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

When should discharge planning begin?

1. AAfter the patient has gone home
2. BOn the morning of discharge
3. COnly after the doctor agrees to discharge
4. DOn admission, or as early as possible

Dasar ulser tekanan ditutupi sepenuhnya oleh slof dan eskar gelap. Bagaimanakah ia dikelaskan?

1. ATidak boleh ditahap (unstageable), kerana kedalamannya tidak dapat dilihat
2. BKategori 1, kerana kulit tidak terbuka
3. CKategori 2, kerana ia tertutup
4. DSembuh, kerana kerak telah terbentuk

Pengimbas kod bar memberi amaran bahawa ubat tidak sepadan dengan rekod pesakit. Apakah yang patut dilakukan oleh jururawat?

1. AMemberikan ubat dan melaporkan amaran itu kemudian pada syif yang sama
2. BMengimbas gelang tangan pesakit lain
3. CBerhenti dan ketahui puncanya sebelum memberikan ubat
4. DMengatasi amaran dan memberikan ubat

While preparing an IV medication, a nurse sees that the syringe tip touched the medication tray after the cap came off. What should the nurse do?

1. ABlow on the tip to remove any dust
2. BDiscard the syringe and prepare the dose again with new equipment
3. CWipe the tip with an alcohol swab and give the dose
4. DGive the dose anyway, because the medication tray was cleaned this morning

A patient with asthma uses a peak flow meter. A reading below 50% of personal best is in the red zone. Which statement shows correct understanding?

1. A“I will wait until tomorrow morning to see if the reading gets better on its own.”
2. B“I will stop all my inhalers until the reading is back up.”
3. C“I will go for a short run to open up my lungs.”
4. D“I will use my reliever inhaler and get emergency help straight away.”

A patient has a heart rate of 38/min, feels dizzy and has a blood pressure of 80/50 mmHg. Which drug is usually given first, as prescribed?

1. AAtropine
2. BDiltiazem
3. CMetoprolol
4. DDigoxin

Penilaian manakah yang paling baik mengesan sindrom petak selepas kaki patah dibalut dengan simen (cast)?

1. ASakit yang tidak setimpal dengan kecederaan, terutamanya pada regangan pasif
2. BDenyutan kuat di kaki
3. CGatal ringan di bawah simen
4. DKaki yang hangat dan merah jambu

Why is a patient kept under observation for several hours after successful treatment of anaphylaxis?

1. AThe patient must stay until all allergy tests are complete
2. BSymptoms can return later in a biphasic reaction
3. CAdrenaline always causes a heart attack hours later
4. DAntihistamines cause dangerous drowsiness for 24 hours

A patient with type 1 diabetes has the flu, is eating little and has a glucose of 290 mg/dL (16.1 mmol/L). Which advice is correct?

1. AWait 3 days before checking the glucose again
2. BKeep taking insulin and check blood or urine ketones
3. CDrink only water and avoid all carbohydrate foods
4. DStop all insulin until you are eating normally again

After lying on the floor for many hours, a patient has a CK of 40,000 U/L, a potassium of 6.1 mEq/L and dark urine. Which prescribed treatment is the priority?

1. AFluid restriction to protect the heart from overload
2. BAn oral potassium supplement with each meal
3. CHigh-dose NSAIDs for the muscle pain
4. DLarge-volume IV fluids with cardiac monitoring

Which rule applies to intravenous potassium chloride?

1. AIt is mixed into blood products to save time
2. BIt is given as a rapid IV push to correct low levels quickly
3. CIt must be diluted and given as an infusion, never as an IV push
4. DIt may be given intramuscularly if there is no IV access

A toddler swallowed many of his mother's iron tablets. He has vomiting and bloody diarrhoea. Which drug may be used to bind iron?

1. AActivated charcoal given by mouth
2. BAcetylcysteine
3. CNaloxone
4. DDeferoxamine (desferrioxamine)

A patient on ramipril is to start sacubitril/valsartan for heart failure. What is the key safety point?

1. ASacubitril/valsartan is safe to start on the same morning
2. BThe ACE inhibitor dose should be doubled during the change
3. CThe ACE inhibitor must be stopped first, with a gap before starting
4. DBoth drugs should be taken together each day for the best effect

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

1. A"I will have regular INR blood tests."
2. B"I will tell my dentist that I take warfarin."
3. C"If I miss a dose, I will take two the next day."
4. D"I will check before taking any new medicines or herbal remedies."

A bladder scan straight after voiding shows 450 mL of urine still in the bladder. What does this show?

1. AThe patient has drunk too little fluid
2. BThe kidneys are making too little urine
3. CThe bladder is not emptying properly
4. DThe patient is passing urine normally

Seorang pesakit kanser paru-paru dan SIADH mempunyai natrium 112 mmol/L dan mengalami sawan. Rawatan manakah yang paling sesuai?

