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

Pesakit mempunyai suhu 38.6 °C, kadar jantung 118/min, kadar pernafasan 24/min dan kekeliruan baharu. Apakah yang patut disyaki dahulu?

1. APemulihan pascaoperasi yang normal
2. BDehidrasi akibat kurang minum air sahaja
3. CSepsis
4. DHipoglisemia sahaja

A patient wants to keep taking St John's wort, a herbal remedy, while in hospital. Why should the nurse tell the prescriber?

1. AHerbal remedies are always banned in hospital
2. BIt has no effects, so it is a waste of time
3. CIt must be swapped for a prescribed antidepressant at once
4. DIt interacts with many medicines and can reduce their effect

Which nursing care reduces the risk of ventilator-associated pneumonia?

1. ARegular oral care to reduce bacteria in the mouth
2. BLying the patient flat for most of the day
3. CChanging the ventilator circuit every few hours
4. DLeaving secretions in the mouth to protect the airway

A nurse asks a colleague to “just glance” at an insulin infusion before starting it. What makes a check truly independent?

1. AThe second nurse signs the record after the infusion has already been started by the first
2. BThe second nurse checks the order, drug, dose and pump settings separately without being told the answer
3. CThe second nurse looks at the bag label from the doorway
4. DThe first nurse reads the details aloud and the second agrees

A nurse teaches a patient about levothyroxine. Which statement shows a need for further teaching?

1. A“I will take it at the same time each morning.”
2. B“I will take it on an empty stomach with a glass of water.”
3. C“I will keep taking it even when I feel well.”
4. D“I will take it at breakfast with my calcium tablet.”

The charge nurse overhears four instructions from an RN to a nursing assistant. Which one needs to be corrected?

1. A“Walk him to the bathroom and back, and stay with him the whole time.”
2. B“Help him wash and change, and tell me at once if you see any red or broken skin.”
3. C“Check his glucose before lunch and tell me the number straight away.”
4. D“Check his glucose and give the insulin according to the sliding scale.”

Which group of symptoms suggests hypothyroidism?

1. AExcessive thirst and passing large volumes of urine
2. BWeight loss, heat intolerance and tremor
3. CFever, neck stiffness and photophobia
4. DTiredness, weight gain and feeling cold

Penilaian kejururawatan manakah yang paling membantu mengesan kemerosotan awal pada pesakit selepas pembedahan besar?

1. AMemeriksa luka hanya semasa pelepasan
2. BMengukur suhu sekali sehari
3. CSet pemerhatian lengkap secara berkala dengan skor amaran awal dan semakan trend
4. DBertanya pesakit sama ada mereka berasa sihat sahaja

When several samples are drawn at the same venipuncture, which tubes or bottles are filled first?

1. ACoagulation (citrate) tubes
2. BEDTA (complete blood count) tubes
3. CBlood culture bottles
4. DFluoride (glucose) tubes

Seorang pesakit dengan kalsium 6.8 mg/dL (1.7 mmol/L) tiba-tiba mengalami pernafasan bising dan suara serak. Apakah yang dicadangkan oleh ini?

1. ALaringospasme, kecemasan yang memerlukan bantuan segera dan kalsium IV
2. BKebimbangan tentang keputusan darah, yang memerlukan pujukan yang tenang
3. CSelsema biasa yang bermula pagi ini
4. DTindak balas normal yang akan berlalu tanpa rawatan

Bagaimanakah metformin terutamanya menurunkan glukosa darah?

1. AIa menyekat penyerapan glukosa di buah pinggang
2. BIa merangsang pembebasan insulin daripada pankreas
3. CIa mengurangkan penghasilan glukosa oleh hati
4. DIa menggantikan insulin yang hilang

A patient taking metoprolol is also started on verapamil. Which adverse effect is most likely?

1. ASevere bradycardia and heart block
2. BRebound tachycardia and hypertension
3. CHypoglycaemia and weight gain
4. DHyperkalaemia and muscle weakness

A patient with COPD is prescribed long-term oxygen therapy. How many hours a day is it usually needed to improve survival?

1. AOnly when walking outside
2. BAt least 15 hours a day
3. COnly during meals
4. DAbout one hour each morning

A patient regains a pulse after a ventricular fibrillation arrest that was probably caused by a heart attack. Which investigation is most urgent?

1. ASpirometry
2. BAn abdominal ultrasound
3. CA 12-lead ECG
4. DA lumbar puncture

A woman who takes the combined contraceptive pill is starting carbamazepine. What should she be taught?

1. AShe should take both at the same time so they are absorbed together
2. BThere is no interaction between these two medicines
3. CCarbamazepine can make the pill less effective, so other contraception is needed
4. DThe pill makes carbamazepine toxic, so she must stop the pill

Seorang jururawat menjaga empat pesakit. Pesakit manakah yang perlu dilihat dahulu?

