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

A patient can wash their face and arms but cannot reach their back and feet. What is the best approach?

1. ALeave the back and feet unwashed
2. BAsk the patient to wait until a relative visits
3. CWash the patient completely yourself to save time and effort
4. DLet the patient do what they can and help with the rest

Temuan apa yang menunjukkan luka tekan kategori 1 sedang berkembang?

1. ATulang atau tendon terpapar
2. BKehilangan seluruh ketebalan kulit dengan lemak terlihat tetapi tanpa tulang yang terpapar
3. CLepuh terbuka dengan dasar merah
4. DKulit utuh dengan kemerahan yang tidak memucat di atas area bertulang

A family member tells the nurse, “My father is not himself. Something is wrong.” The hospital has a family-activated rapid response system. What is correct?

1. AThe family can call the rapid response team if they are worried and staff have not responded
2. BOnly doctors may call the rapid response team
3. CThe family must wait for the next scheduled ward round to raise the concern with a doctor
4. DThe family should call emergency services from outside the hospital

A patient with a common cold asks for antibiotics “to be on the safe side”. Which response is best?

1. ASuggest using leftover antibiotics from a previous illness
2. BExplain that antibiotics do not work on viruses and overuse breeds resistant bacteria
3. CAsk the provider to prescribe antibiotics anyway so that the patient is reassured
4. DTell the patient that antibiotics will shorten the cold by several days

A nasogastric tube has just been placed for feeding. What must happen before the first feed is given?

1. AThe feed is started slowly to see if the patient coughs
2. BThe tube is flushed with a large volume of water
3. CPlacement is confirmed by an approved method
4. DThe patient is asked if the tube feels comfortable

Seorang pasien mengalami kesulitan berbicara mendadak 45 menit yang lalu. Tindakan mana yang memiliki prioritas tertinggi?

1. AMenunggu sampai ahli saraf dapat memeriksa pasien pada visite pagi
2. BMemberikan air agar pasien dapat meminum obat pagi yang biasa
3. CSegera memberikan aspirin lewat mulut untuk membatasi bekuan
4. DMengaktifkan tim stroke untuk pencitraan segera, dengan mencatat kapan terakhir terlihat baik

Seorang pasien setelah kecelakaan lalu lintas mengalami sesak napas berat, suara napas tidak terdengar di satu sisi, tekanan darah rendah, dan trakea bergeser ke sisi lain. Apa diagnosis yang mungkin?

1. APneumonia
2. BTension pneumothorax
3. CAsma
4. DEdema paru

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. BIrregular breathing pauses
3. CA slow pulse with high blood pressure
4. DA fixed, dilated pupil on both sides

A patient with recurrent gout starts allopurinol. Which laboratory result shows that the treatment is achieving its goal?

1. AA falling serum uric acid
2. BA rising serum calcium
3. CA falling serum potassium
4. DA rising white cell count

A patient on high-dose dexamethasone has a white cell count of 15 × 10³/µL, mostly mature neutrophils with no bands. They have no fever and no signs of infection. What is the most likely explanation?

1. AA new leukemia that is confirmed by this result alone
2. BA steroid effect that moves neutrophils into the circulating blood
3. CCertain sepsis that needs antibiotics started without delay
4. DA laboratory error, because steroids always lower the white count

A patient is starting lamotrigine. Which adverse effect should the patient report at once?

1. AA brief change in taste
2. BMild headache on the first day
3. CSlight tiredness in the afternoon
4. DAny new skin rash

A patient with an epidural infusion of local anaesthetic becomes hypotensive. What is the most likely mechanism?

1. AThe local anaesthetic causes a severe allergic reaction
2. BThe epidural catheter has caused heavy bleeding
3. CBlockade of sympathetic nerves causes vasodilation
4. DThe drug increases urine output and causes dehydration

A patient is going home with a 24-hour Holter monitor. Which instruction is most important?

1. AKeep a diary of symptoms and activities with the times
2. BRemove the monitor whenever symptoms occur and restart it
3. CStay in bed for the full 24 hours so the trace is clear
4. DShower as normal with the monitor on

A patient with a COPD exacerbation has been on NIV for two hours. They are now more drowsy, and the pH has fallen further despite a good mask fit. What should the nurse do?

1. ARemove the mask and give nebulised bronchodilators only from now on
2. BContinue NIV unchanged and repeat the blood gas tomorrow morning
3. CEscalate urgently for review of intubation or a ceiling of care
4. DGive a sedative to help the patient tolerate the mask

A patient with Alzheimer's disease starts donepezil. Which side effects should the nurse look for?

1. AWeight gain, high glucose and swollen ankles
2. BNausea, diarrhoea and a slow heart rate
3. CDry mouth, constipation and a fast heart rate
4. DA persistent dry cough and a raised potassium

A patient on carbamazepine is admitted confused, with a sodium of 121 mmol/L. Which explanation is most likely?

