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

A patient's blood pressure is much higher than in all previous readings. What is the best first step?

1. ATell the patient they are having a stroke
2. BRecord it and give an extra dose of the blood pressure tablet
3. CRecheck it, making sure the technique and cuff size are correct
4. DIgnore it, as it must be a machine error

A patient has been taught to walk with underarm crutches. Which statement shows a need for further teaching?

1. A"I'll rest my weight on the tops of the crutches under my arms."
2. B"I'll keep the crutch tips about a step out to the side and front."
3. C"I'll check the rubber tips regularly for wear."
4. D"I'll take my weight through my hands on the hand grips."

When should the transparent dressing over a peripheral IV site be changed?

1. AEvery hour, so the site can be cleaned again
2. BOnly when the IV catheter is removed, whatever its state
3. COnly when the patient asks for a new dressing
4. DWhen it is damp, loose or visibly soiled

A nurse has raised a safety concern about an order with the prescriber, who dismissed it without addressing it. What should the nurse do next?

1. ARefuse to care for the patient for the rest of the shift until the prescriber apologizes
2. BDiscuss the concern with the patient and let them decide
3. CState the concern clearly a second time and, if still unresolved, use the chain of command
4. DCarry out the order as written, because the prescriber has heard the concern

A patient has taken prednisone (prednisolone in many countries) for several months. Which statement shows a need for further teaching?

1. A“I will tell my dentist and other doctors that I take a steroid.”
2. B“I will take the tablets with food.”
3. C“I will report signs of infection early.”
4. D“I will stop the tablets as soon as I feel better.”

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. CTeaching the patient about a low-sodium diet at home
4. DSeizure precautions and close neurological checks

Why should a urinary catheter drainage bag be kept below the level of the bladder?

1. ATo stop the catheter from falling out
2. BTo prevent urine flowing back into the bladder
3. CTo make the bag easier for the nurse to empty
4. DTo keep the urine warm

Why must severe chronic hyponatraemia be corrected slowly?

1. ASodium given quickly causes immediate cardiac arrest
2. BFast correction causes severe hypoglycaemia and seizures in most patients
3. CToo-rapid correction can cause osmotic demyelination in the brain
4. DFast correction makes the kidneys stop producing urine

A patient with diabetes is found unconscious with a blood glucose of 38 mg/dL (2.1 mmol/L). Which treatment is appropriate?

1. AGlucose tablets placed between the patient's teeth
2. BOrange juice poured slowly into the patient's mouth
3. CA dose of rapid-acting insulin to stabilize the glucose
4. DGlucagon by injection, or IV dextrose as prescribed

Two weeks after a sore throat, a child develops dark (cola-colored) urine, puffy eyes and high blood pressure. Urinalysis shows red cell casts and protein. Which condition is most likely?

1. APost-streptococcal glomerulonephritis
2. BLower urinary tract infection (cystitis)
3. CKidney stone in the ureter
4. DPrerenal acute kidney injury

A patient with a fentanyl patch is given home-care advice. Which instruction is correct?

1. ACut the patch in half if the pain is mild
2. BThrow used patches loose into the household bin with the packaging
3. CApply each new patch over the same skin area
4. DAvoid heating pads, hot baths and saunas over or near the patch

A patient taking a GLP-1 receptor agonist such as semaglutide has severe, constant upper abdominal pain spreading to the back, with vomiting. What should the nurse suspect?

1. AConstipation; a laxative will solve the problem
2. BExpected nausea; the patient should take the next dose with food
3. CHypoglycaemia; the patient should eat sweets and continue as usual
4. DAcute pancreatitis; the drug is stopped and urgent assessment arranged

How do clopidogrel and ticagrelor work?

1. AThey dissolve fibrin in existing clots
2. BThey inhibit the vitamin K-dependent clotting factors in the liver
3. CThey directly inhibit thrombin in the plasma
4. DThey block the platelet ADP (P2Y₁₂) receptor

A ventilated patient is coughing, and the high-pressure alarm sounds. Coarse sounds are heard over the trachea. What should the nurse do first?

1. ADeflate the endotracheal tube cuff fully
2. BIncrease the tidal volume on the ventilator to overcome it
3. CTurn the alarm off and reassess the patient in an hour
4. DAssess the patient and suction if secretions are present

Why should antiepileptic drugs not be stopped suddenly?

