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

A dying patient has noisy, rattling breathing that is upsetting the family. Which nursing action helps?

1. ATell the family it means the patient is choking and needs help
2. BReposition the patient and explain the cause to the family
3. CGive large volumes of oral fluids
4. DStart deep suction every 10 minutes

Why should only the patient press the button of a patient-controlled analgesia (PCA) pump?

1. AVisitors might damage the pump or change its settings if they touch it
2. BA drowsy patient stops pressing, which helps prevent overdose
3. CNurses are not allowed to give opioids
4. DThe pump only works with the patient's fingerprint

A small spill of blood is found on the floor. How should it be cleaned?

1. AWipe it up quickly with a dry cloth using bare hands, then wash the hands well
2. BWear gloves, absorb the blood, then clean the area with an approved disinfectant
3. CCover it with a clean sheet and keep working
4. DLeave it until housekeeping arrives the next morning

A nurse has just started a unit of red blood cells when a colleague asks for urgent help with another patient. What is the best action?

1. ASpeed up the transfusion so it finishes sooner
2. BLeave to help the other patient, and check the transfusion again in about an hour
3. CStay with the transfusing patient for the first 15 minutes and ask another nurse to help
4. DPause the transfusion until the nurse is free again

A patient on a medical unit tells the nurse he has a plan to end his life and has saved tablets at home. What is the priority action?

1. AReassure him that things usually look better in the morning after some sleep
2. BAsk him to promise he will not harm himself
3. CArrange a psychiatry appointment for next week
4. DEnsure constant observation and remove anything he could use to harm himself

A patient at 36 weeks of pregnancy has sudden severe abdominal pain, a hard, board-like uterus and dark vaginal bleeding. What should the nurse suspect?

1. AA urinary tract infection
2. BNormal labor contractions starting
3. CPlacenta previa, which is usually painless
4. DPlacental abruption, which is an emergency

Why is blood pressure monitored closely in a patient with an epidural infusion?

1. AThe local anaesthetic can block sympathetic nerves and cause hypotension
2. BBlood pressure readings show whether the catheter is infected
3. CThe epidural pump uses the blood pressure to set the rate
4. DEpidurals always cause severe hypertension that needs regular treatment

A patient with central chest pain has ST elevation on the 12-lead ECG. What is the main aim of urgent treatment?

1. ARestoring blood flow through the blocked coronary artery quickly
2. BWaiting for the troponin result before taking any action
3. CStarting a cholesterol-lowering drug before any other treatment is given
4. DStrict bed rest for several days before deciding on treatment

An older adult takes lisinopril and furosemide and recently started daily ibuprofen for knee pain. The creatinine has risen from 1.0 to 1.8 mg/dL (88 to 159 µmol/L). What is the most likely cause?

1. AA laboratory error, since ibuprofen has no effect on the kidney
2. BThe NSAID reduces kidney blood flow on top of the other two drugs
3. CMore activity has increased the patient's muscle mass quickly
4. DNormal aging of the kidneys over a period of a few weeks

Seorang pesakit penyakit buah pinggang kronik mempunyai fosfat 7.2 mg/dL (2.3 mmol/L). Pengajaran diet manakah yang paling sesuai?

1. AMinum lebih banyak minuman ringan jenis kola untuk kekal terhidrat
2. BTingkatkan susu dan keju untuk melindungi tulang daripada kehilangan kalsium
3. CHadkan makanan kaya fosfat, seperti makanan diproses dan kola
4. DAmbil suplemen kalsium dengan perut kosong dan bukan pengikat

Why is simvastatin traditionally taken in the evening?

1. AIt is short-acting, and cholesterol synthesis peaks at night
2. BIt is inactivated by sunlight during the day
3. CIt must be taken with the largest meal of the day
4. DIt causes too much drowsiness to be taken in the morning

Why is vancomycin given by mouth, not intravenously, for Clostridioides difficile infection?

1. AThe oral form is cheaper but has the same effect as IV
2. BOral vancomycin is not absorbed, so it reaches high levels in the colon
3. COral vancomycin is absorbed into the blood better than IV vancomycin
4. DIntravenous vancomycin causes C. difficile infection

Mengapakah nitrat digunakan dengan sangat berhati-hati dalam infarksi ventrikel kanan?

1. ANitrat tidak diserap apabila ventrikel kanan terjejas
2. BVentrikel kanan bergantung pada prabeban, jadi tekanan darah boleh jatuh mendadak
3. CNitrat menyebabkan hiperkalemia yang berbahaya dalam jenis infarksi ini
4. DNitrat menyebabkan infarksi merebak ke ventrikel kiri

A one-way speaking valve is fitted to a patient's tracheostomy tube while the cuff is still inflated. What is the danger?

1. AThe valve will humidify the air too much
2. BThe patient will speak too loudly
3. CThe patient cannot breathe out and may suffocate
4. DThere is no danger, as the valve works with any cuff

Seorang pesakit mempunyai hipertensi yang sukar dikawal dan kalium yang rendah secara berterusan, tanpa mengambil diuretik. Keadaan manakah yang patut dipertimbangkan?

