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nclex review1
| Question | Answer |
|---|---|
| Stay with client for 1st ____ min of blood transfusion | 15 |
| Infuse blood within ____ hours | 4 |
| What type blood transfusion reaction manifests in pruritus, respiratory distress,urticaria, and flushing | allergic |
| What type of blood transfusion reaction manifests in flank pain, chest pain, fever, chills, tachycardia, and tachypnea | hemolytic |
| Erythropoietin is produced in the _________ | kidneys |
| Pernicious anemia results from a deficiency in _____ usually caused by lack of the intrinsic factor in gastric juice | B12 |
| Lead poisoning can cause _____________ anemia | hemolytic |
| Pain med of choice for sickle cell anemia | dilaudid |
| Dilute liquid ________ preparations in juice or water and administer with a plastic straw to avoid staining teeth | iron |
| Avoid antacids, coffee, tea, dairy products or whole grain breads for ___ after oral iron administration | 1 hr |
| For iron injections, use a _______ guage, ___ inch needle | 20, 3 |
| Massage after injecting iron. t/f | False |
| Change needles between drawing up iron and injecting to prevent staining. t/f | True |
| A 45 year old man's lipid profile results are sent to the nurse practitioner. They are as follows total cholesterol= 287; HDL= 30' LDL= 165; triglycerides =150. The nurse interprets these results as: | Abnormal: the total cholesterol and LDL levels are elevated, and the HDL is too low. |
| Barium swallow series | Upper GI tract exam under fluoroscopy after ingesting barium sulfate to detect anatomical or functional abnormalities of the esophagus, stomach and small intestines |
| Increased fluids and laxatives may be prescribed after a swallow series to increase elimination of ________ | barium |
| Lower GI tract exam done by ex-ray and fluoroscopy of the large intestine after rectal insertion of a ___________ | Barium enema |
| Give clear liquid diet and laxative day before procedure, NPO after midnight, and cleansing enema before a ________________ and _____________ | barium enema study, colonoscopy |
| For a colonoscopy, patient lies on ______ side with knees drawn up to chest | left |
| x-ray that requires the client to consume a high-fat meal at 1200, a low-fat meal at 1700, and contrast tablets 12 hours before the procedure | cholecystogram |
| Have client lie on ______ side for 1-2 hours after a liver biopsy | Right |
| Assess placement of NG tube before each feeding and every ___ hours with continuous feeding | 4 |
| Always refeed residual of NG tube unless it exceeds ____ mL | 100 |
| TPN must be administered through a ___________ for rapid dilution and blood flow | central line |
| Maintain __________ technique during TPN dressing changes | aseptic |
| Change all TPN tubing and filters every ____ hours | 24 |
| Check blood glucose every __ hours for TPN | 4 |
| Methods to avoid ____________ include eating small frequent meals, avoiding liquids with meals, lying down after meals, and eating high-protein, high-fat, LOW-CARB meals | Dumping syndrome |
| Eat a _____ residue diet to prevent diverticulitis and a ____ residue diet to heal it - ALWAYS avoid ______ | high, low, seeds |
| Ulcerative colitis | Bowel disease effecting large bowel, causing bleeding, pain, weight loss, and severe diarrhea |
| Crohn's Disease | Bowel disease effecting small bowel, causing perianal involvement, fistulas, colicky pain, weight loss, and diarrhea |
| Hepatitis A | Virus transmitted by fecal-oral contact; often seen with contaminated water or shellfish |
| Hepatitis B | Virus transmitted through infected blood or unprotected sex - most common |
| Hepatitis C | Virus transmitted through blood transfusions, IV drug abuse, health care exposure |
| Appropriate immune serum globulin must be administered within ____ days of exposure to Hepatitis viruses | 2-7 |
| cirrhosis diet | This condition requires a high-calorie; low/no protein; low-fat; low-sodium diet |
| medication used to lower blood ammonia levels | lactulose |
| Which condition can be treated with a Sengstaken-Balemore tube? | esophageal varices |
| Murphy's sign | Palpation of right subcostal area while client takes a deep breath - extreme pain indicates acute cholecystitis |
| Elevated serum amylase and lipase are seen with __________ | pancreatitis |
| NPO with NG tube in place and TPN for moderate to severe cases occurs with ____________ | pancreatitis |
| ID sites | inner forearm,back,chest |
| SQ sites | abdomen,outer arm,anterior thigh |
| SQ Heparin sites | abdomen,posterior upper arm,low back,thigh,upper back |
| IM sites | deltoid,ventrogluteal,dorsogluteal,vastus lateralis |
| dont use more than 2ml injection where? | deltoid |
| preferred site for IM adults | ventrogluteal |
