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

How should the opening of a stoma bag be cut?

1. ASmaller than the stoma so it grips it tightly
2. BIn any shape, as long as the bag sticks
3. CMuch larger than the stoma so that the edge never rubs against it
4. DTo fit closely around the stoma without pressing on it

Which simple measure helps reduce the risk of delirium in an older inpatient?

1. AMaking sure they have their glasses and hearing aids
2. BMoving them to a different bed every night to vary their surroundings
3. CKeeping the lights on all night
4. DLimiting visits from family members

A patient with delirium is at risk of falls and of pulling out lines. Which option is less restrictive than restraints?

1. AFour side rails raised and the door closed so the patient stays in bed
2. BA trained sitter or video monitoring with staff nearby
3. CA vest restraint applied for the whole night
4. DA sedative given every few hours as needed

Dua vial ubat berbeza yang kelihatan serupa disimpan bersebelahan, dan seorang jururawat hampir mengambil yang salah. Respons manakah yang paling mencerminkan budaya adil?

1. AMengenakan tindakan disiplin ke atas jururawat yang hampir mengambil vial yang salah
2. BMenyuruh jururawat lebih berhati-hati dan tidak melakukan apa-apa lagi
3. CMerahsiakan insiden itu untuk melindungi reputasi unit
4. DMelaporkannya dan membetulkan sistem, contohnya dengan mengasingkan vial

Seorang jururawat yang biasanya bekerja dalam obstetrik ditugaskan sementara ke unit perubatan dewasa. Pesakit manakah yang paling sesuai ditugaskan kepada jururawat ini?

1. APesakit pneumonia yang stabil dengan antibiotik oral
2. BPesakit dengan infusi insulin berterusan untuk ketoasidosis diabetes
3. CPesakit dengan pendarahan gastrousus atas yang aktif
4. DPesakit dengan trakeostomi baharu

A nurse has a needlestick injury from a used needle. What should the nurse do first?

1. AWash the area with soap and water
2. BSqueeze the wound hard and suck it
3. CFinish the shift and report it tomorrow
4. DScrub the area with bleach

A patient is started on spironolactone while already taking an ACE inhibitor. Which blood result should be watched most closely?

1. APotassium, because both drugs can raise it
2. BCalcium, because both drugs lower it
3. CGlucose, because both drugs cause hyperglycaemia
4. DSodium, because both drugs raise it sharply

An arterial blood gas shows a low PaO₂ with a low or normal PaCO₂. How is this classified?

1. AType 2 respiratory failure
2. BNormal blood gas
3. CMetabolic acidosis
4. DType 1 respiratory failure

A patient had a total thyroidectomy yesterday. Which laboratory value is most important to monitor in the first days after surgery?

1. ASerum glucose
2. BSerum sodium
3. CSerum calcium
4. DSerum potassium

A patient without symptoms has a finger-stick glucose of 340 mg/dL (18.9 mmol/L). The previous values were normal, and the patient has just peeled an orange. What should the nurse do first?

1. AReport the result as a new diagnosis of diabetes mellitus
2. BGive a correction dose of insulin for a glucose of 340 mg/dL
3. CAsk the laboratory to measure HbA1c from the same drop of blood
4. DHave the patient wash and dry their hands, then repeat the test

A person who has never been vaccinated against tetanus has a deep, dirty wound. What is usually given?

1. ATetanus vaccine and tetanus immunoglobulin
2. BTetanus vaccine only, after the wound heals
3. CNo treatment unless symptoms appear
4. DOral antibiotics only

A woman with chronic hypertension who takes lisinopril is now pregnant. What is the key concern?

1. AAll antihypertensives must be stopped in pregnancy
2. BACE inhibitors harm fetal kidneys, so a safer drug is used
3. CLisinopril works better in pregnancy, so the dose should be increased
4. DLisinopril has no known fetal effects and should be continued

Why must intravenous potassium chloride never be given as a rapid push or undiluted?

1. AA sudden high potassium level can cause cardiac arrest
2. BIt immediately lowers the blood glucose to dangerous levels
3. CIt works only when given by mouth
4. DIt turns into solid crystals inside the vein and blocks it

During a thrombolytic infusion for an MI, the patient develops a sudden severe headache, vomiting and new confusion. What should the nurse do first?

1. AStop the infusion and call for urgent medical help
2. BContinue the infusion, as headache is a common side effect
3. CSlow the infusion and give an antiemetic
4. DGive a second dose to finish the treatment

Selepas trombolisis IV untuk strok, pemerhatian manakah yang paling penting dalam 24 jam pertama?

1. AAliran puncak dan ketepuan oksigen setiap jam
2. BBunyi usus dan lilitan abdomen setiap jam
3. CSemakan neurologi dan TD yang kerap
4. DBerat harian dan imbangan cecair sahaja

A patient with lung cancer is confused, dehydrated and constipated, with a corrected calcium of 3.4 mmol/L (about 13.6 mg/dL). What is usually the first treatment?

