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

Why should the same pain scale be used each time a patient's pain is assessed?

1. ASo the patient learns the right answer to give
2. BBecause only one scale is valid for adults
3. CBecause using different pain scales on one patient is against the law
4. DSo scores can be compared to see whether pain is improving

A patient describes burning, shooting pain with pins and needles in both feet. Which type of pain is most likely?

1. ANeuropathic pain
2. BReferred pain
3. CAcute somatic pain
4. DVisceral pain

Salin steril tertumpah pada langsir steril yang terletak di atas meja tidak steril. Apakah maksudnya?

1. AMedan tercemar, kerana kelembapan boleh membawa organisma menembusi langsir
2. BHanya bahagian yang basah tercemar, jadi item boleh dialihkan ke bahagian yang kering
3. CMedan menjadi steril semula apabila ia kering
4. DMedan kekal steril, kerana salin itu steril

Patients contaminated with radioactive dust arrive at the hospital. Which step removes most of the external contamination?

1. AWrapping the patient in a blanket
2. BRemoving the patient’s clothing
3. CScrubbing the skin until it is red
4. DGiving the patient potassium iodide

A patient reports pain of 8/10. Before giving the prescribed as-needed analgesic, what does the nurse do first?

1. ATell the patient to wait until the next scheduled dose is due in two hours
2. BAsk the nursing assistant to reposition the patient
3. CGive the strongest analgesic on the chart straight away
4. DAssess the location, character and onset of the pain and the vital signs

A patient with SIADH has a serum sodium of 120 mEq/L and is newly confused. Which nursing action has priority?

1. AHelping the patient to walk in the corridor alone
2. BEncouraging the patient to drink plenty of water
3. CSeizure precautions and close neurological checks
4. DTeaching the patient about a low-sodium diet at home

How does ulcerative colitis differ from Crohn's disease?

1. AUlcerative colitis affects only the colon, continuously from the rectum
2. BUlcerative colitis always affects the full thickness of the bowel wall
3. CUlcerative colitis typically causes patchy "skip" lesions
4. DUlcerative colitis can affect any part of the gut from mouth to anus

A nurse teaches a patient with reflux disease. Which statement shows a need for further teaching?

1. A"I will raise the head of my bed with blocks."
2. B"I will cut down on alcohol."
3. C"A big meal just before bed is fine if I take my tablet."
4. D"I will try to lose some weight over the next months."

A patient with chronic kidney disease has a magnesium of 3.8 mEq/L (1.9 mmol/L). Which product is the most likely cause?

1. AExcess alcohol use over many years
2. BProton pump inhibitors taken long term
3. CMagnesium-containing laxatives or antacids
4. DLoop diuretics such as furosemide

A patient in hyperosmolar hyperglycemic state has a glucose of 1,050 mg/dL (58 mmol/L), very dry mucous membranes and a fast pulse. Which treatment is usually the first priority?

1. AStrict fluid restriction
2. BOral glucose-lowering tablets
3. CAn IV bolus of sodium bicarbonate
4. DLarge-volume IV fluid replacement

During a rapid infusion of vancomycin, a patient develops flushing and a red rash on the face, neck and upper body. What is the most likely cause and action?

1. AAcute kidney failure; stop all IV fluids and antibiotics at once
2. BAn infusion reaction; stop or slow the infusion and inform the prescriber
3. CA normal effect; increase the infusion rate to finish sooner
4. DA sign that the infection is spreading; give a second dose

Seorang wanita yang menggunakan pil perancang gabungan mula mengambil karbamazepin untuk epilepsi. Apakah kebimbangan utama?

1. AKegagalan kontraseptif kerana hormon dimetabolismekan lebih cepat
2. BHipoglisemia teruk daripada gabungan itu
3. CTiada kebimbangan, kerana ubat tidak berinteraksi
4. DKetoksikan karbamazepin kerana pil menyekat metabolismenya dengan kuat

A patient is starting doxazosin, an alpha-blocker, for hypertension. Which advice is most important?

1. ATake the first dose at bedtime, as dizziness and fainting can occur
2. BTake it with a large glass of grapefruit juice to improve absorption
3. CStop it suddenly if the heart rate rises after the first few doses
4. DAvoid all potassium-containing foods

Thirty minutes after extubation, a patient develops a high-pitched noise on breathing in and is anxious. SpO₂ is falling. What should the nurse do?

1. AGive a large drink of cold water to soothe the throat and settle it
2. BEncourage the patient to sleep it off and recheck them in an hour
3. CSit the patient up, give oxygen and call for urgent airway help
4. DLay the patient flat and reassure them

When a patient sticks out their tongue, it points to the right. Which nerve is affected?

1. AThe left trigeminal nerve (V)
2. BThe right facial nerve (VII)
3. CThe right hypoglossal nerve (XII)
4. DThe left hypoglossal nerve (XII)

A large pituitary tumour presses on the optic chiasm. Which visual field defect is most typical?