1. APesakit hipotiroidisme stabil yang perlu mengambil levotiroksin
2. BPesakit selepas kraniotomi yang anak mata kanannya baru melebar dan lambat bertindak balas
3. CPesakit CKD yang bertanya tentang pengikat fosfatnya
4. DPesakit dialisis peritoneal dengan efluen jernih

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

1. AAvoid taking blood pressure on the arm with the line
2. BUse the PICC arm for heavy lifting to keep it flexible
3. CFlush the line only when it blocks
4. DLeave the external length unchecked once it is placed

A few hours after an ERCP, a patient has severe epigastric pain radiating to the back, with vomiting. Which complication is most likely?

1. AAcute appendicitis
2. BBiliary colic from a new stone
3. CPost-ERCP pancreatitis
4. DHepatitis B infection

A baby has prolonged jaundice at 3 weeks with pale, chalky stools and dark urine. What should the nurse suspect?

1. APhysiological jaundice
2. BErythema toxicum
3. CBreast milk jaundice
4. DBiliary atresia

A woman at 32 weeks with type 1 diabetes has nausea, vomiting, abdominal pain, rapid breathing and a glucose of 16 mmol/L (about 290 mg/dL). Which complication should be suspected?

1. AHyperemesis gravidarum
2. BNormal pregnancy nausea
3. CHypoglycaemia
4. DDiabetic ketoacidosis

Which advice about screen use reflects common paediatric guidance for children under about 18 months?

1. AScreens are fine as long as the volume is low
2. BUp to 2 hours a day of educational TV programmes is beneficial for language
3. CBackground TV helps language development
4. DAvoid screen media, apart from video calls with family

A 2-week-old suddenly starts vomiting bright green fluid. What should the nurse do?

1. ATreat it as a surgical emergency and get urgent medical review
2. BAdvise smaller, more frequent feeds and review the baby in a week
3. CChange to a lactose-free formula
4. DReassure the parents that this is normal reflux

A man taking risperidone reports breast enlargement and his partner says he has lost interest in sex. Which effect is the most likely cause?

1. ARaised blood calcium
2. BRaised prolactin
3. CLow thyroid hormone
4. DLow blood sodium

A man whose wife died a month ago is rude and angry with the nurses about small things. What is the best understanding of his behaviour?

1. AHe does not care about his wife's death and is using it as an excuse to be rude
2. BHe has antisocial personality disorder that was not noticed before
3. CHis anger may be part of grief, displaced onto staff, so she should not take it personally
4. DHe should be told that his behaviour is unacceptable and that visits will be stopped

Latihan (nilai rekaan, bukan panduan klinikal). Satu dos dicatat pada 10:00 PM. Entri yang manakah merupakan masa yang sama pada jam 24 jam? Klik padanya.

1. 123:00
2. 221:00
3. 310:00
4. 422:00

Latihan (nilai rekaan, bukan panduan klinikal). Semasa satu syif, seorang pesakit mengambil ¾ cawan daripada teh, 1 tsp daripada sirap batuk, 6 fl oz daripada jus. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Seorang pesakit berberat 15 kg dan dipreskripsikan 10 mg/kg sebagai dos tunggal. Cari dos D dalam mg.

Preskripsi ialah 80 mikrogram. Ampul mengandungi 0.5 mg/mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

Titisan berjalan pada 60 gtt/min melalui set 60 gtt/mL. Berapa mililiter V yang diterima pesakit dalam 2 jam?

Sebuah beg mengandungi 1 g ubat dalam 250 mL. Arahannya ialah 4 mg seminit. Pada kadar R berapakah anda menetapkan pam, dalam mL/j?

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).

Latihan (nilai rekaan, bukan panduan klinikal). Satu beg 1000 mL berjalan dengan pam pada 60 mL/j. Pada 18:30, 500 mL telah diinfuskan. Berapa jam t sehingga beg kosong? Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan dinilai dengan skala jatuh Morse: sejarah jatuh dalam 3 bulan yang lalu: tidak; diagnosis sekunder: ya; alat bantu berjalan: berpegang pada perabot; terapi IV atau kunci salina: ya; cara berjalan: terjejas; status mental: tahu had sendiri. Cari jumlah Morse MFS.

Latihan (nilai rekaan, bukan panduan klinikal). Pada 5 minit selepas lahir, seorang bayi baru lahir latihan mempunyai kulit biru atau pucat di seluruh badan, tiada denyutan jantung, tiada respons terhadap rangsangan, anggota lembik tanpa tonus otot dan tidak bernafas. Skorkan APGAR dan klik bagaimana skor itu ditafsirkan.

1. 1menenangkan
2. 2tidak normal secara sederhana
3. 3rendah