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

Which care best protects the skin of a patient with frequent urinary incontinence?

1. AScrubbing the area with soap and hot water twice a day
2. BLeaving the skin wet so it does not dry out
3. CApplying talcum powder thickly after each episode
4. DGentle cleansing after each episode and a barrier product

A patient with delirium tries to leave the ward at night, saying they are going home, and would be at serious risk outside. What is correct (England and Wales)?

1. ALock them in a side room until the morning for their own safety
2. BGive a sedative without asking anyone
3. CLet them leave, as all adults are free to go wherever they like
4. DAssess capacity and, if it is lacking, act in their best interests

A nurse pours sterile saline into a bowl on a sterile field. Which technique is correct?

1. AHold the bottle with the label in the palm and pour without touching the bowl
2. BPour from below the level of the field to reduce splashing
3. CReach across the field to fill the bowl at the far side
4. DRest the lip of the bottle on the edge of the bowl so that the saline does not splash

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. BWipe the tip with an alcohol swab and give the dose
3. CDiscard the syringe and prepare the dose again with new equipment
4. DGive the dose anyway, because the medication tray was cleaned this morning

A patient reports pain of 8/10. Before giving the prescribed as-needed analgesic, what does the nurse do first?

1. ATell the patient to wait until the next scheduled dose is due in two hours
2. BAssess the location, character and onset of the pain and the vital signs
3. CAsk the nursing assistant to reposition the patient
4. DGive the strongest analgesic on the chart straight away

Six hours after surgery, a patient has not passed urine, feels the urge to go and has a firm swelling above the pubic bone. What is the most likely problem?

1. ADehydration from fasting before surgery
2. BAcute kidney injury with no urine made
3. CUrinary retention
4. DA normal effect of the anesthetic

What is the most common cause of hypernatraemia in frail older inpatients?

1. ANot drinking enough water
2. BEating too much salt in one meal
3. CToo much exercise
4. DTaking too many vitamins

Konsantre potasyum klorür neden asla hızlı damar içi enjeksiyonla verilmemelidir?

1. AÖlümcül kalp ritim bozukluklarına yol açabilir
2. BDamarda kristalleşir ve kanülü tıkar
3. CHızlı verilirse etkisi olmaz
4. DAni böbrek yetmezliğine neden olur

A nurse has a needlestick injury from a patient with unknown HIV status. Which test is usually done for the nurse as soon as possible?

1. AA thyroid panel test
2. BA baseline HIV test
3. CA serum lipase test
4. DA sweat chloride test

A patient with a stable INR on warfarin starts rifampin (rifampicin) for tuberculosis. Two weeks later the INR is 1,3. What is the most likely explanation?

1. ARifampin speeds up warfarin metabolism
2. BRifampin contains a lot of vitamin K
3. CRifampin raises the INR, so it is wrong
4. DTuberculosis causes the INR to fall

A patient given haloperidol develops a sudden painful twisting of the neck and the eyes roll upward. Which drug is usually given?

1. AA second dose of haloperidol
2. BAn anticholinergic such as benzatropine (benztropine)
3. CNaloxone
4. DDantrolene by mouth to relax the twisted neck muscles

Bir hastada ilk amoksisilin dozuna anafilaktik reaksiyon gelişiyor. Bu advers reaksiyon yaygın A/B sisteminde nasıl sınıflandırılır?

1. ATip A; çünkü doza bağlı ve ilacın farmakolojisinden öngörülebilirdir
2. BTip B; çünkü öngörülemez ve ilacın normal etkisiyle ilgisizdir
3. CTip A; çünkü doz çok yüksekti
4. DTip B; çünkü yalnızca uzun süreli kullanımdan sonra ortaya çıkar

Why is pyridoxine (vitamin B6) often given with isoniazid?

1. ATo prevent orange discolouration of urine
2. BTo prevent peripheral neuropathy
3. CTo prevent loss of colour vision
4. DTo prevent gout attacks

After a faulty gas heater was found at home, a patient has headache, nausea and confusion. SpO₂ is 99% on air. What is the priority treatment?

1. AParacetamol (acetaminophen) and observation only
2. BHigh-concentration oxygen via a non-rebreather mask
3. CReassurance, because the oxygen saturation is normal
4. DOxygen at 1 L/min via nasal cannula

A patient taking warfarin is diagnosed with an intracerebral haemorrhage. What is the priority treatment?

1. AIV thrombolysis within 4,5 hours
2. BUrgent reversal of the anticoagulant effect
3. CDoubling the warfarin dose to stabilise the INR
4. DStarting aspirin to prevent further clots

A patient with CKD has a potassium of 6,5 mmol/L. Which medicine combination is the most likely contributor?

1. AFurosemide, salbutamol and insulin
2. BParacetamol (acetaminophen), omeprazole and senna
3. CRamipril, spironolactone and trimethoprim
4. DAmlodipine, simvastatin and aspirin

Why are antimotility drugs such as loperamide avoided in C. difficile infection?

