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

What is the correct order of techniques when assessing the abdomen?

1. AAuscultation, palpation, inspection, percussion
2. BInspection, palpation, percussion, auscultation
3. CInspection, auscultation, percussion, palpation
4. DPalpation, inspection, auscultation, percussion

Three days after abdominal surgery, a patient coughs and the wound opens with bowel visible. What should the nurse do first?

1. APush the bowel gently back into the abdomen, then apply a firm bandage over it
2. BLeave the wound uncovered so the surgeon can see it
3. CSit the patient fully upright and ask them to cough again
4. DCover it with sterile saline-soaked dressings and call for urgent help

Which technique is correct when collecting a wound culture?

1. AClean the wound with sterile saline first, then swab clean tissue
2. BUse one swab to sample two different wounds
3. CCollect the sample only after antibiotics have been started
4. DSwab the old pus on the dressing that was just removed from the wound

A patient who speaks little English is being discharged with new medications. The patient’s 12-year-old child offers to interpret. What should the nurse do?

1. AGive written instructions in English only
2. BUse a professional medical interpreter
3. CUse simple English and many hand gestures
4. DLet the child interpret, because the family prefers it

Tugas manakah yang paling sesuai untuk didelegasikan oleh RN kepada LPN/LVN?

1. AMemulakan unit pertama sel darah merah
2. BMelakukan penilaian kemasukan pesakit baharu
3. CMemasukkan kateter kencing tetap pada pesakit yang stabil
4. DMemberi pengajaran discaj kepada pesakit yang baru memulakan insulin

Which finding after a laparoscopic cholecystectomy is expected and needs only reassurance and comfort measures?

1. AYellow skin with dark urine on the second day
2. BA heart rate of 125/min with a falling blood pressure
3. CIncreasing abdominal pain with a temperature of 39 °C
4. DRight shoulder pain from the gas used during surgery

A patient has lost more than 10% of their body weight without trying over the last few months and has a low BMI. What is the most appropriate action?

1. AWeigh the patient again in six months and review at that point
2. BRestrict fluids to encourage appetite and give a low-protein diet instead
3. CRefer to the dietitian and start a nutrition care plan with food charts
4. DEncourage a low-calorie diet

A patient has new facial weakness. Which feature suggests a stroke rather than Bell's palsy?

1. AThe patient has had a recent cold
2. BThe whole of one side of the face, including the forehead, is weak
3. CThe patient has pain behind the ear
4. DThe forehead can still be wrinkled on the affected side

A stable adult who is not bleeding receives one unit of packed red cells. By about how much is the hemoglobin expected to rise?

1. AAbout 3 g/dL (30 g/L)
2. BAbout 0.1 g/dL (1 g/L)
3. CAbout 5 g/dL (50 g/L)
4. DAbout 1 g/dL (10 g/L)

Corak keputusan manakah yang sesuai dengan SIADH?

1. ANatrium serum rendah, osmolaliti serum tinggi dan air kencing cair
2. BNatrium serum rendah, osmolaliti serum rendah dan air kencing pekat
3. CNatrium serum tinggi, osmolaliti serum tinggi dan air kencing sangat cair
4. DNatrium normal dengan air kencing sangat cair

Mengapakah NSAID seperti ibuprofen meningkatkan risiko ulser perut?

1. AIa meningkatkan bilangan bakteria Helicobacter pylori dalam perut
2. BIa mengurangkan prostaglandin pelindung dalam lapisan perut
3. CIa menaikkan pH asid gastrik
4. DIa melarutkan lapisan mukus secara langsung

A patient with type 2 diabetes starts a high dose of prednisolone for a flare of COPD. Which change should the nurse expect?

1. ALower potassium only, with no effect on glucose
2. BLower blood glucose, so the diabetes medicines should be stopped
3. CHigher blood glucose, so more frequent glucose checks are needed
4. DNo change in glucose, as steroids act only in the lungs

A patient's blood pressure is 120/60 mmHg. What is the approximate mean arterial pressure?

1. A100 mmHg
2. B80 mmHg
3. C90 mmHg
4. D60 mmHg

A patient has been on continuous NIV via a full-face mask for two days. Which nursing measure helps prevent the most common complication?

1. ATighten the straps as far as they will go to stop any leak
2. BRemove the mask for an hour each time the alarm sounds
3. CUse the same mask size for every patient
4. DCheck mask fit and protect the bridge of the nose

Lima belas minit selepas rawatan dengan tablet glukosa, glukosa pesakit telah meningkat daripada 3.2 kepada 5.1 mmol/L. Waktu makan seterusnya ialah dua jam lagi. Apakah yang patut berlaku seterusnya?

