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NCLEX Review Deck > Kaplan QBank > Flashcards

Kaplan QBank Flashcards

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1
Q

What is the purpose of OCD for the pt?

A

To avoid or alleviate increasing levels of anxiety

COntrol and relieve tension and axiety

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2
Q

What is a Weber test?

A

Simple screening test for hearing loss

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3
Q

What is the purpose of the cuff on a tracheostomy tube?

A

To decrease the chance of aspiration into the trachea

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3
Q

What is the purpose of the cuff on a tracheostomy tube?

A

To decrease the chance of aspiration into the trachea

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4
Q

What are the functions of the cerebellum?

A

Maintain balance, msk coordination, precise movements of hands, legs, arms.

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5
Q

For pts with RA, should they engage in passive or active exercises? like….

A

Active (low impact - yoga, swimming)

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6
Q

What age is a child who can walk steps alternating feet, bend over easily without falling, stand on one foot breifly and jum horizontally?

A

3 yrs

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7
Q

What are the electrolyte imbalances associated with Cushings?

A

HyperK
Hypernatremia

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8
Q

Why is a PSA test done?

A

To screen for prostate cancer

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9
Q

When do these reflexes disappear?

Babinksi:
Moro:
Tonic neck:
Grasp: (palmer and plantar)

A

12m/1yr

3-4 m

3-4m

Palmer by 3m
Plantar by 8m

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10
Q

What is the age difference in population between pts with gastric vs duodenal ulcers?

A

Gastric =. middle aged / older adults

Duodenal = younger pts 20-50 yrs

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11
Q

When do pts with duodenal ulcers experience pain?

A

After meals (midmorning/midafteroon)

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12
Q

Ages for Tdap

A

2, 4, 6 months

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13
Q

Age for MMR

A

12-15m and 4-6 yrs

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14
Q

Age for rotovirus vax (3 dose)

A

2, 4, 6 months

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15
Q

Age for varicella vax

A

12-15 m

4-6 yrs

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16
Q

Seratonin toxicity s/s

A

Fever

Abnormal eye movement

hallucinations

diarrhea

loss of coordination

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17
Q

What are the parameters that a pt on heparin should have their dose changes and you should notify the HCP?

A

aPTT <50 seconds

aPTT>100 seconds

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18
Q

What is the relationship between digoxin and potassium levels?

A

Hypokalemia can increase digoxin toxicity

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19
Q

What is the purpose of an electromyography (EMG)?

A

Electrodes are attached to the muscles and the test measures muscle response and electrical activity. The test takes 30-60 mins

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20
Q

With hypoparathyroidism, what happens to calcium levels? What about phosphorous levels?

A

They fall (hypocalcemia)

Hyperposphotemia

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21
Q

What does “failure to thrive” mean for newborns?

A

Weight gain is significantly below other children the same age.

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22
Q

Phenelzine is what type of drug?

A

MAOI

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23
Q

What type of med is Buspirone?

A

anti-anxiety

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24
Q

What type of med is Prochlorperazine?

A

Anti-emetic

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25
Q

After a minor head injury, what is NOT an expected side effect and should be reported to the HCP immediately? (6)

A

Vomiting

Blurred vision

Drainage from ear/nose

Weakness

Slurred speech

Worsening HA

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26
Q

At what age is immitative behavior most seen?

A

Preschoolers

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27
Q

How is a myelogram performed?
What’s its purpose?

A

Contrast medium is injected into the spinal fluid in the subarachnoid space through a lumbar spinal puncture.

It identified tumors, cycsts, herniated vertebral disks that protrude into the spinal canal

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28
Q

How should a pt with a cane walk UP stairs?

A

Step with strong leg
Bring weak leg and cane

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29
Q

How should a pt with a cane walk DOWN stairs?

A

Weak leg goes down first

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30
Q

What lab value will be monitored in a pt taking allopurinol?

A

CBC to monitor WBC because the drug depresses the bone marrow.

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31
Q

Which two drugs when used together can lead to hyponatremia in OAs?

A

Citalopram and Hydrochlorothiazide

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32
Q

In a pt with hyponatremia what will be monitored with fluids (advised)?