1. AThey cause serious liver failure in most patients who take them
2. BThey may keep toxin in the bowel and risk toxic megacolon
3. CThey kill the normal bowel bacteria
4. DThey make the stool sample test positive falsely

A patient who takes NSAIDs suddenly develops severe epigastric pain, a rigid abdomen and shoulder-tip pain. Which finding would most support the likely diagnosis?

1. AA raised serum lipase three times the upper limit
2. BFree air under the diaphragm on an erect chest X-ray
3. CTall, peaked T waves on a 12-lead ECG
4. DFluid levels in the bladder on an ultrasound scan

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. BCollect a urine sample for culture and inform the provider
3. CAdvise her to drink less to reduce frequency
4. DAdvise cranberry juice and no further action

A labouring woman has had an epidural for 3 hours. The fundus is displaced and a bulge is seen above the pubic bone. What should the nurse do?

1. ACheck for bladder distension and empty the bladder
2. BPrepare her for an emergency caesarean
3. CStart an oxytocin infusion
4. DIncrease the rate of the epidural

Kanül takılmadan önce topikal anestezik krem (lidokain–prilokain) planlanıyor. Neyi bilmek önemlidir?

1. Aİğneden yalnızca birkaç saniye önce uygulanmalıdır
2. BÖnceden, genellikle yaklaşık 60 dakika önce, oklüzif bir pansumanın altında uygulanmalıdır
3. CCilde sertçe sürülmeli ve pansuman olmadan yaklaşık 1 dakika sonra silinmelidir
4. DDaha hızlı etki için bütünlüğü bozulmuş cilde uygulanmalıdır

A 7-year-old has a high fever, refuses to bear weight and has a warm, very tender area over the lower tibia. Which plan is most likely?

1. ABlood cultures and prompt IV antibiotics for possible osteomyelitis
2. BRest, ice and an elastic bandage for a sprained ankle, with review in a week
3. CMassage and physiotherapy to loosen the muscle
4. DA plaster cast and discharge home the same day

The nurse notices that she is spending much longer with one patient than with the others and feels she is the only one who can help him. What does this most likely indicate?

1. AThat the patient needs to be transferred to another unit
2. BTransference by the patient towards the nurse, which is never the nurse's concern
3. CPossible boundary problems that she should discuss in supervision
4. DAn ideal therapeutic relationship

On a mental health ward, which task is most appropriate for the nurse to delegate to a healthcare assistant?

1. ATeaching a patient about the side effects of lithium
2. BEvaluating whether a PRN medicine given an hour ago has worked
3. CCarrying out the full admission suicide risk assessment of a newly admitted patient
4. DAccompanying a stable patient to the dining room and recording his food intake

Alıştırma (uydurma değerler, klinik rehber değildir). Bir ağırlık dönüşümü 26,3199 kg veriyor. Bu alıştırmadaki kural şudur: ağırlıklar en yakın kilogramın onda birine yuvarlanır. Hangi değeri x kaydedersiniz?

Alıştırma (uydurma değerler, klinik rehber değildir). Bir infüzyon 22:20 saatinde başlıyor ve ertesi sabah 01:15 saatinde bitiyor (24 saatlik saat). t kaç dakika sürdü?

Bir hasta 25 kg ve tek doz olarak 15 mg/kg order edilmiş. Dozu D mg cinsinden bulun.

Reçete 1450 ünitedir; ilaç 5000 ünite/mL olarak gelir. Dozu 1 mL’lik şırıngaya çekin: hangi hacmi V verirsiniz?

15 damla/mL'lik bir setle 250 mL'yi 6 saatte verin. Damla hızı R'ü dakikada damla olarak bulun. En yakın tam sayıya yuvarlayın.

1000 mg ilaç 250 mL içinde seyreltiliyor ve 60 gtt/mL’lik bir setle yerçekimiyle veriliyor. İstem saatte 400 mg. Damla hızı R değerini dakikadaki damla olarak bulun.

Alıştırma (uydurma değerler, klinik rehber değildir). Kayıt, bir hastanın 12 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 torba pompayla 125 mL/h hızla gidiyor. Saat 18:30’de 200 mL zaten verilmiş. Torba kaç saat t sonra boşalır? Bir ondalık basamağa yuvarlayın.

Alıştırma (uydurma değerler, klinik rehber değildir). Kafa travması geçirmiş bir alıştırma hastası gözlerini yalnızca basıya (ağrılı uyarana) açıyor, yalnızca inleme gibi anlaşılmaz sesler çıkarıyor ve en iyi motor yanıt olarak şunu gösteriyor: hiç hareket yok. GCS’yi hesaplayın ve kafa travmasını ona göre sınıflandırın. Cevabınıza tıklayın.

1. 1hafif
2. 2orta
3. 3ağır

Alıştırma (uydurma değerler, klinik rehber değildir). Bir alıştırma hastası Morse düşme skalasıyla değerlendiriliyor: son 3 ayda düşme öyküsü: hayır; 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. 0–24 düşük, 25–44 orta ve 45 ve üzeri yüksek kesme değerlerini kullanarak düşme riski düzeyine tıklayın.

1. 1düşük risk
2. 2orta risk
3. 3yüksek risk