Soalan latihan gaya NCLEX-PN (LPN/LVN): pek ulang kaji kilat

A patient cannot stand to be measured for the MUST screening tool. How can their height be estimated?

1. AFrom the length of the bed
2. BFrom the size of the patient's shoes
3. CFrom the length of the forearm (ulna)
4. DBy asking a visitor to guess

What is the best way to check that a patient has learned to use an inhaler correctly?

1. AAsk whether they have any questions
2. BAsk them to repeat the drug's name
3. CAsk whether they have read the leaflet
4. DAsk the patient to show how they use it

A patient with a fever and a cough arrives in a crowded clinic waiting room. What should the nurse do?

1. AAsk the patient to wait outside in the car park
2. BGive everyone else in the waiting room a mask instead
3. CGive the patient a mask and seat them apart from others
4. DDo nothing until the patient is seen by the provider

Seorang pesakit pernah mengalami MRSA pada luka dan kini memerlukan penukaran pembalut. PPE manakah yang sesuai?

1. ASarung tangan steril sahaja, tanpa gaun atau perlindungan lain
2. BRespirator N95 sahaja, kerana MRSA ialah organisma yang rintang
3. CGaun dan sarung tangan, serta perlindungan mata dan pelitup muka jika percikan mungkin berlaku
4. DTiada PPE, jika tangan dibersihkan selepas itu

On day 3 after hip surgery, a patient suddenly becomes short of breath with sharp chest pain and an SpO₂ of 88%. What should the nurse do first?

1. AMassage the patient’s calves to ease any muscle cramp
2. BEncourage the patient to walk to improve the circulation
3. CRaise the head of the bed, give oxygen and call for urgent help
4. DGive the next dose of oral analgesia and reassess the patient in an hour

Seorang pembantu jururawat mengukur tanda vital 15 minit selepas dos pertama morfin pesakit. Mereka melaporkan kadar pernafasan 10/min dan berkata pesakit sukar dikejutkan. Apakah yang patut dilakukan oleh jururawat?

1. APergi serta-merta, kejutkan pesakit, sokong pernafasan dan sediakan nalokson mengikut arahan
2. BMendokumenkan dapatan dan memberitahu pembekal penjagaan pada pusingan berjadual seterusnya
3. CMeminta pembantu memeriksa semula kadar pernafasan dalam 15 minit dan melapor semula
4. DMenelefon pembekal penjagaan untuk arahan sebelum pergi melihat pesakit

A patient on the ward has shingles with open blisters. Which people are most at risk from contact?

1. APeople who have already had chickenpox in childhood and are now healthy
2. BPregnant women and immunocompromised people who have not had chickenpox
3. COnly people over 80 who have already had shingles themselves
4. DNo one, because shingles cannot spread

Pesakit selepas pembedahan besar mempunyai tekanan darah yang menurun, kadar jantung yang meningkat dan abdomen bengkak serta tegang, walaupun pembalut luka kering. Apakah yang patut disyaki?

1. ABengkak pascaoperasi normal yang tidak membimbangkan
2. BSembelit
3. CPendarahan dalaman
4. DJangkitan saluran kencing

When should the nurse check the glucose before giving a mealtime dose of rapid-acting insulin (such as lispro)?

1. ATwo hours after the meal, then giving the insulin dose
2. BJust before the meal, giving insulin when the food is ready
3. CAt bedtime only, then giving the mealtime insulin overnight
4. DOnly once a day, then giving the same dose before every meal

After lying on the floor for many hours, a patient has a CK of 40,000 U/L, a potassium of 6.1 mEq/L and dark urine. Which prescribed treatment is the priority?

1. AHigh-dose NSAIDs for the muscle pain
2. BFluid restriction to protect the heart from overload
3. CAn oral potassium supplement with each meal
4. DLarge-volume IV fluids with cardiac monitoring

Apakah yang menjadikan terlebih dos antidepresan trisiklik seperti amitriptilin amat berbahaya?

1. ABatu karang
2. BKegagalan hati teruk dalam beberapa jam
3. CAritmia jantung dan sawan
4. DGlukosa darah tinggi mendadak

A patient on rifampicin, isoniazid, pyrazinamide and ethambutol develops a painful swollen big toe. Which drug is most likely responsible?

1. AIsoniazid
2. BEthambutol
3. CRifampicin
4. DPyrazinamide

A patient with heart failure is comfortable at rest but becomes breathless walking across a room. Which NYHA class fits best?

1. AClass III
2. BClass II
3. CClass I
4. DClass IV

Two adults with cystic fibrosis are admitted to the same ward. What is the correct infection-control plan?

1. AUse standard precautions only, as CF is not infectious
2. BPut them in the same bay so they can support each other
3. CNurse them in separate single rooms and keep them apart
4. DLet them share physiotherapy sessions and equipment

Seorang pesakit strok hemisfera kanan mengabaikan makanan di sebelah kiri pinggan. Apakah ini dipanggil?

1. APengabaian sebelah kiri (neglect)
2. BAtaksia serebelum
3. CDisfagia
4. DAfasia ekspresif

A patient is being assessed for brain death (brainstem death). Which condition must be excluded before testing?

