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

A patient tells the nurse about abuse and asks them to keep it a secret. What should the nurse say?

1. AThat they promise to keep it secret, so the patient keeps trusting them
2. BThat they will tell everyone on the ward so the patient is safe
3. CThat they cannot promise secrecy if someone is at risk of harm
4. DThat they cannot listen to this and the patient should tell a doctor

The wife of a man with terminal cancer cries often and says she is already grieving for him. What is this called?

1. AComplicated grief
2. BAnticipatory grief
3. CDelayed grief
4. DDisenfranchised grief

Which household item is a strangulation risk for young children?

1. ALooped cords on window blinds
2. BA plastic picture book
3. CA large wooden building block
4. DSoft cotton socks

A patient on oxygen needs an MRI scan. Which plan is safe?

1. ARemove the oxygen for the scan without telling anyone
2. BUse only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room
3. CLeave the steel cylinder on the patient’s bed during the scan
4. DTake the usual steel cylinder into the room if it is tightly strapped to the trolley frame

A patient on a nasal cannula at 6 L/min still has a low SpO₂. What should the nurse do?

1. ARemove the oxygen to see if the SpO₂ changes
2. BRecheck the SpO₂ at the next routine set of observations in four hours
3. CReport it, because a different oxygen device is likely to be needed
4. DTurn the nasal cannula up to 15 L/min

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

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

Skor NEWS2 pesakit telah meningkat kepada 7. Apakah tindak balas yang sewajarnya?

1. ABeri sedatif dan semak semula kemudian
2. BPenilaian kecemasan oleh pasukan klinikal dengan kemahiran rawatan rapi
3. CTeruskan pemerhatian setiap 12 jam
4. DRekodkan skor, tingkatkan pemerhatian dan tunggu rondaan wad pagi

An older patient with delirium is trying to leave the ward at night, saying he must go home. What is the best initial approach?

1. APhysically restrain him in bed until the morning so that he cannot fall
2. BGive a sedative straight away without a prescription
3. CLet him leave, because adults can always do as they wish whatever their state
4. DCalmly reassure and redirect him while the team assesses his capacity and safety

A patient taking a statin reports new, unexplained muscle pain and weakness. Which laboratory test would the nurse expect to be ordered?

1. ACreatine kinase (CK)
2. BSerum lipase
3. CCardiac troponin
4. DSerum ammonia

A woman who is 34 weeks pregnant has high blood pressure, right upper abdominal pain, a platelet count of 70 × 10³/µL, raised ALT and AST, and a raised LDH. Which condition fits best?

1. AHELLP syndrome
2. BGestational diabetes
3. CPhysiologic anemia of pregnancy
4. DAcute cholecystitis

Berapa lamakah, secara kira-kira, bagi ubat yang diberi pada selang masa tetap untuk mencapai keadaan mantap?

1. A4 hingga 5 separuh hayat
2. BBergantung pada saiz dos sahaja
3. C10 separuh hayat
4. D1 separuh hayat

Mengapakah pesakit yang mengambil nitrat bertindak panjang dinasihatkan mempunyai tempoh bebas nitrat selama beberapa jam setiap hari?

1. AUntuk mengurangkan risiko pendarahan
2. BUntuk mengelakkan nitrat terkumpul dalam tisu lemak
3. CUntuk membolehkan hati pulih daripada ketoksikan
4. DUntuk mencegah toleransi terhadap nitrat

How should a patient breathe in when using a pressurised metered-dose inhaler without a spacer?

1. ASlowly and deeply while pressing the canister, then hold the breath
2. BNormally, while breathing out through the mouthpiece
3. CAs hard and fast as possible, then press the canister afterwards
4. DIn short gasps through the nose while pressing the canister

After positive end-expiratory pressure (PEEP) is increased on a ventilated patient, the blood pressure falls. What is the most likely reason?

1. APEEP causes immediate blood loss from the alveolar capillaries
2. BPEEP directly weakens the heart muscle and its contraction
3. CPEEP lowers the blood oxygen level
4. DHigher chest pressure reduces venous return to the heart

Mengapakah kateterisasi sendiri berselang sering diajar selepas kecederaan saraf tunjang?

1. APundi kencing mungkin tidak kosong, dan pengosongan secara tetap melindungi buah pinggang
2. BIa menyingkirkan sepenuhnya semua risiko jangkitan saluran kencing
3. CIa melatih pundi kencing untuk membesar secara beransur-ansur dari semasa ke semasa
4. DIa terutamanya digunakan untuk mengukur pengeluaran air kencing dengan tepat

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

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

Dysphagia that started with solids and now includes liquids, with weight loss, most suggests which cause?

