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

Why should a tourniquet not be left on for a long time before taking blood?

1. AIt makes the blood turn blue in the tube
2. BIt stops the needle from entering the vein because the vein is too hard
3. CIt makes the patient's arm grow stronger
4. DIt can change the results, for example by concentrating the blood

An 82-year-old takes nine regular medicines and has had two falls this month. What is the most useful next step?

1. AStop all the medicines straight away
2. BAdvise the patient to stay in bed
3. CAsk for a full medication review
4. DAdd a sedative to help them rest

A patient has fallen, and the nurse completes an incident report. Which statement about this report is correct?

1. AIt replaces the need to document the fall in the patient’s record
2. BIt is only needed when the patient is injured
3. CIt is written factually and does not replace documenting the fall in the patient’s record
4. DA copy of it is placed in the patient’s chart so all staff know about the fall

A patient dies after a wrong-drug error, and the hospital carries out a root cause analysis. What is its main focus?

1. AIdentifying which staff member made the error and should be disciplined
2. BFinding the system and process weaknesses that allowed the error
3. CDeciding whether to tell the family about the error
4. DEstimating the legal costs for the hospital

A young adult has just started an SSRI antidepressant for major depression. What should the nurse monitor most closely in the first weeks?

1. ARising blood glucose levels
2. BThoughts of suicide or self-harm
3. CWeight loss from too much appetite
4. DHair growth and skin color

A nurse teaches a patient to inject enoxaparin at home. Which statement shows a need for further teaching?

1. A“I will inject into the fat of my abdomen, away from the navel.”
2. B“I will rub the area after the injection to help it absorb.”
3. C“I will tell my doctor if I notice unusual bruising or bleeding.”
4. D“I will change the injection site each time.”

What is the most common cause of hypernatraemia in frail older inpatients?

1. AToo much exercise
2. BNot drinking enough water
3. CEating too much salt in one meal
4. DTaking too many vitamins

Which action is most important in protecting a patient with severe neutropenia from infection?

1. AKeeping fresh flowers and plants in the room to help the patient's mood
2. BGiving routine intramuscular injections
3. CTaking rectal temperatures regularly
4. DStrict hand hygiene by everyone who has contact with the patient

A patient has a hot, swollen big toe. The serum uric acid is normal. Which statement is correct?

1. AGout is ruled out, as uric acid is always high in an attack
2. BGout can only be diagnosed with a CT scan of the foot
3. CGout is still possible, as urate can be normal in an attack
4. DGout is certain, as a normal urate proves the diagnosis

A patient using an insulin pump has a glucose of 300 mg/dL (16.7 mmol/L) that has not fallen 2 hours after a correction bolus through the pump. Blood ketones are 1.8 mmol/L. What is the most likely problem and action?

1. ARebound after a hypo; give fast-acting carbohydrate and recheck in 15 minutes
2. BInsulin overdose from the pump; suspend the pump and stop all insulin for a day
3. CInsulin delivery failure; inject a correction dose by pen and change the set
4. DNormal pump function; wait for the next mealtime bolus to lower the glucose

After several years of levodopa treatment, which problem is common?

1. ASevere hypoglycaemia after each dose
2. BPermanent hearing loss
3. CComplete and permanent loss of all Parkinson's symptoms
4. DDyskinesias and "on–off" fluctuations in response

A patient with severe liver cirrhosis needs a benzodiazepine for alcohol withdrawal. Why is lorazepam often chosen instead of diazepam?

1. ALorazepam does not cause sedation in liver disease
2. BLorazepam is a stronger anticonvulsant than all other benzodiazepines
3. CLorazepam is cleared by simple conjugation and has no active metabolites
4. DLorazepam is excreted unchanged in the urine without any metabolism

A patient has episodes of severe headache, sweating and palpitations with very high blood pressure. Which rare cause should be considered?

1. AAsthma
2. BAortic stenosis
3. CPhaeochromocytoma
4. DStable angina

A 28-year-old woman taking the combined pill comes in breathless and anxious. RR is 30/min, heart rate 118/min and SpO₂ 90% on air. A colleague says it is a panic attack. What should the nurse conclude?

1. ABreathing into a paper bag is the best first treatment for her
2. BThe saturation is normal for an anxious person who is breathing fast
3. CShe should be sent home after a sedative
4. DLow oxygen saturation is not explained by anxiety; PE must be excluded

A patient takes levodopa for Parkinson's disease. Which teaching point is correct?

1. ALarge high-protein meals can reduce how well the drug works
2. BThe drug cures the disease if taken for a full year
3. CThe tablets work best taken with a large steak dinner
4. DStop the drug for a day each week to avoid tolerance

Seorang pesakit yang mengambil litium mengalami poliuria dan dahaga, dan air kencing tidak memekat selepas desmopresin. Apakah punca yang paling mungkin?

