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

Which approach suits teaching an older adult with poor eyesight and mild memory problems?

1. AShort sessions, large-print materials and repeating key points
2. BOne long session with all the information at once
3. CA detailed leaflet in small print for them to read later at home
4. DTeaching only the family and not the patient

Seorang jururawat mengalami kecederaan tercucuk jarum daripada jarum terpakai. Apakah tindakan pertama yang betul?

1. AHisap luka untuk mengeluarkan darah
2. BBiarkan luka berdarah dengan bebas, basuh dengan sabun dan air mengalir, kemudian lapor segera
3. CMenghabiskan syif dan melapor pada hari berikutnya
4. DGosok kawasan itu kuat-kuat dengan berus dan alkohol, kemudian lapor pada akhir syif

When is a prophylactic antibiotic usually given to prevent a surgical site infection?

1. AThe day after surgery, once the wound is closed
2. BWithin about 60 minutes before the incision
3. COne week before surgery
4. DOnly if a fever develops after surgery

A patient rescued from a house fire has a headache and confusion, but the pulse oximeter reads 99%. Why might this reading be misleading?

1. APulse oximetry cannot tell carbon monoxide-bound hemoglobin from oxygen-bound hemoglobin
2. BPulse oximeters always read falsely low after any kind of smoke exposure
3. CConfusion and headache make pulse oximetry readings inaccurate in every patient
4. DThe reading is accurate, so carbon monoxide poisoning is ruled out

A patient has a serum potassium of 6.8 mEq/L. Which action comes first?

1. AGive the patient’s scheduled potassium supplement
2. BPlace the patient on a cardiac monitor
3. CRecheck the level next week
4. DEncourage foods high in potassium

Which patient is the best choice for the room closest to the nurses’ station?

1. AA patient admitted for a planned scan, feeling well
2. BA young adult waiting for discharge tomorrow
3. CA confused older adult at high risk of falls
4. DA patient with stable diabetes who walks independently

Which type of painkiller should a patient with liver cirrhosis usually avoid?

1. AParacetamol (acetaminophen), given in a carefully reduced and monitored dose
2. BLocal anaesthetic creams
3. CHot packs applied to a painful joint
4. DNon-steroidal anti-inflammatory drugs such as ibuprofen

Which task is most appropriate for a registered nurse to delegate to a trained healthcare assistant (unlicensed assistive personnel)?

1. AGiving a dose of intravenous antibiotic
2. BMeasuring and recording vital signs on a stable patient
3. CAssessing a patient who has just reported new chest pain
4. DTeaching a patient to inject insulin for the first time

A healthy patient has a mildly raised CK after running a marathon yesterday, without dark urine or symptoms. What is the most likely explanation?

1. AAn acute myocardial infarction has occurred
2. BThe patient has developed acute pancreatitis
3. CThe patient has developed acute hepatitis
4. DStrenuous exercise raised CK from skeletal muscle

A patient with severe sepsis is oozing blood from IV sites. Platelets 40 × 10³/µL, fibrinogen low, D-dimer very high, PT and aPTT both prolonged. Which condition fits best?

1. AHemophilia A (factor VIII deficiency)
2. BImmune thrombocytopenic purpura (ITP)
3. CHeparin-induced thrombocytopenia (HIT)
4. DDisseminated intravascular coagulation (DIC)

Bagaimanakah heparin menghasilkan kesan antikoagulan?

1. AIa merencat COX-1 platelet secara tak berbalik
2. BIa meningkatkan antitrombin, yang menyahaktifkan trombin dan faktor Xa
3. CIa memecahkan fibrin dalam bekuan sedia ada
4. DIa menyekat sintesis faktor pembekuan dalam hati yang bergantung pada vitamin K

Pesakit yang mengambil warfarin memulakan kursus rifampisin. Apakah kesan yang mungkin?

1. AINR meningkat kerana warfarin dimetabolismekan lebih perlahan
2. BWarfarin ditukar kepada vitamin K
3. CINR jatuh kerana warfarin dimetabolismekan lebih cepat
4. DTiada kesan, kerana rifampisin tidak diserap

A patient is going home with a 24-hour Holter monitor. Which instruction is most important?

1. ARemove the monitor whenever symptoms occur and restart it
2. BStay in bed for the full 24 hours so the trace is clear
3. CShower as normal with the monitor on
4. DKeep a diary of symptoms and activities with the times

Seorang pesakit asma mempunyai sejarah mengi selepas mengambil aspirin. Ibuprofen dipreskripsikan untuk kesakitan pasca-operasi. Apakah yang patut dilakukan oleh jururawat?

1. AMemberikannya, kerana ibuprofen tidak berkaitan dengan aspirin
2. BMenahannya dan meminta alternatif
3. CMemberikannya hanya jika skor kesakitan melebihi 8/10
4. DMemberikannya bersama inhaler pelega pada masa yang sama

A routine blood test shows a potassium of 6.4 mmol/L. The lab reports that the sample was haemolysed. The patient feels well. What should the nurse do?

