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

How should oxygen cylinders be stored on a ward?

1. ASecured upright in a holder or trolley, away from heat
2. BLying loose on the floor under the bed so they cannot fall over
3. CStacked on top of each other in a corridor
4. DIn a warm cupboard next to the radiator

A nurse develops vomiting and diarrhoea during a norovirus outbreak. When can they usually return to work (UK guidance)?

1. AThe next shift, if they feel well enough
2. B48 hours after the symptoms have stopped
3. CAfter a full week, whatever the symptoms
4. DAs soon as the vomiting stops

When should the transparent dressing over a peripheral IV site be changed?

1. AWhen it is damp, loose or visibly soiled
2. BOnly when the patient asks for a new dressing
3. COnly when the IV catheter is removed, whatever its state
4. DEvery hour, so the site can be cleaned again

Semasa pemasukan kateter urin dengan teknik steril, hujung kateter menyentuh paha pesakit. Apakah yang patut dilakukan oleh jururawat?

1. AMengelap hujung dengan antiseptik dan meneruskan
2. BMembuang kateter dan menggunakan yang baharu dan steril
3. CMembilas hujung dengan air steril dan kemudian meneruskan
4. DMeneruskan, kerana paha telah dibersihkan

A patient speaks little English, and the nurse needs to explain a new procedure. What is the best way to communicate?

1. ASpeak loudly and slowly in English
2. BAsk the patient’s 10-year-old child to translate
3. CUse a professional medical interpreter
4. DUse hand gestures and hope the patient understands

A medical-unit nurse is floated to intensive care and given a patient on a ventilator, which the nurse has never managed. What is the best response?

1. AAccept the full assignment without comment to avoid conflict
2. BLeave the intensive care unit and go back to the medical unit without telling anyone
3. CTell the charge nurse about the gap, accept tasks within competence and ask for support
4. DRefuse to work and go home, because the assignment is unsafe

What is the best way to protect the heels of a bed-bound patient from pressure damage?

1. AMassage the heels firmly several times a day to help circulation
2. BOffload the heels so they do not touch the mattress
3. CApply a tight bandage to the heels
4. DRest the heels on a rolled-up towel

Pesakit yang disyaki meningitis mengalami demam, kekejangan leher dan ruam tidak memucat. Apakah keutamaan?

1. ATunggu keputusan pungsi lumbar sebelum memulakan sebarang rawatan
2. BMalapkan lampu, galakkan rehat dan semak semula pemerhatian dalam empat jam
3. CBeri parasetamol untuk demam dan semak pesakit esok
4. DSemakan segera dan antibiotik serta-merta, tanpa menunggu ujian

A patient with iron-deficiency anemia started oral iron. Which result is usually the earliest sign that treatment is working?

1. AA fall in the white cell count
2. BA fall in the mean cell volume (MCV)
3. CA rise in the reticulocyte count
4. DA rise in the platelet count

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

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

Why is a spacer recommended with a metered-dose inhaler?

1. AIt turns the inhaler into a nebuliser
2. BMore drug reaches the lungs and less stays in the mouth
3. CIt removes the need to shake the inhaler
4. DIt doubles the dose of drug released by each puff of the inhaler

A pregnant woman develops a deep vein thrombosis. Which anticoagulant is usually preferred?

1. AAspirin alone
2. BRivaroxaban, a direct oral factor Xa inhibitor
3. CLow-molecular-weight heparin, such as enoxaparin
4. DWarfarin

A patient taking simvastatin drinks a large glass of grapefruit juice every morning. Why is this a concern?

1. AIt stops the statin from being absorbed from the gut at all
2. BIt raises statin levels and the risk of muscle damage
3. CIt causes the cholesterol level to rise sharply
4. DIt turns the statin into a blood thinner

After positive end-expiratory pressure (PEEP) is increased on a ventilated patient, the blood pressure falls. What is the most likely reason?

1. AHigher chest pressure reduces venous return to the heart
2. BPEEP directly weakens the heart muscle and its contraction
3. CPEEP lowers the blood oxygen level
4. DPEEP causes immediate blood loss from the alveolar capillaries

A patient with migraine takes painkillers or triptans on most days and now has a headache almost every day. What is the likely problem?

1. AAn allergy to the painkillers
2. BNormal progress of migraine
3. CA brain tumour, which is almost certain
4. DMedication overuse headache

A patient has erratic glucose readings. The nurse finds a soft, rubbery lump where they always inject. What is the most important teaching?

1. ADouble the insulin dose because the lump blocks the insulin
2. BKeep injecting into the lump, because it hurts less there
3. CMassage the lump firmly after every injection
4. DUse healthy sites and check glucose often, as less insulin may be needed

Which description fits a category (stage) 4 pressure ulcer?