1. AThe drugs build up in the body and become toxic after stopping
2. BSudden withdrawal can trigger seizures, including status epilepticus
3. CStopping them suddenly causes a dangerous rise in blood pressure
4. DStopping them suddenly causes permanent damage to the liver and kidneys

Selepas pembedahan, pengeluaran air kencing pesakit ialah 15 mL/j selama 3 jam, dengan nadi 110/min, TD 96/58 mmHg dan membran mukus kering. Apakah punca yang paling mungkin bagi pengeluaran air kencing yang rendah?

1. ADiabetes insipidus selepas anestesia
2. BLebihan cecair daripada cecair IV
3. CAKI prarenal akibat hipovolemia
4. DSIADH disebabkan oleh pembedahan

Skor manakah yang digunakan untuk menilai risiko dalam pendarahan GI atas sebelum endoskopi?

1. ASkor Glasgow-Blatchford
2. BSkor risiko ulser tekanan Waterlow
3. CSkala Koma Glasgow
4. DSkor Wells untuk DVT

An incontinent patient has diffuse, shiny, red and broken skin in the natal cleft and buttocks with irregular edges, not over a bony prominence. What is most likely?

1. AA full-thickness burn
2. BAn arterial ulcer caused by poor circulation
3. CA category 4 pressure ulcer over the sacrum
4. DIncontinence-associated dermatitis

A breastfed baby has jaundice in the first week with poor feeding and few wet nappies. What is the most likely cause?

1. AABO incompatibility
2. BSuboptimal intake jaundice
3. CBiliary atresia with obstruction
4. DBreast milk jaundice

A fetus has severe oligohydramnios from the second trimester. Which complication is a major concern for the newborn?

1. ANeonatal hypoglycaemia
2. BPulmonary hypoplasia
3. CMacrosomia
4. DNeural tube defect

Which newborn problem may be the first sign of cystic fibrosis?

1. APhysiological jaundice
2. BUmbilical hernia
3. CErythema toxicum
4. DMeconium ileus

A baby born at 27 weeks has grunting, chest retractions and rising oxygen needs. Which treatment directly addresses the cause?

1. APhototherapy
2. BOral glucose gel rubbed into the gums
3. CIV antibiotics for 7 days
4. DSurfactant given into the trachea

Selain paras litium, ujian manakah yang dipantau secara berkala dalam rawatan litium jangka panjang?

1. AKetumpatan tulang sahaja
2. BFungsi buah pinggang dan fungsi tiroid
3. CFungsi paru-paru sahaja
4. DUjian pendengaran

An 82-year-old started amitriptyline last week. Which finding is most concerning?

1. AMild constipation that responds to extra fluids and fibre in the diet
2. BFeeling a little drowsy in the evening
3. CNew confusion and difficulty passing urine
4. DA slightly dry mouth

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit setinggi 189 cm. Dengan menggunakan 1 inci = 2.54 cm, cari ketinggian h dalam inci. Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Semasa satu syif, seorang pesakit mengambil 1 tsp daripada sirap batuk, ¼ cawan daripada teh, 1 tbsp daripada suplemen cecair, 6 fl oz daripada jus. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Seorang kanak-kanak seberat 9 kg dipreskripsikan 5 mg/kg ubat. Larutan stok mengandungi 25 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?

Preskripsi ialah 1420 mikrogram. Ampul mengandungi 2 mg/mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

Infuskan 500 mL selama 3 jam dengan set pemberian 20 gtt/mL. Cari kadar titisan R dalam titis seminit. Bundarkan kepada nombor bulat yang terdekat.

Sebuah beg mengandungi 1 g ubat dalam 250 mL. Arahannya ialah 1 mg seminit. Pada kadar R berapakah anda menetapkan pam, dalam mL/j?

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 jumlah pengambilan I dalam mL.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi 1000 mL bermula pada 07:00 dengan 100 mL/j. Selepas 2 jam kadar ditukar kepada 75 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: ya; diagnosis sekunder: ya; alat bantu berjalan: berpegang pada perabot; terapi IV atau kunci salina: ya; cara berjalan: normal, rehat di katil atau kerusi roda; status mental: tahu had sendiri. Cari jumlah Morse MFS.

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