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NCLEX 2012 Review

Questions to help prepare

Hypertension, what lifestyle modifications should be implemented? Limit alcohol, exercise regularly, reduce sodium intake, and stop smoking.
After an abdominal aortic aneurysm resection what is a priority assessment? Urine output
What would indicate pulmonary edema is improving? No adventitious lung sounds
Coronary artery bypass, what medication is important to stop one week prior? Coumadin
Stress test for 11 a.m., should it be rescheduled if patient smoked this morning? Yes
Digoxin and Lasix, what adverse reaction can occur? Light-headedness, due to possible hypotension
Aortic aneurysm repair, what might indicate shock? Urine output of 20 ml
What is a complication with endocarditis? Valvular disease
True or false: Hiccups are a sign of complication after a pacemaker placement? True
True or false: You must rotate nitroglycerin topical patch sites? True
If a patient is receiving heparin IV for DVT and has an aPTT value of 96 seconds what would you do? Stop infusion immediately
What difference sign may or may not be present in a patient with an arterial venous leg ulcer? Claudication
What sided heart failure is manifested by weak peripheral pulses, right or left? Left-sided heart failure
What is a lab level of an increase in creatinine kinase indicative of? MI/Heart attach
What would it indicate if a patient has increased difficulty after a 1 mile walk? patient who has dilated cardiomyopathy Left Ventricular Failure
A patient who is recovering from a CABG and has a B/P of 140/82 on inspiration, and a B/P of 154/90 on expiration indicate? Cardiac Temponade
What is one of the biggest disease risk factors for peripheral artery disease? Diabetes
True or false: A patient who is on Coumadin for DVT is at a therapeutic range with a INR of 2.5? True
What would a patient with heart failure and atrial fib who develops slurred speech indicate? Possible emboli
What intervention should the nurse perform first (other than calling MD)if a new patient has a hypertensive crisis and develops a B/P of 254/139? Initiate IV
True or False: Thrombolytic therapy is contraindicated in a patient who is 1 week S/P surgery for an MI? True
True or False: A patient who is on an ACE Inhibitor should notify the doctor if a persistent cough develops? True
What allergy is essential to ask about when a patient is to undergo a coronary angiography? Shell fish allergy
True or False: A patient who has a heart transplant, may not be able to feel chest pain any longer? True
EKG/ECG shows 70 complexes/min, PR interval 0.16, QRS measures 0.16 sec, PR interval slightly irregular, what cardiac rhythm would this be? Sinus dysrhythmia
What sided failure is would jugular vein distension and dependent edema be indicative of? Right-sided heart failure
What sided CVA would be manifested by visual spatial deficits, left hemianopsia, and one-sided neglect? Right CVA
What is the highest priority in monitoring a patient with hear failure receiving a blood transfusion? Lung sounds, for crackles in the lungs
What is a priority to monitor for after a patient has had a CVA/stroke? Dysphagia
What sign would indicate a CVA/stroke victim is suffering from homonymous hemianopsia? Patient turns head to view visual field
What reflex is most important to check for on a patient who had a left-sided CVA/stroke? Gag-relfex
How many minutes do you hold pressure after drawing ABGs on a patient who has a continuous drip of heparin infusing? 20 minutes (5 minutes if not on anticoagulants)
What is a common side-effect of Glucophage to watch for? GI disturbances
A patient who cannot communicate what would indicate that the patient needs pain medication? Increase in heart rate, increased respirations, restlessness, and increase blood pressure.
A patient with liver cirrhosis what would you implement to prevent esophageal varicies? Stool softner
Hyperkalemia would show up how on an EKG/ECG? Tented T-waves
What is important for a nurse to incorporate in the plan of care after a bronchoscopy? Keep patient NPO until cough reflex returns
Heat stroke patient what should nurse implement first? Cooled normal saline IV
Inderal is contraindicated with what disease? Asthma patient
If you run out of TPN what action should the nurse take? Run dextrose 10% in water until TPN is available.
Patients on coumadin should avoid what medications? Aspirin, barbiturates, ginger, ginseng, and oral contraceptives...to name a few.
Does constant bubbling in a closed water-seal drain system require immediate action? Yes, it indicates an air leak
Laryngectomy a nursing priority with nursing care is? Increase in mucus production
What explanation should a nurse give a patient about their Type 2 diabetes? Their pancreas is working, but not producing enough insulin.
What type of seizure is indicated by an aura prior? Partial seizure
Should a patient who is receiving TPN increase their TPN rate on days that they have increased exercise? No
What indicates server airflow obstruction in a patient who has a history of asthma and has pneumonia? Silent chest
Patient who has extreme shortness of breath and an inability to lie down, and is using accessory muscles to breath, and still has hypoxia on 100% O2 what would you suspect? ARDS Acute Respiratory Distress Syndrome.
