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

In which direction should a female patient's perineum be cleaned?

1. AEither way, as long as soap is used
2. BIn circles starting at the anus
3. CFrom back to front
4. DFrom front to back

According to the gate control theory, why can rubbing a bumped elbow ease the pain?

1. ARubbing removes the damaged tissue from the elbow
2. BRubbing makes the elbow numb by stopping its blood supply
3. CTouch signals reduce pain signals passing up the spinal cord
4. DRubbing increases the release of pain chemicals so the nerves tire out

A portable x-ray is taken at the bedside. Which action protects the nurse?

1. AStand next to the patient and hold the film without protection
2. BStep away from the patient or wear a lead apron during the exposure
3. CStay close to the patient to keep them still without protection
4. DLook directly at the x-ray tube during the exposure to check its position

Semasa penukaran pembalut talian pusat yang steril, seorang rakan sekerja menjangkau melintasi medan steril yang terbuka untuk menyerahkan segulung pita kepada jururawat. Apakah yang patut dilakukan oleh jururawat?

1. AMenganggap medan tercemar dan menyediakan yang baharu
2. BMengeluarkan hanya item yang paling hampir dengan tempat lengan itu melintas
3. CMeneruskan, kerana rakan sekerja tidak menyentuh sebarang item steril
4. DMenutup medan dengan tuala steril dan meneruskan di atasnya

Seorang pembantu jururawat menolak tugas yang didelegasikan, dengan berkata dia belum dilatih melakukannya. Apakah respons terbaik daripada jururawat?

1. AMelaporkan pembantu kepada pengurus kerana menolak tugas
2. BMeninggalkan tugas itu untuk syif seterusnya, apabila ada orang terlatih yang bertugas
3. CBerterima kasih kepada pembantu, pastikan tugas dilakukan dengan selamat dan aturkan latihan
4. DMemberitahu pembantu bahawa ia ada dalam huraian kerja dan mesti dilakukan

Seorang pesakit menerima pemakanan parenteral melalui talian pusat. Dapatan manakah yang memerlukan tindakan segera?

1. APertambahan berat 0.2 kg sejak semalam
2. BPembalut yang kering dan utuh di atas talian
3. CBerpeluh, menggeletar dan glukosa 62 mg/dL (3.4 mmol/L) selepas infusi terhenti tanpa dijangka
4. DGlukosa 150 mg/dL (8.3 mmol/L) semasa infusi sedang berjalan

Seorang pesakit mengalami sakit abdomen berkolik, abdomen bengkak, muntah dan tidak melepaskan najis atau angin selama dua hari. Apakah masalah yang mungkin?

1. AHalangan usus
2. BApendisitis tanpa komplikasi
3. CSindrom usus mudah rangsang
4. DGastroenteritis

A patient with a central venous catheter needs the line removed. Which position reduces the risk of air embolism during removal of a neck or chest line?

1. ALying on the right side with the legs raised
2. BSitting fully upright and taking a deep breath in as the line comes out
3. CLying flat or slightly head-down, holding the breath or breathing out
4. DStanding up and walking

Seorang pesakit dengan infusi heparin mempunyai aPTT 110 saat; sasaran protokol ialah 1.5–2.5 kali kawalan 30 saat. Apakah yang patut dilakukan oleh jururawat?

1. ABeri vitamin K seperti yang ditetapkan dan teruskan infusi
2. BTingkatkan kadar infusi, kerana keputusan berada di atas julat sasaran
3. CIkut protokol heparin, periksa pendarahan dan maklumkan pembekal penjagaan
4. DTeruskan tanpa perubahan dan ulang aPTT pada pagi esok

The nurse teaches a patient starting lithium. Which statement shows a need for further teaching?

1. A"I will tell my doctor if I have vomiting or diarrhea"
2. B"I will check with the pharmacist before taking ibuprofen"
3. C"I will drink plenty of fluids, especially in hot weather"
4. D"I will cut out salt from my diet completely to stay healthy"

Which technique is correct when giving subcutaneous enoxaparin from a prefilled syringe?

1. AExpel the air bubble from the syringe first, then inject into the deltoid muscle
2. BInject into the abdomen away from the navel and do not rub the site afterwards
3. CInject into a vein on the back of the hand
4. DMassage the site well for one minute after the injection

A patient has received a sodium nitroprusside infusion for several days. He becomes confused and develops a metabolic acidosis. What should be suspected?

1. AAn allergic reaction to the plastic of the infusion bag
2. BHyperkalaemia from the infusion
3. CHypoglycaemia from nitroprusside
4. DCyanide toxicity from nitroprusside breakdown

How do clopidogrel and ticagrelor work?

