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

How is a 24-hour urine collection started?

1. AA sample is taken every four hours and the rest discarded
2. BOnly urine passed at night is collected
3. CThe first urine of the morning is discarded and the time noted, then all urine is kept
4. DThe first urine of the morning is kept and the rest of the day's urine is discarded

A pulse oximeter reads 82% on a patient with cold hands who is talking in full sentences with a normal respiratory rate. What is the best first action?

1. AIgnore the reading because the patient looks well
2. BCheck the patient and probe, then warm the hand or move the probe
3. CRemove any oxygen because the reading must be wrong
4. DRecord the reading and recheck it at the next routine set of observations

A patient has orthostatic hypotension. Which teaching helps to prevent falls?

1. AAvoid drinking fluids in the morning to reduce trips to the toilet
2. BSit on the edge of the bed for a short time before standing up slowly
3. CStand up straight after a hot shower to increase blood flow
4. DGet out of bed quickly so the dizziness passes sooner

Seorang pesakit yang keliru terus menarik tiub nasogastrik. Pendekatan manakah yang patut dicuba dahulu?

1. ASekatan pergelangan tangan serta-merta untuk melindungi tiub
2. BMengeluarkan tiub tanpa berunding dengan pasukan
3. CSedatif supaya pesakit tidur dengan tenang sepanjang malam
4. DLangkah yang kurang menyekat, seperti orientasi semula dan penjaga

Which patient is most suitable for the nurse to assign to a nurse who has just finished orientation?

1. AA patient on a continuous heparin infusion with rising aPTT values
2. BA patient with stable cellulitis on scheduled IV antibiotics
3. CA patient with a new tracheostomy who needs frequent suctioning
4. DA patient with sepsis whose blood pressure is falling

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. ANormal bruising from blood tests
2. BVitamin C deficiency
3. CAn allergic reaction to the adhesive tape
4. DDisseminated intravascular coagulation (DIC)

Tangga analgesik WHO mengesyorkan:

1. AMemulakan semua pesakit dengan opioid kuat
2. BBergerak daripada bukan opioid kepada opioid lemah kemudian opioid kuat apabila sakit bertambah
3. CMemberi analgesia hanya apabila sakit menjadi teruk
4. DMenggunakan kaedah bukan ubat sahaja untuk sakit kanser

Dalam triaj, pesakit manakah yang patut dilihat dahulu?

1. APesakit dengan sakit tekak selama dua hari
2. BPesakit yang meminta preskripsi ulangan
3. CPesakit dengan buku lali terseliuh dan bengkak ringan
4. DPesakit dengan pernafasan berbunyi dan bibir bengkak selepas makan kacang tanah

A patient with an upper gastrointestinal bleed has a BUN of 48 mg/dL (urea 17 mmol/L) and a normal creatinine. What is the most likely explanation?

1. ASkeletal muscle is breaking down because of the blood loss
2. BThe kidneys have suddenly lost most of their function
3. CThe liver has stopped making urea because of the bleeding
4. DDigested blood adds protein, which the liver turns into urea

A patient's bedside glucose meter shows "HI" (above its measuring range). The patient is drowsy. What should the nurse do?

1. AAssume the meter is broken and give the usual insulin dose
2. BGive oral glucose in case the reading is wrong and the patient is low
3. CRecord "HI" and repeat the meter test at the next scheduled time
4. DSend a venous sample to the lab and inform the provider at once

Why are patients taking simvastatin often advised to avoid large amounts of grapefruit juice?

1. AGrapefruit speeds up simvastatin breakdown in the liver, so the drug stops working
2. BGrapefruit inhibits CYP3A4 in the gut, raising simvastatin levels and myopathy risk
3. CGrapefruit blocks cholesterol absorption and causes low cholesterol
4. DGrapefruit makes the tablet dissolve in the mouth

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"I will tell someone if I have thoughts of harming myself."
3. C"I may have some nausea at first."
4. D"It may take a few weeks to feel the full effect."

A patient uses a glyceryl trinitrate (nitroglycerin) patch for angina. Why is it usually removed for several hours each day?

1. AA nitrate-free interval prevents tolerance
2. BIt lowers the risk of a high potassium level
3. CThe patch works only during the night
4. DThe skin needs a break to absorb a larger dose

Three days after an MI, a patient faints on the commode while straining hard to open the bowels. The heart rate was 42/min at the time. What is the most likely mechanism?

1. AA new pulmonary embolism
2. BA vagal response to straining
3. CLow blood glucose from fasting
4. DAn allergic reaction to the commode

A patient has confirmed meningococcal meningitis. What is usually offered to their close household contacts?

1. AA full course of IV antibiotics in hospital
2. BPreventive antibiotics
3. CA lumbar puncture to check for infection
4. DNo action unless they develop symptoms

A patient with lung cancer is confused, dehydrated and constipated, with a corrected calcium of 3.4 mmol/L (about 13.6 mg/dL). What is usually the first treatment?

