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

When should blood cultures be taken in a patient with suspected sepsis?

1. AAfter the patient has recovered from the infection
2. BBefore antibiotics are given, as long as this does not delay them
3. COnly after three days of antibiotics, to see if they are working
4. DOnly if the temperature rises above 40 °C

A patient on regular paracetamol (acetaminophen) also takes an over-the-counter cold and flu remedy. Why is this a concern?

1. ACold remedies stop paracetamol from working, so the pain will not be controlled
2. BMany cold remedies also contain paracetamol, risking liver damage
3. CThere is no concern, as cold remedies contain no drugs
4. DParacetamol makes cold remedies cause drowsiness

A patient is on suicide precautions. Which room safety measure is appropriate?

1. AAllow glass bottles if the patient seems calm
2. BKeep the door closed at all times so the patient has privacy
3. CLet the patient keep a personal razor for shaving, as long as staff are told
4. DRemove items that could be used for self-harm, such as belts and cords

A nurse finds an unknown liquid leaking from a container in the utility room, with a strong smell. What should the nurse do first?

1. AMove closer and smell it carefully to identify what the substance is
2. BMop it up with paper towels
3. CPour water over it to dilute it
4. DLeave the area, keep others out and alert the trained response team

A patient’s chest tube becomes disconnected from the drainage system. What should the nurse do first?

1. AWait for the provider to arrive before doing anything else
2. BRemove the tube and cover the site
3. CClamp the tube for the rest of the shift
4. DPlace the end of the tube in a bottle of sterile water

During surgery under general anesthesia, a patient develops rising end-tidal carbon dioxide, muscle rigidity and a rapidly increasing temperature. Which drug should the nurse anticipate?

1. ADantrolene
2. BNaloxone
3. CFlumazenil
4. DAtropine

Why must levodopa for Parkinson's disease be given at the exact times prescribed in hospital?

1. AEarly doses cause severe low blood glucose and sweating attacks
2. BThe drug only works if taken at midnight
3. CLate doses cause dangerous high potassium
4. DDelays can quickly worsen rigidity, immobility and swallowing

A patient with a confirmed pulmonary embolism is started on anticoagulation. Which statement best explains its purpose?

1. AIt dissolves the clot completely within minutes of the first dose being given
2. BIt thins the blood so that the lungs absorb more oxygen
3. CIt stops the clot growing and prevents new clots while the body breaks it down
4. DIt is mainly given to lower the blood pressure

A blood sample drawn just after a patient ate a fatty meal is reported as "lipemic." What does this mean for the results?

1. AThe sample was contaminated by an IV fluid with dextrose
2. BThe sample shows the patient has diabetic ketoacidosis
3. CThe results are more accurate than in a fasting sample
4. DHigh fat in the sample may interfere with some test results

Two sets of blood cultures were taken from separate sites. Only one bottle in one set grows coagulase-negative staphylococci, and the patient has no line or implant. What is the most likely interpretation?

1. AProbable skin contamination of the sample
2. BProof that the patient has infective endocarditis
3. CCertain bloodstream infection needing treatment
4. DInfection with a resistant organism such as MRSA

Bagaimana gliseril trinitrat (GTN) meredakan angina?

1. AGTN meningkatkan kekuatan kontraksi jantung sehingga jantung memompa darah lebih efisien
2. BGTN memblokir reseptor beta-1 dan memperlambat jantung
3. CGTN melarutkan bekuan di arteri koroner
4. DGTN melepaskan nitrat oksida yang terutama melebarkan vena dan mengurangi beban kerja jantung

A patient taking digoxin has nausea, yellow-green vision and a dangerous arrhythmia. Which specific treatment can bind the drug?

1. AFlumazenil
2. BProtamine sulfate
3. CIntravenous vitamin K (phytomenadione) given slowly
4. DDigoxin immune Fab (antibody fragments)

Which investigation is most often used to confirm a pulmonary embolism?

1. ACT pulmonary angiography
2. BSputum culture
3. CPeak flow measurement
4. DAbdominal ultrasound

A healthcare assistant (unlicensed assistive personnel) reports four observations. Which one needs the nurse's attention first?

1. AA patient with heart failure who is newly confused, with SpO₂ 89%
2. BA patient with COPD whose SpO₂ is 90% on 1 L/min, which is usual for him
3. CA patient with a DVT whose leg is less swollen today
4. DA patient after a PCI asking for a cup of tea

Several hours after a carotid endarterectomy, which finding needs the most urgent action?

1. AAn expanding neck swelling with noisy breathing
2. BMild pain at the incision site
3. CA blood pressure slightly above the baseline
4. DA small amount of dried blood on the dressing

Seorang perawat merawat empat pasien. Pasien mana yang perlu dilihat pertama?

