NCLEX-PN tarzı alıştırma soruları (LPN/LVN): hızlı tekrar paketi

Why are older adults at higher risk of dehydration?

1. ATheir kidneys hold on to more water
2. BTheir sense of thirst is often reduced
3. CThey lose less water through the skin
4. DThey usually drink more than younger adults

In an emergency a doctor gives a verbal order for a medicine. What should the nurse do?

1. ARefuse to give any medicine until a written prescription has been completed
2. BAsk another nurse to remember the order
3. CWrite it down, read it back and make sure it is signed later as per policy
4. DGive it and tell the doctor nothing more

A portable x-ray is taken at the bedside. Which action protects the nurse?

1. AStand next to the patient and hold the film without protection
2. BLook directly at the x-ray tube during the exposure to check its position
3. CStay close to the patient to keep them still without protection
4. DStep away from the patient or wear a lead apron during the exposure

A nurse discovers that an insulin infusion was programmed using the wrong drug concentration in the pump library. What should the nurse do first?

1. ALeave it running and check the glucose at the next routine time
2. BStop the infusion and check the patient’s blood glucose
3. CDouble the rate to correct for the error
4. DReprogram the pump and finish the shift before reporting

Which patient on an addiction unit should the nurse see first?

1. AIn recovery for a year; came to the clinic today for a routine check and a repeat prescription
2. BLast drink two days ago; now shaking, sweating, heart rate 124/min and seeing insects
3. CLast drink this morning; asking when lunch will arrive
4. DLast drink one week ago; asking about support groups

A team has an RN, an LPN/LVN and a nursing assistant. Which task is the best one to assign to the LPN/LVN?

1. AMeasuring the vital signs and weights of every patient on the unit before breakfast
2. BAssessing a patient who returned from surgery 30 minutes ago
3. CGiving a scheduled subcutaneous anticoagulant injection to a stable patient
4. DWriting the discharge teaching plan for a patient with new diabetes

A patient has a continuous stream of bubbles in the water seal chamber of their chest drain. What does this most likely indicate?

1. AAn air leak, from the lung or from the drainage system
2. BThe drain is working normally for a fluid collection only
3. CThe lung has fully re-expanded
4. DThe drain is blocked

A patient with small cell lung cancer has hyponatraemia, concentrated urine and no signs of dehydration. Which condition and first measure fit best?

1. ASIADH, often managed first with fluid restriction
2. BDiabetes insipidus, managed with extra fluids
3. CCushing's syndrome, managed with potassium
4. DDehydration, managed with an IV fluid bolus

A healthy woman at 28 weeks of pregnancy has a mildly lower hemoglobin than before pregnancy, with a normal MCV and ferritin. What is the most likely explanation?

1. AThe fetus is destroying the mother's red cells in the circulation
2. BPlasma volume rises more than red cell mass, diluting the blood
3. CIron is being lost through the kidneys during the pregnancy
4. DPregnancy hormones stop the bone marrow from making red cells

A patient with a round face, central weight gain and purple stretch marks has a glucose of 210 mg/dL (11,7 mmol/L) and a potassium of 3,1 mEq/L. Which condition fits best?

1. AHypothyroidism
2. BCushing syndrome
3. CDiabetes insipidus
4. DAdrenal insufficiency

Uzun süreli ağızdan kortikosteroidler neden aniden kesilmemelidir?

1. ABağışıklık sistemi hemen karaciğere ve adrenal bezlere saldırır
2. BKesmek kan şekerinde ani bir yükselmeye yol açar
3. CAdrenal bezler baskılanmıştır ve yeterli kortizol üretemeyebilir
4. Dİlaç kesildiğinde toksik metabolitler oluşturur

Gentamisin dozlaması neden kan düzeyleriyle izlenir?

1. ATamamen karaciğerde metabolize edilir, bu yüzden dozu karaciğer fonksiyonu belirler
2. BYalnızca çok yüksek konsantrasyonlarda etki eder
3. CNefrotoksik ve ototoksiktir, terapötik indeksi dardır
4. DAğır hipoglisemiye yol açar

How do clopidogrel and ticagrelor work?

1. AThey dissolve fibrin in existing clots
2. BThey block the platelet ADP (P2Y₁₂) receptor
3. CThey inhibit the vitamin K-dependent clotting factors in the liver
4. DThey directly inhibit thrombin in the plasma

A nurse teaches a patient who has a new permanent pacemaker. Which statement shows a need for further teaching?

1. A"I will keep my follow-up appointments for device checks."
2. B"I will carry my pacemaker identification card with me at all times."
3. C"I will keep my mobile phone in my shirt pocket over the device."
4. D"I will tell staff about the device before any MRI scan."

İnme için IV trombolizisten sonra ilk 24 saatte en önemli izlemler hangileridir?

1. AYalnızca günlük tartı ve sıvı dengesi
2. BSık nörolojik kontroller ve KB
3. CSaatlik bağırsak sesleri ve karın çevresi
4. DSaatlik tepe akım ve oksijen satürasyonu

A patient with polycystic kidney disease suddenly has the worst headache of their life and neck stiffness. What should the nurse suspect?

1. AA urinary infection that has spread
2. BPain spreading upwards from a kidney cyst
3. CA migraine linked to high blood pressure
4. DA subarachnoid haemorrhage from a brain aneurysm

How can low-dose opioids help a patient with breathlessness from advanced cancer?

