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

A nurse posts about an "interesting patient" on social media without naming them. Why is this a problem?

1. AIt is not a problem because no name was given
2. BIt is not a problem if the account is private
3. CIt is only a problem if the post also includes a photograph of the patient
4. DThe patient may still be identifiable, which breaches confidentiality

Pesakit yang berkeupayaan menolak rawatan yang dipreskripsikan. Apakah yang patut dilakukan oleh jururawat?

1. AMeminta saudara-mara memberi persetujuan sebagai ganti
2. BMemberi rawatan itu juga, kerana ia telah dipreskripsikan dan doktor telah memutuskan ia demi kepentingan terbaik mereka
3. CMenghormati penolakan itu, memastikan mereka memahami akibatnya, memaklumkan pasukan dan mendokumenkannya
4. DMenyembunyikan ubat dalam makanan pesakit

Which household item is a strangulation risk for young children?

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

A nurse calls a provider using SBAR about a patient with falling blood pressure. Which statement is the “Recommendation”?

1. A“He is 72 and had a bowel resection yesterday.”
2. B“I think he needs to be assessed now. Can you come within the next 15 minutes?”
3. C“His blood pressure has fallen from 130/80 to 88/50 over the last two hours.”
4. D“I am calling about Mr. Jansen in room 12, who is hypotensive.”

A patient with a valid do-not-resuscitate order (DNR; called DNACPR in the UK) stops breathing and has no pulse. What should the nurse do?

1. AStart chest compressions but not rescue breaths
2. BCall the cardiac arrest team and let them decide
3. CStart CPR and stop when the family arrives
4. DFollow the DNR order and do not start CPR

A patient with a severe asthma attack had a PaCO₂ of 32 mmHg (4.3 kPa) on arrival. An hour later it is 46 mmHg (6.1 kPa), and the patient seems tired. What does this suggest?

1. AThe asthma is improving, because the PaCO₂ is now near normal
2. BRespiratory muscle fatigue with possible impending respiratory failure
3. CThe patient is hyperventilating even more than before and needs calming
4. DA laboratory error that should be ignored

Which factor is most likely to slow wound healing?

1. AGood blood glucose control
2. BA diet rich in protein
3. CAdequate fluid intake
4. DSmoking

A patient with a COPD exacerbation remains acidotic with a high PaCO₂ despite optimal medical treatment and controlled oxygen. Which treatment is usually considered next?

1. A15 L/min oxygen via a non-rebreathe mask
2. BNon-invasive ventilation
3. CStopping all oxygen therapy
4. DSedation to slow the breathing

Kumpulan dapatan manakah yang sesuai dengan hiperkalsemia?

1. AGelombang T runcing dan kelemahan otot sahaja
2. BDahaga dengan air kencing yang sangat cair sebagai satu-satunya tanda
3. CTetani, kejang otot dan tanda Chvostek yang positif
4. DSembelit, keletihan, kekeliruan dan batu karang

A patient with kidney stones and fatigue has a calcium of 11.6 mg/dL (2.9 mmol/L), a high parathyroid hormone (PTH) and a low phosphate. Which condition is most likely?

1. AHypoparathyroidism
2. BPrimary hyperparathyroidism
3. CCancer-related hypercalcemia
4. DVitamin D deficiency

A patient takes regular paracetamol (acetaminophen) at home. Which teaching point best prevents accidental overdose?

1. AUse paracetamol only on an empty stomach
2. BCheck cold and flu remedies, as many also contain paracetamol
3. CTake paracetamol with alcohol to improve absorption
4. DTake an extra dose if the first one does not work within 10 minutes

In myxoedema coma, why is hydrocortisone often given before or with thyroid hormone?

1. AHydrocortisone prevents the hypoglycaemia caused by levothyroxine
2. BThyroid hormone is inactive unless hydrocortisone is given
3. CThyroid hormone can trigger adrenal crisis if cortisol is also low
4. DHydrocortisone makes thyroid hormone work faster

Seorang pesakit asma menggunakan inhaler pelegaannya lebih daripada tiga kali seminggu. Apakah yang ditunjukkan oleh ini?

1. AAsma terkawal dengan baik dengan pelan semasa
2. BKawalan asma lemah dan rawatan perlu disemak semula
3. CInhaler pencegah tidak lagi diperlukan
4. DInhaler pelega tidak lagi berfungsi dan patut dihentikan

Two days after coronary artery bypass surgery, a patient feels palpitations. The pulse is irregularly irregular at 140/min and BP is 112/70 mmHg. Which rhythm is most likely?

1. ASinus tachycardia
2. BComplete heart block
3. CVentricular fibrillation
4. DAtrial fibrillation

After pressing the plunger of an insulin pen, what should the patient do?

1. AInject a second dose straight away to be sure
2. BPull the needle out at once and rub the site firmly
3. CLeave the needle on the pen for the next injection
4. DKeep the needle in the skin for about 10 seconds

Seorang pesakit strok dengan kelemahan sebelah kanan sedia dipindahkan dari katil ke kerusi. Pendekatan manakah yang paling selamat?