1. APasien setelah kraniotomi yang pupil kanannya baru melebar dan lambat bereaksi
2. BPasien PGK yang bertanya tentang pengikat fosfatnya
3. CPasien dialisis peritoneal dengan efluen jernih
4. DPasien hipotiroidisme stabil yang jadwal levotiroksinnya tiba

After a percutaneous liver biopsy, how is the patient usually positioned at first?

1. AProne, with the head lower than the feet
2. BOn the right side, to press on the puncture site
3. COn the left side, to drain the liver
4. DSitting upright, with the legs over the edge of the bed

Why is folinic acid (leucovorin) given after high-dose methotrexate?

1. ATo treat the patient's anaemia only
2. BTo rescue normal cells from methotrexate toxicity
3. CTo prevent hair loss during treatment
4. DTo increase the anticancer effect on the tumour

Which statement describes the "4 Ts" causes of postpartum haemorrhage?

1. ATrauma, tension, temperature and thrombosis
2. BTemperature, tachycardia, tears and time
3. CTone, trauma, tissue and thrombin
4. DTone, tachycardia, transfusion and tissue

A woman 1 day after a caesarean asks how to hold her baby for breastfeeding without pressure on her wound. Which position is best?

1. AThe football (rugby) hold or side-lying
2. BStanding up while breastfeeding
3. CLying flat on her back with the baby on her abdomen
4. DThe cradle hold with the baby across the incision

How should the nurse position the ear when giving ear drops to a 2-year-old?

1. APull the pinna gently up and back
2. BLeave the pinna alone and tilt the head
3. CPull the earlobe gently forward and up
4. DPull the pinna gently down and back

The parents of a 9-year-old who wets the bed most nights have been punishing him. What is the best advice?

1. AStop punishing him, praise dry nights and consider a bedwetting alarm
2. BWait, as no help is available until he is a teenager
3. CStop all drinks after lunch and keep him in nappies
4. DWake him every hour through the night and make him change his own sheets

A woman with advanced dementia keeps asking for her mother, who died many years ago. Which response is most appropriate?

1. A"Your mother will visit you later this afternoon."
2. B"Your mother died 30 years ago. You know that."
3. C"Please stop asking about her now and finish your lunch before it gets cold."
4. D"You're thinking about your mother. Tell me about her."

A man with gambling disorder has lost his savings and has large debts. He tells the nurse, "My family would be better off without me." What should the nurse do?

1. AReassure him that his family will forgive him
2. BChange the subject to his gambling triggers and how to avoid the betting shop
3. CFocus only on helping him create a budget
4. DAsk directly about suicidal thoughts and plans, and assess his risk

Latihan (nilai rekaan, bukan pedoman klinis). Seorang bayi baru lahir memiliki berat 5 lb 2 oz. Dengan 1 lb = 16 oz dan 1 kg = 2,2 lb, cari berat m dalam kilogram. Bulatkan ke dua tempat desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah resep tertulis 1½ tsp suspensi oral setiap 8 jam selama 14 hari. Dengan 1 tsp = 5 mL, berapa mL V yang dibutuhkan untuk seluruh pengobatan?

Seorang pasien dengan berat 120 kg memiliki luas permukaan tubuh 2,06 m². Resepnya 100 mg/m². Tentukan dosis D dalam mg.

Anda harus menyiapkan 200 mL larutan 2% (b/v) dari larutan stok 20% (b/v). Berapa air W yang harus ditambahkan ke stok?

Infuskan 500 mL selama 6 jam dengan set 10 tts/mL. Tentukan laju tetesan R dalam tetes per menit. Bulatkan ke bilangan bulat terdekat.

Sebuah kantong berisi 1 g obat dalam 500 mL. Resepnya 3 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). Hitung serpihan es setengah volumenya.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah kantong 500 mL dijalankan dengan pompa pada 150 mL/h. Pada pukul 09:30, 250 mL sudah diinfuskan. Berapa jam t lagi sampai kantong kosong? Bulatkan ke satu angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Gunakan bagan NEWS2 (SpO₂ skala 1) untuk observasi berikut: frekuensi napas 16/menit, SpO₂ 99% dengan udara ruangan, tekanan darah 100/60 mmHg, nadi 110/menit, sadar penuh, suhu 35,2 °C. Berapa total skor NEWS2?

Latihan (nilai rekaan, bukan pedoman klinis). Tim menargetkan tekanan arteri rata-rata minimal 70 mmHg. Tekanan sistolik seorang pasien adalah 116 mmHg. Dengan MAP = (SBP + 2·DBP)/3, berapa tekanan diastolik terendah DBP yang masih memberi MAP 70 mmHg?