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

An older patient is found to be mildly hypothermic. Which care is most appropriate?

1. AGradual rewarming with blankets and warm surroundings
2. BPutting the patient in a very hot bath straight away
3. CPlacing hot water bottles directly on the skin
4. DGiving an alcoholic drink to warm them up

A dying patient's breathing gets deeper and faster, then shallower, followed by a pause with no breathing, in a repeating cycle. What is this pattern called?

1. AParadoxical breathing
2. BKussmaul breathing
3. CCheyne–Stokes breathing
4. DBiot's breathing

A nurse finds an unlabeled syringe of clear fluid on the medication counter. What should the nurse do?

1. AGive it to the patient whose medication is due
2. BLabel it with the most likely drug name
3. CDiscard it, because its contents cannot be confirmed
4. DAsk nearby staff and use it if someone recognizes it

A woman in late pregnancy is choking and cannot speak or cough. Which technique should the rescuer use?

1. AAbdominal thrusts
2. BChest thrusts
3. CBack blows only
4. DBlind finger sweeps

A nurse has given rapid-acting insulin, and then learns that the patient’s meal tray will be 45 minutes late. What should the nurse do?

1. AGet the patient some carbohydrate food now and check the glucose
2. BAsk the patient to walk around the ward until the food arrives
3. CTell the patient to wait and do nothing until the tray comes
4. DGive a second, smaller dose of insulin when the meal tray finally arrives

Two hours after a femoral cardiac catheterization, the nurse sees blood spreading from the puncture site. What is the first action?

1. ARemove the dressing and leave the site open to the air
2. BRaise the head of the bed so the patient can sit up
3. CApply firm, direct pressure just above the puncture site
4. DAsk the patient to bend the leg at the hip to stop the bleeding

A patient who injects drugs has a fever, a new heart murmur and small dark lines under the nails. What is the likely diagnosis?

1. AMyocardial infarction
2. BRheumatic fever
3. CPericarditis
4. DInfective endocarditis

An older patient with delirium is trying to leave the ward at night, saying he must go home. What is the best initial approach?

1. ALet him leave, because adults can always do as they wish whatever their state
2. BCalmly reassure and redirect him while the team assesses his capacity and safety
3. CGive a sedative straight away without a prescription
4. DPhysically restrain him in bed until the morning so that he cannot fall

A patient without symptoms has a fasting plasma glucose of 132 mg/dL (7.3 mmol/L) on Monday and 138 mg/dL (7.7 mmol/L) on Thursday. What does this show?

1. AThe results are within the normal fasting range
2. BThe results meet the criteria for diabetes
3. CThe results show prediabetes only
4. DThe results show reactive hypoglycemia

A patient with suspected Cushing syndrome takes dexamethasone at night. The next morning, the cortisol is still high. What does this suggest?

1. AThe patient has primary hypothyroidism instead
2. BThe adrenal glands are not able to produce enough cortisol
3. CCortisol is being produced without normal feedback control
4. DThe result is normal, as dexamethasone raises cortisol

Methylergometrine (methylergonovine) is prescribed for postpartum bleeding. Which finding would make the nurse withhold it and check with the prescriber?

1. ATemperature of 37.2 °C (99 °F)
2. BHaemoglobin slightly below normal
3. CBlood pressure of 160/105 mmHg
4. DHeart rate of 88 per minute

A patient on warfarin also takes ginkgo and high-dose garlic supplements and is having minor surgery next week. What should the nurse do?

1. ATell the surgical team, as the supplements can increase bleeding
2. BIgnore the supplements, as natural products are safe with warfarin
3. CAdvise taking extra supplements to improve healing
4. DAdvise stopping warfarin without telling anyone

A patient with a long QT interval develops a polymorphic ventricular tachycardia that twists around the baseline but still has a pulse. Which drug is used first?

1. AIntravenous potassium chloride as a bolus
2. BIntravenous magnesium sulfate
3. COral digoxin
4. DIntravenous adenosine

A patient with obstructive sleep apnoea who uses CPAP at home is having surgery. Which plan is safest after the operation?

1. AUse their CPAP machine and monitor closely, using opioids with caution
2. BNurse the patient lying flat on their back to keep the airway open
3. CLeave the CPAP machine at home, as it is not needed while in hospital
4. DGive extra opioids so the patient sleeps through the night

During continuous bladder irrigation, 3200 mL drains out in a shift. 2500 mL of irrigation fluid was put in. What is the true urine output?