1. AThey increase the oxygen level in the blood
2. BThey open the airways like an inhaler
3. CThey cure the underlying lung disease
4. DThey reduce the feeling of breathlessness

On the ward after surgery, a patient has a red, blistered area of skin under where the diathermy plate was. What should the nurse do?

1. AWash it with alcohol and leave it uncovered
2. BIgnore it because skin changes after surgery are normal and expected to fade
3. CApply a hot water bottle to improve the circulation
4. DTreat it as a possible burn, report it and complete an incident form

A pregnant woman asks why she needs a whooping cough (pertussis) vaccine in pregnancy. Which answer is correct?

1. AHer antibodies cross the placenta and protect the newborn
2. BIt protects her from pre-eclampsia
3. CIt prevents the baby from developing rubella
4. DIt is a live vaccine that gives the baby lifelong immunity to whooping cough

Magnezyum sülfat alan bir kadının eşi ilacın ne işe yaradığını soruyor. Hangi yanıt doğrudur?

1. APreeklampsinin neden olduğu nöbetlerin önlenmesine yardımcı olur
2. BDoğumu hızlandırır
3. CBebeğin çok büyümesini engeller
4. DKan basıncını düşüren ana ilaçtır

A parent asks how to care for a child with mild croup at home. Which advice is correct?

1. ALay the child flat in a cool room so the airway can relax
2. BKeep the child calm and upright, and get urgent help if there is noisy breathing at rest
3. CHold the child over a bowl of hot, steaming water to loosen the cough
4. DGive an over-the-counter cough syrup every hour until the barking cough stops

A child with a new forearm cast has severe pain not relieved by analgesia and screams when the nurse gently moves the fingers. What should the nurse suspect?

1. ANormal pain after a fracture; give more time
2. BCompartment syndrome; report it at once
3. CItching under the cast; give an antihistamine
4. DAnxiety; distract the child with play

The wife of a man with alcohol dependence organises her life around his drinking, hides it from others and neglects her own needs. What does this pattern suggest?

1. ACodependency
2. BEnabling by the healthcare team
3. CDelirium tremens
4. DLearned helplessness in the patient

A new nurse asks why the therapeutic relationship is different from a social relationship. Which statement is correct?

1. AThe patient is responsible for setting the boundaries of the relationship
2. BIt is goal-directed and focused on the patient's needs, with the nurse responsible for keeping boundaries
3. CIt has no fixed end, and it can continue as a friendship after discharge if both the nurse and the patient want it to
4. DBoth people share their needs equally, as in any friendship

Alıştırma (uydurma değerler, klinik rehber değildir). Bir enjeksiyon için doz hesaplaması 4,1021 mL veriyor. Bu alıştırmadaki kural şudur: 1 mL ve üzeri hacimler en yakın mL’nin onda birine yuvarlanır. Hangi değeri x kaydedersiniz?

Alıştırma (uydurma değerler, klinik rehber değildir). Bir kan glukozu sonucu 439 mg/dL. Glukoz için 1 mmol/L = 18 mg/dL kullanarak c değerini mmol/L cinsinden bulun. Bir ondalık basamağa yuvarlayın.

Bir hasta 12 kg. Order edilen doz günde 5 mg/kg, 2 eşit dozda veriliyor. Doz başına kaç miligram D verilir?

Reçete 330 mikrogramdır. Ampul 1 mg/mL içerir. Dozu 1 mL’lik şırıngaya çekin: hangi hacmi V verirsiniz?

Bir damla infüzyonu 15 gtt/mL’lik bir setle 30 gtt/min hızla akıyor. Hasta 4 saatte kaç mililitre V alır?

500 mg ilaç 500 mL içinde seyreltiliyor ve 15 gtt/mL’lik bir setle yerçekimiyle veriliyor. İstem saatte 20 mg. Damla hızı R değerini dakikadaki damla olarak bulun.

Alıştırma (uydurma değerler, klinik rehber değildir). Kayıt, bir hastanın 8 saatlik bir vardiyadaki aldığı ve çıkardığını gösteriyor. IV infüzyon vardiya boyunca gösterilen hızla gitti. Toplam alınan I değerini mL cinsinden bulun.

Alıştırma (uydurma değerler, klinik rehber değildir). 500 mL’lik bir infüzyon saat 07:30’de 80 mL/h hızla başlıyor. 3 saat sonra hız 150 mL/h’ye değiştiriliyor ve bir daha değiştirilmiyor. Başlangıçtan kaç saat t sonra torba boşalır? Bir ondalık basamağa yuvarlayın.

Alıştırma (uydurma değerler, klinik rehber değildir). Bir alıştırma hastası Morse düşme skalasıyla değerlendiriliyor: son 3 ayda düşme öyküsü: evet; ikincil tanı: hayır; yürüme yardımcısı: koltuk değneği, baston ya da yürüteç; IV tedavi ya da salin kilidi: hayır; yürüyüş: zayıf; mental durum: kendi sınırlarını biliyor. Morse toplamını MFS bulun.

Alıştırma (uydurma değerler, klinik rehber değildir). Ekip en az 65 mmHg’lik bir ortalama arter basıncını hedefliyor. Bir hastanın sistolik basıncı 91 mmHg. MAP = (SKB + 2·DKB)/3 formülünü kullanarak hâlâ 65 mmHg MAP veren en düşük diyastolik basınç DBP kaçtır?