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

An older patient is found to be mildly hypothermic. Which care is most appropriate?

1. AGradual rewarming with blankets and warm surroundings
2. BPutting the patient in a very hot bath straight away
3. CGiving an alcoholic drink to warm them up
4. DPlacing hot water bottles directly on the skin

Which sign is usually a late sign of hypoxia?

1. AA rising heart rate
2. BCyanosis
3. CRestlessness
4. DA rising respiratory rate

An order uses the abbreviation “MS”. Why is this unsafe?

1. AIt is the abbreviation for milliseconds, not a drug
2. BIt can mean either morphine sulfate or magnesium sulfate
3. CIt means the drug must be given by mouth only
4. DIt is reserved for drugs used in multiple sclerosis

Seorang jururawat yang bekerja dengan pesakit yang menjalani langkah berjaga-jaga sentuhan menyedari gaun mempunyai koyakan pada lengan baju. Apakah yang patut dilakukan oleh jururawat?

1. AMemakai gaun kedua di atas gaun yang koyak
2. BMenjauhi pesakit, menanggalkan PPE dengan selamat di pintu, membersihkan tangan dan memakai gaun baharu
3. CMenutup koyakan dengan secebis pita dan meneruskan
4. DTerus bekerja, kerana koyakan itu kecil dan hanya pada lengan baju

A child with fever and headache develops a purple rash that does not fade when pressed with a glass. What should the nurse do?

1. AAdvise the family to see their doctor next week
2. BGive acetaminophen (paracetamol) and reassess in four hours
3. CApply a soothing cream to the rash
4. DTreat it as an emergency and escalate at once

After a vaginal birth, the uterus is firm and central, but bright red blood keeps trickling steadily. What should the nurse suspect?

1. AUterine atony that needs more massage
2. BA full bladder pushing the uterus aside
3. CA tear in the birth canal or cervix
4. DNormal lochia for the first hour

Which advice is correct for a patient taking levothyroxine?

1. AStop taking it once the symptoms improve
2. BTake it on an empty stomach, usually before breakfast
3. CTake it only on days when feeling tired
4. DTake it with a large meal to avoid nausea and stomach upset

In a patient with a head injury, which is usually the earliest sign of rising intracranial pressure?

1. AA slow pulse with high blood pressure
2. BIrregular breathing pauses
3. CA change in level of consciousness
4. DA fixed, dilated pupil on both sides

A 55-year-old has a positive fecal immunochemical test (FIT) during routine screening. What is the usual next step?

1. AStart an iron supplement only
2. BRepeat the test in 10 years
3. CNo action if there are no symptoms
4. DReferral for colonoscopy

A patient's AST is about twice the ALT, both moderately raised, and the GGT is high. Which cause is most likely?

1. AAcute myocardial infarction
2. BAlcohol-related liver disease
3. CGallstone blocking the bile duct
4. DAcute viral hepatitis A

Why are many drugs started at lower doses in older adults?

1. AKidney and liver clearance often decline, and sensitivity to drugs increases
2. BOlder adults absorb no drugs from the stomach
3. COlder adults always weigh more than younger adults, so drugs last longer
4. DLower doses are cheaper for older patients

A patient with severe liver cirrhosis takes oral propranolol, a drug with a high first-pass metabolism. What effect is expected?

1. AThe drug is excreted faster by the kidney, so it works for a shorter time
2. BThe first-pass effect increases, so the drug becomes inactive
3. CLess drug is absorbed from the gut, so a higher dose is needed
4. DMore drug reaches the circulation, so a lower dose may be needed

How can a patient reduce wound pain when coughing after abdominal surgery?

1. ALie flat on the back with the legs straight
2. BAvoid coughing completely until all the stitches are removed
3. CHold the breath for as long as possible
4. DHold a pillow firmly against the wound while coughing

Empat jam selepas PCI melalui arteri femoral, pembalut di pangkal paha basah dengan darah dan bengkak yang keras semakin membesar. Apakah tindakan segera?

1. AMembuka pembalut dan membiarkan tapak terdedah kepada udara
2. BMembantu pesakit duduk dan berjalan ke tandas untuk membuang air kecil
3. CMenekan dengan kuat tepat di atas tapak tusukan dan memanggil bantuan
4. DMenaikkan kadar infusi heparin supaya tiada bekuan terbentuk di tapak

Seorang pesakit yang mengambil dapagliflozin (perencat SGLT2) muntah, dengan keton darah 4.5 mmol/L tetapi glukosa hanya 11 mmol/L. Apakah yang patut disyaki?

1. AKesan sampingan biasa yang tidak memerlukan tindakan
2. BHipoglisemia akibat muntah
3. CKeadaan hiperosmolar hiperglisemik
4. DKetoasidosis diabetes euglisemik

A patient with SIADH is taught about a fluid restriction. Which statement shows a need for further teaching?

