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

Matlamat pesakit manakah yang ditulis dengan cara SMART?

1. APesakit akan memperbaik mobiliti
2. BPesakit akan berjalan 20 meter dengan kerangka menjelang hari Jumaat
3. CPesakit akan berasa lebih baik tidak lama lagi
4. DPesakit akan cuba makan lebih banyak

A small fire starts in a patient's room. What is the first action?

1. ATry to put out the fire with water
2. BGo and find the fire safety officer to ask what should be done
3. COpen the windows to let out the smoke
4. DMove the patient away from immediate danger

A patient has received oral radioactive iodine therapy. Which precaution is usually taken?

1. AEncourage pregnant visitors to sit close to the patient to give emotional support
2. BLimit time close to the patient and handle body fluids per radiation policy
3. CLet the patient share a bathroom with other patients
4. DPlace the patient on droplet precautions with a surgical mask

A visitor becomes very agitated and starts shouting at the nurse in a patient’s room. What should the nurse do first?

1. ATouch the visitor’s arm to help them calm down
2. BRaise the voice to show who is in charge
3. CKeep a safe distance and a clear exit, speak calmly and call security if needed
4. DTurn away from the visitor and continue with the patient’s care as normal

Selepas serah tugas, pesakit manakah yang patut dilihat dahulu oleh jururawat?

1. APesakit asma yang menggunakan otot tambahan dan mempunyai SpO₂ 88%
2. BPesakit pneumonia, suhu 38.2 °C, yang menerima antipiretik 30 minit lalu
3. CPesakit dua hari selepas penggantian pinggul dengan kesakitan 5/10
4. DPesakit diabetes yang glukosanya sebelum sarapan ialah 160 mg/dL (8.9 mmol/L)

After a head injury, a patient passes large amounts of very dilute urine, is thirsty and has a rising serum sodium. Which condition is most likely?

1. ASIADH
2. BDiabetes insipidus
3. CAcute kidney injury with oliguria
4. DDiabetic ketoacidosis

Seorang pesakit selepas kemalangan jalan raya mengalami sesak nafas teruk, bunyi nafas tiada di satu sisi, tekanan darah rendah dan trakea beralih ke sisi lain. Apakah diagnosis yang mungkin?

1. APneumotoraks tegang
2. BAsma
3. CPneumonia
4. DEdema pulmonari

Which nursing measure helps reduce raised intracranial pressure?

1. ALying the patient flat with the neck flexed forward on two pillows
2. BTilting the patient head-down
3. CFrequent suctioning and encouraging strong coughing
4. DRaising the head of the bed to about 30° with the head kept midline

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. AA sudden failure of the bone marrow
2. BA laboratory error in the first sample
3. CIncreased red cell production
4. DDilution of the blood by the IV fluid

A patient with heavy alcohol use and a poor diet has a hemoglobin of 10.1 g/dL (101 g/L), an MCV of 110 fL and a low red cell folate. Which explanation fits best?

1. AAnemia caused by long-standing chronic kidney disease
2. BFolate deficiency, made worse by a direct alcohol effect
3. CThalassemia trait inherited from one of the parents
4. DIron deficiency from slow, chronic bleeding in the gut

A patient with suspected sepsis has blood cultures ordered and a first antibiotic dose due. What should the nurse do?

1. ATake the blood cultures first, then give the antibiotic at once
2. BGive the antibiotic first, then take blood cultures the next day
3. CWait for the culture results before giving any antibiotic
4. DGive the antibiotic only if the temperature is above 40 °C (104 °F)

A toddler swallowed many of his mother's iron tablets. He has vomiting and bloody diarrhoea. Which drug may be used to bind iron?

1. AActivated charcoal given by mouth
2. BAcetylcysteine
3. CDeferoxamine (desferrioxamine)
4. DNaloxone

What is the purpose of a mucolytic such as carbocisteine in chronic productive cough?

1. ATo stop the patient coughing completely, day and night
2. BTo widen the airways within minutes
3. CTo make sputum thinner and easier to cough up
4. DTo kill bacteria in the airways

A one-way speaking valve is fitted to a patient's tracheostomy tube while the cuff is still inflated. What is the danger?

1. AThe valve will humidify the air too much
2. BThe patient will speak too loudly
3. CThe patient cannot breathe out and may suffocate
4. DThere is no danger, as the valve works with any cuff

Why is IV calcium gluconate given in severe hyperkalaemia?

1. AIt removes potassium through the kidneys
2. BIt protects the heart from arrhythmias
3. CIt binds potassium in the gut
4. DIt moves potassium into the cells

A patient with motor neurone disease reports morning headaches, poor sleep and sleepiness during the day. What do these symptoms suggest?

1. AWeak breathing at night, so a review for ventilation support
2. BNormal tiredness that needs no specific action
3. CA side effect of riluzole, which should be stopped straight away by the nurse
4. DLow mood, which should be treated with an antidepressant first

Why is the "whoosh" test no longer used to check nasogastric tube position?

