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

Pesakit demensia lanjut tidak dapat menerangkan sakitnya. Bagaimanakah sakit patut dinilai?

1. ADengan menggunakan skala penilaian berangka 0–10 sahaja
2. BDengan alat sakit pemerhatian yang menskor tingkah laku seperti ekspresi muka
3. CDengan menganggap tiada sakit selagi pesakit tidak mengadu atau meminta bantuan
4. DDengan meminta pelawat meneka skor sakit

Pesakit yang berkeupayaan menolak rawatan yang dipreskripsikan. Apakah yang patut dilakukan oleh jururawat?

1. AMemberi rawatan itu juga, kerana ia telah dipreskripsikan dan doktor telah memutuskan ia demi kepentingan terbaik mereka
2. BMenghormati penolakan itu, memastikan mereka memahami akibatnya, memaklumkan pasukan dan mendokumenkannya
3. CMeminta saudara-mara memberi persetujuan sebagai ganti
4. DMenyembunyikan ubat dalam makanan pesakit

An older adult has trouble getting in and out of the bath. Which measures make bathing safer?

1. ALocking the bathroom door for privacy
2. BBath oil to help the person slide in and out
3. CA shower chair, grab bars and a non-slip mat
4. DA loose rug beside the tub to stand on

Victims of a chemical spill arrive at the emergency department with liquid on their skin and clothing. What is the priority before they enter the building?

1. ADecontaminate them outside, with staff wearing appropriate PPE
2. BTake a full history in the waiting room
3. CGive them hospital gowns and seat them in triage
4. DTake them straight into the resuscitation room so treatment is not delayed

During a blood transfusion, a patient develops chills, back pain and a fever. What is the nurse’s first action?

1. AFinish the unit quickly through a pressure bag so that the reaction does not last long
2. BSlow the transfusion and recheck in an hour
3. CGive an antipyretic and continue the transfusion
4. DStop the transfusion and keep the IV open with normal saline via new tubing

Which patient needs airborne precautions rather than droplet precautions?

1. AA teenager with mumps
2. BA child with pertussis (whooping cough)
3. CA child with chickenpox (varicella)
4. DAn adult with influenza

Dalam tempoh masa manakah trombolisis IV lazimnya diberi untuk strok iskemia akut?

1. ADalam masa 48 jam selepas bermulanya gejala
2. BPada bila-bila masa dalam seminggu
3. CDalam masa 4.5 jam selepas bermula gejala
4. DHanya selepas 24 jam

A patient with poorly controlled hyperthyroidism develops a high fever, very fast heart rate, agitation and vomiting during an infection. What is likely?

1. AHypoglycaemia
2. BMyxoedema coma
3. CThyroid storm
4. DAddisonian crisis

A patient with chronic kidney disease receives an erythropoiesis-stimulating agent such as epoetin alfa. Which assessments are most important?

1. ALiver enzymes and bilirubin
2. BSerum glucose and ketones
3. CSerum amylase and lipase
4. DHemoglobin and blood pressure

A patient on warfarin with an INR of 3.6 fell and hit their head an hour ago. They now report a worsening headache and drowsiness. What is the priority?

1. AReport urgently for imaging and possible reversal
2. BGive acetaminophen (paracetamol) and recheck the INR tomorrow
3. CEncourage rest in a dark room to settle the pain
4. DHold warfarin for one dose and observe at home

A patient must mix regular (soluble) insulin and NPH (isophane) insulin in one syringe. What is the correct order?

1. ADraw up the clear regular insulin first, then the cloudy NPH insulin
2. BDraw up the cloudy NPH insulin first, then the clear regular insulin
3. CShake both vials hard, then draw them up in any order
4. DDraw them up in separate syringes, then mix them in a cup

Which finding most favours serotonin syndrome over neuroleptic malignant syndrome?

1. AA very high creatine kinase
2. BRapid onset with hyperreflexia and clonus
3. CRecent start of an antipsychotic drug
4. DSlow onset over days with lead-pipe rigidity

How is orthostatic (postural) hypotension usually assessed?

1. ABP lying after rest, then again after 1 and 3 minutes standing
2. BBP once sitting, then once lying down straight after a large meal
3. CBP in both arms at the same moment while sitting
4. DBP only standing, after a brisk walk along the corridor

A 25-year-old non-smoker has wheeze and cough that come and go, worse at night and after exercise. Spirometry improves markedly after a bronchodilator. Which diagnosis is most likely?

1. AIdiopathic pulmonary fibrosis
2. BHeart failure
3. CCOPD
4. DAsthma

Seorang pesakit terjaga dengan gejala strok. Mereka tidur dalam keadaan sihat pada pukul 23:00 dan terjaga pada pukul 06:30. Masa manakah yang digunakan sebagai masa permulaan?

1. AMasa imbasan CT dilakukan
2. B06:30, ketika gejala mula-mula disedari
3. CMasa tiba di hospital
4. D23:00, ketika mereka kali terakhir diketahui sihat

A patient with Guillain–Barré syndrome has a blood pressure that swings between 80/50 and 190/100 mmHg and a heart rate that changes suddenly. What does this suggest?

