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

What does the Visual Infusion Phlebitis (VIP) score assess?

1. AThe patient's eyesight before surgery
2. BThe risk of an allergic reaction to IV drugs
3. CThe cannula site for signs of phlebitis
4. DThe speed of an infusion pump

A colleague asks the nurse to countersign the controlled drug register for a dose the nurse did not see being prepared or given. What should the nurse do?

1. ASign it later, at the end of the shift, once the colleague explains
2. BSign, but only if the colleague is senior
3. CRefuse, as they can only sign for what they have witnessed
4. DSign, as the colleague is trustworthy

A nurse wants to set up a sterile field in the morning for a procedure that will take place after lunch. What is correct?

1. ASet it up in the morning and leave it uncovered in an empty room
2. BSet it up in the morning and cover it with a clean towel until the procedure starts
3. CSet it up in the morning and ask a colleague to check it once
4. DSet it up just before the procedure, because a waiting field may become contaminated

A nurse teaches a patient with neutropenia about preventing infection at home. Which statement shows a need for further teaching?

1. A“I will avoid crowds and people who have colds.”
2. B“I will wash my hands often and ask visitors to do the same.”
3. C“I will check my temperature and call if I have a fever.”
4. D“I can clean the cat’s litter box if I wear a face mask.”

On a postpartum unit, which patient is the most appropriate to assign to an LPN/LVN?

1. ADay 1 after an uncomplicated vaginal birth, stable vital signs
2. BA new admission transferred from the labor ward with a fever of 38.6 °C
3. CSevere pre-eclampsia on a magnesium sulfate infusion
4. DOne hour after birth with heavy bleeding and a boggy uterus

A patient admitted with a stroke this morning asks for a glass of water. What should the nurse do first?

1. ACheck that a swallow screen has been done before giving anything by mouth
2. BGive thickened fluids without checking the swallow
3. CGive the water through a straw so it goes down slowly
4. DAsk the family to help the patient drink while sitting upright in a chair at the bedside

Pesakit penyakit buah pinggang kronik lazimnya patut mengehadkan perkara manakah dalam dietnya?

1. AKalium dan fosfat
2. BVitamin C dan serat
3. CVitamin larut air sahaja
4. DKarbohidrat sepenuhnya

Why are patients with nephrotic syndrome at increased risk of blood clots?

1. ATheir blood pressure is always very low
2. BAnticoagulant proteins are lost in the urine and clotting factors rise
3. CThey lose most of their platelets in the urine every day
4. DThey lose all their red cells in the urine, which thickens the remaining blood

An older adult with chronic kidney disease starts trimethoprim-sulfamethoxazole for a urinary tract infection. Which electrolyte should be monitored closely?

1. ASodium, because the drug causes heavy sodium retention
2. BCalcium, because the drug binds calcium in the gut
3. CChloride, because the drug causes chloride loss
4. DPotassium, because trimethoprim can raise it

A patient in hyperosmolar hyperglycemic state has a glucose of 1,050 mg/dL (58 mmol/L), very dry mucous membranes and a fast pulse. Which treatment is usually the first priority?

1. ALarge-volume IV fluid replacement
2. BAn IV bolus of sodium bicarbonate
3. CStrict fluid restriction
4. DOral glucose-lowering tablets

Which approach is usually recommended to prevent constipation in a patient on regular opioids?

1. ANo laxative until the patient has not opened the bowels for a week
2. BA stimulant laxative such as senna, often with a stool softener
3. CBulk-forming fibre alone, with fluid intake restricted
4. DAn antidiarrhoeal drug at night to slow the gut

Carboprost is a prostaglandin used for postpartum haemorrhage. In which woman should it be avoided?

1. AA woman with iron deficiency anaemia
2. BA woman with asthma
3. CA woman who had a vaginal birth
4. DA woman who is breastfeeding

Why are IV fluids given cautiously to a patient with heart failure?

1. AIV fluids stop diuretics from being absorbed
2. BIV fluids directly damage the heart valves
3. CIV fluids lower the blood pressure dangerously
4. DExtra volume can quickly cause pulmonary oedema

An older patient with three rib fractures is breathing shallowly and refuses to cough because of pain. What is the priority intervention?

1. AWithhold analgesia to avoid depressing breathing
2. BKeep the patient flat and still in bed until the pain settles
3. CStrap the chest tightly with bandages to stop the ribs moving
4. DEffective analgesia so they can breathe deeply and cough

Which statement about storing insulin is correct?

1. AInsulin that has been frozen can be used once it has thawed
2. BUnopened insulin goes in the fridge and must never be frozen
3. CAll insulin must be stored in the freezer to keep it stable
4. DInsulin should be kept on a sunny windowsill to stay warm

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. ALebihan cecair daripada cecair IV
2. BAKI prarenal akibat hipovolemia
3. CSIADH disebabkan oleh pembedahan
4. DDiabetes insipidus selepas anestesia

In the UK National Early Warning Score (NEWS2), what does an aggregate score of 5 or more usually trigger?