A

Restrict fluids to 800-1000ml because you want to increase the sodium in their blood

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33
Q

On streptomycin, what are s/s of aminoglycoside toxicity? (2)

A

Ototoxicity and nephrotoxicity

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34
Q

If a client with an NG tube vomits what nursing action in best?

A

Irrigate the NG tube with 20ml of NS

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35
Q

Common adverse effects of metformin

A

N/V

Diarrhea

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35
Q

Common adverse effects of metformin

A

N/V

Diarrhea

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36
Q

What are the interventions that should be initiated prior to a scheduled exercise stress test in a pt with chest tightness?

A
  1. Pt ed
  2. Ensure NPO for 4 hrs prior
  3. 12 lead EKG immediately prior to test (and during and after)
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37
Q

Is yellow exudate from the site of a circumcision normal? What should be done about it?

A

yes

Do not remove the exudate – the circumcision site should be cleaned with warm water.

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38
Q

What are the first s/s of hypocalcemia seen in a pt who had a thyroidectomy?

A

Tinglishing in the lips and fingertips

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39
Q

Muscle flacidity = hypo or hypercalcemia?

A

Hyper

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40
Q

When a pt is having a delusion (ex: someone is trying to hurt me) as a result of their schizophrenia, What should you help the pt focus on? What should you avoid?

A

Focus on: feelings that the delusions generate

Avoid: arguing about the content of the delusion. Avoid dwelling on it.

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41
Q

By 18m how many words should a child speak?

A

6-20

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42
Q

What is the tx of choice for a pt diagnosed with CHB who is symptomatic?

A

Pacemaker

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43
Q

A pt is pacing and continuously wringing their hangs and the pt voice becomes louder and angrier. What should the nurse do?

A

De-escalate by assisting the pt to express feelings of anger/frustration. Also, remove threatening components of the environment.

Avoid: disagreeing / threatening

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44
Q

What is one of the most common symptoms of Hep A in children?

A

Anorexia (symptoms of flu: fever, malaise, lethargy)

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45
Q

What are the symptoms of hep A in children 6 yrs + ?

A

Asymmtomatic often

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46
Q

Normal serum albumin. What can it be a good objective indicator of?

A

3.5 - 5.5

proetin intake

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47
Q

For the manic phase of bipolar, what should you do with the pt?

A

Redirect the pt (to safe behaviors) and reduce stimuli

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48
Q

How should a parent check the bathwater before their child goes in? Water should be no warmer than_____F.

A

Check with elbow not hands

Water should be no warmer than 120F

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49
Q

When doing a routine exam on a toddler, what are best practices of the care provider?

A
  1. Toddler removes clothing one item at a time as necessary for exam
  2. Introduce equipment for the exam and explain whats going to happen. Let the child hold the equipment
  3. praise the toddler and proovide positive feedback for cooperating during the exam.
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50
Q

The root of GAD is

A

conflict between expressing unacceptable impulses and the need to hold social approval

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51
Q

What electrolyte imbalance occurs in OAs?

A

Hyponatremia

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52
Q

Hypoglycemia is a BG lower than _____-

A

70

53
Q

What is Azotemia?

A

Classic s/s of AKI

Buildup of nitrogenous products in the bloodstream.

Hallmarks: increased BUN and Cr

54
Q

AKI s/s

A

Azotemia

Pruritis

Nausea / Vomiting

Hyperkalemia

55
Q

During crisis management how many ppl should be in charge?

A

1 - Autocratic or directive leadership is appropriate

56
Q

What does sodium polystyrene sulfonate treat?

A

Hyperkalemia

57
Q

The nurse prepares to complete a health history with a client in a community clinic. Which action will the nurse take first?

A

Provide physical and psychological comfort –then the health assessment can go as smoothly as possible

58
Q

When obtaining a urine sample, what type of technique should be used?

A

Aseptic

59
Q

What is the initial tx for when a DVT occurs?

A

Bed rest w/affected leg elevated to decrease interstitial swelling and promote venous return from the leg

60
Q

Which is achieved first: bowel or bladder control?

A

Bowel

61
Q

At what age does voluntary control of anal and urethral sphincters typically occur?

A

18-24 m

62
Q

What should the lighting in a room be for a pt with alcohol withdrawal?

A

Well lit

63
Q

What is the first s/s of a perforated duodenal ulcer?