1. A3200 mL
2. B2500 mL
3. C700 mL
4. D5700 mL

Dua hari selepas kecederaan saraf tunjang C5, seorang pesakit cemas, dengan kadar pernafasan 30/min dan kapasiti vital yang menurun. Apakah yang patut dilakukan oleh jururawat?

1. AMembaringkan pesakit mendatar dengan kepala didongakkan untuk membuka saluran udara
2. BMenyemak semula kapasiti vital sekali lagi dalam kira-kira 12 jam
3. CMembuat eskalasi segera: edema saraf tunjang boleh menyebabkan kegagalan pernafasan
4. DMemberikan sedatif untuk memperlahankan pernafasan dan melegakan kebimbangan

In the SBAR communication tool, what belongs under "A"?

1. AThe nurse's assessment of what the problem is
2. BThe patient's admission date only
3. CA list of the patient's allergies only
4. DThe address and phone number of the patient's next of kin

A few hours after thyroid surgery, a patient's neck swells rapidly and they become short of breath with stridor. What is most likely?

1. ANormal swelling after neck surgery
2. BLow blood calcium from the surgery
3. CAn allergy to the wound dressing
4. DA haematoma pressing on the airway

Which statement describes the "4 Ts" causes of postpartum haemorrhage?

1. ATone, trauma, tissue and thrombin
2. BTone, tachycardia, transfusion and tissue
3. CTemperature, tachycardia, tears and time
4. DTrauma, tension, temperature and thrombosis

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

How should a parent respond to a 2-year-old's temper tantrum in a safe place?

1. AStay calm, keep the child safe and do not give in to the demand
2. BSmack the child to show that tantrums are not allowed
3. CGive the child the sweet he wants so the tantrum stops
4. DShout loudly at the child to make the tantrum stop sooner

The mother of a 6-week-old says the baby cries for hours and she fears she might lose control. What is the best advice?

1. APut the baby safely in the cot, take a few minutes' break and ask for support
2. BHold the baby face down on her lap until he falls asleep, however long it takes
3. CShake the baby gently for a few seconds to stop the crying and calm him
4. DGive the baby a little honey on a dummy to settle him at night

Apakah nasihat tentang garam dan cecair yang patut diterima oleh pesakit yang mengambil litium?

1. AAmbil tablet garam setiap hari
2. BIkut diet rendah garam yang ketat dan minum cecair sesedikit mungkin, terutamanya dalam cuaca panas
3. CMinum air sesedikit mungkin
4. DKekalkan pengambilan garam yang stabil dan normal serta minum cecair yang mencukupi, terutamanya dalam cuaca panas atau semasa sakit

A voluntary patient asks to leave the ward now. While talking, he says he plans to jump from a bridge on the way home. What should the nurse do?

1. ATell him to go home now and come back tomorrow morning when he feels calmer and safer
2. BAsk him to promise that he will not jump, and then let him go home on his own
3. CLet him leave, because voluntary patients can always go when they want
4. DStay with him and inform the team at once, so he can be urgently assessed under mental health law

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit setinggi 6 kaki 4 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 8 fl oz daripada jus, 2 cawan daripada teh, 2½ tsp daripada sirap batuk, 3 tbsp daripada suplemen cecair. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Seorang pesakit seberat 97 kg mempunyai luas permukaan badan 1.93 m². Preskripsi ialah 175 mg/m². Cari dos D dalam mg.

Preskripsi ialah 640 mikrogram. Ampul mengandungi 4 mg/mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

Infuskan 500 mL selama 8 jam dengan set pemberian 60 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 750 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. Pesakit berberat 67 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 09:15 dan berjalan dengan pam pada 50 mL/j. Berapa mL V yang tinggal dalam beg pada 12:45?

Latihan (nilai rekaan, bukan panduan klinikal). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 10/min, SpO₂ 88% bernafas udara bilik, tekanan darah 112/68 mmHg, nadi 110/min, sedar, suhu 38.8 °C. Apakah jumlah skor NEWS2?

Latihan (nilai rekaan, bukan panduan klinikal). Pada 5 minit selepas lahir, seorang bayi baru lahir latihan mempunyai badan merah jambu dengan tangan dan kaki biru, kadar denyutan jantung 70/min, menangis, batuk atau bersin apabila dirangsang, sedikit fleksi pada lengan dan kaki dan pernafasan perlahan dan tidak teratur dengan tangisan lemah. Skorkan APGAR dan klik bagaimana skor itu ditafsirkan.

1. 1menenangkan
2. 2tidak normal secara sederhana
3. 3rendah