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

When should blood cultures be taken in a patient with suspected sepsis?

1. AAfter the patient has recovered from the infection
2. BBefore antibiotics are given, as long as this does not delay them
3. COnly after three days of antibiotics, to see if they are working
4. DOnly if the temperature rises above 40 °C

Why should a near miss be reported even though no harm occurred?

1. AIt does not need reporting if no one was harmed
2. BSo the nurse involved can be identified and disciplined
3. CBecause insurance companies require a report for every shift worked
4. DIt helps find and fix system problems before someone is harmed

Seorang jururawat mengalami kecederaan tertusuk jarum daripada pesakit yang diketahui menghidap HIV. Mengapakah penting untuk melaporkannya dengan segera?

1. APelaporan boleh dibuat pada bila-bila masa dalam sebulan tanpa mengubah risiko
2. BPelaporan hanya diperlukan bagi kecederaan daripada jarum IV
3. CPelaporan hanya diperlukan jika luka berdarah atau dalam
4. DProfilaksis pasca-pendedahan paling berkesan jika dimulakan dalam masa beberapa jam

A nurse teaches new parents how to cope with an infant’s crying. Which statement shows a need for further teaching?

1. A“If I get frustrated, I will put him safely in the crib and take a short break.”
2. B“I will check whether he is hungry, wet or too warm.”
3. C“If he won’t stop crying, a quick shake will get his attention.”
4. D“I can call a friend or family member to help when I am tired.”

A nursing assistant offers to suction a patient’s new tracheostomy. Which response from the RN is best?

1. A“Thank you, please suction him as needed and tell me how it went.”
2. B“Suctioning a new tracheostomy is my task; I will do it myself.”
3. C“Ask the patient’s family to do the suctioning today.”
4. D“Leave the suctioning until the next shift arrives.”

A patient opens their eyes only to pain, uses inappropriate words and withdraws from pain. What is the Glasgow Coma Scale score?

1. A9
2. B7
3. C13
4. D11

A patient who injects drugs has a fever, a new heart murmur and small dark lines under the nails. What is the likely diagnosis?

1. APericarditis
2. BRheumatic fever
3. CInfective endocarditis
4. DMyocardial infarction

A patient with lung cancer develops swelling of the face and arms, distended neck veins and breathlessness that is worse lying down. What should be suspected?

1. AHypothyroidism
2. BRight-sided heart failure from valve disease
3. CSuperior vena cava obstruction
4. DAn allergic reaction to food

A patient with central diabetes insipidus starts desmopressin. Which laboratory result is most important to monitor for an adverse effect?

1. ASerum potassium, which may rise too high
2. BSerum sodium, which may fall too low
3. CSerum glucose, which may rise very high
4. DSerum calcium, which may rise too high

A patient with long-term heavy alcohol use is admitted with alcohol withdrawal. Which group of electrolyte problems is most common?

1. ALow chloride, high bicarbonate and high calcium
2. BHigh magnesium, high phosphate and high potassium
3. CLow magnesium, low phosphate and low potassium
4. DHigh sodium, high calcium and high glucose

Kesan buruk manakah yang tipikal bagi metoklopramid, terutamanya pada orang muda?

1. ASembelit teruk
2. BBatuk kering
3. CGlukosa darah rendah
4. DGangguan pergerakan ekstrapiramidal seperti distonia akut

A patient has a serum potassium of 7.0 mmol/L (mEq/L) and peaked T waves on the ECG. Which drug is given first to protect the heart?

1. AIntravenous calcium gluconate
2. BOral sodium polystyrene sulfonate
3. COral potassium chloride
4. DIntravenous furosemide

A patient's blood pressure is high in clinic but normal on home readings. Which step best confirms the diagnosis?

1. AStarting two antihypertensive drugs at once at full dose
2. BAmbulatory or structured home blood pressure monitoring
3. CA single repeat reading in the same clinic visit
4. DA chest X-ray

Seorang pesakit dengan penyakit arteri periferi yang diketahui tiba-tiba mengalami kaki sejuk, putih dan sakit tanpa nadi serta jari kaki kebas. Apakah keutamaan?

1. AMembuat eskalasi serta-merta sebagai kecemasan; pastikan kaki sama aras, tiada haba
2. BMenaikkan kaki di atas bantal dan menghangatkan kaki dengan botol air panas
3. CMenggalakkan berjalan untuk membuka peredaran kolateral
4. DMengenakan bebat mampatan untuk memperbaik peredaran darah

When a patient sticks out their tongue, it points to the right. Which nerve is affected?

