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

A patient is getting up for the first time after several days in bed. What should the nurse do first?

1. AHave the patient sit on the edge of the bed for a short time before standing
2. BGive the patient a large drink of water while standing
3. CHelp the patient stand up quickly, so that the dizziness has less time to start
4. DAsk the patient to walk to the bathroom alone

Which patient should the nurse see first?

1. AA postoperative patient with SpO₂ 89% on air and a respiratory rate of 28
2. BA patient who is waiting for their discharge letter and medicines
3. CA patient who is asking for help to walk to the toilet now
4. DA patient with a pain score of 3/10 whose analgesia is due in an hour

A nurse pours sterile saline into a bowl on a sterile field. Which technique is correct?

1. AReach across the field to fill the bowl at the far side
2. BRest the lip of the bottle on the edge of the bowl so that the saline does not splash
3. CPour from below the level of the field to reduce splashing
4. DHold the bottle with the label in the palm and pour without touching the bowl

A patient weighs 180 kg and needs to be moved from bed to chair. The standard ceiling lift on the unit has a lower weight limit. What should the nurse do?

1. AUse the standard lift, because limits include a safety margin
2. BUse bariatric-rated equipment and enough trained staff
3. CAsk the patient to stand and pivot without help
4. DHave two staff lift the patient by hand

Which patient is at the highest risk of falling?

1. AAn 84-year-old taking a diuretic who has fallen before and gets up at night
2. BA 45-year-old with asthma who is alert and independent
3. CA 30-year-old after an appendectomy who walks with steady steps
4. DA 60-year-old admitted for chest pain that has since been ruled out by tests

A chemical cleaning fluid splashes into a patient’s eye. What should the nurse do first?

1. ACover the eye with a dry patch and wait for the provider
2. BGive antibiotic eye drops first
3. CRub the eye gently with a clean tissue to remove the chemical
4. DFlush the eye with plenty of water or saline straight away

What is one advantage of a direct oral anticoagulant (DOAC) such as apixaban compared with warfarin?

1. AIt has no risk of bleeding
2. BIt is safe in all patients with severe kidney failure
3. CIt never interacts with other drugs
4. DIt does not need routine INR monitoring

A patient who has had a kidney stone is taught about prevention. Which statement shows a need for further teaching?

1. A"I will follow the diet advice for my stone type."
2. B"I will aim to drink plenty of fluids spread through every day."
3. C"I will drink less water so I don't need to pass urine as often."
4. D"I will try to pass pale urine."

Seorang pesakit yang mengambil warfarin untuk fibrilasi atrium mempunyai INR 5.2 dan tiada pendarahan. Apakah tindakan terbaik jururawat?

1. ATahan dos warfarin dan maklumkan pemreskripsi
2. BMenasihati pesakit supaya berhenti makan sayur-sayuran hijau mulai hari ini
3. CBeri dos berganda
4. DBeri dos biasa dan semak semula dalam sebulan

A patient without diabetes in the ICU with sepsis has a glucose of 260 mg/dL (14.4 mmol/L) and an HbA1c of 5.2%. What is the best interpretation?

1. AType 1 diabetes from autoimmune damage
2. BLong-standing undiagnosed type 2 diabetes
3. CStress hyperglycemia from acute illness
4. DA meter error, because HbA1c is normal

How is adenosine given for supraventricular tachycardia?

1. AAs a tablet under the tongue
2. BAs a slow infusion over one hour
3. CAs an intramuscular injection into the outer thigh muscle
4. DAs a rapid IV push followed by a fast saline flush

Pesakit yang baru mula mengambil haloperidol mengalami demam tinggi, kekejangan otot "paip plumbum", kekeliruan dan kreatin kinase yang sangat tinggi. Apakah diagnosis yang paling mungkin?

1. ASindrom neuroleptik malignan
2. BHipertermia malignan akibat anestesia
3. CSindrom serotonin
4. DDistonia akut

A 70 kg patient has passed 20 mL of urine per hour for the last three hours. How should this be interpreted?

1. AHigh, suggesting fluid overload that needs a diuretic
2. BBelow 0.5 mL/kg/h, suggesting poor kidney perfusion
3. CNormal, because any measurable urine output is reassuring
4. DNormal, because the target is 0.1 mL/kg/h

Shortly after a thoracentesis, a patient becomes breathless with sharp chest pain and reduced breath sounds on the same side. What complication is most likely?

1. ARe-accumulation of the effusion
2. BPneumothorax
3. CInfection at the puncture site
4. DPulmonary embolism from the leg

Which group of drugs is a well-known cause of SIADH and hyponatraemia, especially in older people?

1. ABulk-forming laxatives
2. BSSRI antidepressants
3. CProton pump inhibitors
4. DPenicillin antibiotics

The nurse has four urology patients. Which one needs to be seen first?

