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

A patient has pneumonia in the right lung only. In which side-lying position is oxygenation usually best?

1. ALying face down
2. BLying on the right side
3. CLying on the left side
4. DLying flat on the back

A woman leaks small amounts of urine when she coughs, sneezes or laughs. Which type of incontinence is this?

1. AUrge incontinence
2. BOverflow incontinence
3. CStress incontinence
4. DFunctional incontinence

Mengapakah pen insulin tidak boleh digunakan untuk lebih daripada seorang pesakit, walaupun dengan jarum baharu?

1. ASetiap pen hanya mengandungi satu dos insulin
2. BBerkongsi pen mengubah dos yang disampaikan
3. CInsulin dalam pen akan luput lebih cepat apabila dikongsi
4. DDarah boleh mengalir balik ke dalam kartrij dan menyebarkan jangkitan

A nurse has raised a safety concern about an order with the prescriber, who dismissed it without addressing it. What should the nurse do next?

1. ACarry out the order as written, because the prescriber has heard the concern
2. BState the concern clearly a second time and, if still unresolved, use the chain of command
3. CRefuse to care for the patient for the rest of the shift until the prescriber apologizes
4. DDiscuss the concern with the patient and let them decide

A nurse teaches a patient who has started warfarin. Which statement shows a need for further teaching?

1. A“I will use a soft toothbrush.”
2. B“I will keep my INR blood test appointments.”
3. C“I will tell my dentist and pharmacist that I take warfarin.”
4. D“If I miss a dose, I will take two the next day.”

Seorang jururawat menganggap dos yang ditetapkan tidak selamat. Pemreskripsi menyuruh memberikannya juga. Apakah yang patut dilakukan oleh jururawat?

1. ABeri separuh dos sebagai kompromi dan dokumenkan sebabnya
2. BLangkau dos secara senyap dan tidak berkata apa-apa untuk mengelakkan konflik
3. CBeri dos itu, kerana pemreskripsi kini bertanggungjawab atasnya
4. DTahan dos dan eskalasi melalui rantaian pemerintahan

What should the nurse regularly check for a patient with a syringe driver?

1. AOnly that the battery is charged and the device is switched on
2. BNothing, once the syringe driver is running
3. COnly the patient's weight, measured once a week on the same scales
4. DThe infusion site, the rate and volume remaining, and the patient's symptoms

A catheterised postoperative patient has passed only 10 mL of urine in the last two hours. What should the nurse check first?

1. AThe patient's cholesterol level from the admission bloods
2. BThat the catheter and tubing are not kinked or blocked
3. CThe patient's weight from last year
4. DWhether the patient has eaten breakfast

Seorang pesakit yang sedar dengan glukosa darah 54 mg/dL (3.0 mmol/L) telah mengambil 15 g karbohidrat bertindak pantas. Bilakah glukosa patut diperiksa semula?

1. APada waktu makan seterusnya
2. BSelepas kira-kira 15 minit
3. CSelepas kira-kira 2 jam
4. DPagi esok

The nurse teaches a patient starting lithium. Which statement shows a need for further teaching?

1. A"I will tell my doctor if I have vomiting or diarrhea"
2. B"I will drink plenty of fluids, especially in hot weather"
3. C"I will check with the pharmacist before taking ibuprofen"
4. D"I will cut out salt from my diet completely to stay healthy"

A child is starting methylphenidate for ADHD. Which advice is appropriate?

1. AExpect weight gain as the main side effect
2. BGive the drug only at weekends
3. CGive doses early in the day and monitor appetite and growth
4. DGive the last dose at bedtime to help the child sleep

A woman has received a high-dose oxytocin infusion with large volumes of hypotonic fluid for many hours. She now has a headache, confusion and a low serum sodium. What is the most likely cause?

1. AAn allergic reaction to oxytocin causing brain swelling
2. BExcessive salt in the infusion fluid
3. CWater intoxication from the antidiuretic effect of oxytocin
4. DNormal tiredness after a long labour

Before the first treatment dose of a low-molecular-weight heparin for a PE, what does the nurse need to make sure of?

1. AA chest drain is in place
2. BThe patient's blood glucose is above 10 mmol/L (180 mg/dL)
3. CThe patient has fasted for 12 hours
4. DAn accurate, recent body weight is recorded

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 lowers the blood oxygen level
3. CPEEP causes immediate blood loss from the alveolar capillaries
4. DPEEP directly weakens the heart muscle and its contraction

Which picture fits anterior cord syndrome?

