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

Which measure is appropriate for a patient with a fever who feels hot and uncomfortable?

1. AAn ice bath until the patient shivers
2. BRestricting fluids so the patient sweats less during the fever
3. CExtra blankets to make the patient sweat it out
4. DLight bedclothes, plenty of fluids and a prescribed antipyretic

A nurse realises that a dose of analgesia given two hours ago was not documented. What is correct?

1. AAsk a colleague to sign that they gave it
2. BWrite it in the space for two hours ago as if it was recorded then
3. CLeave it out, as it is now too late to record it in the notes
4. DWrite it now as a late entry, stating when it was given

Mengapakah ubat cecair oral diberikan dengan picagari oral atau enteral dan bukannya picagari IV piawai?

1. ATiada sebab keselamatan; ia hanya tradisi
2. BPicagari IV tidak dapat menyukat isi padu kecil cecair oral dengan tepat
3. CPicagari oral menyukat dos intravena dengan lebih tepat
4. DPicagari oral tidak muat pada talian IV, mencegah kesilapan laluan yang salah

A patient refuses to wear an identification wristband. What should the nurse do?

1. AAccept the refusal and identify the patient by room number and bed space instead
2. BExplain why it is needed, use other ID methods per policy and document
3. CStop giving the patient any care until they agree to wear the band
4. DForce the band onto the patient’s wrist

A patient had a colostomy formed yesterday. Which stoma appearance should be reported straight away?

1. AMoist and pink-red
2. BSlightly swollen
3. CA little bleeding when cleaned
4. DDark purple or black

A patient with diabetic ketoacidosis is about to start an IV insulin infusion. The serum potassium is 3.0 mEq/L. What should the nurse do?

1. AIgnore the result, since potassium is always high in this condition and will correct itself
2. BStart the insulin at once, because the glucose is the bigger problem
3. CGive the insulin as a fast bolus to bring the potassium up
4. DReport the result before starting, because insulin will push potassium even lower

Which advice should be given to a patient with a new permanent pacemaker?

1. ATell staff about the pacemaker before any MRI scan or procedure
2. BNever raise the arm on that side again
3. CAvoid using all household electrical appliances such as kettles
4. DStop all heart medicines straight away

An adult with capacity refuses a blood transfusion for religious reasons, even though it may save their life. What should the nurse do?

1. AGive the transfusion while the patient is asleep, as it is in their best interests
2. BSedate the patient so the transfusion can be given
3. CRespect the refusal, check it is informed and document it, and inform the team
4. DAsk a family member to consent instead

A patient receiving chemotherapy has an ANC of 300/µL and a new temperature of 38.3 °C (100.9 °F). What should the nurse do first?

1. ARemove extra blankets and offer a tepid sponge bath
2. BReport it at once so cultures and antibiotics start quickly
3. CEncourage oral fluids and record the fever in the chart
4. DGive acetaminophen (paracetamol) and recheck the temperature in 4 hours

A patient with sepsis has the following new results. Which set best shows organ dysfunction?

1. AWBC 11.5 × 10³/µL, potassium 4.2 mEq/L, albumin 3.8 g/dL
2. BPlatelets 70 × 10³/µL, creatinine doubled, bilirubin raised
3. CHemoglobin 12.5 g/dL, sodium 138 mEq/L, glucose 105 mg/dL
4. DCalcium 9.4 mg/dL, phosphate 3.5 mg/dL, magnesium 1.9 mEq/L

Why is hypovolaemia corrected with IV fluids before or while starting a vasopressor?

1. AVasopressors only work when they are diluted in large fluid volumes
2. BFluids stop the vasopressor causing a fever
3. CVasopressors cannot keep perfusion up if the circulation is under-filled
4. DVasopressors cause the patient to retain too much fluid

During an IV glyceryl trinitrate (nitroglycerin) infusion for chest pain, the patient's blood pressure drops to 82/50 mmHg and he feels faint. What is the nurse's first action?

1. AGive a sublingual nitroglycerin tablet and increase the rate to relieve the remaining chest pain
2. BStop or reduce the infusion as per protocol, lay the patient flat and notify the prescriber
3. CSit the patient fully upright and give paracetamol for the headache
4. DIncrease the infusion rate to improve blood flow to the heart

Monitor menunjukkan fibrilasi ventrikel. Pesakit tidak bertindak balas dan tidak bernafas dengan normal. Apakah rawatan utama?

1. AKardioversi bersegerak di bawah sedasi dalam
2. BAtropin IV dan pacu luaran
3. CCPR dan defibrilasi secepat mungkin
4. DAdenosin IV pantas diikuti dengan bilasan

A patient with a valid, documented do-not-attempt-CPR decision (DNACPR in the UK, DNR or DNAR in the US) is found in cardiac arrest. What should the nurse do?

