the glucose

Which IV fluid can be given with packed red blood cells in the same line?

1. ALactated Ringer’s (Hartmann’s) solution
2. B0,9% sodium chloride
3. C5% dextrose in water
4. D5% dextrose in 0,45% sodium chloride

A nurse teaches a patient going home with an MRSA wound infection. Which statement shows a need for further teaching?

1. A“I will keep the wound covered with a clean, dry dressing.”
2. B“I can share towels with my family if I wash them every week.”
3. C“I will put used dressings in a sealed bag before throwing them out.”
4. D“I will wash my hands after touching my dressing.”

A patient with severe neutropenia needs a room. Which roommate is the safest choice?

1. AA patient with C. difficile diarrhea
2. BA patient with influenza
3. CA patient after a knee replacement with no signs of infection
4. DA patient with an infected, draining leg wound

On an addiction unit, which patient should the nurse assess first?

1. AAnxious, with goose bumps, stomach cramps and loose stools
2. BYawning, with a runny nose and dilated pupils
3. CAsking for an extra blanket and a hot drink
4. DDrowsy with pinpoint pupils and a respiratory rate of 7/min

Seorang pasien diabetes yang tidak sadar memiliki glukosa darah 2,1 mmol/L dan tidak ada akses IV. Apa yang dapat diberikan?

1. AGlukagon intramuskular
2. BInsulin subkutan
3. CJus buah lewat mulut
4. DTablet glukosa lewat mulut

Which statement about oxygen in a patient with suspected acute coronary syndrome is correct?

1. AOxygen replaces the need for an ECG
2. BHigh-flow oxygen should always be given, whatever the SpO₂
3. COxygen is given if the SpO₂ is below the target range
4. DOxygen must never be given in chest pain

A healthy woman at 28 weeks of pregnancy has a mildly lower hemoglobin than before pregnancy, with a normal MCV and ferritin. What is the most likely explanation?

1. APlasma volume rises more than red cell mass, diluting the blood
2. BIron is being lost through the kidneys during the pregnancy
3. CThe fetus is destroying the mother's red cells in the circulation
4. DPregnancy hormones stop the bone marrow from making red cells

A patient with suspected Cushing syndrome takes dexamethasone at night. The next morning, the cortisol is still high. What does this suggest?

1. AThe adrenal glands are not able to produce enough cortisol
2. BThe result is normal, as dexamethasone raises cortisol
3. CCortisol is being produced without normal feedback control
4. DThe patient has primary hypothyroidism instead

Mengapa pasien yang mengonsumsi klozapin memerlukan pemeriksaan darah lengkap secara teratur?

1. AKlozapin sering menyebabkan anemia defisiensi besi
2. BKlozapin menaikkan jumlah trombosit secara berbahaya
3. CKlozapin dapat menyebabkan agranulositosis
4. DKlozapin mengubah golongan darah

A patient with heart failure on furosemide is also given metolazone, a thiazide-like diuretic. Which risk increases most?

1. ASevere hypertension, tachycardia and fluid retention
2. BSevere hypokalaemia, hyponatraemia and dehydration
3. CHypoglycaemia and weight gain
4. DHyperkalaemia and fluid overload

A patient stops ramipril because of a troublesome dry cough. Which drug class is a common alternative?

1. AAn angiotensin II receptor blocker such as losartan
2. BA non-selective beta-blocker such as propranolol
3. CA loop diuretic such as furosemide
4. DA nitrate such as isosorbide mononitrate

A patient with a valid, documented do-not-attempt-CPR decision (DNACPR in the UK, DNR or DNAR in the US) is found in cardiac arrest. What should the nurse do?

1. AStart CPR but use only chest compressions
2. BStart full CPR because the patient's family is not present
3. CNot start CPR, call for support, and provide dignity and comfort
4. DCall the arrest team and let them decide whether to resuscitate

Which statement about giving IV potassium is correct?

1. AIt is diluted and given through an infusion pump, never as a bolus
2. BIt is safest given through a small vein in the hand at a fast rate
3. CIt needs no monitoring at all once the infusion is running
4. DIt can be given quickly as a push to correct the level fast

A patient with untreated end-stage kidney disease has chest pain that is worse lying flat and better sitting forward. A rub is heard over the heart. What is most likely?

1. AIndigestion from phosphate binders
2. BA stable angina attack, which needs only a nitrate spray and rest
3. CUraemic pericarditis, which usually needs urgent dialysis
4. DA rib fracture from coughing

During the first infusion of a monoclonal antibody such as rituximab, which problem is most important to watch for?