1. AA faulty blood pressure cuff that should be replaced and the readings ignored
2. BAnxiety that will settle with reassurance alone
3. CAutonomic dysfunction, which needs continuous cardiac monitoring
4. DA drug reaction that means all medicines must stop

Which liver function test pattern suggests bile duct obstruction?

1. ANormal bilirubin with a low ALP and low GGT
2. BVery high ALT with a normal bilirubin only
3. CA low albumin with all other results normal
4. DHigh bilirubin with a markedly raised ALP and GGT

A patient with diabetes on continuous enteral feeding and an insulin regimen has the feed stopped for a procedure. What is the main concern?

1. ARefeeding syndrome from too much glucose
2. BDiarrhoea from stopping the feed suddenly
3. CHypoglycaemia if insulin continues without the feed
4. DHyperglycaemia because the stomach is empty

A woman 4 hours after birth has severe perineal pain and pressure. Her fundus is firm, lochia is normal, and her heart rate is rising. What should the nurse suspect?

1. AA urinary tract infection
2. BA vulvar or vaginal haematoma
3. CUterine atony
4. DNormal afterpains

At 18 weeks, a woman's maternal serum alpha-fetoprotein is well above the normal range for her dates. Which condition does this result most suggest?

1. APre-eclampsia
2. BGestational diabetes
3. CDown syndrome (trisomy 21)
4. DAn open neural tube defect

Which measure is most important in preventing infection in a child with neutropenia?

1. AWearing a mask only when the child has a fever
2. BCareful hand hygiene by everyone in contact with the child
3. CKeeping all visitors, including the parents, out of the child's room
4. DGiving routine antibiotics to all family members

After surgery for a perforated appendix, why is a child often nursed in a semi-upright position?

1. ATo prevent the child from sleeping too deeply
2. BTo stop the wound drain from removing fluid too fast during the first day
3. CTo help infected fluid collect in the pelvis rather than spread upwards
4. DTo make it easier for the child to watch television

A man taking risperidone reports breast enlargement and his partner says he has lost interest in sex. Which effect is the most likely cause?

1. ARaised prolactin
2. BRaised blood calcium
3. CLow blood sodium
4. DLow thyroid hormone

A patient with anorexia nervosa is found doing sit-ups in her room after every meal. What is the best nursing response?

1. ATell her she will be tube-fed if she does it again
2. BIgnore it, because exercise is always healthy
3. CCalmly follow the agreed care plan on activity and observation, without arguing or punishing
4. DPraise her for being so active and motivated, because it shows she is taking care of her health

Latihan (nilai rekaan, bukan panduan klinikal). Satu pengiraan dos untuk suntikan memberikan 12.6978 mL. Peraturan dalam latihan ini ialah isi padu 1 mL atau lebih dibundarkan kepada persepuluh mL yang terdekat. Apakah nilai x yang anda rekodkan?

Latihan (nilai rekaan, bukan panduan klinikal). Satu arahan berbunyi 1 mcg/kg/min untuk pesakit seberat 96 kg. Nyatakan kadar dos D dalam mg/h. Bundarkan kepada dua tempat perpuluhan.

Seorang kanak-kanak seberat 15 kg dipreskripsikan 3 mg/kg ubat. Larutan stok mengandungi 25 mg/mL. Sedut dos itu: berapakah isi padu V yang anda berikan?

Preskripsi ialah 660 mikrogram. Ampul mengandungi 2 mg/mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

Infuskan 250 mL selama 8 jam dengan set pemberian 20 gtt/mL. Cari kadar titisan R dalam titis seminit. Bundarkan kepada nombor bulat yang terdekat.

Satu titisan berjalan pada 50 gtt/min melalui set 60 gtt/mL. Terdapat 900 mL lagi dalam beg. Berapa jam t sehingga ia kosong?

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 imbangan cecair B = pengambilan − pengeluaran dalam mL (jawapan negatif bermaksud kehilangan bersih). Kira ketulan ais sebagai separuh isi padunya.

Latihan (nilai rekaan, bukan panduan klinikal). Satu beg 500 mL berjalan dengan pam pada 80 mL/j. Pada 08:00, 300 mL telah diinfuskan. Berapa jam t sehingga beg kosong? Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu carta latihan merekodkan GCS 13, dengan E4 dan V4. Apakah skor motor M yang direkodkan, dan respons yang manakah yang dihuraikannya? Berikan nombornya.

Latihan (nilai rekaan, bukan panduan klinikal). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 18/min, SpO₂ 93% dengan oksigen tambahan, tekanan darah 142/86 mmHg, nadi 58/min, sedar, suhu 37.7 °C. Kumpulan risiko klinikal yang manakah pesakit itu termasuk? Klik padanya.

1. 1rendah
2. 2rendah–sederhana
3. 3sederhana
4. 4tinggi