1. ALoss of movement and pain sense, with position sense kept
2. BNormal movement but complete loss of position sense
3. CWeakness on one side and loss of pain sensation on the other side
4. DArms much weaker than legs after a neck injury

A patient with a cervical spinal cord injury is helped to sit up for the first time. They become dizzy and pale, and the BP falls from 110/70 to 78/46 mmHg. What should the nurse do?

1. AGive a large meal and a strong coffee to raise the blood pressure
2. BLower the patient back towards lying, then raise them gradually later
3. CContinue sitting them upright, because it will pass in an hour
4. DStand the patient up to improve the blood flow to the legs

Why is a pregnancy test often done before surgery in women who could be pregnant?

1. AIt is needed to calculate the anaesthetic drug dose
2. BPregnancy always makes surgery impossible
3. CPregnant women cannot sign consent forms
4. DAnaesthesia, drugs and some tests may harm a fetus

Which patient has the highest risk of postoperative nausea and vomiting?

1. AA man with no history of nausea having local anaesthetic only
2. BA male smoker having a short procedure without opioids
3. CA non-smoking woman with motion sickness who will need opioids
4. DA smoker who has never had nausea after surgery

A woman received an opioid shortly before giving birth, and the baby is born with poor breathing effort. Which statement about the baby's care is correct?

1. ANaloxone is given before any ventilation is started
2. BEffective ventilation comes first; naloxone is not routine
3. CFlumazenil is given to reverse the opioid
4. DNo support is needed because the effect lasts only seconds

A woman at 6 weeks has vaginal spotting and one-sided pelvic pain. Her hCG rose only slightly over 48 hours and no pregnancy is seen in the uterus on transvaginal ultrasound. What is the priority concern?

1. AA molar pregnancy
2. BA complete miscarriage with no further risk
3. CAn ectopic pregnancy
4. DA normal early pregnancy

What is a normal capillary refill time in a child?

1. A15 to 20 seconds
2. B5 seconds or less
3. C2 seconds or less
4. D8 to 10 seconds

A 25 kg child needs maintenance IV fluids. Using the 100–50–20 rule, what is the hourly rate?

1. AAbout 25 mL per hour
2. BAbout 50 mL per hour
3. CAbout 104 mL per hour
4. DAbout 67 mL per hour

Which communication approach is best with a patient who has paranoid personality disorder?

1. AAvoid explaining anything so that the patient does not become suspicious
2. BBe clear, honest and business-like, and explain the reasons for actions
3. CBe very warm and joke often to put the patient at ease
4. DTalk about the patient with colleagues in whispers within his sight

A community nurse visits an older woman with hoarding disorder whose home is so cluttered that the exits are blocked. What is the most appropriate approach?

1. AWork with her to clear the exits first, then agree a gradual plan together
2. BArrange for the whole house to be cleared while she is out
3. CIgnore the clutter, because it is her own home
4. DTell her that she will be evicted unless everything is thrown away today

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit setinggi 4 kaki 10 inci. Dengan menggunakan 1 kaki = 12 inci dan 1 inci = 2.54 cm, cari ketinggian h dalam sentimeter, kepada sentimeter bulat yang terdekat.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi memberikan 15 mcg/min. Nyatakan kadar dos ini D dalam mg/h.

Berapa miligram ubat m terdapat dalam 5 mL larutan 5% (b/i)?

Anda perlu menyediakan 100 mL larutan 5% (w/v) daripada larutan stok 20% (w/v). Berapakah isi padu stok V₁ yang anda perlukan?

Satu infusi diarahkan pada 100 mL/j, tetapi tiada pam tersedia. Ia berjalan secara graviti melalui set pemberian 60 gtt/mL. Cari kadar titisan R dalam titisan seminit.

Satu titisan berjalan pada 50 gtt/min melalui set 15 gtt/mL. Terdapat 300 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 jumlah pengambilan I dalam mL.

Latihan (nilai rekaan, bukan panduan klinikal). Satu beg 1000 mL berjalan dengan pam pada 50 mL/j. Pada 07:30, 400 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: tidak; diagnosis sekunder: tidak; alat bantu berjalan: tongkat ketiak, tongkat atau alat bantu berjalan; terapi IV atau kunci salina: ya; cara berjalan: terjejas; status mental: melebih-lebihkan atau melupakan had. Cari jumlah Morse MFS.

Latihan (nilai rekaan, bukan panduan klinikal). Pasukan menyasarkan tekanan arteri purata sekurang-kurangnya 70 mmHg. Tekanan sistolik pesakit ialah 104 mmHg. Dengan menggunakan MAP = (SBP + 2·DBP)/3, apakah tekanan diastolik terendah DBP yang masih memberikan MAP 70 mmHg?