1. AA fluid restriction
2. BOral calcium tablets
3. CIV calcium gluconate and vitamin D
4. DIV fluids to rehydrate the patient

Suplemen herba manakah yang lazim ditanya sebelum pembedahan kerana ia mungkin meningkatkan pendarahan?

1. AGinkgo biloba
2. BKamomil
3. CKranberi
4. DMinyak pudina

A patient with a leg ulcer has an ABPI of 0.5. The doctor's plan mentions starting strong compression bandages. What should the nurse do?

1. AApply compression but only at night
2. BApply the strongest compression to speed healing
3. CWithhold strong compression and discuss urgent vascular referral
4. DApply compression and elevate the leg above the heart all day

A breastfed baby has jaundice in the first week with poor feeding and few wet nappies. What is the most likely cause?

1. AABO incompatibility
2. BBreast milk jaundice
3. CBiliary atresia with obstruction
4. DSuboptimal intake jaundice

A woman is 10 cm dilated with an urge to push. The fetal head is at station 0 and the tracing is normal. Which approach is supported by current practice?

1. ALet her push with her urge in a position she prefers
2. BAsk her to push continuously from 7 cm onwards
3. CInsist she lies flat on her back and holds her breath for long periods
4. DTell her not to push until the head is visible

A 13-year-old with scoliosis has been prescribed a brace. Which teaching is most important?

1. AWear it only when the back hurts, then take it off
2. BWear it over thick clothing to make it more comfortable
3. CWear it only at weekends and in the holidays, when it does not interfere with school
4. DWear it for the prescribed hours each day, with a thin cotton shirt underneath

A baby born to a mother who used opioids in pregnancy has a high-pitched cry, tremors, sneezing and poor feeding. Which plan is best?

1. AGive naloxone to reverse the effects of the opioid
2. BLow-stimulation care, swaddling, small frequent feeds and a withdrawal scoring tool
3. CKeep the baby in a bright, busy area of the unit and stimulate them often to keep them awake
4. DDelay all feeds until the tremors and sneezing have settled

A patient at high risk of suicide is placed on constant (one-to-one) observation. What does this mean?

1. AThe patient can be left alone while asleep
2. BA staff member stays with the patient at all times, at the distance set by policy, including in the bathroom
3. CThe patient is seen once a shift by the nurse in charge, and otherwise checked by camera from the office when staff are free
4. DThe patient is checked every hour during the day only

Seorang pesakit yang dirawat untuk ketagihan opioid akan menerima dos buprenorfin yang pertama. Dia terakhir menggunakan heroin 2 jam lalu. Apakah risikonya?

1. ABuprenorfin tidak akan mempunyai sebarang kesan
2. BTiada risiko; ia patut diberikan serta-merta
3. CBuprenorfin akan menambah heroin dan menyebabkan dos berlebihan opioid yang berbahaya dengan kemurungan pernafasan
4. DBuprenorfin boleh menyebabkan penarikan yang dicetuskan jika diberikan semasa agonis penuh masih aktif

Latihan (nilai rekaan, bukan panduan klinikal). Satu pengiraan kadar titisan memberikan 125.668 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). Semasa satu syif, seorang pesakit mengambil 1 cawan daripada teh, 2½ tsp daripada sirap batuk, 1 fl oz daripada jus. Dengan menggunakan setara yang diberikan, cari jumlah pengambilan oral V dalam mL.

Seorang pesakit berberat 90 kg dan dipreskripsikan 2 mg/kg sebagai dos tunggal. Cari dos D dalam mg.

Satu infusi mengandungi 40000 unit ubat dalam 500 mL. Preskripsi ialah 1000 unit sejam. Pada kadar R berapakah anda menetapkan pam, dalam mL/j?

Satu infusi diarahkan pada 90 mL/j, tetapi tiada pam tersedia. Ia berjalan secara graviti melalui set pemberian 20 gtt/mL. Cari kadar titisan R dalam titisan seminit.

Satu beg mengandungi 400 mg ubat dalam 500 mL dan berjalan pada 12 mL/j. Berapa miligram sejam D yang diterima pesakit?

Latihan (nilai rekaan, bukan panduan klinikal). Rekod menunjukkan pengambilan dan pengeluaran seorang pesakit untuk satu syif 12 jam. Pesakit berberat 85 kg. Cari pengeluaran air kencing purata U dalam mL/kg/j. Bundarkan kepada dua tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi 1000 mL bermula pada 15:00 dengan 125 mL/j. Selepas 4 jam kadar ditukar kepada 50 mL/j dan tidak ditukar lagi. Berapa jam t selepas permulaan beg akan kosong? Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 16/min, SpO₂ 91% bernafas udara bilik, tekanan darah 112/68 mmHg, nadi 88/min, sedar, suhu 37.0 °C. Apakah jumlah skor NEWS2?

Latihan (nilai rekaan, bukan panduan klinikal). Pasukan menyasarkan tekanan arteri purata sekurang-kurangnya 65 mmHg. Tekanan sistolik pesakit ialah 115 mmHg. Dengan menggunakan MAP = (SBP + 2·DBP)/3, apakah tekanan diastolik terendah DBP yang masih memberikan MAP 65 mmHg?