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

Skor Skala Koma Glasgow manakah yang menunjukkan pesakit yang sepenuhnya peka?

1. A12
2. B3
3. C15
4. D10

A patient taking furosemide has a serum potassium of 3.0 mmol/L (3.0 mEq/L). Why is this important?

1. AFurosemide raises potassium, so this level is falsely low and can be ignored
2. BThe level is normal and needs no action
3. CLow potassium only causes mild thirst
4. DLoop diuretics cause potassium loss, and low levels can cause arrhythmias

A parent says, “I tell my son his medicine is candy so he takes it.” What should the nurse teach?

1. ADo not call medicine candy, because the child may take it when no one is watching
2. BThis is a good idea and makes giving medicine easier
3. CIt only matters for medicines that taste bitter or are hard to swallow
4. DIt is fine as long as the medicine is kept in the fridge

Seorang jururawat yang bekerja dengan pesakit yang menjalani langkah berjaga-jaga sentuhan menyedari gaun mempunyai koyakan pada lengan baju. Apakah yang patut dilakukan oleh jururawat?

1. AMemakai gaun kedua di atas gaun yang koyak
2. BMenutup koyakan dengan secebis pita dan meneruskan
3. CTerus bekerja, kerana koyakan itu kecil dan hanya pada lengan baju
4. DMenjauhi pesakit, menanggalkan PPE dengan selamat di pintu, membersihkan tangan dan memakai gaun baharu

A parent of a child with influenza talks with the nurse. Which statement shows a need for further teaching?

1. A“I will call if my child has trouble breathing.”
2. B“I will give my child aspirin to bring the fever down.”
3. C“I will give my child plenty of fluids.”
4. D“I will keep my child home from school and away from others while unwell.”

A patient with untreated hyperthyroidism has surgery and develops a temperature of 40 °C, a heart rate of 160/min and severe agitation. What is most likely happening?

1. AA normal reaction to pain
2. BOpioid withdrawal
3. CThyroid storm
4. DMyxedema coma

Why is lactulose given to a patient with hepatic encephalopathy?

1. ATo stop bleeding from varices
2. BTo lower the blood glucose
3. CTo reduce the absorption of ammonia from the gut
4. DTo increase the liver's production of albumin

A patient with type 1 diabetes is nil by mouth before surgery. Why must their insulin not simply be stopped?

1. AWithout any insulin they can develop diabetic ketoacidosis
2. BInsulin is needed for the anaesthetic to work
3. CInsulin prevents wound infection on its own
4. DStopping insulin causes immediate hypoglycaemia during the operation

A patient has burning on urination and frequency. The dipstick is positive for nitrites and leukocyte esterase, and a urine culture is ordered. When should the sample be taken?

1. AAfter the symptoms have fully settled
2. BAfter 3 days of antibiotic treatment
3. CAt any time, as antibiotics do not matter
4. DBefore the first dose of antibiotic

A child with sickle cell disease and a recent viral illness is pale and tired. The hemoglobin has fallen sharply, and the reticulocyte count is very low. What is the most likely problem?

1. AA normal finding in sickle cell disease
2. BA vaso-occlusive pain crisis in the bones
3. CIron deficiency from a poor diet over months
4. DAn aplastic crisis, often caused by parvovirus B19

Which blood test is used to monitor warfarin therapy?

1. AINR (prothrombin time)
2. BPlatelet count
3. CActivated partial thromboplastin time (aPTT)
4. DSerum albumin

A patient who used cocaine has chest pain, agitation, a high temperature, sweating, tachycardia and dilated pupils. Which drug class is commonly first-line for the agitation and sympathetic overactivity?

1. AAnticholinergic drugs
2. BOpioid antagonists
3. CBenzodiazepines
4. DAntihistamines

Which finding shows that long-standing hypertension has caused target organ damage?

1. AA heart rate of 72/min
2. BA normal fasting glucose
3. CLeft ventricular hypertrophy on the ECG
4. DClear lung fields on the chest X-ray

Seorang pesakit yang diventilasi dalam penjagaan kritikal berisiko mengalami pneumonia berkaitan ventilator. Langkah kejururawatan manakah yang membantu mengurangkan risiko ini?

1. AMengekalkan pesakit mendatar untuk melindungi tiub endotrakeal
2. BMengekalkan kepala katil dinaikkan pada 30–45°
3. CMengelakkan penjagaan mulut untuk mencegah gusi berdarah
4. DMenukar tiub ventilator setiap beberapa jam

A patient with untreated hyperthyroidism is losing weight. Which diet is most appropriate until the condition is controlled?

1. AA diet very high in caffeine for energy
2. BA strict low-protein diet
3. CA low-calorie diet to protect the heart
4. DA high-calorie diet with enough protein

After removal of a cortisol-producing adrenal adenoma, why may the patient need hydrocortisone for months?

