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

Bagaimanakah pesakit yang menerima pemakanan tiub patut diposisikan untuk mengurangkan risiko aspirasi?

1. ABerbaring sepenuhnya mendatar
2. BDengan kepala katil dinaikkan kira-kira 30–45 darjah
3. CBerbaring meniarap
4. DDalam posisi kepala ke bawah

Pesakit yang keliru berulang kali cuba memanjat penghadang katil yang dinaikkan. Apakah pendekatan paling selamat?

1. AMengikat pergelangan tangan pesakit pada katil
2. BMenaikkan penghadang lebih tinggi dan meninggalkan pesakit bersendirian di bilik yang tenang supaya dia bertenang
3. CMemberi sedatif tanpa semakan perubatan
4. DMenilai semula dan mempertimbangkan alternatif seperti katil rendah dan pemerhatian lebih rapat

Teknik menanggalkan sarung tangan manakah yang betul?

1. ACuci tangan yang bersarung dan guna semula sarung tangan untuk tugas seterusnya
2. BTanggalkan sarung tangan kedua dengan mencubit bahagian luarnya menggunakan tangan kosong, kemudian cuci tangan
3. CTanggalkan yang pertama dengan memegang bahagian luarnya, kemudian selitkan jari kosong di bawah kolar sarung tangan kedua
4. DTarik kedua-dua sarung tangan serentak pada hujung jari

Which position is especially dangerous for a patient in physical restraints?

1. ALying on the back with the head raised
2. BLying face down (prone)
3. CSitting upright in bed
4. DLying on the side

A patient with diabetes is unresponsive and has a blood glucose of 40 mg/dL (2.2 mmol/L). What should the nurse do first?

1. APour orange juice into the patient’s mouth
2. BGive IV dextrose or glucagon as prescribed
3. CWait 15 minutes and recheck the glucose
4. DGive the scheduled dose of insulin

A patient with severe sepsis starts oozing blood from IV sites and the gums, and bruises appear on the skin. What should the nurse suspect?

1. AAn allergic reaction to the adhesive tape
2. BNormal bruising from blood tests
3. CDisseminated intravascular coagulation (DIC)
4. DVitamin C deficiency

Why is it important to prevent hypothermia during and after surgery?

1. AIt causes high blood glucose only
2. BIt increases the risk of wound infection, bleeding and cardiac complications
3. CIt makes the patient's pain disappear
4. DIt makes the patient wake up too quickly and become agitated in recovery

A patient taking regular ibuprofen suddenly develops severe upper abdominal pain, a rigid abdomen and becomes tachycardic. What is most likely?

1. AIrritable bowel syndrome
2. BConstipation
3. CA perforated peptic ulcer
4. DIndigestion that will settle with antacids

A trauma patient receives 2 L of IV crystalloid. The hemoglobin falls from 13.0 to 11.4 g/dL (130 to 114 g/L), and the vital signs are now stable. Which explanation is most likely?

1. ADilution of the blood by the IV fluid
2. BA laboratory error in the first sample
3. CA sudden failure of the bone marrow
4. DIncreased red cell production

Seorang pesakit dengan kiraan platelet 35 × 10³/µL ditetapkan suntikan intramuskular. Apakah yang patut dilakukan oleh jururawat?

1. ABeri suntikan dan letakkan pek panas
2. BTanya pemreskripsi sama ada laluan lain boleh digunakan
3. CBeri suntikan seperti yang ditetapkan dan urut tapak dengan kuat
4. DBeri suntikan dengan jarum yang lebih panjang

An Rh-negative mother gives birth to an Rh-positive baby. When is anti-D immunoglobulin usually given?

1. AWithin 72 hours after the birth
2. BIt is not needed if the baby is Rh-positive
3. COnly at the start of the next pregnancy
4. DAt least two weeks after the birth

A patient starting sertraline is taught about the drug. Which statement shows a need for further teaching?

1. A"If I feel better after a week, I can stop taking it."
2. B"It may take a few weeks to feel the full effect."
3. C"I will tell someone if I have thoughts of harming myself."
4. D"I may have some nausea at first."

A patient on theophylline develops nausea, vomiting, a fast heart rate and restlessness. What should the nurse suspect?

1. ATheophylline toxicity
2. BA theophylline allergy causing a rash
3. CAn expected sign that the drug is working
4. DHypoglycaemia caused by the drug

A patient with obstructive sleep apnoea who uses CPAP at home is having surgery. Which plan is safest after the operation?

1. AGive extra opioids so the patient sleeps through the night
2. BNurse the patient lying flat on their back to keep the airway open
3. CLeave the CPAP machine at home, as it is not needed while in hospital
4. DUse their CPAP machine and monitor closely, using opioids with caution

Before surgery for a phaeochromocytoma, why is an alpha-blocker started before any beta-blocker?

