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

Posisi mana yang direkomendasikan untuk mengurangi tekanan pada sakrum dan panggul ketika pasien berbaring miring?

1. ABerbaring telentang dengan kepala ditinggikan curam
2. BBerbaring langsung di atas panggul pada 90 derajat
3. CDuduk tegak di tempat tidur selama berjam-jam
4. DKemiringan 30 derajat yang ditopang bantal

Seorang pasien PPOK dengan target saturasi 88–92% menerima oksigen. SpO₂-nya sekarang 97%. Apa yang harus dilakukan perawat?

1. AMenurunkan oksigen untuk mengembalikan saturasi ke rentang target
2. BMelepas semua oksigen dan menghentikan pemantauan
3. CMenaikkan oksigen agar kadarnya tetap tinggi
4. DMembiarkannya, karena saturasi yang lebih tinggi selalu lebih baik bagi pasien PPOK

A nurse finds a used needle in a patient’s bed linen. What should the nurse do?

1. ALeave it where it is for the housekeeping staff to remove later in the day
2. BRecap it with two hands before throwing it away
3. CFold it into the linen and send it to the laundry
4. DPick it up by the hub or with forceps, put it in a sharps container and report it

Saat penggantian balutan kateter sentral secara steril, seorang rekan menjangkau melintasi area steril yang terbuka untuk memberikan gulungan plester kepada perawat. Apa yang harus dilakukan perawat?

1. AMenganggap area terkontaminasi dan menyiapkan yang baru
2. BMenutup area dengan duk steril dan melanjutkan di atasnya
3. CHanya membuang alat yang paling dekat dengan tempat lengan melintas
4. DMelanjutkan, karena rekan tidak menyentuh alat steril mana pun

A parent calls to say their toddler has just swallowed drain cleaner. What should the nurse advise?

1. AMake the child vomit straight away to bring up the chemical
2. BWait to see whether the child develops any symptoms first
3. CGive a large glass of fizzy drink or milk to dilute the cleaner before calling anyone
4. DDo not make the child vomit; call poison control or emergency services now

A patient with MRSA in a wound is on contact precautions. Which instruction to the nursing assistant is correct?

1. AWear a respirator mask in the room, because MRSA in a wound spreads through the air to others
2. BNo special precautions are needed if the wound is covered with a dressing
3. COnly wear gloves when touching the wound itself; skin and bedding are safe
4. DWear a gown and gloves for contact with the patient or the room, and use dedicated equipment

A patient without diabetes is started on high-dose prednisolone. Why might capillary blood glucose be monitored?

1. ASteroids always cause hypoglycaemia
2. BSteroids can raise the blood glucose
3. CSteroids make glucose meters inaccurate
4. DSteroids destroy the pancreas

Seorang pasien pascaoperasi memiliki denyut jantung 115/menit, suhu 38,6 °C, frekuensi napas 26/menit, dan tekanan darah 85/50 mmHg meskipun telah diberi bolus cairan. Apa yang paling mungkin ditunjukkan hal ini?

1. ARespons inflamasi normal pada beberapa hari pertama setelah operasi
2. BKecemasan menjelang pemulangan
3. CSyok septik yang memerlukan evaluasi perawatan kritis segera
4. DHanya dehidrasi ringan

Seorang pasien dengan nyeri dada yang dimulai satu jam lalu memiliki troponin pertama yang normal. Interpretasi mana yang benar?

1. ATroponin tidak berguna pada pasien dengan nyeri dada
2. BInfark belum disingkirkan; troponin diulang sesuai protokol
3. CPasien dapat langsung dipulangkan
4. DInfark sudah disingkirkan, sehingga tidak perlu pemeriksaan troponin lagi

Two days after bowel surgery, a patient with nasogastric suction has a distended abdomen, absent bowel sounds and muscle weakness. The potassium is 2,8 mEq/L. Which interpretation is best?

1. AThe low potassium is due to the patient drinking too much water
2. BThe potassium is normal for the second day after surgery
3. CHypokalemia from gastric losses is contributing to paralytic ileus
4. DHyperkalemia from tissue damage is causing the bowel to stop

Bagaimana heparin menghasilkan efek antikoagulannya?

1. AHeparin meningkatkan kerja antitrombin, yang menginaktifkan trombin dan faktor Xa
2. BHeparin memblokir sintesis faktor pembekuan yang bergantung pada vitamin K di hati
3. CHeparin menghambat COX-1 trombosit secara ireversibel
4. DHeparin menguraikan fibrin dalam bekuan yang sudah ada

Five days after starting clindamycin, a patient has frequent watery diarrhoea, abdominal cramps and a fever. What should the nurse suspect and do?

1. AFood poisoning; encourage a high-fibre diet and plenty of milk products
2. BAn allergy to clindamycin; give an antihistamine and continue the antibiotic
3. CA normal side effect; give loperamide and continue as usual
4. DC. difficile infection; send stool, use contact precautions, avoid antidiarrhoeals

Why is a beta-blocker started at a low dose and increased slowly in heart failure?

1. AIt must be stopped as soon as symptoms improve
2. BIt can briefly worsen symptoms before long-term benefit appears
3. CIt works only if the dose is never changed after the first day
4. DIt is safe only at the highest possible dose from the very start

An older patient's varicose vein bursts at the ankle and bleeds heavily. What is the most effective first aid?