1. A"I will count all drinks, including soup, in my daily total."
2. B"I will weigh myself every morning."
3. C"If I feel thirsty, I can drink as much water as I like."
4. D"I will report any headaches or confusion."

Aspirate from a nasogastric tube has a pH of 7. What should the nurse do?

1. AStart the feed slowly and watch the patient closely for coughing
2. BFlush with 50 mL of air and start the feed
3. CDo not use it; re-test later or arrange an X-ray as per policy
4. DGive the medicines but not the feed

A patient on modified-release morphine for cancer pain has needed four breakthrough doses every day for several days. What should the nurse do?

1. AGive all breakthrough doses at the same time
2. BStop the breakthrough doses to reduce opioid use
3. CReport it, as the regular background dose may need review
4. DTell the patient to put up with the pain between doses

Why are pregnant women at increased risk of urinary tract infection and pyelonephritis?

1. AProgesterone dilates the ureters and slows the flow of urine
2. BPregnancy greatly reduces the production of urine
3. CThe urine becomes more acidic in pregnancy
4. DThe bladder empties more completely in pregnancy

A preterm infant receiving oxygen has saturations that are consistently 100%. What should the nurse do?

1. ARemove the saturation probe to save the skin
2. BWean the oxygen to the target saturation range
3. CIncrease the oxygen to provide a safety margin
4. DLeave it unchanged because 100% is ideal

How are feeds usually restarted after a pyloromyotomy for pyloric stenosis?

1. ANot until 10 days after surgery, when the wound has healed
2. BOnly by nasogastric tube for the first month at home
3. CWith large, full-volume feeds straight away to make up for the weight lost
4. DWithin hours, increasing gradually as per protocol; some vomiting can be expected

In England, a 15-year-old asks a nurse for contraception and does not want her parents told. Which principle applies?

1. AShe can never receive contraception without written consent from a parent
2. BThe nurse must inform her parents and her school straight away
3. CContraception may only be given once she reaches the age of 18
4. DShe may consent herself if judged competent (Gillick and Fraser)

A woman is convinced that a famous actor she has never met is secretly in love with her and sends her signals through his films. Which type of delusion is this?

1. AErotomanic
2. BNihilistic
3. CSomatic
4. DGrandiose

During a session, a patient asks the nurse, "Are you married? Do you have children?" Which response is most appropriate?

1. AIgnore the question completely and stay silent until the patient changes the subject
2. BAnswer briefly or decline politely, then return the focus to the patient
3. CShare details about the nurse's family to build a friendship
4. DEnd the session because personal questions are not allowed

Latihan (nilai rekaan, bukan panduan klinikal). Suhu seorang pesakit ialah 97.6 °F. Tukarkan kepada darjah Celsius T dengan °C = (°F − 32) × 5/9. Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu arahan berbunyi 10 mcg/kg/min untuk pesakit seberat 99 kg. Nyatakan kadar dos D dalam mg/h. Bundarkan kepada dua tempat perpuluhan.

Seorang pesakit berberat 60 kg. Dos yang dipreskripsikan ialah 2 mg/kg sehari, diberi dalam 2 dos yang sama. Berapakah miligram D yang diberi bagi setiap dos?

Seorang kanak-kanak berberat 28 kg dipreskripsi 10 mg/kg setiap dos suspensi oral yang mengandungi 250 mg dalam 5 mL. Berapakah isi padu V yang anda berikan?

1000 mL diarahkan selama 8 jam. Selepas 3 jam anda mendapati 790 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 100 mg ubat dalam 500 mL dan berjalan pada 5 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. Pesakit berberat 66 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 10:45 dan berjalan dengan pam pada 80 mL/j. Berapa mL V yang tinggal dalam beg pada 18:45?

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan selepas kecederaan kepala membuka mata apabila dipanggil, hanya mengeluarkan bunyi yang tidak difahami seperti mengerang dan menunjukkan respons motor terbaik: fleksi lengan yang tidak normal (postur dekortikat). Tentukan GCS dan klasifikasikan kecederaan kepala mengikutnya. Klik jawapan anda.

1. 1ringan
2. 2sederhana
3. 3teruk

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan dinilai dengan skala Braden: persepsi deria: sangat terhad; kelembapan: sangat lembap; aktiviti: terhad pada kerusi; mobiliti: sedikit terhad; pemakanan: mungkin tidak mencukupi; geseran dan ricih: potensi masalah. Gunakan jalur 19–23 tiada risiko, 15–18 ringan, 13–14 sederhana, 10–12 tinggi dan 9 atau kurang sangat tinggi. Klik tahap risikonya.

1. 1tiada risiko
2. 2risiko ringan
3. 3risiko sederhana
4. 4risiko tinggi
5. 5risiko sangat tinggi