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

Why are older adults at higher risk of dehydration?

1. ATheir kidneys hold on to more water
2. BThey usually drink more than younger adults
3. CThey lose less water through the skin
4. DTheir sense of thirst is often reduced

Which nursing diagnosis is written in the problem–aetiology–signs (PES) format?

1. ATurn the patient every two hours to protect the skin
2. BPneumonia related to a bacterial infection in the right lung
3. CPain related to pain, as shown by the patient saying that it hurts a lot
4. DImpaired skin integrity related to immobility, as shown by a sacral wound

A patient on nasal cannula oxygen has dry lips. Which product should the nurse offer?

1. AAn oil-based lip balm
2. BPetroleum jelly
3. CA scented petroleum ointment
4. DA water-based lip lubricant

Seorang pesakit yang keliru dalam sekatan pergelangan tangan mempunyai jari yang sejuk dan pucat pada satu tangan serta nadi radial yang lemah pada sebelah itu. Apakah yang patut dilakukan oleh jururawat dahulu?

1. AMengetatkan sekatan yang satu lagi untuk menghalang pesakit menarik
2. BMenaikkan tangan di atas bantal, membiarkan sekatan seperti sedia ada
3. CMendokumenkan penemuan dengan teliti dan menyemak semula dalam dua jam
4. DMelonggarkan sekatan itu dan menilai peredaran darah tangan

Dapatan manakah yang tidak dijangka dan memerlukan tindakan susulan segera?

1. APesakit sirosis yang diketahui mempunyai kulit kuning yang tidak berubah
2. BPesakit COPD yang sudah lama mempunyai dada berbentuk tong
3. CPesakit dengan infusi heparin mengalami najis hitam berbau tar yang baharu
4. DPesakit sehari selepas pembedahan pundi hempedu laparoskopi mengalami sakit bahu kanan

A chemical cleaning fluid splashes into a patient’s eye. What should the nurse do first?

1. AGive antibiotic eye drops first
2. BCover the eye with a dry patch and wait for the provider
3. CRub the eye gently with a clean tissue to remove the chemical
4. DFlush the eye with plenty of water or saline straight away

Pemindahan darah hampir bermula. Apakah semakan keselamatan yang paling penting?

1. AMenghangatkan semua darah dalam ketuhar gelombang mikro
2. BMenyemak berat pesakit sahaja
3. CPengenalpastian positif pesakit yang dipadankan dengan komponen darah di sisi katil
4. DMenyemak keutamaan pemakanan pesakit

After a head injury, a patient has clear fluid leaking from the nose. What does this most likely suggest?

1. AAcute sinusitis
2. BA normal and harmless response to head trauma
3. CAllergic rhinitis triggered by the hospital environment
4. DA base-of-skull fracture with a cerebrospinal fluid leak

Seorang pesakit dengan aritmia ventrikel menunjukkan corak berpusing (torsades de pointes) pada monitor. Elektrolit manakah yang lazim diberikan secara IV sebagai rawatan?

1. AKalsium karbonat
2. BKalium fosfat
3. CMagnesium sulfat
4. DNatrium bikarbonat

A patient with blood pressure that is hard to control has a potassium of 2.9 mEq/L, a sodium of 144 mEq/L and a raised serum bicarbonate, without taking a diuretic. Which condition is most likely?

1. APrimary adrenal insufficiency
2. BCentral diabetes insipidus
3. CPrimary hyperaldosteronism
4. DSyndrome of inappropriate ADH

Which drug is used for torsades de pointes?

1. AIntravenous magnesium sulfate
2. BOral digoxin
3. CIntravenous verapamil
4. DIntravenous adenosine (rapid push)

Why is vancomycin given by mouth, not intravenously, for Clostridioides difficile infection?

1. AIntravenous vancomycin causes C. difficile infection
2. BThe oral form is cheaper but has the same effect as IV
3. COral vancomycin is absorbed into the blood better than IV vancomycin
4. DOral vancomycin is not absorbed, so it reaches high levels in the colon

A patient has pneumonia in the right lung only. In which side-lying position will oxygenation usually be best?

1. AFlat on the back with no pillows
2. BLying on the left side, with the healthy lung down
3. CProne with the head down
4. DLying on the right side, with the affected lung down

Which task for a stable patient with heart failure can the registered nurse most appropriately delegate to a healthcare assistant (unlicensed assistive personnel)?

1. AAssessing lung sounds for new crackles
2. BDeciding whether to give the furosemide dose
3. CTeaching the patient about a low-salt diet
4. DMeasuring and recording the morning weight

After a kidney biopsy, which observation is most important?