1. AThe air always makes the tube block
2. BAir can be heard even when the tube is in the lung
3. CThe test is far too painful for most patients to tolerate
4. DIt needs an X-ray machine at the bedside

On the morning of elective hip surgery, a patient says she took her usual warfarin last night despite being told to stop. What should the nurse do?

1. AProceed with the usual checklist and say nothing
2. BInform the surgical and anaesthetic teams, who will check the INR
3. CGive a double dose of vitamin K by mouth without waiting for a prescription
4. DTell her the surgery must be cancelled for a month

Apakah yang biasanya ditunjukkan oleh akselerasi kadar denyutan jantung janin?

1. ATidur janin
2. BMampatan tali pusat
3. CJanin mendapat oksigen yang mencukupi
4. DInsufisiensi plasenta

On abdominal palpation, the nurse feels a hard, round, movable mass in the fundus, and the fetal heart is heard above the umbilicus. What does this suggest?

1. AAn occiput posterior position
2. BA breech presentation
3. CA transverse lie with the head in the pelvis
4. DA cephalic presentation

When is the best time to tell a 2-year-old about an upcoming procedure?

1. ANot at all, to avoid upsetting the child beforehand
2. BJust before it happens, in simple, concrete words
3. CThe day before, with a detailed explanation
4. DAbout a week before, so there is time to get used to it

Seorang kanak-kanak bertatih dengan tetralogi Fallot menangis kuat dan menjadi sianosis yang mendalam dan lembik. Apakah yang patut dilakukan oleh jururawat dahulu?

1. ALetakkan kanak-kanak dalam kedudukan lutut–dada, pastikan dia tenang dan minta bantuan
2. BBawa kanak-kanak berjalan-jalan untuk menenangkannya
3. CUkur lilitan kepala
4. DBaringkan kanak-kanak rata dengan kaki diangkat untuk meningkatkan pulangan darah ke jantung

Seorang pesakit skizofrenia berkata, "Suara-suara itu mengatakan saya jahat." Respons manakah yang terbaik?

1. A"Mari kita tidak bercakap tentang suara itu buat masa ini. Ceritakan tentang keluarga dan rancangan anda sebaliknya."
2. B"Saya tidak mendengar suara itu, tetapi saya nampak ia mengganggu anda. Apakah yang dikatakannya kepada anda?"
3. C"Jika anda mendengar suara, anda pasti sangat sakit."
4. D"Suara itu tidak nyata, jadi abaikan sahaja."

Seorang pesakit yang berkeupayaan telah menandatangani persetujuan untuk satu kursus ECT. Selepas dua sesi, dia berkata dia mahu berhenti. Apakah yang betul?

1. ADia boleh menarik balik persetujuannya pada bila-bila masa, dan keputusannya mesti dihormati dan dilaporkan kepada pasukan
2. BDia hanya boleh berhenti jika keluarganya bersetuju
3. CPersetujuan bertandatangannya menjadi mengikat selepas sesi pertama, maka kursus yang dipersetujui kini mesti diselesaikan
4. DDia mesti menyelesaikan kursus itu setelah dia menandatangani

Latihan (nilai rekaan, bukan panduan klinikal). Satu penukaran berat memberikan 21.3657 kg. Peraturan dalam latihan ini ialah berat dibundarkan kepada persepuluh kilogram yang terdekat. Apakah nilai x yang anda rekodkan?

Latihan (nilai rekaan, bukan panduan klinikal). Semasa satu syif, seorang pesakit mengambil ½ tsp daripada sirap batuk, 1½ tbsp daripada suplemen cecair, 1 cawan daripada teh, 2 fl oz daripada jus. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Dos 25 mg diperlukan daripada larutan 0.5% (b/i). Isi padu V manakah yang mengandungi dos ini?

Seorang kanak-kanak berberat 24 kg dipreskripsi 10 mg/kg setiap dos suspensi oral yang mengandungi 200 mg dalam 5 mL. Berapakah isi padu V yang anda berikan?

Satu infusi diarahkan pada 60 mL/j, tetapi tiada pam tersedia. Ia berjalan secara graviti melalui set pemberian 60 gtt/mL. Cari kadar titisan R dalam titisan seminit.

Satu titisan berjalan pada 40 gtt/min melalui set 20 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. Infusi IV berjalan pada kadar yang ditunjukkan sepanjang syif. Cari jumlah pengambilan I dalam mL.

Latihan (nilai rekaan, bukan panduan klinikal). Satu beg 500 mL berjalan dengan pam pada 60 mL/j. Pada 21:30, 250 mL telah diinfuskan. Berapa jam t sehingga beg kosong? Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit mempunyai nadi 70/min dan tekanan darah 139/83 mmHg. Cari indeks kejutan SI = HR/SBP. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 28/min, SpO₂ 96% bernafas udara bilik, tekanan darah 142/86 mmHg, nadi 88/min, sedar, suhu 36.1 °C. Kumpulan risiko klinikal yang manakah pesakit itu termasuk? Klik padanya.

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