Patient with a potassium level of 6.5, what EKG changes could you expect? Peaked T-waves
In respiratory acidosis what causes acid/base imbalance? Retension of carbon dioxide.
Should patient on Synthroid notify their doctor if their heart rate is racing? Yes, this is an adverse effect
What other complication or disease would you suspect of a patient who has Cushings disease and has been on long-term use of corticosteroids? Osteoporosis
What should nurse recommend to a patient who is on cogentin and has dry mouth? Brush teeth regularly
How do you care for pins on a patient on skeletal traction? Rinse pin sites with sterile saline
What is a nursing priority with a patient who has systemic lupus erythematous (SLE)? Patient's fatigue
What should the nurse tell to a patient who has nephrotic syndrome, who asks what causes the edema? The loss of protein in the urine causes edema
What test would indicate that the Lactated Ringers solution has been effective in replacing the NG output? Urine specific gravity at 1.020
Should the nurse report cloudy dialysate drainage in a patient who is receiving peritoneal dialysis? Yes, it indicates that the patient could have inflammation of the peritoneum.
What should the nurse watch for in a patient receiving Kenalog? Thinning of skin
What is the main symptom of hypovolemia? Increased rapid pulse
Respiratory Alkalosis is indicated by? Decrease in PaCO2, and PCO2 and SaO2 at hypoxic levels, and Ph is alkaline.
What other effect would be likely in a patient's labs with hypernatremia (high sodium blood level)? Decrease in serum osmolarity
With Coumadin what effect should be reported by the patient to the doctor if it occurs? Confusion
What is the goal of a patient who has had a knee arthroplasty upon discharge? 90 Degree bending of the knee
What position should the nurse put a patient who has a central venous catheter pull out of a subclavian vein? Left side in Trandelenburg position
How long should a women sustain from having intercourse after undergoing loop electrosurgical excision for cervical cancer? 3 weeks or until her doctors okays it
What would help prevent intracranial pressure in a patient with a head injury? Elevate the head of bed 30 Degrees
What position do you want the paitent's leg to be in after a hip arthroplasty surgical intervention? Avoid position of adduction, no inward rotation of the surgical leg. (Abduction is acceptable)
What is an adverse eye effect of a patient who has TB and is receiving Ethambutol? Optic neuritis
If a patient suffered a basilar skull fracture and is experiencing serosanginous nasal drainage, how would you test this? Look for halo sign, by collecting nasal drainage on a dressing and watch for yellowish ring to form.
What action should the nurse take if she has a patient who is AB positive and she notices the blood that is infusing is B negative blood? It's okay, just monitor for adverse reaction
What stage of ulcer would be one that has a shallow crater that involves the epidermis? Stage II ulcer
What should the nurse implement for a paitent who is experiencing atelectasis after cardiac surgery? Preform incentive spirometry every 2 hours
Where would you check for Murphy's sign in a patient who is experiencing abdominal pain to rule out appendicitis? Right upper quadrant of abdomen
What blood pressure change would indicate a concern in a patient with a traumatic brain injury? Widening pulse pressures (for example: having B/P go from 130/80 to 150/50)
What should the precaution should the nurse implement with a patient with bacterial meningitis? Wearing a surgical mask
If a patient in the PACU has a systolic B/P of 88 and their baseline B/P was from 124-130 what nursing action should the nurse take? Administer O2 and lie the patient flat
What eye condition would be the result of microvascular compromise in a patient with Type 2 diabetes? Retinopathy
What supplement should be initiated for a patient with chronic renal failure? Folic acid
How many ml of blood should be discarded from a central venous catheter to have accurate results of a blood specimen collected? 5-10 mls
What are 3 things that should be included in caring for a client after they have a transurethral resection of the prostate? Reposition frequently, monitor temperature every 4 hours, and apply warm compresses to manage bladder spasms.
PICC line care should include: Assess site every 8 hours, flush with 10 cc, change dressing every 7 days (unless otherwise indicated)
What diet change can a patient with COPD implement in their self-care to better control their disease? A diet low in carbohydrates (a high carb diet causes an increase in carbon dioxide)
What kind of stroke would be manifested by a sudden headache, decrease level of consciousness, and hypertension? Hemorrhagic stroke (caused by bleeding into the brain)
With Myasthenia Gravis you would expect the patient to exhibit muscle weakness that improves with rest and what other issue? Ptosis (dropping eye-lid)
What would these finding indicate: Ph 7.48, HCO3 24, SaO2 85%, PCO2 30, PO2 55, and the patient is anxious and has tingling lips and fingers? Respiratory alkalosis
Created by: rebander