1. ANo change unless the patient complains
2. BAn urgent review by a clinician skilled in acute illness
3. CRoutine observations once every 12 hours, with no other change in care
4. DDischarge planning for the next day

A patient with suspected appendicitis says the pain suddenly eased, but an hour later has a temperature of 38.9 °C, a rigid abdomen and a pulse of 118/min. What does this suggest?

1. ASimple constipation that needs a laxative
2. BPerforation with peritonitis
3. CA side effect of the analgesia given
4. DThe appendicitis has settled by itself

Contractions start at 10:00, 10:04 and 10:08, and each lasts 60 seconds. How should the nurse describe them?

1. AEvery 3 minutes, lasting 60 seconds
2. BEvery 5 minutes, lasting 60 seconds
3. CEvery 4 minutes, lasting 60 seconds
4. DEvery 4 minutes, lasting 240 seconds

A labouring woman has a temperature of 38.5 °C (101.3 °F), and the fetal baseline has risen from 140 to 170 bpm over the last hour. What is the most likely explanation?

1. AFetal tachycardia due to a maternal opioid
2. BFetal tachycardia due to maternal fever or infection
3. CFetal head compression
4. DReassuring fetal response to contractions

Which early sign may tell a child with haemophilia that a joint bleed is starting?

1. ATingling or warmth in the joint
2. BA cold, pale hand or foot
3. CA sudden fever with a rash
4. DAn itchy feeling on the skin over the elbow

Seorang remaja perempuan berumur 15 tahun meminta jururawat merahsiakan aktiviti seksualnya daripada ibu bapanya. Tiada tanda penderaan atau risiko kemudaratan serius. Apakah tindak balas yang paling sesuai?

1. AMemberitahu ibu bapanya serta-merta
2. BEnggan membincangkannya sehingga ibu bapanya hadir
3. CMenghormati kerahsiaannya, memberi maklumat dan menerangkan bilakah maklumat perlu dikongsi
4. DBerjanji bahawa tiada apa yang dikatakannya akan dikongsi dengan sesiapa, apa pun yang didedahkannya pada masa hadapan

A patient taking valproate is starting lamotrigine. Why must lamotrigine be increased especially slowly?

1. AValproate makes lamotrigine work faster, so the dose must be increased quickly
2. BThe two drugs together cause severe hair growth
3. CValproate raises lamotrigine levels, which increases the risk of a serious rash
4. DLamotrigine will lower the valproate level until it has no effect

A new nurse asks why the therapeutic relationship is different from a social relationship. Which statement is correct?

1. AThe patient is responsible for setting the boundaries of the relationship
2. BIt has no fixed end, and it can continue as a friendship after discharge if both the nurse and the patient want it to
3. CBoth people share their needs equally, as in any friendship
4. DIt is goal-directed and focused on the patient's needs, with the nurse responsible for keeping boundaries

Latihan (nilai rekaan, bukan panduan klinikal). Satu dos dicatat pada 7:25 AM. Entri yang manakah merupakan masa yang sama pada jam 24 jam? Klik padanya.

1. 106:25
2. 207:25
3. 319:25
4. 408:25

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi bermula pada 20:55 dan tamat pada 06:25 keesokan paginya (jam 24 jam). Berapa minit t ia berjalan?

Seorang kanak-kanak seberat 14 kg dipreskripsikan 7.5 mg/kg ubat. Larutan stok mengandungi 25 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?

Preskripsi ialah 0.17 mg. Ampul mengandungi 500 mikrogram setiap mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

Titisan berjalan pada 20 gtt/min melalui set 20 gtt/mL. Berapa mililiter V yang diterima pesakit dalam 4 jam?

Satu titisan berjalan pada 20 gtt/min melalui set 20 gtt/mL. Terdapat 400 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. Pesakit berberat 106 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 10:45 dan berjalan dengan pam pada 150 mL/j. Berapa mL V yang tinggal dalam beg pada 13:45?

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit mempunyai nadi 108/min dan tekanan darah 83/54 mmHg. Cari indeks kejutan SI = HR/SBP. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan dinilai dengan skala jatuh Morse: sejarah jatuh dalam 3 bulan yang lalu: tidak; diagnosis sekunder: ya; alat bantu berjalan: tiada, rehat di katil atau dibantu jururawat; terapi IV atau kunci salina: tidak; cara berjalan: terjejas; status mental: melebih-lebihkan atau melupakan had. Dengan menggunakan nilai potongan 0–24 rendah, 25–44 sederhana dan 45 atau lebih tinggi, klik tahap risiko jatuh.

1. 1risiko rendah
2. 2risiko sederhana
3. 3risiko tinggi