1. ASevere constipation within the first hour of starting the infusion
2. BSudden hair loss during the infusion
3. CAn infusion reaction, such as fever, rigors or breathlessness
4. DA rise in platelet count above normal

Six hours after surgery, a patient has not passed urine, has lower abdominal discomfort and a bladder scan shows 750 mL. What should the nurse do?

1. ARestrict fluids until the urge returns
2. BWait another twelve hours before acting
3. CGive a diuretic to increase urine flow
4. DCatheterise as per protocol or prescription

Which factors help start the newborn's first breath?

1. AChemical, thermal, mechanical and sensory cues
2. BOnly the pressure from the obstetrician's hand
3. COnly the cutting of the umbilical cord
4. DOnly the baby's first cry from hunger

A preterm baby is being prepared for discharge. Which statement by the parents shows understanding of kangaroo (skin-to-skin) care?

1. A"Skin-to-skin is only for full-term babies."
2. B"She should be fully dressed and wrapped before I hold her."
3. C"Skin-to-skin increases her risk of getting cold."
4. D"Holding her on my bare chest keeps her warm."

Which signs suggest digoxin toxicity in a child?

1. AIncreased appetite, extra energy and rapid weight gain over a few days
2. BHigh fever with a spreading red rash
3. CFast heart rate with high blood pressure
4. DNausea, vomiting, poor feeding and a slow heart rate

The nurse has taught the parents of a newborn about safe sleep. Which statement shows a need for further teaching?

1. A"We will put her on her back for every sleep, including naps."
2. B"We will put a soft bumper and a pillow in the cot so she is comfortable."
3. C"We will keep her cot in our bedroom for the first months."
4. D"Nobody will smoke in the house or in the car."

A patient taking clozapine complains of drooling, especially at night. How should the nurse respond?

1. ATell him that it means the clozapine dose is too low and needs to be increased
2. BRecognise it as a common side effect, report it and suggest a towel on the pillow
3. CStop the clozapine immediately, because this is a sign of agranulocytosis
4. DExplain that it is a sign of an allergic reaction to the medicine

After her house burned down, a woman developed delusions and disorganised speech. Ten days later the symptoms have gone completely and she is back to normal. Which diagnosis best fits?

1. ASchizophreniform disorder
2. BSchizophrenia
3. CDelusional disorder
4. DBrief psychotic disorder

Latihan (nilai rekaan, bukan pedoman klinis). Perhitungan dosis untuk suatu suntikan menghasilkan 10,4799 mL. Aturan dalam latihan ini adalah volume 1 mL atau lebih dibulatkan ke persepuluhan mL terdekat. Nilai x berapa yang Anda catat?

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah infus dimulai pada 18:40 dan selesai pada 03:25 keesokan paginya (jam 24 jam). Berapa menit t infus itu berjalan?

Seorang pasien berbobot 80 kg. Dosis yang diresepkan 25 mg/kg per hari, diberikan dalam 4 dosis yang sama. Berapa miligram D yang diberikan per dosis?

Anda harus menyiapkan 500 mL larutan 2% (b/v) dari larutan stok 50% (b/v). Berapa volume stok V₁ yang Anda perlukan?

Infus diresepkan pada 30 mL/h, tetapi tidak ada pompa. Infus berjalan dengan gravitasi melalui set infus 10 gtt/mL. Tentukan laju tetes R dalam tetes per menit.

Sebuah kantong berisi 400 mg obat dalam 100 mL dan mengalir dengan laju 12 mL/h. Berapa miligram per jam D yang diterima pasien?

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). Hitung serpihan es setengah volumenya.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah infus 1000 mL dimulai pada pukul 12:30 dengan laju 120 mL/h. Setelah 4 jam lajunya diubah menjadi 80 mL/h dan tidak diubah lagi. Berapa jam t setelah dimulai kantong akan kosong? Bulatkan ke satu angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Gunakan bagan NEWS2 (SpO₂ skala 1) untuk observasi berikut: frekuensi napas 12/menit, SpO₂ 90% dengan oksigen tambahan, tekanan darah 100/60 mmHg, nadi 58/menit, sadar penuh, suhu 36,0 °C. Berapa total skor NEWS2?

Latihan (nilai rekaan, bukan pedoman klinis). Gunakan bagan NEWS2 (SpO₂ skala 1) untuk observasi berikut: frekuensi napas 20/menit, SpO₂ 97% dengan udara ruangan, tekanan darah 118/70 mmHg, nadi 40/menit, sadar penuh, suhu 37,5 °C. Pasien termasuk kelompok risiko klinis yang mana? Klik kelompok itu.

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