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

A student nurse is asked to carry out a procedure they have not been trained to do. What should they do?

1. ADo it anyway, carefully, to avoid upsetting the team or delaying care
2. BWatch a video and then do it alone
3. CAsk the patient to talk them through it
4. DExplain that they have not been trained and ask for supervision

Aspirate from a newly placed nasogastric tube has a pH of 7. What should the nurse do?

1. AStart the feed, as a pH of 7 confirms that the tube is in the stomach
2. BPush air down the tube and listen over the stomach
3. CNot use the tube and follow policy, which may mean a chest X-ray
4. DFlush the tube with water and start the feed

A nurse finds a used needle in a patient’s bed linen. What should the nurse do?

1. ARecap it with two hands before throwing it away
2. BPick it up by the hub or with forceps, put it in a sharps container and report it
3. CFold it into the linen and send it to the laundry
4. DLeave it where it is for the housekeeping staff to remove later in the day

A patient’s white cell differential shows a raised number of band (immature) neutrophils, called a “shift to the left”. What does this usually suggest?

1. AAn allergic reaction
2. BA typical viral infection
3. CAn acute bacterial infection
4. DA long-standing parasitic infection

Seorang pesakit yang baru diberitahu dia menghidap kanser menangis, tetapi juga telah muntah beberapa kali dan tidak dapat menahan cecair. Apakah yang ditangani dahulu oleh jururawat?

1. AMuntah dan kehilangan cecair
2. BPengajaran tentang kemoterapi
3. CMenghubungi pendeta hospital
4. DSokongan emosi tentang diagnosis

A patient with major depression has been withdrawn for weeks but is suddenly calm and cheerful and gives away her belongings. What should the nurse suspect?

1. AA side effect of her antidepressant medicine that needs no special action
2. BA full recovery, so observation can be reduced
3. CThat she is getting ready for discharge as planned
4. DA raised risk of suicide, because she may have made a decision

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. AInfective endocarditis
2. BMyocardial infarction
3. CPericarditis
4. DRheumatic fever

Why should chronic hypernatraemia be corrected gradually?

1. AFast correction causes osmotic demyelination from swelling of the kidneys
2. BLowering the sodium too fast can cause cerebral oedema
3. CSlow correction is only needed in children
4. DFast correction causes severe hyperkalaemia

Seorang pesakit sirosis mempunyai albumin 2.2 g/dL (22 g/L). Dapatan manakah yang paling berkaitan?

1. AHiperkalemia
2. BEdema dan asites
3. CPeningkatan keluaran air kencing
4. DTekanan darah tinggi

A patient has painless jaundice, itching, dark urine and pale stools. ALP is markedly raised, conjugated (direct) bilirubin is high and ALT is only mildly raised. What is the most likely cause?

1. ABlockage of bile flow, for example by a tumor in the bile duct
2. BGilbert syndrome, a harmless inherited bilirubin disorder
3. CIncreased breakdown of red blood cells (hemolytic anemia)
4. DAcute viral hepatitis with widespread liver cell damage

How does sucralfate help a peptic ulcer heal?

1. AIt forms a protective coating over the ulcer base
2. BIt kills Helicobacter pylori directly
3. CIt blocks histamine H2 receptors in the stomach
4. DIt neutralises acid by releasing bicarbonate

A patient taking hydralazine for several months develops joint pain, fever and a rash. Anti-histone antibodies are positive. What is the most likely diagnosis?

1. AAn acute viral infection
2. BDrug-induced lupus
3. CGout
4. DRheumatoid arthritis

How does intermittent pneumatic compression help prevent DVT?

1. AIt keeps the legs completely still to protect the veins
2. BIt breaks up and dissolves clots that have already formed in the veins
3. CIt warms the legs gently so the blood becomes thinner and flows faster
4. DIt squeezes the legs in cycles to push venous blood towards the heart

A patient with severe aortic stenosis is prescribed glyceryl trinitrate (nitroglycerin) for chest pain. Why should the nurse use particular caution?

1. AVasodilators can cause a severe fall in BP with a fixed outflow obstruction
2. BGTN makes the narrowed aortic valve tighten further within a few minutes
3. CGTN raises the blood pressure dangerously in aortic stenosis
4. DThere is no reason for caution, because GTN acts only on the coronary arteries

A patient has acute low back pain with no red flags. Which advice is most appropriate?

1. AStay in bed for two weeks until the pain is gone
2. BWear a rigid back brace all day and night for at least three months
3. CAvoid all movement until an MRI scan has been done
4. DStay as active as possible and use simple pain relief

Selepas tiroidektomi total, seorang pesakit menjadi cemas dengan stridor dan bengkak tegang di leher. Apakah yang patut dilakukan oleh jururawat dahulu?