A

Sudden sharp mid-epigastric pain –> board-like abd

64
Q

When are verbal orders acceptable?

A

For emergency situations not routine medication adjustments

65
Q

At what age do colonoscopies begin? How often are they done?

A

Start at 45 yrs

q 10 yrs

66
Q

Central venous pressure measures what?

A

Right atruim pressure

67
Q

Should you share at change of shift any new HCP perscriptions?

A

Yes

68
Q

When assessing a pt before a cardiac cath, which assessment is MOST critical for the nurse to perform?

A

Allergy to shellfish or iodine

69
Q

Pts who recieved what vaccine might have a false-positive on a TST?

A

Pts who got a BCG vaccine (this vax prevents the development of TB)

70
Q

How long does it take for a plaster cast to dry?

A

24-72 hrs

71
Q

For a pt in isolation, what items should be marked as biohazardous when being removed from the room?

A

lab specimens

Discarded syringes

72
Q

Prior to providing wound therapy to a pt with a negative pressure wound tx, what action should the nurse take prior to initiating therapy?

A

Check serum protein levels

  • protein is essential for wound healing and if their protein level is low, wound healing will be impaired and the negative pressure wound therapy may not be helpful
73
Q

When should toddlers be told that their parent is pregnant?

A

Not until shortly prior to the birth because they have little perception of time

74
Q

Where is the safest spot in the car for the infant car seat?

A

Back, middle

75
Q

How much alcohol a day is recommended for adult females?

A

One serving a day

76
Q

Is coffee a recognized risk factor for HTN?

A

No

77
Q

What does aging do to pain tolderance?

A

Lowers pain tolderance because of diminished adaptive capacity

78
Q

What is the diet for a pt with severe liver disease?

A

Low Protein
High carb

  • reduces the risks of ammonia build up that occurs from the breakdown of proteins
79
Q

Which vaccines are safe to give in pregnancy?

A

Tetanus

Hep B

Influenza

(any inactivated ones)

80
Q

A pt requires a paracentesis. Which is most important for the nurse to place at the pt bedside prior to the procedure?

A. tape measure
B. Emesis basin
C. BP cuff
D. Scale

A

C. BP Cuff

You must continuously measure the BP to assess for the development of shock from the removal of fluid

81
Q

Don’t use “its normal to…” – why?

A

Because this is a closed response and doesn’t allow pts to further verbalize their concerns

82
Q

When should an infant urinate after a circumcision?

A

6-8 hrs

83
Q

When should the meconium stool be passed by?

A

12-24 hrs

84
Q

When prepping a pt for a radioactive iodine uptake test, what should the pt not have prior to the test?

A

Restrict foods/medicines containing iodine for one week prior to the study. Dietary intake of iodine can affect the results of lab tests used to diagnose thyroid dysfunction.

85
Q

What factors affect sleep apnea (3)

A

Obesity

Short neck

Smoking

86
Q

When administering an IV vesicant for chemo, where is the correct spot for the IV?

A

Forearm (it doesn’t involve a moveable joint)

87
Q

What should the diet of a pt with pancreatitis look like?

A

Low fat

High protein

Moderate carbs

88
Q

Is Potassium affected by prednisone?

A

Yes - Hypokalemia can occur

89
Q

What does a spacer do for asthma meds?

A

Improves the amount of medication recieved

90
Q

Visual changes for color perception happen with glaucoma or cataracts?

What about artificial lights having rainbows around them?

A

Cataracts

Glaucoma

91
Q

Which actions prevent VAP?

A

Elevate HOB to 30-45

Perform daily spontaneous breathing trials

Drain condensation from the vent tubing

(you don’t need to wear a mask during suctioning)

92
Q

Pulmonary artery occlusion pressure in elevated- what is normal levels? What med is given to treat this and why?

A

Normal: 4-12 mmhg

Furosemide for diuresis because an elevated PAOP indicated fluid overload

93
Q

What intervention can reduce the risk of cardiac dysrrhythmias occuring during a blood transfusion?

A

Blood warmer

94
Q

What medication should be included as a core measure in stroke care when discharging a pt?

A

Statins

95
Q

______ med is an anticholinergic used in end of life care to reduce the production of secretions

A

Scopolamine

96
Q

For clients with confusion and disoridentation risks, what is most important to implement to resolve this issue?