1. AThe order of the two drugs makes no difference
2. BA beta-blocker alone can cause a dangerous rise in BP
3. CAlpha-blockers lower the blood glucose before surgery
4. DBeta-blockers given first would make the tumour grow faster

Three days after a stroke, a patient with dysphagia on a modified diet has a temperature of 38.2 °C (100.8 °F), a respiratory rate of 24/min and crackles at the right lung base. What should the nurse do?

1. ASuspect aspiration pneumonia, stop oral intake and escalate for review
2. BRecord the findings and recheck them at the next routine observation
3. CGive paracetamol (acetaminophen) and continue the modified diet as before
4. DEncourage more fluids by mouth to treat the fever

Tanda manakah yang menunjukkan pankreatitis akut yang teruk dengan pendarahan ke dalam tisu?

1. APerubahan warna kuning pada kuku jari
2. BRuam ungu pada tapak tangan dan kaki
3. CLebam di sekeliling pusat atau rusuk
4. DBengkak pada bibir, lidah dan muka

A patient with long-standing chronic pancreatitis now has weight loss, thirst and passing large volumes of urine. What should the nurse check first?

1. ACapillary blood glucose
2. BAbdominal girth
3. CSerum amylase level
4. DPeak expiratory flow

What should parents be taught about the water for a newborn's bath?

1. ACheck that it is warm, not hot, before the baby goes in
2. BLeave the baby briefly if the water is only shallow
3. CUse very hot water so that germs on the skin are killed
4. DAdd adult bubble bath to soften the baby's skin

A labouring woman has had an epidural for 3 hours. The fundus is displaced and a bulge is seen above the pubic bone. What should the nurse do?

1. AStart an oxytocin infusion
2. BCheck for bladder distension and empty the bladder
3. CPrepare her for an emergency caesarean
4. DIncrease the rate of the epidural

A child with type 1 diabetes is unconscious from hypoglycaemia at school. What should be done?

1. ALet the child sleep and check again in an hour
2. BGive a glass of orange juice by mouth
3. CGive glucagon and call emergency services
4. DGive the child's usual dose of insulin

A 15-year-old boy with mumps develops a painful, swollen testis. What is the most likely explanation?

1. AMumps orchitis, a known complication after puberty
2. BTesticular cancer unrelated to the infection
3. CAn inguinal hernia caused by coughing
4. DA late side effect of the MMR vaccine given in childhood

Which group of signs suggests drug-induced pseudoparkinsonism in a patient taking haloperidol?

1. ALip smacking, tongue thrusting and grimacing after years of treatment
2. BSudden muscle spasm of the neck with the eyes rolled upwards
3. CRestless pacing and an inability to sit still
4. DShuffling gait, mask-like face, rigidity and a resting tremor

A patient who stopped drinking 24 hours ago has a generalised tonic-clonic seizure in bed. What is the nurse's first action?

1. AProtect the airway and keep him safe from injury
2. BGive oral thiamine with a glass of water
3. CPut something in his mouth to stop him biting his tongue
4. DRestrain his arms and legs to stop the movements

Latihan (nilai rekaan, bukan panduan klinikal). Suhu seorang pesakit ialah 96 °F. Tukarkan kepada darjah Celsius T dengan °C = (°F − 32) × 5/9. Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Semasa satu syif, seorang pesakit mengambil 2 cawan daripada teh, 1 tsp daripada sirap batuk, 2 fl oz daripada jus. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Seorang kanak-kanak seberat 16 kg dipreskripsikan 7.5 mg/kg ubat. Larutan stok mengandungi 40 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?

Preskripsi ialah 370 mikrogram. Ampul mengandungi 0.5 mg/mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

1000 mL diarahkan selama 6 jam. Selepas 2 jam anda mendapati 810 mL masih ada dalam beg, dan arahan itu mesti masih siap tepat pada masanya. Kepada kadar R dalam mL/j berapakah pam mesti ditetapkan semula?

Satu beg mengandungi 250 mg ubat dalam 250 mL dan berjalan pada 30 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 12 jam. Pesakit berberat 60 kg. Cari pengeluaran air kencing purata U dalam mL/kg/j. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi 1000 mL bermula pada 14:30 dengan 125 mL/j. Selepas 3 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 94% bernafas udara bilik, tekanan darah 118/70 mmHg, nadi 58/min, keliru baharu, suhu 35.5 °C. Apakah jumlah skor NEWS2?

Latihan (nilai rekaan, bukan panduan klinikal). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 14/min, SpO₂ 99% dengan oksigen tambahan, tekanan darah 124/74 mmHg, nadi 70/min, sedar, suhu 35.5 °C. Kumpulan risiko klinikal yang manakah pesakit itu termasuk? Klik padanya.

1. 1rendah
2. 2rendah–sederhana
3. 3sederhana
4. 4tinggi