1. AMeletakkan kerusi di sebelah kanan dan mengangkat pada lengan yang lemah
2. BMenarik pesakit bangun pada bahu dan pergelangan tangan kanan
3. CMeminta pesakit berdiri seorang diri dan berjalan ke kerusi
4. DMeletakkan kerusi di sebelah kiri dan berputar ke arahnya

Which early symptoms suggest local anaesthetic systemic toxicity?

1. AA red rash only at the injection site, with no other symptoms
2. BTingling around the mouth, a metallic taste and tinnitus
3. CIncreased hunger and thirst over several hours, with a dry mouth
4. DMild itching of the feet the next day

Which preoperative task can a registered nurse usually delegate to a healthcare assistant (nursing assistant)?

1. ATeaching the patient how to use a PCA pump
2. BAssessing the patient's understanding of the surgery
3. CDeciding whether abnormal results need reporting
4. DRecording baseline vital signs

Which placental hormone causes insulin resistance in the second half of pregnancy?

1. AHuman chorionic gonadotrophin (hCG)
2. BHuman placental lactogen (hPL)
3. COxytocin
4. DRelaxin

A woman with a history of postnatal depression is pregnant again. What is the most appropriate plan?

1. ATell her that breastfeeding will prevent it
2. BPlan early support and monitoring before and after birth
3. CAdvise her that it will not happen again
4. DWait to see whether depression returns after birth

Seorang kanak-kanak perempuan berumur 3 tahun yang dahulu bercakap dalam ayat pendek telah berhenti bercakap dan tidak lagi bertindak balas terhadap namanya. Apakah perkara yang paling penting?

1. AIa bermakna kanak-kanak itu letih dan patut dilihat dalam setahun
2. BKehilangan kemahiran yang telah diperoleh pada mana-mana peringkat umur memerlukan penilaian segera
3. CIa ialah regresi normal pada usia ini
4. DBahasa berkembang secara mendadak, maka ini adalah dijangka

How should a child who is still drowsy after a tonsillectomy be positioned?

1. AFlat on the back with the head tilted backwards
2. BProne with the face directly in the pillow
3. COn the side or semi-prone, so secretions can drain from the mouth
4. DSitting fully upright with the head bent forward on the chest

What should a patient taking chlorpromazine be taught about sun exposure?

1. ASun exposure has no effect while taking this medicine
2. BUse sunscreen and protective clothing, because the skin may burn easily
3. CSunbathe for longer each day to improve mood
4. DAvoid going outside at all, even in winter, for the rest of his life

A 15-year-old tells the school nurse she has been cutting herself and asks her not to tell her parents. What is the best response?

1. ATell her that cutting is a phase that many teenagers go through and it needs no help
2. BPhone her parents at once without telling her
3. CExplain that safety information must be shared, and involve her in how this is done
4. DPromise never to tell anyone about it, so that she keeps trusting the school nurse

Latihan (nilai rekaan, bukan panduan klinikal). Suhu seorang pesakit ialah 37.5 °C. Tukarkan kepada darjah Fahrenheit T dengan °F = °C × 9/5 + 32. Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Semasa satu syif, seorang pesakit mengambil 1½ fl oz daripada jus, ¾ cawan daripada teh, ½ tsp daripada sirap batuk. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Seorang pesakit seberat 63 kg mempunyai luas permukaan badan 1.51 m². Preskripsi ialah 50 mg/m². Cari dos D dalam mg.

Preskripsi ialah 9000 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 8 jam?

Satu beg mengandungi 250 mg ubat dalam 50 mL dan berjalan pada 30 mL/j. Berapa miligram sejam D yang diterima pesakit?

Latihan (nilai rekaan, bukan panduan klinikal). Rekod menunjukkan pengambilan dan pengeluaran seorang pesakit untuk satu syif 8 jam. Infusi IV berjalan pada kadar yang ditunjukkan sepanjang syif. Cari imbangan cecair B = pengambilan − pengeluaran dalam mL (jawapan negatif bermaksud kehilangan bersih). Kira ketulan ais sebagai separuh isi padunya.

Latihan (nilai rekaan, bukan panduan klinikal). Satu beg 1000 mL dimulakan pada 12:45 dan berjalan dengan pam pada 150 mL/j. Berapa mL V yang tinggal dalam beg pada 13:45?

Latihan (nilai rekaan, bukan panduan klinikal). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 32/min, SpO₂ 90% bernafas udara bilik, tekanan darah 88/52 mmHg, nadi 126/min, sedar, suhu 38.8 °C. Apakah jumlah skor NEWS2?

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan dinilai dengan skala Braden: persepsi deria: terhad sepenuhnya; kelembapan: jarang lembap; aktiviti: terhad pada kerusi; mobiliti: tidak bergerak sepenuhnya; pemakanan: sangat lemah; geseran dan ricih: potensi masalah. 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