1. AA patient with a nephrostomy who has rigors and a BP of 86/50 mmHg
2. BA patient after TURP with light pink drainage and mild discomfort
3. CA patient with stress incontinence asking about pelvic floor exercises
4. DA patient with a suprapubic catheter due for a routine change

Which technique is correct when giving a prefilled low molecular weight heparin injection?

1. ARub the site firmly afterwards to help absorption
2. BLeave the air bubble in and inject into a skin fold
3. CInject into a vein in the back of the hand
4. DExpel the air bubble first and inject into the deltoid muscle

Seorang pesakit dengan epidural selepas pembedahan abdomen mempunyai TD 82/48 mmHg, nadi 70/min dan kaki hangat. Pendarahan telah disingkirkan. Apakah punca yang paling mungkin?

1. ASekatan simpatetik daripada epidural
2. BAnafilaksis terhadap anestetik setempat
3. CRenjatan kardiogenik selepas pembedahan
4. DRenjatan hipovolemik akibat kehilangan darah

Di tempat saringan universal untuk streptokokus kumpulan B digunakan, bilakah calitan faraj–rektum biasanya diambil?

1. APada kira-kira 36 hingga 37 minggu
2. BPada kira-kira 20 minggu
3. CSelepas membran pecah semasa bersalin
4. DPada lawatan antenatal pertama

A woman at 34 weeks with type 1 diabetes has a blood glucose of 2.8 mmol/L (50 mg/dL), is sweating and shaky but is alert. What should the nurse do first?

1. AGive her usual insulin dose
2. BWait until her next meal
3. CGive fast-acting glucose by mouth and recheck
4. DCheck the fetal heart rate before any treatment

Why are elbow splints often used after cleft lip repair?

1. ATo stop the baby touching or rubbing the suture line
2. BTo make the baby sleep for longer
3. CTo keep the baby's arms warm and still after surgery and anaesthesia
4. DTo keep the IV cannula from being needed

A boy with haemophilia A bumps his head hard on a table. He seems well. What should the nurse advise?

1. ANo action is needed, because head bleeds are rare in haemophilia
2. BGive aspirin for the pain and apply ice to the bump
3. CWatch him at home for a week and bring him in only if he vomits or has a headache
4. DSeek urgent care, as factor replacement may be needed before symptoms appear

Which risk applies when antipsychotics are used in older people with dementia?

1. AA lower risk of falls than with no medicine at all
2. BImproved memory within a few days
3. CA guaranteed cure of the dementia
4. DAn increased risk of stroke and death

Dua minggu selepas memulakan SSRI, seorang pesakit berkata, "Ini tidak berkesan. Saya akan berhenti mengambilnya." Apakah respons yang terbaik?

1. AMemberitahunya menggandakan dos
2. BBersetuju bahawa dia patut menghentikannya serta-merta, kerana antidepresan yang tidak membantu selepas dua minggu tidak mungkin akan berkesan
3. CTerangkan bahawa ia sering mengambil masa beberapa minggu untuk berkesan sepenuhnya, galakkan dia meneruskan dan pantau mood serta keselamatannya
4. DMemberitahunya antidepresan tidak pernah berkesan

Latihan (nilai rekaan, bukan panduan klinikal). Suhu seorang pesakit ialah 35.7 °C. Tukarkan kepada darjah Fahrenheit T dengan °F = °C × 9/5 + 32. Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi bermula pada 22:45 dan tamat pada 00:25 keesokan paginya (jam 24 jam). Berapa minit t ia berjalan?

Seorang kanak-kanak seberat 28 kg dipreskripsikan 10 mg/kg ubat. Larutan stok mengandungi 40 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?

Preskripsi ialah 1750 unit ubat yang datang sebagai 5000 unit/mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

Infuskan 1500 mL selama 12 jam dengan set pemberian 20 gtt/mL. Cari kadar titisan R dalam titis seminit. Bundarkan kepada nombor bulat yang terdekat.

Satu titisan berjalan pada 28 gtt/min melalui set 15 gtt/mL. Terdapat 450 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 65 kg. Cari pengeluaran air kencing purata U dalam mL/kg/j. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu beg 1000 mL dimulakan pada 06:15 dan berjalan dengan pam pada 60 mL/j. Berapa mL V yang tinggal dalam beg pada 09:15?

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan dinilai dengan skala Braden: persepsi deria: sangat terhad; kelembapan: kadang-kadang lembap; aktiviti: terlantar di katil; mobiliti: sangat terhad; pemakanan: mencukupi; geseran dan ricih: potensi masalah. Cari jumlah Braden B.

Latihan (nilai rekaan, bukan panduan klinikal). Pada 1 minit selepas lahir, seorang bayi baru lahir latihan mempunyai kulit biru atau pucat di seluruh badan, tiada denyutan jantung, tiada respons terhadap rangsangan, anggota lembik tanpa tonus otot dan tidak bernafas. Skorkan APGAR dan klik bagaimana skor itu ditafsirkan.

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