1. ADiabetes insipidus kranial
2. BHipotiroidisme primer
3. CInsufisiensi adrenal primer (Addison)
4. DHiperaldosteronisme primer (Conn)

A patient with a brain injury has a mean arterial pressure of 80 mmHg and an ICP of 25 mmHg. How should the nurse interpret this?

1. AThe ICP cannot affect brain perfusion if the blood pressure is normal
2. BThe cerebral perfusion pressure is 105 mmHg, which is too high
3. CThe cerebral perfusion pressure is 80 mmHg, which is normal
4. DThe cerebral perfusion pressure is 55 mmHg, below the usual target

Tanda manakah yang menunjukkan pankreatitis akut yang teruk dengan pendarahan ke dalam tisu?

1. ARuam ungu pada tapak tangan dan kaki
2. BPerubahan warna kuning pada kuku jari
3. CBengkak pada bibir, lidah dan muka
4. DLebam di sekeliling pusat atau rusuk

A patient on chemotherapy has white plaques on the tongue and cheeks that wipe off to leave red areas. What is most likely?

1. AOral candidiasis
2. BNormal mucositis healing
3. CLeukoplakia from smoking
4. DFood residue only

A woman is about to get out of bed for the first time after birth. What should the nurse do?

1. AHelp her sit, then stand slowly with support
2. BAsk her to stand quickly to reduce dizziness
3. CWait until day 3 before letting her stand
4. DLet her walk alone so she feels independent

A woman at 8 weeks takes valproate for epilepsy. She asks whether she should stop it. Which response is best?

1. ADo not stop it suddenly; arrange urgent specialist review
2. BHalve the dose herself to reduce the risk to the baby
3. CStop the drug today because it causes birth defects
4. DContinue as usual because epilepsy drugs are all safe in pregnancy

A 2-year-old says "No!" when it is time for his liquid medicine. What is the best approach?

1. AAsk him whether he wants to take his medicine or not
2. BTell him he is a bad boy for refusing
3. COffer a limited choice, such as the cup or the syringe
4. DWait until he agrees to take it, even if the dose is hours late

A boy with haemophilia A bumps his head hard on a table. He seems well. What should the nurse advise?

1. AGive aspirin for the pain and apply ice to the bump
2. BWatch him at home for a week and bring him in only if he vomits or has a headache
3. CNo action is needed, because head bleeds are rare in haemophilia
4. DSeek urgent care, as factor replacement may be needed before symptoms appear

How does memantine work in Alzheimer's disease?

1. AIt inhibits the breakdown of acetylcholine
2. BIt blocks dopamine D₂ receptors
3. CIt blocks NMDA glutamate receptors
4. DIt increases serotonin by blocking its reuptake

A patient's mood changes several times a day, usually after conflicts with others. She has chronic feelings of emptiness and a strong fear of being abandoned. Which diagnosis is most likely?

1. ASchizoid personality disorder with low mood
2. BPersistent depressive disorder
3. CBorderline personality disorder
4. DBipolar I disorder

Latihan (nilai rekaan, bukan panduan klinikal). Suhu seorang pesakit ialah 38.4 °C. Tukarkan kepada darjah Fahrenheit T dengan °F = °C × 9/5 + 32. Bundarkan kepada satu tempat perpuluhan.

Latihan (nilai rekaan, bukan panduan klinikal). Satu infusi bermula pada 20:35 dan tamat pada 07:15 keesokan paginya (jam 24 jam). Berapa jam t ia berjalan? Berikan jawapan dalam jam sebagai perpuluhan, dibundarkan kepada dua tempat perpuluhan.

Seorang pesakit berberat 25 kg. Dos yang dipreskripsikan ialah 25 mg/kg sehari, diberi dalam 4 dos yang sama. Berapakah miligram D yang diberi bagi setiap dos?

Preskripsi ialah 880 mikrogram. Ampul mengandungi 1 mg/mL. Sedut dos itu dalam picagari 1 mL: berapakah isi padu V yang anda berikan?

Titisan berjalan pada 25 gtt/min melalui set 15 gtt/mL. Berapa mililiter V yang diterima pesakit dalam 2 jam?

Satu titisan berjalan pada 40 gtt/min melalui set 60 gtt/mL. Terdapat 750 mL lagi dalam beg. Berapa jam t sehingga ia kosong? Bundarkan kepada satu tempat perpuluhan.

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 infusi 500 mL bermula pada 10:30 dengan 75 mL/j. Selepas 2 jam kadar ditukar kepada 125 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). Seorang pesakit latihan selepas kecederaan kepala membuka mata hanya kepada tekanan (rangsangan menyakitkan), hanya mengeluarkan bunyi yang tidak difahami seperti mengerang dan menunjukkan respons motor terbaik: tiada pergerakan langsung. Tentukan GCS dan klasifikasikan kecederaan kepala mengikutnya. Klik jawapan anda.

1. 1ringan
2. 2sederhana
3. 3teruk

Latihan (nilai rekaan, bukan panduan klinikal). Gunakan carta NEWS2 (SpO₂ skala 1) untuk pemerhatian ini: kadar pernafasan 18/min, SpO₂ 86% bernafas udara bilik, tekanan darah 150/90 mmHg, nadi 44/min, sedar, suhu 37.2 °C. Kumpulan risiko klinikal yang manakah pesakit itu termasuk? Klik padanya.

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