Тренировочные вопросы в стиле NCLEX-PN (LPN/LVN): шпаргалка-пакет

A catheterised patient has had no urine in the bag for two hours. What should the nurse check first?

1. AThe patient's blood glucose level and recent insulin doses
2. BWhether the patient has eaten or drunk anything recently
3. CThe tubing for kinks or blockage and where the bag is
4. DNothing, as two hours without urine is normal

A patient's potassium result is 6,8 mmol/L (6,8 mEq/L). Why is this urgent?

1. AVery high potassium can cause life-threatening heart arrhythmias
2. BIt is normal for patients after surgery
3. CIt means the patient urgently needs more potassium
4. DHigh potassium causes only mild muscle cramps that settle without treatment

Why can side rails be dangerous for a confused, restless patient?

1. AThe patient may climb over them or get trapped in gaps
2. BSide rails make the bed move by itself
3. CSide rails always cause pressure injuries
4. DSide rails stop staff from reaching the patient in an emergency

The laboratory reports that a blood sample labeled with one patient’s name has a blood group different from that patient’s previous result. What is the most likely problem and response?

1. AThe previous result was wrong, so it is deleted
2. BA wrong-patient sample, so the test is repeated and the event reported
3. CA normal change in the patient’s blood group over the years since the last test
4. DA laboratory machine fault, so no action is needed

Five days after starting heparin, a patient’s platelet count has fallen by more than half. What should the nurse suspect?

1. AHeparin-induced thrombocytopenia
2. BAn expected effect that needs no action
3. CVitamin K deficiency
4. DIron deficiency anemia

A patient with anorexia nervosa is admitted. Which finding is the priority?

1. ASays she feels fat although she is very thin
2. BHas fine, downy hair on her arms
3. CHeart rate 38/min and potassium 2,8 mEq/L
4. DRefuses to eat in front of other people

Under the Mental Capacity Act 2005 (England and Wales), which principle applies?

1. ACapacity is decided by the next of kin, who must sign a form for every decision
2. BA diagnosis of dementia means the person lacks capacity for all decisions
3. CEveryone over 75 is assumed to lack capacity
4. DA person must be assumed to have capacity unless it is shown that they lack it

Why can pulse oximetry be misleading in carbon monoxide poisoning?

1. ACarbon monoxide makes the oximeter read zero even in a well patient
2. BStandard oximeters cannot tell carboxyhaemoglobin from oxyhaemoglobin
3. CThe oximeter overheats in smoke-exposed patients
4. DCarbon monoxide only affects the heart rate reading

A patient with a potassium of 2,8 mEq/L has potassium chloride prescribed IV. Which statement about giving it is correct?

1. AIt is always diluted and given by infusion pump, never as an IV push
2. BIt may be given as a slow IV push over one minute if the level is very low
3. CIt is added to the IV bag without mixing, so it stays at the bottom
4. DIt is given as an undiluted bolus into a large vein to avoid irritation

A patient on stable digoxin starts amiodarone. A week later, the patient has nausea and visual changes, and the digoxin level is above the range. What is the most likely explanation?

1. ADigoxin has raised the amiodarone level
2. BAmiodarone has lowered potassium only
3. CAmiodarone has raised the digoxin level
4. DThe patient has started a viral illness

After naloxone reverses an opioid overdose, why must the patient be watched closely?

1. ANaloxone itself causes respiratory depression at high doses
2. BNaloxone may wear off before the opioid does, so breathing can slow again
3. CNaloxone makes the opioid stay longer in the body
4. DNaloxone often causes severe low blood glucose a few hours after the dose

A patient on heparin for 7 days has a platelet count that has fallen by more than half, and a new leg vein thrombosis. What is the most likely cause and the key action?

1. AHeparin-induced thrombocytopenia; stop all heparin
2. BWarfarin skin necrosis; switch from heparin to warfarin at once
3. CVitamin K deficiency; give vitamin K and continue heparin
4. DNormal dilution of platelets; continue and recheck in a week

A patient with a mechanical heart valve asks to switch from warfarin to apixaban. What is the correct response?

1. ADirect oral anticoagulants are not used for mechanical valves
2. BAny anticoagulant works equally well once the valve is in place
3. CAspirin alone can replace warfarin once the valve has healed
4. DMechanical valves do not need anticoagulation after the first month

A nurse reviews inhaler use with a patient who has asthma and uses a separate steroid preventer inhaler and a salbutamol reliever. Which statement shows a need for further teaching?

1. A"I use my steroid inhaler when I start to wheeze."
2. B"I rinse my mouth after the steroid inhaler."
3. C"I carry my blue reliever inhaler with me."
4. D"I use my steroid inhaler every day, even when I feel well."

What does a positive pronator drift test show?

1. AA normal response in older adults
2. BLoss of hearing on one side
3. CSubtle weakness in one arm
4. DWeakness of the eye muscles

A patient with long-standing diabetes suddenly has many new floaters and painless loss of vision in one eye. What is most likely, and what is needed?