1. ACall the arrest team and let them decide whether to resuscitate
2. BStart full CPR because the patient's family is not present
3. CStart CPR but use only chest compressions
4. DNot start CPR, call for support, and provide dignity and comfort

Which side effects are common with oxybutynin for an overactive bladder?

1. AA cough and a raised potassium
2. BWeight loss and a fast tremor
3. CDry mouth and constipation
4. DDiarrhoea and heavy sweating

A patient with CKD has a potassium of 6.5 mmol/L. Which medicine combination is the most likely contributor?

1. AFurosemide, salbutamol and insulin
2. BAmlodipine, simvastatin and aspirin
3. CRamipril, spironolactone and trimethoprim
4. DParacetamol (acetaminophen), omeprazole and senna

A patient on enteral feeding develops diarrhoea. What should the nurse review first?

1. AThe medicine chart, including laxatives and antibiotics
2. BThe patient's mobility aids and walking distance
3. CThe patient's eye drops and skin creams
4. DThe colour of the feeding bag label

On day 5 after hip surgery, a patient suddenly becomes breathless, with sharp chest pain on breathing in, a pulse of 120/min and SpO₂ 89%. What should the nurse suspect and do first?

1. AAnxiety; give reassurance and repeat the observations in an hour's time
2. BPulmonary embolism; sit up, give oxygen and call for urgent help
3. CSimple atelectasis; encourage walking around the ward
4. DWound infection; take a wound swab and wait for results

A woman's cultural practice involves eating only warm foods after birth. How should the nurse respond?

1. ATell her the practice is harmful and must stop
2. BInsist that she eat the standard hospital diet
3. CIgnore her requests to save time
4. DRespect it and offer suitable warm foods

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. BGive fast-acting glucose by mouth and recheck
3. CCheck the fetal heart rate before any treatment
4. DWait until her next meal

Dapatan carta pertumbuhan manakah pada bayi berumur 10 bulan yang paling memerlukan penilaian lanjut?

1. ABerat yang telah jatuh merentasi dua garis persentil utama sejak lawatan terakhir
2. BBerat yang kekal pada persentil ke-10 sejak lahir
3. CPanjang pada persentil ke-50 dan berat pada persentil ke-40
4. DLilitan kepala yang mengikut lengkung persentil ke-75

Seorang kanak-kanak bertatih dengan krup kini mempunyai stridor ketika rehat, gelisah dan tarikan dinding dada yang ketara. Apakah keutamaannya?

1. APeriksa tekak dengan penekan lidah untuk mencari punca bunyi pernafasan yang bising
2. BBaringkan kanak-kanak rata untuk berehat
3. CDapatkan bantuan perubatan segera; ini ialah krup teruk yang mungkin memerlukan epinefrin nebulisasi
4. DHantar kanak-kanak itu pulang dengan ubat batuk

What must a patient be told for consent to a new psychotropic medicine to be valid?

1. AOnly the name of the medicine and the time of day it will be given
2. BThe expected benefits, the main risks and the alternatives, including no treatment
3. COnly the benefits, so that the patient is not frightened by the side effects
4. DNothing at all, because psychiatric patients cannot give consent

A patient with alcohol dependence is confused, unsteady on his feet and has abnormal eye movements. Why is it urgent to give thiamine?

1. AThiamine quickly lowers the blood alcohol level
2. BWernicke's encephalopathy can be reversed if treated early, but may otherwise lead to permanent Korsakoff syndrome
3. CThiamine prevents all alcohol withdrawal seizures
4. DThiamine will make him dislike the taste of alcohol in the future, which helps prevent a relapse

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit setinggi 187 cm. Dengan menggunakan 1 inci = 2.54 cm, cari ketinggian h dalam inci. Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Keputusan kreatinina serum ialah 0.9 mg/dL. Dengan menggunakan 1 mg/dL = 88.4 µmol/L untuk kreatinina, cari c dalam µmol/L kepada nombor bulat yang terdekat.

Dos 1000 mg diperlukan daripada larutan 10% (b/i). Isi padu V manakah yang mengandungi dos ini?

Preskripsi ialah 880 unit ubat yang datang sebagai 1000 unit/mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

Infuskan 1000 mL selama 6 jam dengan set pemberian 15 gtt/mL. Cari kadar titisan R dalam titis seminit. Bundarkan kepada nombor bulat yang terdekat.

Satu beg mengandungi 250 mg ubat dalam 50 mL dan berjalan pada 8 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 8 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 120 mL/j. Pada 13:00, 100 mL telah diinfuskan. Berapa jam t sehingga beg kosong? Bundarkan kepada satu tempat perpuluhan.

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

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: ya; cara berjalan: lemah; 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