| watch for sciatic nerve whene using what site | dorsogluteal |
| Potassium High sources include | bananas, peaches, melons, raisins, dried fruits, black licorice, nuts, salt substitutes, vegetables, and tomato, orange, and grape juices, |
| Which side effect of hydrochlorothiazide, a thizide diuretic should a diabetic patient be monitored for? | Increased hyperglycemia |
| An elderly white man with a long history of asthma has recently ben given a diagnosis of hypertension. Which class of antihypertensive agents should the nurse avoid for this client? | Beta Blockers |
| Your patient is receiving unfractionatedheparin. In addition to the PTT, which laboratory value must be monitored? | Platelets |
| Which drug counteracts heparin? | Protamine sulfate |
| CD4 count less than _______ indicates AIDs | 200 |
| chronic inflammatory disease involving vascular and connective tissue of multiple organs causing butterfly rash on cheeks and across nose, polyarthralgia, anemia, fever, malaise, weight loss, Raynaud's | Lupus |
| Which birth control method is contraindicated for patients with Lupus? | IUD |
| Burn percentage of head and neck | 9 |
| Burn percentage of anterior trunk | 18 |
| Burn percentage of posterior trunk | 18 |
| Burn percentage of arms | 18 |
| Burn percentage of legs | 36 |
| Burn percentage of perineum | 1 |
| The shock phase of a burn victim occurs for ___ -____ hours - this is when massive edema, protein and fluid loss, and increase in potassium occurs | 24-48 |
| For burn victims, give half of total fluids in first ___ hours | 8 |
| Sodium High sources include | table salt, processed foods, baking soda, MSG |
| Calcium High sources include | dairy products, sardines, salmon, tofu, soy,and nuts |
| Magnesium High sources include | fruits, peas, nuts, pumpkin seeds, sunflower seeds, spinach, salmon, halibut, black and navy beans |
| Administration of glucose and insulin facilitate entry into cells | Potassium |
| Kayexalate can be given for excess of this electrolyte | Potassium |
| Never give this electrolyte by bolus IV or PO - Must be diluted and infused at no greater than 40 mEq/L | Potassium |
| Use ___ instead of tap water for irrigation or enemas in the presence of hyponatremia | NS |
| In the presence of surplus _________, signs include edema, hypertonicity, dry sticky mucous membranes, elevated temperature, flushed skin, and thirst | Sodium |
| Proportions in body are always inversely related to phosphorus proportions | Calcium |
| May be deficient in hypoparathyroidism or removal of thyroid | Calcium |
| Calcium Deficiency causes | tetany, cramps, tingling, numbness, hyperactive reflexes, cardiac arrhythmias, and Chvostek and Trousseau's signs |
| This vitamin facilitates absorption of calcium | D |
| Deficiency of this can be related to alcoholism | magnesium |
| Do not administer antacids containing ______________ to renal failure patients | magnesium |
| Post-renal biopsy, patient must remain in a _______ position and be on bed rest for ___ hours | supine, 24 |
| Antibiotics of choice for UTIs | sulfonamides |
| Type of acute renal failure resulting in inflammation of the kidney's that is thought to be related to strep infection | glomerulonephritis |
| This type of acute renal failure usually occurs in children and has a good prognosis | glomerulonephritis |
| Reduce dietary protein and sodium and increase calories for ____________________ | glomerulonephritis |
| acute renal failure Symptoms include | sudden onset of oliguria, edema, elevated BUN, creatinine, potassium, decreased protein and calcium, phosphate, decreased specific gravity, acidosis, heart failure |
| Diet for _________ renal failure is low-protein, low-potassium, low sodium, low phosphate, high-carb,, with vitamin and calcium supplements with fluid restriction | Chronic |
| Never clamp a nephrostomy tube. t/f | True |
| Medications which promote urinary flow | alpha-blockers |
| If fluid intake is encouraged, this usually means at least ___________mL per day | 3,000 |
| TURP syndrome | Hyponatremia, confusion, brady./tachycardia, hypo/hypertension, N/V, or visual changes resulting from absorption of irrigating fluids through prostate tissue during surgery |
| Urge incotinence | Type of incontinence in which patient cannot hold urine when stimulus to void occurs |
| Functional incotinence | Type of incontinence when the patient cannot physically get to the bathroom or doesn't know to |
| Stress Incotinence | Type of incontinence when pressure such as coughing, straining, or laughing causes urine to escape |
| Decorticate | Abnormal posturing indicated by rigidity, flexion of arms, clenched fists, extended legs |
| Decerebrate | Abnormal body posturing indicated by rigid extension of arms and legs, downward pointing of toes, and backward arching of head |