1. AKeep the leg hanging down over the bed
2. BStand the patient up so the blood flows away and clots faster
3. CApply a hot compress to the leg to help the vein close up
4. DLie the patient down, raise the leg and press firmly on the site

When a patient sticks out their tongue, it points to the right. Which nerve is affected?

1. AThe right facial nerve (VII)
2. BThe right hypoglossal nerve (XII)
3. CThe left trigeminal nerve (V)
4. DThe left hypoglossal nerve (XII)

A patient with an insulin pump is admitted with nausea, a glucose of 19 mmol/L (342 mg/dL) and blood ketones of 3,1 mmol/L. What is the priority?

1. ASuspect failed insulin delivery and give insulin by another route
2. BIncrease the pump rate and recheck the ketones in 12 hours
3. CDisconnect the pump and give no insulin until the ketones clear
4. DGive an antiemetic only, because nausea is causing the high glucose

How should pancreatic enzyme replacement capsules usually be taken?

1. AOnly on days with abdominal pain
2. BOne hour after meals, on an empty stomach
3. CWith every meal and snack
4. DOnce a day at bedtime

After two days of large volumes of IV 5% glucose, a postoperative patient becomes confused with a headache. Sodium is 124 mmol/L. What is the likely cause?

1. AHyponatraemia from hypotonic fluids
2. BNormal confusion after any anaesthetic
3. CHypoglycaemia from the glucose
4. DHypernatraemia from too much salt

A woman has painful haemorrhoids after a vaginal birth. Which measure is appropriate?

1. AAvoiding all fluids to prevent loose stools
2. BSitz baths, cold pads and stool softeners
3. CSitting on a hard surface for long periods
4. DStraining hard to open the bowels

A baby was born through thick meconium-stained fluid. At birth the baby is crying, has good tone and a heart rate above 100/min. What is the appropriate care?

1. ADeep suctioning of the stomach before the first breath
2. BRoutine care with the mother, with observation
3. CImmediate tracheal intubation and suction
4. DSeparation from the mother for 24 hours

A 2-year-old suddenly began coughing while eating peanuts. He now has a wheeze on one side of the chest only. What is most likely?

1. AViral croup
2. BBronchiolitis
3. CAn inhaled foreign body
4. DA first attack of asthma

Which finding in a 12-month-old needs further developmental evaluation?

1. ASays "mama" and "dada" to the right parent and waves bye-bye
2. BBecomes upset when a stranger picks her up
3. CPulls to stand and walks holding on to furniture
4. DA strong Moro reflex is still present

Which item is part of a safety plan for a person experiencing domestic violence?

1. AKeeping an emergency bag with documents, money and keys somewhere safe
2. BAvoiding contact with friends and support services so as not to provoke him
3. CTelling the abuser about plans to leave so that he can prepare
4. DKeeping all important documents in the shared house

A patient with depression answers every question with one or two words and looks at the floor. Which approach is most helpful?

1. AEncourage him to cheer up and think about the good things in his life
2. BEnd the conversation quickly, because the patient clearly does not want to talk
3. CAsk several open questions in quick succession to keep the conversation going
4. DUse simple statements, allow extra time for answers and stay with the patient even in silence

Latihan (nilai rekaan, bukan pedoman klinis). Suhu seorang pasien adalah 100,7 °F. Konversikan ke derajat Celsius T dengan °C = (°F − 32) × 5/9. Bulatkan ke satu tempat desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah instruksi tertulis 10 mcg/kg/menit untuk pasien dengan berat badan 94 kg. Nyatakan laju dosis D dalam mg/jam. Bulatkan ke dua tempat desimal.

Seorang pasien berbobot 18 kg dan diresepkan 20 mg/kg sebagai dosis tunggal. Tentukan dosisnya D dalam mg.

Sebuah infus berisi 50000 unit obat dalam 1000 mL. Resepnya 2000 unit per jam. Pada laju berapa R Anda mengatur pompa, dalam mL/h?

Infuskan 500 mL selama 12 jam dengan set 20 tts/mL. Tentukan laju tetesan R dalam tetes per menit. Bulatkan ke bilangan bulat terdekat.

Infus berisi 50 mg dalam 500 mL berjalan pada 15 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 46 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 150 mL/h. Pada pukul 16:00, 300 mL sudah diinfuskan. Berapa jam t lagi sampai kantong kosong? Bulatkan ke satu angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah bagan latihan mencatat GCS 6, dengan E1 dan V3. Berapa skor motorik M yang dicatat, dan respons mana yang digambarkannya? Berikan angkanya.

Latihan (nilai rekaan, bukan pedoman klinis). Seorang pasien latihan dinilai dengan skala Braden: persepsi sensorik: sedikit terbatas; kelembapan: kadang-kadang lembap; aktivitas: kadang-kadang berjalan; mobilitas: tanpa keterbatasan; nutrisi: sangat buruk; gesekan dan geseran: bermasalah. Gunakan kategori 19–23 tidak berisiko, 15–18 ringan, 13–14 sedang, 10–12 tinggi, dan 9 atau kurang sangat tinggi. Klik tingkat risikonya.

1. 1tidak berisiko
2. 2risiko ringan
3. 3risiko sedang
4. 4risiko tinggi
5. 5risiko sangat tinggi