1. AGive oral potassium supplements straight away
2. BIgnore it, because haemolysis always gives a normal result
3. CStart dialysis as soon as possible
4. DInform the doctor and arrange an urgent repeat sample

Which patient with a spinal cord injury is at risk of autonomic dysreflexia?

1. AA patient with an injury at L3
2. BA patient with an injury at S2
3. CA patient with an injury at T4
4. DA patient with an injury at L5

Mengapakah pesakit sirosis berisiko lebih tinggi untuk pendarahan?

1. ASirosis meningkatkan kiraan platelet, yang menjadikan platelet lebih lemah
2. BTekanan darah arteri yang tinggi dalam sirosis menyebabkan saluran pecah
3. CFaktor pembekuan yang lebih sedikit, platelet rendah dan varises akibat hipertensi portal
4. DHati yang berparut membebaskan bahan antikoagulan seperti heparin ke dalam darah

A patient with bone metastases is starting regular zoledronic acid. Which advice is important?

1. AAvoid all physical activity for six months
2. BStop drinking all fluids on the day of each infusion
3. CHave a dental check and report jaw pain or loose teeth
4. DTake extra calcium only on the day of infusion

Why is the hearing of newborns screened before discharge or soon after birth?

1. AEarly support improves language development
2. BIt detects congenital heart disease
3. CIt is required before vitamin K can be given
4. DHearing loss can be cured with a single injection

A woman with gestational diabetes on insulin asks about her baby after birth. Which statement by the nurse is accurate?

1. AThe baby will need insulin for the first days
2. BThe baby will be born with diabetes
3. CThe baby's glucose will be checked for hypoglycaemia
4. DThe baby must not be breastfed in the first week

Langkah berjaga-jaga manakah yang terpakai bagi kanak-kanak dengan hemofilia?

1. ALetakkan haba pada sendi yang berdarah
2. BBeri aspirin untuk kesakitan
3. CGalakkan sukan sentuhan seperti ragbi untuk menguatkan sendi dan otot
4. DElakkan suntikan intramuskular dan suhu rektum jika boleh

A 14-year-old has superficial cuts on her forearms. She says cutting helps her cope and that she does not want to die. What is the best nursing response?

1. ATreat the wounds, stay calm and non-judgemental, and refer for assessment
2. BTell her firmly that cutting is attention-seeking behaviour and that she must stop now
3. CAccept that she is not at risk because she says she does not want to die
4. DPromise not to tell anyone so that she keeps talking

A patient taking sertraline wants to take ibuprofen regularly for arthritis. What should the nurse teach?

1. AThe combination is completely safe because they act on different systems
2. BIbuprofen should be taken instead of sertraline on the days when the arthritis pain is bad, to avoid any interaction
3. CThe combination increases the risk of bleeding, especially in the stomach, so discuss it with the prescriber
4. DIbuprofen will make the sertraline work faster

Seorang pesakit dengan OCD melakukan ritual membasuh tangan yang panjang dan terlepas sarapan. Apakah pendekatan awal yang terbaik?

1. ATunjukkan betapa sia-sianya ritual itu dan berkeras supaya pesakit menghentikannya serta-merta sebelum sarapan
2. BKunci bilik air
3. CHentikan ritual itu dengan paksaan
4. DBeri masa untuk ritual itu, rancang jadual di sekelilingnya dan hadkannya secara beransur-ansur bersama pesakit

Latihan (nilai rekaan, bukan panduan klinikal). Satu pengiraan dos untuk suntikan kecil memberikan 0.60573 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 preskripsi berbunyi ½ tbsp ampaian oral empat kali sehari selama 5 hari. Dengan menggunakan 1 tbsp = 15 mL, berapa mL V yang diperlukan untuk seluruh kursus rawatan?

Seorang pesakit berberat 30 kg. Dos yang dipreskripsikan ialah 10 mg/kg sehari, diberi dalam 2 dos yang sama. Berapakah miligram D yang diberi bagi setiap dos?

Anda perlu menyediakan 1000 mL larutan 2% (w/v) daripada larutan stok 10% (w/v). Berapa banyak air W yang mesti ditambah pada stok?

Infuskan 500 mL selama 2 jam dengan set pemberian 10 gtt/mL. Cari kadar titisan R dalam titis seminit. Bundarkan kepada nombor bulat yang terdekat.

Sebuah beg mengandungi 1 g ubat dalam 500 mL. Arahannya ialah 2 mg seminit. Pada kadar R berapakah anda menetapkan pam, dalam mL/j?

Latihan (nilai rekaan, bukan panduan klinikal). Rekod menunjukkan pengambilan dan pengeluaran seorang pesakit untuk satu syif 12 jam. Pesakit berberat 48 kg. Cari pengeluaran air kencing purata U dalam mL/kg/j. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi 500 mL bermula pada 11:00 dengan 75 mL/j. Selepas 4 jam kadar ditukar kepada 60 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). Seorang pesakit mempunyai nadi 92/min dan tekanan darah 94/56 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: tidak; alat bantu berjalan: tongkat ketiak, tongkat atau alat bantu berjalan; terapi IV atau kunci salina: ya; cara berjalan: normal, rehat di katil atau kerusi roda; status mental: tahu had sendiri. 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