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

Which part of the stethoscope is best for hearing low-pitched sounds such as some heart murmurs?

1. AThe earpieces turned backwards
2. BThe bell, pressed firmly on the skin
3. CThe diaphragm, pressed firmly on the skin
4. DThe bell, placed lightly on the skin

A patient has been taught how to prevent constipation. Which statement shows a need for further teaching?

1. A"I'll take a strong laxative every day just in case."
2. B"I'll eat more fruit, vegetables and wholegrains."
3. C"I'll go to the toilet when I first feel the urge."
4. D"I'll drink plenty of fluids during the day."

A patient needs to be moved up in bed and cannot help much. Which approach is safest?

1. ARaise the head of the bed fully and lift the patient up by the shoulders
2. BAsk the patient to push up with their heels alone
3. CUse a friction-reducing sheet with enough staff, with the bed flat if tolerated
4. DHave one nurse pull the patient up by the arms

Seorang pesakit menerima ubat berisiko tinggi melalui infusi berterusan. Semasa serah terima, amalan manakah yang paling selamat?

1. AKedua-dua jururawat menyemak pam dan beg berbanding preskripsi
2. BJururawat yang menggantikan menyemaknya pada akhir syif
3. CHanya kadar disemak, bukan ubat atau kepekatan
4. DJururawat yang bertugas sebelumnya berkata “pam itu baik-baik sahaja” di meja

A patient receives hemodialysis this morning. Which type of medication is often held before dialysis, as prescribed?

1. AEye drops for glaucoma
2. BInhaled bronchodilators
3. CTopical skin creams
4. DAntihypertensive drugs

Pesakit manakah yang merupakan pilihan terbaik untuk dipindahkan keluar daripada rawatan rapi untuk memberi ruang kepada kemasukan baharu?

1. ADiintubasi 1 jam lalu untuk kegagalan pernafasan, masih disedasi
2. BDengan infusi norepinefrin yang dosnya dinaikkan pagi ini
3. CDiekstubasi 2 hari lalu, stabil dengan oksigen hidung 2 L/min, tiada infusi vasoaktif
4. DDimasukkan semalaman dengan pendarahan GI dan masih menerima darah

Seorang pesakit di wad mengalami berdehit dan sesak nafas selepas dos pertama penyekat beta. Sejarah manakah yang menjadikan ini paling mungkin?

1. AOsteoartritis
2. BHipotiroidisme
3. CMigrain
4. DAsma

A patient taking dapagliflozin is vomiting and unwell, with high blood ketones and a blood glucose of only 11 mmol/L (198 mg/dL). What should be suspected?

1. AHyperosmolar hyperglycaemic state
2. BEuglycaemic diabetic ketoacidosis
3. CSimple gastroenteritis with no further concern
4. DHypoglycaemia

A patient with type 2 diabetes starts prednisone each morning. When is the glucose most likely to be highest?

1. AIn the early morning, before the dose
2. BThe glucose will not change
3. CAt midnight only
4. DIn the afternoon and evening

A patient with acute kidney injury after severe dehydration has a rising creatinine. Which urine findings support a prerenal cause rather than acute tubular necrosis (ATN)?

1. AHigh urine sodium and dilute urine with muddy brown granular casts
2. BRed cell casts with heavy protein loss in the urine
3. CLow urine sodium and concentrated urine with a high specific gravity
4. DWhite cell casts with positive nitrites on the dipstick

A patient must mix regular (soluble) insulin and NPH (isophane) insulin in one syringe. What is the correct order?

1. ADraw up the clear regular insulin first, then the cloudy NPH insulin
2. BDraw up the cloudy NPH insulin first, then the clear regular insulin
3. CShake both vials hard, then draw them up in any order
4. DDraw them up in separate syringes, then mix them in a cup

A teenager took a large overdose of diphenhydramine. He is agitated, hot, flushed and confused, with dry skin, dilated pupils and a full bladder. What is this pattern?

1. ACholinergic toxidrome
2. BAnticholinergic toxidrome
3. COpioid toxidrome
4. DSerotonin syndrome

How should a patient breathe in when using a dry powder inhaler?

1. ASeveral times, breathing out into the device between breaths
2. BSlowly and gently over about ten seconds
3. CThrough the nose with the mouthpiece in the mouth
4. DQuickly and deeply, after breathing out away from the device

A patient on three blood pressure drugs still has high readings at every visit. What should the nurse check first?

1. AWhether the readings should be ignored
2. BWhether the patient is taking the medicines as prescribed
3. CWhether a fourth drug can be added at today's appointment
4. DWhether the patient needs surgery on the renal arteries

A patient has Cushing's syndrome. Which nursing assessment is especially important?

1. ARegular blood glucose checks
2. BWatching for weight loss
3. CMonitoring for a high potassium
4. DChecking for low blood pressure

Weeks after starting insulin, a patient with newly diagnosed type 1 diabetes needs much less insulin and has frequent mild hypos. What is the most likely explanation?