1. ADiabetes jenis 1 yang baru berkembang
2. BDI kranial selepas kecederaan kepala
3. CSIADH disebabkan oleh litium
4. DDI nefrogenik disebabkan oleh litium

A day after a spinal anaesthetic, a patient has a headache that is worse when sitting up and better when lying flat. What is the most likely cause?

1. AA side effect of the antibiotic
2. BRaised blood pressure from pain
3. CMigraine caused by hospital lighting
4. DPost-dural puncture headache

Semasa infusi vinkristin IV melalui kanula periferi, pesakit melaporkan rasa terbakar, dan tapak bengkak. Apakah yang patut dilakukan oleh jururawat dahulu?

1. AMembilas kanula dengan salin untuk menolak baki ubat ke dalam vena
2. BMengeluarkan kanula serta-merta dan mengurut kawasan itu untuk menyebarkan ubat
3. CMeneruskan infusi dengan lebih perlahan dan meletakkan paket ais pada tapak
4. DMenghentikan infusi, membiarkan kanula untuk menyedut, mengikut dasar

Which finding in a term newborn's first hours is normal?

1. ACentral cyanosis of the lips and tongue
2. BPauses in breathing of 30 seconds with bradycardia
3. CShort breathing pauses with no colour change
4. DA respiratory rate of 80 at rest with retractions

A breastfeeding mother has a hard, tender lump in one breast without fever. She feels well. What is the most likely cause and the best advice?

1. AA breast abscess; stop breastfeeding completely
2. BA blocked duct; keep feeding and vary positions
3. CBreast cancer; stop breastfeeding at once
4. DMastitis; stop feeding from that breast

Tanda manakah yang mencadangkan kanak-kanak bersedia untuk memulakan latihan tandas?

1. AMampu berjalan
2. BMenyebut perkataan pertama
3. CKekal kering selama kira-kira 2 jam, menunjukkan minat dan mampu mengikut arahan mudah
4. DMencapai hari jadi pertama dan mampu berjalan, sama ada kanak-kanak menunjukkan minat atau tidak

Only one negative-pressure room is available. Which child should be placed in it?

1. AA child with impetigo
2. BA child with norovirus gastroenteritis and vomiting
3. CA child with RSV bronchiolitis
4. DA child with suspected measles

Dalam pemeriksaan status mental, dapatan manakah yang direkodkan di bawah kandungan pemikiran?

1. ALompatan idea
2. BObsesi dan delusi
3. CAsosiasi longgar
4. DPertuturan tertekan

A teenager says she cuts herself "to feel better, not to die." Which statement about this is correct?

1. ANon-suicidal self-injury still increases the long-term risk of suicide, so risk is assessed each time
2. BSelf-injury without suicidal intent shows that she has no mental health problems that need any treatment
3. CSelf-injury without suicidal intent never needs any assessment
4. DShe should be told that cutting is only attention-seeking behaviour

Latihan (nilai rekaan, bukan panduan klinikal). Satu pengiraan kadar titisan memberikan 92.184 gtt/min. Peraturan dalam latihan ini ialah kadar titisan dibundarkan kepada titisan bulat yang terdekat. Apakah nilai x yang anda rekodkan?

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi bermula pada 21:20 dan tamat pada 00:50 keesokan paginya (jam 24 jam). Berapa minit t ia berjalan?

Seorang pesakit berberat 15 kg dan dipreskripsikan 5 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 40 mg dalam 1 mL. Berapakah isi padu V yang anda berikan?

Satu infusi diarahkan pada 100 mL/j, tetapi tiada pam tersedia. Ia berjalan secara graviti melalui set pemberian 15 gtt/mL. Cari kadar titisan R dalam titisan seminit.

Sebuah beg mengandungi 4 g ubat dalam 1000 mL. Arahannya ialah 1.5 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 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 beg 1000 mL dimulakan pada 07:30 dan berjalan dengan pam pada 80 mL/j. Berapa mL V yang tinggal dalam beg pada 15:00?

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan dinilai dengan skala jatuh Morse: sejarah jatuh dalam 3 bulan yang lalu: tidak; diagnosis sekunder: tidak; alat bantu berjalan: berpegang pada perabot; terapi IV atau kunci salina: tidak; 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). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 16/min, SpO₂ 89% bernafas udara bilik, tekanan darah 112/68 mmHg, nadi 92/min, sedar, suhu 37.5 °C. Kumpulan risiko klinikal yang manakah pesakit itu termasuk? Klik padanya.

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