| __ or less on the Glasgow coma Scale indicates that the patient is in a coma | 7 |
| After a lumbar puncture, it is correct to position the patient flat for 20-60 minutes. T/F | True |
| The first sign of increased ICP is altered _____ | LOC |
| Change in LOC, N/V, pupil changes, diplopia, widening pulse pressure, bradycardia, Cheyne-Stokes respirations, and elevated temperature are signs of _______________ | elevated ICP |
| With elevated ICP, keep HOB at ___-___ degrees and head in ________ position | 30-45, neutral |
| Opiates and sedatives are contraindicated for ___________, but ___________ may be used if uncontrolled | elevated ICP, barbituates |
| This med can only be administered with NS and has side effects of ataxia, diplopia, hirsuitism, and gum hypertrophy | Phenytoin |
| medication of choice for status epilepticus | Ativan |
| autonomic dysreflexia | Life threatening syndrome of sudden, severe hypertension in response to noxious stimuli below cord damage such as bowel/bladder distension, pressure ulcers or points, and pain or spasms |
| multiple sclerosis | Chronic, progressive disease of the CNS, characterized by small patches of demyelination in the brain and spinal cord |
| Parkinson's Manifestations include | bradykinesia, rigidity, resting tremor, expressionless fixed gaze, drooling, slurred speech, constipation |
| amyotrophic lateral sclerosis Rapidly progressive, invariably fatal neurological disease that attacks the nerve cells that control the voluntary muscles | |
| myasthenia gravis | Disorder affecting neuromuscular transmission of voluntary muscle causing extreme muscular weakness, increased by fatigue |
| Guillain-Barre Syndrome | Ascending, reversible paralysis cause by acute inflammatory disease of peripheral nerves |
| presbycusis | progressive disorder associated with aging in which the patient loses the ability to hear sounds at high frequencies |
| presbyopia | farsightedness associated with aging |
| Meniere's Disease | Disorder of the inner ear that causes vertigo, tinnitus, hearing loss, and pressure in the ear due to increased fluid |
| Risk for _________ is an area for concern with patients with Meniere's disease | Falls |
| It is important to take precautions against increasing _______ after a cataract surgery - severe pain should be reported immediately | ICP |
| Patients with glaucoma should avoid all ______________ medications | anticholinergic |
| Infant birth weight doubles by ____ months and triples by ____ months | 6, 12 |
| The posterior fontanel closes by ___ months | 2 |
| The anterior fontanel closes by __-___ months | 12-18 |
| Age of child in months minus 6 equals number of ______ | teeth |
| Solids can be introduced into an infants diet around __-___ months | 4-6 |
| Infant can sit alone by __ months | 7,8 |
| Infant can pull self to feet by ___ months | 9 |
| Use a semi-reclining infant car seat that faces rear until ___ lbs | 20 |
| Forward facing seats for children weighing __-___ lbs | 40-80 |
| Sensorimotor Cognitive stage | 12-14 months - objects are cause of action; separation anxiety |
| Preoperational Cognitive stage | 2-7 years - egocentric in though and behavior; concrete, tangible thinking; vivid imagination (magical thinking, peak age for fears) |
| Play of the toddler | parallel |
| Play of the Preschooler | cooperative |
| Concrete Cognitive stage | 7-11 years - classifies and sorts; enjoys collecting; concrete logic and problem solving; less egocentric; inductive thinking |
| formal operations Cognitive stage | 11+ years - abstract thinking; ability to hypothesize |
| Ortalani's sign | Audible click that can be heard with congenital hip dysplasia as the examiner slips the femoral head forward |
| _________ is used during an acute asthma attack, ________ is used daily for chronic asthma | albuterol, salmeterol |
| Overdose of ________ can cause tinnitus, hyperpyrexia, seizures, bleeding, and hyperventilation | aspirin |
| Overdose of _______ can cause liver necrosis in 2-5 days, N/V, Right upper gastric pain; coagulation abnormalities | tylenol |
| Consumption of _________- can cause developmental regression, impaired growth | lead |
| chelation therapy | Treatment for lead poisoning (or other heavy metals) |
| Activated charcoal and gastric lavage are treatment for ______________ and _______________ - do NOT induce emesis | hydrocarbons, corrosives |
| rheumatic fever | Inflammatory disease affecting the heart, joints, and CNS 2-6 weeks after a upper respiratory strep infection |
| Wilm's tumor | renal cancer usually in children around age 3 - Do NOT palpate abdomen |
| nephrotic syndrome | renal disorder in very young children with increased permeability of the glomerular membrane to protein |
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