1. AGlukosa 5% IV pada kadar tinggi sehingga sawan berhenti
2. BPembetulan pantas kepada 140 mmol/L dalam enam jam pertama
3. CAir oral dalam jumlah besar untuk membantu mencairkan air kencing
4. DSalin hipertonik, dipantau, dengan kadar kenaikan yang terhad

Sebesar manakah bukaan perkakas stoma patut dipotong?

1. AKira-kira 2 cm lebih besar daripada stoma di sekelilingnya
2. BSedikit lebih kecil daripada stoma untuk kedapan yang ketat
3. CKira-kira 2–3 mm lebih besar daripada stoma di sekelilingnya
4. DSebarang saiz, asalkan stoma tertutup

Two days after surgery, a patient on regular ibuprofen has a low urine output and a rising creatinine, and intake has been poor. What should the nurse do?

1. AWithhold the next dose and report to the prescriber
2. BIncrease the dose to treat the pain better and encourage fluids
3. CChange to a higher-strength NSAID tablet
4. DGive the next dose with extra food

A preterm baby at 30 weeks has repeated pauses in breathing of more than 20 seconds. Which drug is commonly used?

1. ANaloxone hydrochloride
2. BAtropine sulfate
3. CPhenobarbital
4. DCaffeine citrate

Suhu aksila bayi baru lahir ialah 36.0 °C. Apakah tindakan pertama yang paling sesuai?

1. ABiarkan bayi tidak berpakaian dalam katil bayi untuk memerhatikan warna kulit dengan teliti
2. BLetakkan bayi kulit ke kulit dengan ibu, berselimut, dengan topi dipakai
3. CTunggu pemerhatian rutin seterusnya
4. DMandikan bayi dengan air suam serta-merta

How should the nurse measure the heart rate of a 9-month-old?

1. ACount the radial pulse for 15 seconds and multiply by 4
2. BRead it from the pulse oximeter only
3. CCount the carotid pulse for 30 seconds and multiply by 2
4. DCount the apical pulse for a full minute

Which practice most reduces the risk of errors with high-alert medicines such as insulin or opioid infusions in children?

1. AAsking the child's parent to look at the syringe and confirm that the dose looks right
2. BRounding doses up to the nearest whole number to keep things simple
3. CAn independent double check by a second nurse before giving the medicine
4. DChecking the dose only when the drug is given for the first time

How should a nurse screen a patient for intimate partner violence?

1. AAsk in private, without the partner or family present
2. BAsk the partner instead of the patient
3. CAsk in front of the partner to see how he reacts
4. DOnly ask patients who have visible injuries

A patient with anxiety asks for her PRN lorazepam every time it is due. What is the best nursing approach?

1. AAlways give it as soon as she asks, without assessment
2. BAssess her anxiety each time, offer other coping strategies and give it if indicated
3. CRefuse to give it, because she might become dependent
4. DGive her a placebo tablet instead, without telling her, to see whether she really needs it

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit setinggi 4 kaki 8 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 12 mg/h. Nyatakan kadar dos ini D dalam mcg/min. Bundarkan kepada satu tempat perpuluhan.

Seorang pesakit berberat 45 kg. Dos yang dipreskripsikan ialah 20 mg/kg sehari, diberi dalam 3 dos yang sama. Berapakah miligram D yang diberi bagi setiap dos?

Satu infusi mengandungi 40000 unit ubat dalam 250 mL. Preskripsi ialah 1250 unit sejam. Pada kadar R berapakah anda menetapkan pam, dalam mL/j?

500 mL diarahkan selama 10 jam. Selepas 5 jam anda mendapati 310 mL masih ada dalam beg, dan arahan itu mesti masih siap tepat pada masanya. Kepada kadar R dalam mL/j berapakah pam mesti ditetapkan semula?

Satu infusi 50 mg dalam 250 mL berjalan pada 15 mL/j. Berapa mikrogram seminit D yang diterima pesakit?

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 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 50 mL/j. Pada 18:00, 50 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 Braden: persepsi deria: sedikit terhad; kelembapan: jarang lembap; aktiviti: terhad pada kerusi; mobiliti: tiada had; pemakanan: mencukupi; geseran dan ricih: potensi masalah. Cari jumlah Braden B.

Latihan (nilai rekaan, bukan panduan klinikal). Seorang pesakit latihan dinilai dengan skala Braden: persepsi deria: tiada gangguan; kelembapan: jarang lembap; aktiviti: kerap berjalan; mobiliti: tiada had; pemakanan: mungkin tidak mencukupi; geseran dan ricih: masalah. Gunakan jalur 19–23 tiada risiko, 15–18 ringan, 13–14 sederhana, 10–12 tinggi dan 9 atau kurang sangat tinggi. Klik tahap risikonya.

1. 1tiada risiko
2. 2risiko ringan
3. 3risiko sederhana
4. 4risiko tinggi
5. 5risiko sangat tinggi