1. AThe right hypoglossal nerve (XII)
2. BThe left hypoglossal nerve (XII)
3. CThe left trigeminal nerve (V)
4. DThe right facial nerve (VII)

A patient with a known ureteric stone develops a fever of 39 °C (102.2 °F) and rigors. Scanning shows a blocked, swollen kidney. What is needed?

1. AUrgent drainage of the kidney plus IV antibiotics
2. BOral antibiotics and waiting for the stone to pass
3. CA fluid restriction to reduce the swelling
4. DStrong pain relief alone, then discharge

Why is a urinary catheter usually inserted in a patient with a major burn?

1. ABurns always cause the bladder to rupture
2. BIt is needed to give medicines into the bladder
3. CHourly urine output guides fluid resuscitation
4. DThe catheter prevents wound infection

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. CWound infection; take a wound swab and wait for results
4. DSimple atelectasis; encourage walking around the ward

Which reflex causes the newborn's toes to fan out when the sole is stroked from heel to toe?

1. AStepping reflex
2. BPlantar grasp reflex
3. CBabinski reflex
4. DMoro reflex

A term newborn has rapid breathing at 2 hours after a caesarean without labour. Saturation is normal, there is no fever and the chest X-ray shows fluid in the fissures. What is the most likely diagnosis?

1. AMeconium aspiration syndrome
2. BRespiratory distress syndrome of prematurity
3. CNeonatal pneumonia with sepsis
4. DTransient tachypnoea of the newborn

A child is in skin traction for a leg fracture. Which nursing action is correct?

1. ALet the weights rest on the floor while the child sleeps, so the pull is gentler
2. BKeep the weights hanging freely, clear of the bed and floor
3. CLift the weights off when the child is uncomfortable
4. DRemove the traction tapes every hour to check the skin

The nurse has taught the family of a 7-year-old with coeliac disease. Which statement shows a need for further teaching?

1. A"He can eat normal bread at weekends if he's strict in the week."
2. B"We will check food labels for wheat, barley and rye."
3. C"Plain rice and potatoes are fine for him."
4. D"We will use a separate toaster for his gluten-free bread."

Seorang berumur 19 tahun baru memulakan antidepresan. Apakah yang patut dipantau dengan teliti oleh jururawat pada minggu-minggu pertama?

1. AKeguguran rambut
2. BPerubahan warna mata
3. CFikiran atau tingkah laku membunuh diri yang baharu atau bertambah teruk
4. DPertambahan berat badan yang pantas

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 will make him dislike the taste of alcohol in the future, which helps prevent a relapse
4. DThiamine prevents all alcohol withdrawal seizures

Latihan (nilai rekaan, bukan panduan klinikal). Suhu seorang pesakit ialah 97.3 °F. Tukarkan kepada darjah Celsius T dengan °C = (°F − 32) × 5/9. Bundarkan kepada satu tempat perpuluhan.

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

Seorang pesakit berberat 25 kg dan dipreskripsikan 10 mg/kg sebagai dos tunggal. Cari dos D dalam mg.

Seorang kanak-kanak berberat 14 kg dipreskripsi 20 mg/kg setiap dos suspensi oral yang mengandungi 250 mg dalam 5 mL. Berapakah isi padu V yang anda berikan?

Titisan berjalan pada 30 gtt/min melalui set 20 gtt/mL. Berapa mililiter V yang diterima pesakit dalam 2 jam?

Satu titisan berjalan pada 32 gtt/min melalui set 20 gtt/mL. Terdapat 600 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 8 jam. Pesakit berberat 57 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 berjalan dengan pam pada 60 mL/j. Pada 18:30, 550 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 jatuh Morse: sejarah jatuh dalam 3 bulan yang lalu: ya; diagnosis sekunder: ya; alat bantu berjalan: berpegang pada perabot; terapi IV atau kunci salina: ya; cara berjalan: normal, rehat di katil atau kerusi roda; status mental: melebih-lebihkan atau melupakan had. Cari jumlah Morse MFS.

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan dinilai dengan skala Braden: persepsi deria: tiada gangguan; kelembapan: sentiasa lembap; aktiviti: terhad pada kerusi; mobiliti: tidak bergerak sepenuhnya; pemakanan: sangat lemah; 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