1. ALoss of the outer half of the field in both eyes
2. BLoss of central vision in both eyes
3. CLoss of the inner half of the field in both eyes
4. DComplete blindness in one eye only

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

1. AA narrowing such as an oesophageal tumour
2. BA dry mouth from drinking too little water
3. CNormal ageing of the swallowing muscles
4. DSimple anxiety about swallowing tablets

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

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

A woman at 20 weeks says her gums bleed when she brushes her teeth. What is the best advice?

1. AStop brushing until the bleeding has settled after birth
2. BAvoid all dental visits until after the baby is born
3. CUse a soft brush and keep up routine dental care
4. DReport it at once because it is a sign of a clotting disorder

Seorang wanita yang menerima infusi magnesium sulfat mempunyai kadar pernafasan 10/min dan refleks patela tiada. Apakah yang patut dilakukan oleh jururawat dahulu?

1. AMemberi satu dos nalokson
2. BMenyemak semula refleks dalam 2 jam
3. CMeningkatkan kadar infusi, kerana tanda ini menunjukkan pra-eklampsianya bertambah teruk
4. DMenghentikan infusi dan memanggil pembekal penjagaan dengan segera, dengan kalsium glukonat sedia ada

A family has a 2-year-old. Which advice about medicines at home is best?

1. ACall medicines "sweets" so the child is happy to take them
2. BLock all medicines away, out of reach and sight, in child-resistant containers
3. CRely on child-resistant caps alone, since toddlers are not strong enough to open them
4. DKeep daily medicines in a handbag so they are always at hand

An infant with a large VSD now breathes faster, sweats during feeds and has gained 300 g overnight with puffy eyelids. What does this most likely indicate?

1. AAn allergic reaction to the new high-energy formula started yesterday
2. BDehydration due to sweating during feeds
3. CWorsening heart failure with fluid retention
4. DGood growth thanks to improved feeding

A patient taking oxycodone for chronic pain has also been prescribed diazepam. What is the main safety concern?

1. AThe diazepam will block the pain-relieving effect of oxycodone
2. BThe combination will cause high blood pressure
3. CThere is no interaction between these two drugs
4. DIncreased sedation and respiratory depression

Seorang pesakit meminta jururawat berjanji tidak memberitahu sesiapa bahawa dia merancang untuk membunuh diri. Apakah respons yang terbaik?

1. ABerjanji untuk menyimpan rahsia supaya dia terus bercakap dan mempercayai anda, dan jangan merekodkannya dalam notanya atau memberitahu pasukan
2. BTerangkan dengan baik bahawa anda tidak dapat menyimpan rahsia ini kerana keselamatannya penting, dan anda perlu berkongsinya dengan pasukan
3. CMemberitahunya anda akan memikirkannya
4. DMenukar topik

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit setinggi 6 kaki 8 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). Keputusan kreatinina serum ialah 66 µmol/L. Dengan menggunakan 1 mg/dL = 88.4 µmol/L untuk kreatinina, cari c dalam mg/dL. Bundarkan kepada dua tempat perpuluhan.

Seorang kanak-kanak seberat 36 kg dipreskripsikan 3 mg/kg ubat. Larutan stok mengandungi 20 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?

Seorang kanak-kanak berberat 24 kg dipreskripsi 15 mg/kg setiap dos suspensi oral yang mengandungi 250 mg dalam 5 mL. Berapakah isi padu V yang anda berikan?

Infuskan 1000 mL selama 8 jam dengan set pemberian 10 gtt/mL. Cari kadar titisan R dalam titis seminit. Bundarkan kepada nombor bulat yang terdekat.

Satu infusi 400 mg dalam 500 mL berjalan pada 9 mL/j. Berapa mikrogram seminit 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 infusi 500 mL bermula pada 20:00 dengan 80 mL/j. Selepas 3 jam kadar ditukar kepada 100 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 dinilai dengan skala jatuh Morse: sejarah jatuh dalam 3 bulan yang lalu: tidak; diagnosis sekunder: tidak; alat bantu berjalan: tiada, rehat di katil atau dibantu jururawat; terapi IV atau kunci salina: ya; cara berjalan: normal, rehat di katil atau kerusi roda; status mental: melebih-lebihkan atau melupakan had. Cari jumlah Morse MFS.

Latihan (nilai rekaan, bukan panduan klinikal). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 16/min, SpO₂ 96% dengan oksigen tambahan, tekanan darah 150/90 mmHg, nadi 110/min, sedar, suhu 37.4 °C. Kumpulan risiko klinikal yang manakah pesakit itu termasuk? Klik padanya.

1. 1rendah
2. 2rendah–sederhana
3. 3sederhana
4. 4tinggi