1. AMeletakkan paket ais pada leher dan membaringkan pesakit mendatar
2. BMemberikan analgesia dan menilai semula bengkak dalam sejam
3. CMemanggil bantuan kecemasan: hematoma mungkin menekan saluran udara
4. DMeminta pesakit bercakap sebanyak mungkin untuk menguji suara

A patient had an upper GI endoscopy with a local anaesthetic throat spray. What must the nurse check before giving a drink?

1. AThat the patient has passed urine since the procedure
2. BThat bowel sounds are present in all four quadrants
3. CThat the patient's blood glucose is above normal
4. DThat swallowing and the gag reflex have returned

A patient taking oral capecitabine reports red, painful, peeling palms and soles. What should the nurse do?

1. AReassure that it is a sign of an unrelated allergy to washing powder
2. BTell the patient to take a double dose next time
3. CAdvise hot soaks for the hands and feet
4. DReport it; this is hand-foot syndrome and treatment may need changing

Why is tight glucose control before conception important in women with pre-existing diabetes?

1. AIt prevents the mother from developing pre-eclampsia
2. BIt prevents the need for any monitoring during pregnancy
3. CIt guarantees that the baby will be born at term
4. DEarly hyperglycaemia raises the risk of birth defects

A woman with active genital herpes lesions is admitted in early labour with intact membranes. What should the nurse expect?

1. ARupture of the membranes to speed up labour
2. BA vaginal birth with no special precautions
3. CA caesarean birth to reduce the risk of neonatal herpes
4. DA fetal scalp electrode for close monitoring

A 13-year-old with scoliosis has been prescribed a brace. Which teaching is most important?

1. AWear it only at weekends and in the holidays, when it does not interfere with school
2. BWear it for the prescribed hours each day, with a thin cotton shirt underneath
3. CWear it only when the back hurts, then take it off
4. DWear it over thick clothing to make it more comfortable

A child with a new forearm cast has severe pain not relieved by analgesia and screams when the nurse gently moves the fingers. What should the nurse suspect?

1. AAnxiety; distract the child with play
2. BCompartment syndrome; report it at once
3. CNormal pain after a fracture; give more time
4. DItching under the cast; give an antihistamine

Which item is part of a safety plan for a person experiencing domestic violence?

1. AKeeping all important documents in the shared house
2. BAvoiding contact with friends and support services so as not to provoke him
3. CKeeping an emergency bag with documents, money and keys somewhere safe
4. DTelling the abuser about plans to leave so that he can prepare

A patient with borderline personality disorder says, "If you don't make Anna my nurse again tomorrow, I'll cut myself." What is the most appropriate response?

1. ATake the statement seriously, assess her risk and explain that nursing assignments are decided by the team
2. BAgree to assign Anna to her every day so that she stays safe
3. CTell her that if she cuts herself again, she will be discharged from the ward at once without any follow-up
4. DIgnore the threat, because she is only trying to manipulate staff

Latihan (nilai rekaan, bukan panduan klinikal). Suhu seorang pesakit ialah 35.6 °C. Tukarkan kepada darjah Fahrenheit T dengan °F = °C × 9/5 + 32. Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Keputusan glukosa darah ialah 233 mg/dL. Dengan menggunakan 1 mmol/L = 18 mg/dL untuk glukosa, cari c dalam mmol/L. Bundarkan kepada satu tempat perpuluhan.

Dos 200 mg diperlukan daripada larutan 10% (b/i). Isi padu V manakah yang mengandungi dos ini?

Satu infusi mengandungi 40000 unit ubat dalam 250 mL. Preskripsi ialah 2000 unit sejam. Pada kadar R berapakah anda menetapkan pam, dalam mL/j?

Infuskan 250 mL selama 10 jam dengan set pemberian 60 gtt/mL. Cari kadar titisan R dalam titis seminit.

Satu titisan berjalan pada 40 gtt/min melalui set 15 gtt/mL. Terdapat 900 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 8 jam. Infusi IV berjalan pada kadar yang ditunjukkan sepanjang syif. Cari jumlah pengambilan I dalam mL. Kira ketulan ais sebagai separuh isi padunya.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi 500 mL bermula pada 17:30 dengan 80 mL/j. Selepas 2 jam kadar ditukar kepada 200 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). Satu carta latihan merekodkan GCS 11, dengan E4 dan V3. Apakah skor motor M yang direkodkan, dan respons yang manakah yang dihuraikannya? Berikan nombornya.

Latihan (nilai rekaan, bukan panduan klinikal). Pada 5 minit selepas lahir, seorang bayi baru lahir latihan mempunyai kulit merah jambu di seluruh badan, kadar denyutan jantung 130/min, menangis, batuk atau bersin apabila dirangsang, pergerakan aktif 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