1. AEffects of sedative drugs or severe hypothermia
2. BA haemoglobin of 110 g/L (11 g/dL)
3. CA history of high blood pressure
4. DA previous episode of migraine

Which is correct when caring for a patient with a PICC line?

1. AFlush the line only when it blocks
2. BLeave the external length unchecked once it is placed
3. CAvoid taking blood pressure on the arm with the line
4. DUse the PICC arm for heavy lifting to keep it flexible

A patient with a platelet count of 8 × 10⁹/L (8,000/µL) develops a sudden severe headache and confusion. What should the nurse suspect?

1. AA tension headache from stress
2. BIntracranial bleeding
3. CDehydration from poor intake
4. DNormal effects of chemotherapy

Which placental hormone causes insulin resistance in the second half of pregnancy?

1. AOxytocin
2. BHuman chorionic gonadotrophin (hCG)
3. CRelaxin
4. DHuman placental lactogen (hPL)

Pada hari ke-2 selepas kelahiran caesarean, seorang wanita mempunyai suhu 38.4 °C, uterus yang sakit apabila ditekan dan lokia berbau busuk. Apakah yang paling mungkin?

1. AKembung payudara
2. BPostpartum blues
3. CPemulihan pascasalin yang normal
4. DEndometritis

How should a 4-month-old be protected from the sun?

1. AApply a thick layer of high-factor sunscreen and allow full sun
2. BUse a sunbed for a few minutes to build a protective tan
3. CKeep the baby out of direct sun, in the shade, with light clothing and a hat
4. DExpose the baby to midday sun for vitamin D, then cover up

Seorang bayi berumur 9 bulan yang disyaki intususepsi telah menangis secara berepisod. Sementara menunggu prosedur, bayi itu mengeluarkan najis perang normal dan kesakitan berhenti. Apakah yang patut dilakukan oleh jururawat?

1. AMemberi enema untuk membersihkan usus
2. BMelaporkannya dengan segera, kerana ia mungkin bermakna intususepsi telah berkurang
3. CMenyusukan bayi hidangan besar serta-merta
4. DMengabaikannya, kerana najis normal tidak mempunyai makna klinikal dalam intususepsi

A veteran with PTSD sits with his back to the wall, scans the room constantly and jumps at every door slam. Which symptom group do these behaviours belong to?

1. ADissociative amnesia for the trauma
2. BChanges in arousal and reactivity
3. CAvoidance
4. DIntrusion symptoms

A woman arrives in the emergency department after a sexual assault and has a cut on her head that is bleeding. What is the priority?

1. ACollect forensic evidence before treating any injuries
2. BCall the police and wait until they arrive before doing anything else, so that no evidence is lost by mistake
3. CAsk her for a detailed account of the assault before any care
4. DAssess and treat her physical injuries, then offer forensic examination with her consent

Latihan (nilai rekaan, bukan panduan klinikal). Suhu seorang pesakit ialah 36.6 °C. Tukarkan kepada darjah Fahrenheit T dengan °F = °C × 9/5 + 32. Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Semasa satu syif, seorang pesakit mengambil 1 tbsp daripada suplemen cecair, 2½ tsp daripada sirap batuk, 3 cawan daripada teh, 1½ fl oz daripada jus. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Seorang pesakit berberat 22 kg. Dos yang dipreskripsikan ialah 20 mg/kg sehari, diberi dalam 3 dos yang sama. Berapakah miligram D yang diberi bagi setiap dos?

Preskripsi ialah 3 mg. Ampul mengandungi 4000 mikrogram setiap mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

Infuskan 250 mL selama 6 jam dengan set pemberian 20 gtt/mL. Cari kadar titisan R dalam titis seminit. Bundarkan kepada nombor bulat yang terdekat.

Satu infusi 25 mg dalam 250 mL berjalan pada 6 mL/j. Berapa mikrogram seminit D yang diterima pesakit?

Latihan (nilai rekaan, bukan panduan klinikal). Rekod menunjukkan pengambilan dan pengeluaran seorang pesakit untuk satu syif 12 jam. Infusi IV berjalan pada kadar yang ditunjukkan sepanjang syif. Cari imbangan cecair B = pengambilan − pengeluaran dalam mL (jawapan negatif bermaksud kehilangan bersih). Kira ketulan ais sebagai separuh isi padunya.

Latihan (nilai rekaan, bukan panduan klinikal). Satu beg 500 mL dimulakan pada 13:30 dan berjalan dengan pam pada 80 mL/j. Berapa mL V yang tinggal dalam beg pada 16:00?

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan dinilai dengan skala Braden: persepsi deria: sangat terhad; kelembapan: jarang lembap; aktiviti: terlantar di katil; mobiliti: tiada had; pemakanan: cemerlang; geseran dan ricih: masalah. Cari jumlah Braden B.

Latihan (nilai rekaan, bukan panduan klinikal). Pasukan menyasarkan tekanan arteri purata sekurang-kurangnya 65 mmHg. Tekanan sistolik pesakit ialah 121 mmHg. Dengan menggunakan MAP = (SBP + 2·DBP)/3, apakah tekanan diastolik terendah DBP yang masih memberikan MAP 65 mmHg?