1. ASimple anxiety about swallowing tablets
2. BNormal ageing of the swallowing muscles
3. CA dry mouth from drinking too little water
4. DA narrowing such as an oesophageal tumour

A patient taking IV antibiotics has three unexplained loose stools in 24 hours. What should the nurse do first?

1. AWait two days to see if the diarrhoea settles
2. BMove the patient to a bay with other patients to watch them closely
3. CGive loperamide after each loose stool and continue as usual
4. DIsolate the patient and send a stool sample for testing

On day 1 after birth, a woman's white cell count is mildly raised and she has no symptoms. How should this be interpreted?

1. AIt can be normal soon after birth
2. BIt means she has leukaemia
3. CIt shows she is dehydrated
4. DIt proves she has an infection

A woman at 26 weeks receiving terbutaline for preterm contractions has a heart rate of 132/min and chest tightness. What should the nurse do?

1. AIncrease her IV fluids rapidly to lower her heart rate
2. BWithhold the next dose and report the findings
3. CGive the next dose early to stop contractions
4. DReassure her that this is expected and continue

Which instruction about preparing powdered infant formula is correct?

1. AAdd extra water in hot weather so the baby gets more fluid
2. BFollow the stated water-to-powder ratio exactly and do not warm bottles in a microwave
3. CWarm bottles in the microwave, as long as they are shaken first
4. DAdd an extra scoop of powder to each bottle to help a small baby gain weight faster

The mother of a 6-week-old says the baby cries for hours and she fears she might lose control. What is the best advice?

1. AShake the baby gently for a few seconds to stop the crying and calm him
2. BPut the baby safely in the cot, take a few minutes' break and ask for support
3. CGive the baby a little honey on a dummy to settle him at night
4. DHold the baby face down on her lap until he falls asleep, however long it takes

What should a patient starting zolpidem for insomnia be taught to report?

1. AFeeling slightly more rested and alert the next morning than before starting the medicine
2. BDoing things while not fully awake, such as sleepwalking or driving, with no memory of it
3. CSleeping through the night without waking up
4. DFeeling sleepy about 30 minutes after taking it at bedtime

A nurse is teaching a patient with anxiety how to do progressive muscle relaxation. Which instruction is correct?

1. AHold your breath for as long as possible while lying completely still on the floor
2. BTense each muscle group in turn for a few seconds, then let go and notice the difference
3. CDo the exercise only during a panic attack, never at other times
4. DTense all your muscles at once and keep them tight for 10 minutes

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit setinggi 5 kaki 7 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). Semasa satu syif, seorang pesakit mengambil 3 cawan daripada teh, 1½ tsp daripada sirap batuk, 3 tbsp daripada suplemen cecair, 2 fl oz daripada jus. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Seorang kanak-kanak seberat 31 kg dipreskripsikan 4 mg/kg ubat. Larutan stok mengandungi 20 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?

Preskripsi ialah 6200 unit ubat yang datang sebagai 10000 unit/mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

Titisan berjalan pada 30 gtt/min melalui set 60 gtt/mL. Berapa mililiter V yang diterima pesakit dalam 12 jam?

Sebuah beg mengandungi 2 g ubat dalam 500 mL. Arahannya ialah 2 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. Pesakit berberat 83 kg. Cari pengeluaran air kencing purata U dalam mL/kg/j. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu beg 1000 mL dimulakan pada 13:45 dan berjalan dengan pam pada 150 mL/j. Berapa mL V yang tinggal dalam beg pada 15:45?

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan selepas kecederaan kepala membuka mata secara spontan, bercakap dalam ayat tetapi keliru dan menunjukkan respons motor terbaik: menarik anggota daripada tekanan (fleksi normal). Tentukan GCS dan klasifikasikan kecederaan kepala mengikutnya. Klik jawapan anda.

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

Latihan (nilai rekaan, bukan panduan klinikal). Seorang dewasa seberat 46 kg dan setinggi 165 cm. Kira BMI dan klik kategori berat WHO.

1. 1kekurangan berat badan
2. 2berat badan sihat
3. 3berat badan berlebihan
4. 4obesiti kelas I
5. 5obesiti kelas II
6. 6obesiti kelas III