1. AA migraine aura, needing pain relief
2. BDry eyes, needing lubricating drops
3. CNormal ageing of the lens, needing new glasses
4. DA bleed into the eye from retinopathy, needing urgent review

Which treatment often relieves pain from a bone metastasis?

1. AComplete bed rest for a month
2. BPalliative radiotherapy to the area
3. CA diet low in calcium and vitamin D
4. DIron supplements by mouth for several months

A patient with cirrhosis and ascites has a falling urine output and a rising creatinine. They have not received nephrotoxic drugs and are not dehydrated. Which complication is likely?

1. APolycystic kidney disease
2. BNephrotic syndrome
3. CHepatorenal syndrome
4. DUrinary tract infection

A woman at 24 weeks reports burning on urination and urinary frequency. What is the priority action?

1. AReassure her that urinary frequency is normal in pregnancy
2. BAdvise cranberry juice and no further action
3. CCollect a urine sample for culture and inform the provider
4. DAdvise her to drink less to reduce frequency

A woman with postpartum psychosis is being admitted with her baby to a mother and baby unit. Which statement is accurate?

1. AIt only occurs in women who were depressed in pregnancy
2. BIt is the same as the baby blues and resolves without treatment
3. CIt is an emergency that usually starts within two weeks
4. DIt usually begins several months or years after the birth

Which statement about patient-controlled analgesia (PCA) for a child is correct?

1. AOnly the child presses the button, unless a protocol says otherwise
2. BParents should press the button whenever the child is asleep
3. CAny visitor may press it if the child seems uncomfortable
4. DThe nurse should press it every 5 minutes, day and night, to keep the pain away

A 6-year-old has threadworms. Which plan is correct?

1. ATreat the whole household, with hand washing, short nails and a morning wash
2. BTreat only the child and keep him off school for two weeks until the itching settles
3. CTreat only if the child also has a fever
4. DThrow away all the child's clothes and bedding

A student avoids eating in the canteen and speaking in seminars because she fears others will judge her or see her blush. Which disorder does this suggest?

1. AObsessive-compulsive disorder
2. BSocial anxiety disorder
3. CAgoraphobia
4. DGeneralised anxiety disorder

A patient taking valproate has severe abdominal pain spreading to her back, with nausea and vomiting. What should the nurse suspect?

1. ASimple indigestion
2. BSerotonin syndrome
3. CLithium toxicity
4. DPancreatitis

Учебное упражнение (вымышленные значения, не клиническая рекомендация). Расчёт дозы для инъекции даёт 9,4985 mL. Правило в этом упражнении: объёмы от 1 mL и более округляют до десятых долей mL. Какое значение x вы запишете?

Учебное упражнение (вымышленные значения, не клиническая рекомендация). За смену пациент принимает 3 tsp из сироп от кашля, 4 tbsp из жидкая добавка, 1½ fl oz из сок, 2 стаканов из чай. Используя заданные эквиваленты, найдите общий объём принятого внутрь V в mL.

Флакон содержит 500 mg порошка. На этикетке указано: добавьте 9,6 mL воды для инъекций, чтобы получить общий объём 10 mL. Назначено 150 mg. Какой объём V восстановленного раствора вы введёте?

Назначено 0,5 mg. Ампула содержит 2000 микрограммов на mL. Наберите дозу в шприц на 1 mL: какой объём V вы вводите?

Введите 250 mL за 4 часов системой с фактором 15 кап/mL. Найдите скорость капания R в каплях в минуту. Округлите до ближайшего целого числа.

Пакет содержит 100 mg препарата в 50 mL и капает со скоростью 5 mL/h. Сколько миллиграммов в час D получает пациент?

Учебное упражнение (вымышленные значения, не клиническая рекомендация). В листе учёта указаны поступление и выделение жидкости у пациента за одну смену продолжительностью 8 ч. Внутривенная инфузия шла с указанной скоростью всю смену. Найдите водный баланс B = поступление − выделение в mL (отрицательный ответ означает чистую потерю).

Учебное упражнение (вымышленные значения, не клиническая рекомендация). Пакет 500 mL вводится помпой со скоростью 125 mL/h. В 12:00 уже введено 100 mL. Через сколько часов t пакет опустеет? Округлите до одного знака после запятой.

Учебное упражнение (вымышленные значения, не клиническая рекомендация). Используйте таблицу NEWS2 (шкала SpO₂ 1) для этих наблюдений: частота дыхания 18/мин, SpO₂ 97% на комнатном воздухе, артериальное давление 150/90 mmHg, пульс 88/мин, реагирует только на голос, температура 39,0 °C. Какова общая сумма баллов NEWS2?

Учебное упражнение (вымышленные значения, не клиническая рекомендация). Через 1 минуту после рождения у учебного новорождённого: синяя или бледная кожа по всему телу, отсутствие сердцебиения, нет реакции на стимуляцию, вялые конечности без мышечного тонуса и отсутствие дыхания. Оцените по шкале Апгар и выберите, как интерпретируется результат.

1. 1успокаивающий
2. 2умеренно нарушенный
3. 3низкий