1. AMemberikan dos biasa insulin bertindak pantas serta-merta
2. BMemberikan dos tablet glukosa lagi untuk menaikkannya lebih tinggi
3. CMemberikan snek karbohidrat bertindak lebih lama, seperti sandwic
4. DTiada tindakan lanjut diperlukan sehingga makanan seterusnya dihidangkan kemudian

During a TURP, a patient becomes confused and nauseated, with a slow pulse and a raised BP. The sodium is 121 mmol/L. What is most likely?

1. AA normal reaction to the spinal anaesthetic
2. BHypoglycaemia from fasting for many hours before surgery
3. CAn allergic reaction to the catheter
4. DTURP syndrome from absorbed irrigation fluid

Which advice helps a patient with haemorrhoids?

1. ASit on the toilet for long periods to empty fully
2. BEat less fibre so that stools are smaller
3. CEat more fibre, drink enough fluid and avoid straining
4. DTake a codeine-based painkiller every day

Seorang berumur 74 tahun dengan penyakit buah pinggang kronik mengalami kesakitan teruk selepas pembedahan. Isu opioid manakah yang paling penting?

1. AMetabolit morfin terkumpul, jadi dos yang lebih rendah atau opioid lain mungkin diperlukan
2. BOpioid tidak boleh sekali-kali digunakan pada warga emas, apa pun kesakitannya
3. CFungsi buah pinggang tidak memberi kesan terhadap cara opioid dikendalikan
4. DMorfin ialah opioid paling selamat dalam kegagalan buah pinggang, jadi dos boleh dinaikkan dengan bebas

A woman at 28 weeks asks why her heart rate is higher than before pregnancy. Which response is accurate?

1. AA rise of about 10 to 15 beats per minute is normal in pregnancy
2. BThe heart rate rises because blood pressure is much higher in pregnancy
3. CA higher heart rate in pregnancy always points to heart disease
4. DHeart rate normally falls in pregnancy, so this needs urgent review

A newborn has excessive frothy saliva and chokes and turns blue with the first feed. What is the priority?

1. AContinue feeding more slowly
2. BPlace the baby on its back to sleep
3. CStop feeding and report it urgently
4. DGive the baby water instead of milk

If the MMR and varicella vaccines are not given on the same day, what is the general rule?

1. ASeparate them by at least 1 week
2. BGive the second within 24 hours of the first
3. CSeparate them by at least 4 weeks
4. DNever give both vaccines in the same year

A 4-year-old chokes on a sweet but is coughing forcefully and can speak. What should the nurse do?

1. ADo a finger sweep of the mouth to find the sweet
2. BEncourage her to keep coughing and stay with her, watching closely
3. CGive her a large drink of water to try to wash the sweet down
4. DGive back blows straight away to dislodge the sweet

Which question is the best way to ask a patient about suicidal thoughts?

1. A"You're not thinking of doing anything silly, are you?"
2. B"You wouldn't hurt yourself, would you?"
3. C"Things aren't that bad, are they?"
4. D"Are you having thoughts of killing yourself?"

A patient who stopped drinking 24 hours ago has a generalised tonic-clonic seizure in bed. What is the nurse's first action?

1. AProtect the airway and keep him safe from injury
2. BRestrain his arms and legs to stop the movements
3. CGive oral thiamine with a glass of water
4. DPut something in his mouth to stop him biting his tongue

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit setinggi 5 kaki 3 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, 4 fl oz daripada jus, 3 tsp daripada sirap batuk, 3 tbsp daripada suplemen cecair. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Seorang pesakit berberat 45 kg. Dos yang dipreskripsikan ialah 7.5 mg/kg sehari, diberi dalam 3 dos yang sama. Berapakah miligram D yang diberi bagi setiap dos?

Seorang pesakit seberat 94.6 lb. Preskripsi ialah 1 mg/kg sebagai dos tunggal, dan stok mengandungi 40 mg dalam 1 mL. Dengan menggunakan 1 kg = 2.2 lb, berapakah isi padu V yang anda berikan? Bundarkan kepada satu tempat perpuluhan.

Infuskan 1500 mL selama 8 jam dengan set pemberian 20 gtt/mL. Cari kadar titisan R dalam titis seminit. Bundarkan kepada nombor bulat yang terdekat.

Satu titisan berjalan pada 50 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 beg 1000 mL berjalan dengan pam pada 60 mL/j. Pada 09:00, 100 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). Seorang pesakit latihan dinilai dengan skala Braden: persepsi deria: terhad sepenuhnya; kelembapan: sentiasa lembap; aktiviti: terlantar di katil; mobiliti: tidak bergerak sepenuhnya; pemakanan: mungkin tidak mencukupi; geseran dan ricih: tiada masalah ketara. Gunakan jalur 19–23 tiada risiko, 15–18 ringan, 13–14 sederhana, 10–12 tinggi dan 9 atau kurang sangat tinggi. Klik tahap risikonya.

1. 1tiada risiko
2. 2risiko ringan
3. 3risiko sederhana
4. 4risiko tinggi
5. 5risiko sangat tinggi