1. AFull-thickness loss with exposed bone, tendon or muscle
2. BA shallow wound into the dermis only
3. CA blister filled with clear fluid over the heel or sacrum
4. DIntact skin with redness that does not blanch

A nurse teaches a patient to self-inject low molecular weight heparin at home. Which statement shows a need for further teaching?

1. A"I'll put the used syringe in the sharps bin."
2. B"I'll report any unusual bruising or bleeding."
3. C"I'll change the injection site each day."
4. D"I'll rub the area afterwards to spread the medicine."

Which measure helps prevent infant abduction from a maternity unit?

1. ALetting any visitor carry the baby in the corridor
2. BLeaving babies in the nursery overnight
3. CChecking staff ID before handing over a baby
4. DPosting the baby's name and room on the door

Enam jam selepas kelahiran, seorang wanita belum membuang air kecil. Fundus lembik dan teranjak ke kanan, dan pendarahan bertambah. Mengapakah ini menjadi keutamaan?

1. ARetensi air kencing hanya penting selepas kelahiran caesarean, bukan selepas kelahiran pervaginam
2. BIa menunjukkan epidural masih berfungsi dengan baik
3. CPundi kencing yang penuh menghalang uterus daripada mengecut dan menambah pendarahan
4. DPundi kencing yang penuh ialah tanda pemulihan yang normal

Langkah bukan ubat manakah yang mengurangkan kesakitan prosedur pada bayi baru lahir, contohnya semasa cucukan tumit?

1. APenyusuan, sentuhan kulit ke kulit atau sukrosa oral
2. BAir sejuk pada tumit sebelum cucukan
3. CMembiarkan bayi bersendirian dalam katil bayi
4. DMenunggu sehingga bayi tidur, tanpa sebarang keselesaan lain

Seorang kanak-kanak berumur 2 tahun mengalami sawan tonik–klonik dengan demam tinggi. Apakah yang patut dilakukan oleh jururawat dahulu?

1. APegang anggota kanak-kanak dengan kuat untuk menghentikan pergerakan dan mencegah kecederaan akibat sentakan
2. BLetakkan kanak-kanak dalam mandian sejuk
3. CLindungi kanak-kanak daripada kecederaan, catat masa sawan dan pusingkan kanak-kanak mengiring
4. DLetakkan sudu dalam mulut kanak-kanak untuk melindungi lidah

A patient with PTSD begins to dissociate during a conversation. Which grounding technique can the nurse use?

1. AAsk her to close her eyes and think back to the worst moment of the trauma
2. BLeave her alone until the episode has passed on its own
3. CAsk her to name things she can see, hear and touch in the room right now
4. DAsk her to describe the traumatic event in as much detail as she can

An 82-year-old started amitriptyline last week. Which finding is most concerning?

1. ANew confusion and difficulty passing urine
2. BA slightly dry mouth
3. CMild constipation that responds to extra fluids and fibre in the diet
4. DFeeling a little drowsy in the evening

Latihan (nilai rekaan, bukan panduan klinikal). Seorang bayi baru lahir seberat 4 lb 15 oz. Dengan menggunakan 1 lb = 16 oz dan 1 kg = 2.2 lb, cari berat m dalam kilogram. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi bermula pada 17:10 dan tamat pada 07:15 keesokan paginya (jam 24 jam). Berapa minit t ia berjalan?

Seorang kanak-kanak seberat 24 kg dipreskripsikan 4 mg/kg ubat. Larutan stok mengandungi 20 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?

Seorang kanak-kanak berberat 8 kg dipreskripsi 20 mg/kg setiap dos suspensi oral yang mengandungi 100 mg dalam 5 mL. Berapakah isi padu V yang anda berikan?

Infuskan 1000 mL selama 6 jam dengan set pemberian 20 gtt/mL. Cari kadar titisan R dalam titis seminit. Bundarkan kepada nombor bulat yang terdekat.

Sebuah beg mengandungi 4 g ubat dalam 1000 mL. Arahannya ialah 4 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. 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 dimulakan pada 14:00 dan berjalan dengan pam pada 50 mL/j. Berapa mL V yang tinggal dalam beg pada 15:30?

Latihan (nilai rekaan, bukan panduan klinikal). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 12/min, SpO₂ 86% bernafas udara bilik, tekanan darah 124/74 mmHg, nadi 82/min, sedar, suhu 36.1 °C. Apakah jumlah skor NEWS2?

Latihan (nilai rekaan, bukan panduan klinikal). Pasukan menyasarkan tekanan arteri purata sekurang-kurangnya 65 mmHg. Tekanan sistolik pesakit ialah 123 mmHg. Dengan menggunakan MAP = (SBP + 2·DBP)/3, apakah tekanan diastolik terendah DBP yang masih memberikan MAP 65 mmHg?