1. AThe patient actually has type 2 diabetes
2. BA honeymoon phase, but insulin is still needed
3. CThe diabetes has been cured, so insulin can stop
4. DThe insulin has gone off and should be replaced

Which advice helps a person with diabetes prevent foot ulcers?

1. ACheck the feet every day and never walk barefoot
2. BCut corns off at home with a sharp blade
3. CSoak the feet in very hot water every evening
4. DWear tight shoes to support the ankles

After several days of a tight CPAP mask, a patient has a red, broken area on the bridge of the nose. What is this, and what should the nurse do?

1. AA burn from the oxygen; apply ice to the area
2. BA normal mark; take no action until it heals
3. CA device-related pressure injury; protect skin and refit the mask
4. DAn allergic rash; stop the CPAP for good and give oral antihistamines

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

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

A woman with gestational diabetes asks if she will have diabetes after the baby is born. Which reply is accurate?

1. AIt always becomes type 1 diabetes after birth
2. BIt will continue unless she stops breastfeeding
3. CIt never returns, so no further glucose testing is needed after birth
4. DIt usually resolves, but her risk of type 2 diabetes stays higher

Which diet is usually recommended for a child with cystic fibrosis?

1. AA high-energy, high-fat diet with fat-soluble vitamin supplements
2. BA low-protein diet to reduce the work of the pancreas
3. CA low-salt diet to protect the heart and kidneys from damage later in life
4. DA low-fat diet to reduce greasy stools and abdominal pain

A sexually active 17-year-old has no symptoms and asks why chlamydia testing is offered. What is the best answer?

1. AChlamydia always causes severe pain, so testing is only a formality
2. BTesting is required by law before any young person can see a nurse or doctor for any reason
3. CChlamydia can only be caught from shared towels and toilet seats
4. DChlamydia often causes no symptoms but can lead to pelvic inflammatory disease and infertility

A man with few physical symptoms is convinced he has cancer, checks his body many times a day and is not reassured by normal test results. According to DSM-5, which disorder does this suggest?

1. ASomatic symptom disorder
2. BIllness anxiety disorder
3. CConversion disorder
4. DFactitious disorder

Seorang pesakit berjalan mundar-mandir, mengepal penumbuk dan menjerit kepada kakitangan. Apakah pendekatan pertama yang paling sesuai?

1. AKekang pesakit serta-merta
2. BGunakan penurunan ketegangan secara lisan yang tenang, kekalkan jarak yang selamat dan pastikan kedua-dua anda mempunyai jalan keluar
3. CBerdiri dekat dengan pesakit dan tinggikan suara anda supaya anda jelas mengawal keadaan
4. DBerpaling dan abaikan tingkah laku itu

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit setinggi 6 kaki 0 inci. Dengan menggunakan 1 kaki = 12 inci dan 1 inci = 2.54 cm, cari ketinggian h dalam sentimeter, kepada sentimeter bulat yang terdekat.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi memberikan 10 mg/h. Nyatakan kadar dos ini D dalam mcg/min. Bundarkan kepada satu tempat perpuluhan.

Seorang pesakit seberat 62 kg mempunyai luas permukaan badan 1.55 m². Preskripsi ialah 75 mg/m². Cari dos D dalam mg.

Seorang kanak-kanak berberat 28 kg dipreskripsi 20 mg/kg setiap dos suspensi oral yang mengandungi 250 mg dalam 5 mL. Berapakah isi padu V yang anda berikan?

Infuskan 250 mL selama 8 jam dengan set pemberian 60 gtt/mL. Cari kadar titisan R dalam titis seminit. Bundarkan kepada nombor bulat yang terdekat.

Satu titisan berjalan pada 20 gtt/min melalui set 15 gtt/mL. Terdapat 450 mL lagi dalam beg. Berapa jam t sehingga ia kosong? Bundarkan kepada satu tempat perpuluhan.

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 jumlah pengambilan I dalam mL. Kira ketulan ais sebagai separuh isi padunya.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi 500 mL bermula pada 19:00 dengan 120 mL/j. Selepas 3 jam kadar ditukar kepada 60 mL/j dan tidak ditukar lagi. Berapa jam t selepas permulaan beg akan kosong? Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan selepas kecederaan kepala membuka mata hanya kepada tekanan (rangsangan menyakitkan), tidak mengeluarkan bunyi dan menunjukkan respons motor terbaik: ekstensi lengan dan kaki (ekstensi tidak normal). Tentukan GCS dan klasifikasikan kecederaan kepala mengikutnya. Klik jawapan anda.

1. 1ringan
2. 2sederhana
3. 3teruk

Latihan (nilai rekaan, bukan panduan klinikal). Pasukan menyasarkan tekanan arteri purata sekurang-kurangnya 65 mmHg. Tekanan sistolik pesakit ialah 95 mmHg. Dengan menggunakan MAP = (SBP + 2·DBP)/3, apakah tekanan diastolik terendah DBP yang masih memberikan MAP 65 mmHg?