1. AThe patient's appetite at the next meal
2. BThe temperature every four hours only
3. CThe colour of the patient's skin on the face
4. DSigns of bleeding, such as haematuria and a rising pulse

A kidney transplant recipient has had vomiting and diarrhoea for two days. Why should the transplant team be contacted?

1. AThe patient may not be absorbing their immunosuppressants
2. BThe tablets will make the vomiting stop
3. CThe kidney will start to produce far too much urine
4. DVomiting proves that rejection has already happened

Why are urinary catheters removed as early as possible after surgery?

1. ATo reduce the risk of catheter-associated infection
2. BBecause catheters always cause kidney stones
3. CBecause the catheter stops the bowel working
4. DBecause patients cannot drink normally while a catheter is in place

A surgical patient's MUST score is 3 and the wound is healing slowly. What is the most appropriate action?

1. AEncourage fasting to reduce wound exudate and the size of the dressing
2. BRepeat the score in three months' time
3. CRestrict protein to help the kidneys
4. DRefer to the dietitian, start a nutrition plan and monitor intake

When the Moro reflex is tested, the baby moves only one arm. What could this suggest?

1. AA normal finding in all term babies
2. BLow blood glucose only
3. CA clavicle fracture or nerve injury
4. DHearing loss in the ear on that side

A woman has been breastfeeding for 3 weeks. Her baby has gained little weight, feeds briefly and falls asleep at the breast. What is the most appropriate first action?

1. AAdvise her to stop breastfeeding and use formula only
2. BReassure her that slow weight gain is normal
3. CTell her to feed only every 6 hours to build hunger
4. DObserve a full feed to assess latch and milk transfer

A 2-year-old suddenly began coughing while eating peanuts. He now has a wheeze on one side of the chest only. What is most likely?

1. AViral croup
2. BAn inhaled foreign body
3. CBronchiolitis
4. DA first attack of asthma

Newborn pulse oximetry screening shows 97% in the right hand and 91% in the foot. What does this mean?

1. ANormal transition; no further checks are needed
2. BAn abnormal screen that must be followed up promptly under the screening protocol
3. CA faulty probe or a cold foot; repeat the whole test at the 6-week check
4. DA normal result, because foot readings are always lower

A severely depressed older patient says, "My insides have rotted away; I am already dead." Which type of delusion is this?

1. AErotomanic
2. BPersecutory
3. CGrandiose
4. DNihilistic

The daughter of a man with moderate dementia says she is exhausted, is not sleeping and feels guilty for getting angry with him. What is the most helpful nursing response?

1. ASuggest that she stops visiting him for a few months so that she can rest and forget about her guilt
2. BAcknowledge her strain and discuss support such as respite care and carers' groups
3. CTell her that good daughters do not get angry with their parents
4. DAdvise her to take on more responsibility for his care so that she feels less guilty

Latihan (nilai rekaan, bukan panduan klinikal). Satu pengiraan dos untuk suntikan memberikan 7.4268 mL. Peraturan dalam latihan ini ialah isi padu 1 mL atau lebih dibundarkan kepada persepuluh mL yang terdekat. Apakah nilai x yang anda rekodkan?

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

Sebuah vial mengandungi serbuk 500 mg. Label menyatakan: tambah 4.6 mL air untuk suntikan untuk mendapatkan jumlah isi padu 5 mL. Preskripsi ialah 200 mg. Berapakah isi padu V larutan yang dilarutkan semula yang anda berikan?

Anda perlu menyediakan 250 mL larutan 0.5% (w/v) daripada larutan stok 50% (w/v). Berapa banyak air W yang mesti ditambah pada stok?

1000 mL diarahkan selama 12 jam. Selepas 7 jam anda mendapati 530 mL masih ada dalam beg, dan arahan itu mesti masih siap tepat pada masanya. Kepada kadar R dalam mL/j berapakah pam mesti ditetapkan semula?

1500 mL diarahkan selama 6 jam. Selepas 2 jam anda mendapati 1300 mL masih ada dalam beg, dan arahan itu mesti masih siap tepat pada masanya. Berapa peratus Δ kadar pam asal mesti dinaikkan?

Latihan (nilai rekaan, bukan panduan klinikal). Rekod menunjukkan pengambilan dan pengeluaran seorang pesakit untuk satu syif 8 jam. Pesakit berberat 69 kg. Cari pengeluaran air kencing purata U dalam mL/kg/j. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi 500 mL bermula pada 10:00 dengan 120 mL/j. Selepas 2 jam kadar ditukar kepada 50 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 mempunyai nadi 124/min dan tekanan darah 161/89 mmHg. Cari indeks kejutan SI = HR/SBP. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan dinilai dengan skala Braden: persepsi deria: tiada gangguan; kelembapan: jarang lembap; aktiviti: terlantar di katil; mobiliti: tiada had; pemakanan: cemerlang; 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