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

A patient with a large pericardial effusion has a systolic pressure that falls by more than 10 mmHg during inspiration. What is this finding called?

1. AA pulse deficit
2. BA collapsing pulse
3. CPulsus alternans
4. DPulsus paradoxus

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

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

Which task can the registered nurse delegate to a trained healthcare assistant (nursing assistant)?

1. AAssessing a confused patient whose glucose is 2.6 mmol/L (47 mg/dL)
2. BTeaching a new patient how to inject insulin
3. CChecking pre-meal glucose and reporting results out of range
4. DDeciding the dose of correction insulin from the glucose result

Which statement about pain in older adults is correct?

1. AOlder adults feel less pain because nerves wear out
2. BThey may under-report pain, so active assessment is needed
3. COpioids must never be used in people over 70
4. DPain is a normal part of ageing and does not need any treatment at all

A patient with haematemesis becomes drowsy and starts to vomit blood again. What is the immediate priority?

1. AComplete the admission paperwork and medication history
2. BSend a stool sample for faecal occult blood testing
3. CTurn the patient onto their side to protect the airway
4. DGive a large glass of iced water to slow the bleeding

A pregnant woman takes warfarin for a mechanical heart valve. Why is she usually switched to heparin for much of the pregnancy?

1. AHeparin can be taken as a tablet once a day
2. BWarfarin crosses the placenta and can harm the fetus
3. CHeparin crosses the placenta better and also protects the fetus
4. DWarfarin is ineffective in pregnancy

After a severe postpartum haemorrhage, a woman cannot breastfeed because her milk does not come in, and she feels very tired. Which condition should be suspected?

1. ABreast engorgement
2. BSheehan syndrome
3. CPostpartum thyroiditis
4. DMastitis

Langkah manakah yang menjadi teras dalam pengurusan krisis vaso-oklusif (kesakitan) dalam penyakit sel sabit?

1. ASuplemen zat besi
2. BCecair, pelega sakit yang berkesan dan oksigen jika kanak-kanak hipoksik
3. CSekatan cecair untuk melindungi buah pinggang dan kompres sejuk pada kawasan yang sakit
4. DRehat di katil yang ketat tanpa analgesik

A child on a morphine infusion is very hard to wake, with a respiratory rate of 8 per minute and pinpoint pupils. What should the nurse do first?

1. AGive a sedative to keep the child calm
2. BStop the infusion, support breathing and give naloxone as per protocol
3. CLet the child sleep, as this shows the pain is controlled
4. DReduce the infusion rate slightly and recheck the child's breathing in an hour

A patient says, "Nobody at work likes me." Which nurse response best reflects cognitive restructuring?

1. A"You should find a new job where people like you."
2. B"Why do you care what people at work think?"
3. C"I'm sure everybody likes you."
4. D"What evidence do you have that nobody likes you?"

A patient with depression and a family history of bipolar disorder started an antidepressant 2 weeks ago. He now sleeps 3 hours a night, talks rapidly and is spending large amounts of money. What should the nurse suspect?

1. ANormal relief and extra energy now that his depression has finally lifted after the treatment
2. BA switch into mania or hypomania triggered by the antidepressant
3. CSerotonin syndrome caused by a high dose
4. DThe expected improvement in mood from the antidepressant

Latihan (nilai rekaan, bukan panduan klinikal). Satu pengiraan dos untuk suntikan kecil memberikan 0.86315 mL. Peraturan dalam latihan ini ialah isi padu di bawah 1 mL dibundarkan kepada perseratus mL yang terdekat. Apakah nilai x yang anda rekodkan?

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi memberikan 0.5 mg/h. Nyatakan kadar dos ini D dalam mcg/min. Bundarkan kepada satu tempat perpuluhan.

Dos 50 mg diperlukan daripada larutan 2% (b/i). Isi padu V manakah yang mengandungi dos ini?

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

Satu infusi diarahkan pada 90 mL/j, tetapi tiada pam tersedia. Ia berjalan secara graviti melalui set pemberian 10 gtt/mL. Cari kadar titisan R dalam titisan seminit.

Satu beg mengandungi 1000 mg ubat dalam 100 mL dan berjalan pada 10 mL/j. Berapa miligram sejam 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).

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi 500 mL bermula pada 09:00 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). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 18/min, SpO₂ 99% bernafas udara bilik, tekanan darah 150/90 mmHg, nadi 70/min, bertindak balas kepada kesakitan sahaja, suhu 37.9 °C. Apakah jumlah skor NEWS2?

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 155/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