1. AConfusion is a normal, expected effect of carbamazepine and is unrelated to sodium
2. BCarbamazepine causes salt loss through severe diarrhoea
3. CCarbamazepine can cause hyponatraemia through an SIADH-like effect
4. DThe low sodium proves the patient has stopped taking the drug

Tindakan mana yang membantu mencegah sindrom lisis tumor pada pasien berisiko tinggi?

1. APembatasan cairan dengan tablet kalium
2. BHidrasi IV dengan alopurinol atau rasburikase
3. CMenghentikan semua cairan IV dan oral selama kemoterapi
4. DSuplemen kalsium dan fosfat setiap hari

A patient with a sacral pressure ulcer keeps sliding down the bed when the head is raised high. Which advice best reduces shear?

1. AUse a dry sheet and drag the patient up the bed
2. BKeep the head of the bed at or below 30° if possible; use slide sheets
3. CRaise the head of the bed to 90° and pull the patient up the bed by the arms
4. DSit the patient upright without any support for the feet

Two days after a caesarean, a woman feels bloated with gas pains. Which advice is most helpful?

1. ADrink fizzy drinks to bring up the gas
2. BUse straws to drink fluids
3. CStay in bed until the pain stops
4. DWalk around regularly

The triage nurse receives four phone calls from pregnant women. Who should be told to come in immediately?

1. AAt 25 weeks with mild backache after standing
2. BAt 36 weeks with constant pain and a hard uterus
3. CAt 12 weeks with mild nausea in the mornings
4. DAt 30 weeks with heartburn after large meals

How are feeds usually restarted after a pyloromyotomy for pyloric stenosis?

1. AWithin hours, increasing gradually as per protocol; some vomiting can be expected
2. BNot until 10 days after surgery, when the wound has healed
3. CWith large, full-volume feeds straight away to make up for the weight lost
4. DOnly by nasogastric tube for the first month at home

Selama pengobatan ketoasidosis diabetik, seorang anak berusia 9 tahun menjadi mudah marah, mengeluh sakit kepala, lalu menjadi mengantuk. Apa yang harus dicurigai perawat?

1. AKelelahan normal setelah pengobatan
2. BHipoglikemia akibat cairan
3. CAnak lapar
4. DEdema serebral, suatu keadaan darurat

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

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

A patient with borderline personality disorder and frequent self-harm says, "I'm going to kill myself tonight," after an argument on the phone. A colleague says, "She always says that." What should the nurse do?

1. AWait until the next morning to see if she still feels the same once the argument has settled down
2. BCarry out a full suicide risk assessment, as with any patient who expresses suicidal intent
3. CTell the patient she is only seeking attention
4. DAgree with the colleague and take no action at all

Latihan (nilai rekaan, bukan pedoman klinis). Seorang pasien memiliki tinggi 5 ft 11 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). Selama satu shift seorang pasien mengonsumsi 3 fl oz dari jus, 2 cangkir dari teh, 3 tsp dari sirup batuk. Dengan ekuivalen yang diberikan, cari total asupan oral V dalam mL.

Seorang anak dengan berat 30 kg diresepkan 3 mg/kg suatu obat. Larutan stok mengandung 50 mg/mL. Tarik dosisnya: berapa volume V yang Anda berikan?

Resepnya 4350 unit obat yang tersedia sebagai 5000 unit/mL. Tarik dosis dalam alat suntik 1 mL: berapa volume V yang Anda berikan?

Sebuah infus menetes 60 gtt/min melalui set 60 gtt/mL. Berapa mililiter V yang diterima pasien dalam 2 jam?

1000 mg obat diencerkan dalam 250 mL dan diberikan dengan gravitasi melalui set 15 gtt/mL. Resepnya 80 mg per jam. Tentukan laju tetes R dalam tetes per menit.

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 kantong 1000 mL dimulai pada pukul 08:30 dan dijalankan dengan pompa pada 80 mL/h. Berapa mL V yang tersisa di kantong pada pukul 09:30?

Latihan (nilai rekaan, bukan pedoman klinis). Seorang pasien latihan dinilai dengan skala Braden: persepsi sensorik: terbatas sepenuhnya; kelembapan: kadang-kadang lembap; aktivitas: kadang-kadang berjalan; mobilitas: tanpa keterbatasan; nutrisi: sangat baik; gesekan dan geseran: tidak tampak masalah. Cari total Braden B.

Latihan (nilai rekaan, bukan pedoman klinis). Pada menit ke-5 setelah lahir, seorang bayi baru lahir dalam latihan menunjukkan kulit biru atau pucat di seluruh tubuh, tidak ada denyut jantung, tidak ada respons terhadap rangsang, anggota gerak lunglai tanpa tonus otot, dan tidak bernapas. Hitung skor APGAR dan klik bagaimana skor itu diinterpretasikan.

1. 1menenangkan
2. 2abnormal sedang
3. 3rendah