1. AHydrocortisone helps the wound to heal
2. BThe operation always removes both adrenal glands
3. CThe tumour will grow back quickly without it
4. DThe other adrenal gland has been suppressed

Seorang pesakit dengan konduit ileal (urostomi) bimbang tentang mukus dalam air kencing. Apakah penjelasan yang betul?

1. AIa tanda batu karang buah pinggang dan mesti dilaporkan hari ini
2. BIa normal, kerana konduit dibuat daripada usus kecil
3. CIa bermakna stoma gagal dan memerlukan pembedahan
4. DIa menunjukkan sekatan usus sedang berkembang

Seorang pesakit yang dipasang stent koronari dua bulan lalu, mengambil aspirin dan klopidogrel, hadir dengan melena dan kini stabil. Apakah pendekatan yang paling sesuai terhadap ubat antiplatelet?

1. AMenghentikan kedua-dua ubat secara kekal, kerana sebarang pendarahan bermakna ia tidak lagi selamat
2. BMelaporkan pendarahan; pasukan memutuskan dengan input kardiologi, menimbang pendarahan berbanding trombosis stent
3. CMenggandakan kedua-dua dos, kerana pendarahan bermakna stent berisiko lebih besar untuk berbekuan
4. DMeneruskan kedua-dua ubat tanpa perubahan dan tidak menyebut pendarahan kepada pasukan

Dapatan manakah yang menunjukkan kemurungan selepas bersalin dan bukan baby blues?

1. ATangisan dan perubahan emosi pada hari ke-3 yang reda dalam beberapa hari tanpa rawatan
2. BBerasa letih selepas malam bersama bayi yang menangis
3. CBerasa beremosi apabila pelawat pulang
4. DMood yang rendah dan hilang minat yang berlangsung lebih daripada 2 minggu dan menjejaskan kehidupan harian

A woman with known mitral stenosis is pregnant. When is she at greatest risk of heart failure?

1. AWhen blood volume peaks in late pregnancy and in the hours after birth
2. BOnly in the first trimester, when nausea is worst
3. CRisk is the same at every point in pregnancy
4. DOnly during the first stage of labour

Which medicine may be used to close a patent ductus arteriosus in a preterm baby?

1. AProstaglandin E1
2. BIbuprofen or indomethacin
3. CSalbutamol
4. DIntravenous furosemide infusion

A teenager with severe anorexia nervosa starts nutritional rehabilitation. Which blood result is most important to watch in the first days?

1. AAmylase
2. BPhosphate
3. CBilirubin
4. DCholesterol

Which nurse statement is most consistent with motivational interviewing?

1. A"I've decided that you need to stop drinking completely."
2. B"If you don't stop drinking now, you'll die."
3. C"You're an alcoholic, and you need to admit it."
4. D"What would be different for you if you drank less?"

In the working phase of the relationship, a patient who has been talking openly starts missing sessions and changes the subject whenever her childhood is mentioned. What is the best interpretation?

1. AShe may be showing resistance as painful topics come closer, which the nurse can gently explore
2. BThe nurse has made a serious mistake and should hand her care to a colleague immediately
3. CShe no longer needs any help, so the sessions should end at once
4. DShe is being rude to the nurse on purpose and should be warned

Latihan (nilai rekaan, bukan panduan klinikal). Suhu seorang pesakit ialah 105.1 °F. Tukarkan kepada darjah Celsius T dengan °C = (°F − 32) × 5/9. Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Semasa satu syif, seorang pesakit mengambil 4 tbsp daripada suplemen cecair, 1 tsp daripada sirap batuk, ½ fl oz daripada jus, 1½ cawan daripada teh. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Seorang kanak-kanak seberat 19 kg dipreskripsikan 10 mg/kg ubat. Larutan stok mengandungi 50 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?

Seorang pesakit setinggi 166 cm dan seberat 55 kg. Preskripsi ialah 175 mg/m². Dengan menggunakan formula Mosteller BSA = √(tinggi (cm) × berat (kg)/3600), cari dos D dalam mg.

Titisan berjalan pada 30 gtt/min melalui set 60 gtt/mL. Berapa mililiter V yang diterima pesakit dalam 2 jam?

1000 mL diarahkan selama 6 jam. Selepas 3 jam anda mendapati 570 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 97 kg. Cari pengeluaran air kencing purata U dalam mL/kg/j. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu beg 500 mL dimulakan pada 08:45 dan berjalan dengan pam pada 60 mL/j. Berapa mL V yang tinggal dalam beg pada 16:15?

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit mempunyai nadi 62/min dan tekanan darah 113/62 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: sentiasa lembap; aktiviti: terlantar di katil; mobiliti: tiada had; pemakanan: mungkin tidak mencukupi; 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