1. AA fluid restriction
2. BIV fluids to rehydrate the patient
3. CIV calcium gluconate and vitamin D
4. DOral calcium tablets

Apakah tanda paling awal hipertermia malignan semasa anestesia?

1. APeningkatan CO₂ akhir tidal yang tidak dapat dijelaskan
2. BKulit kemerahan dengan aras CO₂ yang menurun
3. CPenurunan suhu badan yang berterusan
4. DKadar jantung yang memperlahan dan tekanan darah rendah

A nurse teaches a patient with GORD. Which statement shows a need for further teaching?

1. A"I'll stop smoking because it makes reflux worse."
2. B"Peppermint tea after dinner will settle my reflux."
3. C"I'll try to lose some weight over the next months."
4. D"I'll keep a diary of foods that trigger my symptoms."

A newborn at 42 weeks has dry, cracked, peeling skin, long nails and little vernix. How is this baby best described?

1. APost-term (postmature)
2. BLarge for gestational age
3. CSmall for gestational age only
4. DPreterm

Which finding in a newborn at 6 hours requires the most urgent action?

1. ASmall white milia on the nose and chin
2. BAcrocyanosis of the hands and feet
3. CMild moulding of the head
4. DCentral cyanosis, fast breathing and grunting

Which approach best helps a 4-year-old during a vaccination?

1. AHave staff hold the child flat on the couch so the injection is quick
2. BPromise a reward only if the child stays completely still and does not cry
3. CTell the child the injection will not hurt at all
4. DHold the child upright on a parent's lap and use distraction, such as blowing bubbles

Seorang kanak-kanak usia sekolah akan menjalani pembedahan. Pendekatan penyediaan manakah yang paling sesuai dengan usia ini?

1. ABincangkan segalanya dengan ibu bapa tetapi tidak dengan kanak-kanak, supaya kanak-kanak tidak ketakutan
2. BElakkan menerangkan kerana ia hanya akan menyebabkan ketakutan
3. CTerangkan prosedur dengan gambar rajah mudah, benarkan soalan dan libatkan kanak-kanak dalam membuat pilihan
4. DGunakan cakap bayi dan mainan untuk bayi sahaja

Pemantauan manakah yang amat penting bagi pesakit yang mengambil antipsikotik generasi kedua seperti olanzapin?

1. AKiraan platelet sahaja
2. BKetumpatan tulang sahaja
3. CBerat badan, lilitan pinggang, glukosa darah dan lipid
4. DPendengaran dan penglihatan sahaja, kerana ia paling terjejas oleh ubat ini

A behaviour plan states that staff will no longer give attention to a child's tantrums but will praise calm behaviour. For the first few days, the tantrums become worse. What does this most likely show?

1. AThat the plan has failed and should be stopped immediately
2. BThat the tantrums are caused by a physical illness
3. CAn extinction burst, which is expected before the behaviour decreases
4. DThat the child needs firm punishment for each tantrum instead

Latihan (nilai rekaan, bukan panduan klinikal). Satu dos dicatat pada 05:30 (jam 24 jam). Entri yang manakah merupakan masa yang sama pada jam 12 jam? Klik padanya.

1. 17:30 AM
2. 25:30 AM
3. 35:30 PM
4. 44:30 AM

Latihan (nilai rekaan, bukan panduan klinikal). Keputusan kreatinina serum ialah 2.1 mg/dL. Dengan menggunakan 1 mg/dL = 88.4 µmol/L untuk kreatinina, cari c dalam µmol/L kepada nombor bulat yang terdekat.

Seorang kanak-kanak seberat 40 kg dipreskripsikan 4 mg/kg ubat. Larutan stok mengandungi 25 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?

Seorang kanak-kanak berberat 14 kg dipreskripsi 12.5 mg/kg setiap dos suspensi oral yang mengandungi 250 mg dalam 5 mL. Berapakah isi padu V yang anda berikan?

Infuskan 500 mL selama 5 jam dengan set pemberian 60 gtt/mL. Cari kadar titisan R dalam titis seminit.

Satu infusi 100 mg dalam 250 mL berjalan pada 18 mL/j. Berapa mikrogram seminit 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. Kira ketulan ais sebagai separuh isi padunya.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi 500 mL bermula pada 11:30 dengan 75 mL/j. Selepas 2 jam kadar ditukar kepada 125 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 latihan dinilai dengan skala Braden: persepsi deria: sedikit terhad; kelembapan: sentiasa lembap; aktiviti: kerap berjalan; mobiliti: tidak bergerak sepenuhnya; pemakanan: mungkin tidak mencukupi; geseran dan ricih: masalah. Cari jumlah Braden B.

Latihan (nilai rekaan, bukan panduan klinikal). Seorang dewasa seberat 132 kg dan setinggi 165 cm. Kira BMI dan klik kategori berat WHO.

1. 1kekurangan berat badan
2. 2berat badan sihat
3. 3berat badan berlebihan
4. 4obesiti kelas I
5. 5obesiti kelas II
6. 6obesiti kelas III