A

Monitoring noise levels during the night

97
Q

List 3 common symptoms of acute leukemia

A

Petechiae

Orthostatic Hypotension (d/t anemia)

Joint Pain

98
Q

If a pt hasn’t pooped in 4 days and you know there is a ball of hard feces in the rectum, what med should be given?

A

Oil retention enema to soften the stool

99
Q

A pt who got IV morphine 20 mins ago now has dyspnea and bilateral rales. Which med should the nurse plan to administer next?

A

Atropine SL

  • the anticholinergic effects can reduce secretions and the dyspnea should improve and the rales should dissipate
100
Q

Should a client with a DVT ambulate?

A

No

101
Q

What type of dysrrhythmia is non concerning and typically occurs in the first few hrs after an MI?

A

PVCs

102
Q

Is diziness after a pacemaker insertion a concern?

A

Yes - could indicate that the pacemaker isn’t functioning properly

103
Q

How freq is BG monitoring done on a pt admitted and being treated for DKA?

A

Usually hourly

104
Q

What is the purpose of a TEE?

A

To rule out thrombus in the heart

105
Q

What type of med can be used to treat urinary retention in a pt with BPH?

A

Alpha adrenergic antagonists like Alfuzosin

106
Q

What type of med is Tolterodine?

A

Muscarinic receptor antagonist for overactive bladder contractions - treats urinary incontinence and overactive bladder

107
Q

What type of med is Amitriptyline?

A

Tryclilic antidepressant that can be used to reduce overactive bladder contractions

108
Q

How frequently are CPR compressions done (rate)?

How freq should rescuers change positions?

A

100bpm

q2 min

109
Q

Cushings triad

What is this indicitive of?

A

bradycardia

Irregular resps

Widened pulse pressure

Increased ICP

110
Q

Meniere disease is characterized by….

A

severe dizziness and vertigo - can’t walk straight –> fall risk

111
Q

What type of med is Alendronate?

How long does it need to be taken for?

A

Biphosphante to treat poor bone density

At least 3 yrs, then you do another bone density test and it might be continued or d/c

112
Q

Can NAP accompany / assist the transfer of pts from PACU?

A

Yes

113
Q

Pt says there is a change in their central vision- it is now blurry / distorted. What do you suspect?

A

Macular degeneration

114
Q

Pt says there is a change in their vision- it is now cloudy. What do you suspect?

A

Cataracts

115
Q

Pt says there is a change in their vision- they now have poor peripheral vision. What do you suspect?

A

Glaucoma

116
Q

Pt says there is a change in their vision- they have a sudden loss of partial / complete vision in one eye. What do you suspect?

A

Detached retina

117
Q

What is the purpose of a TIPS procedure?

A

Shunts blood away from esophageal varices for pts with liver dysfunction

118
Q

s/s glaucoma (4)

A

Cloudy, blurry vision

Artificial lights appear to have rainbows around them

Decreased peripheral vision

HA

119
Q

What ECG change is Torsades de pointes associated with?

A

Prolonged QT interval

120
Q

Administration of nasal drops instruction

A

Sit with the neck flexed backwards for 5 mins after instilling the drops

121
Q

Which factor is most likely to cause accidental injuries in school age children?

A

Peer pressure and risk-taking behavior

122
Q

Pt is hypernatremic. Which type of fluids will they be given?

A

5% dextrose solution (it’s a sodium free solution) – LR and NS have Na+

123
Q

What type of fluid drainage is most common in the immediate post op period?

What aout 1-2 days later?

A

Sanguineous

Serosanguineous

124
Q

The nurse works in a psychiatric facility that applies behavioral therapy. Which group of clients benefits most from this method?

A

Children in general

125
Q

Precaution type: RSV

A

Contact

126
Q

The _______ is the best referral because this person works in collaboration with other departments and community agencies to take care of the client’s multiple needs.

A

case manager

127
Q

When a client with a blood transfusion shows s/s of overload should you stop or slow the transfusion?

A

Slow

128
Q

The nurse provides care for a client who exhibits a sacral pressure injury. The foam dressing was changed 13 hours ago. No drainage is noted on the dressing. Which action should the nurse take next?

A

Document that the dressing is intact.

Unless the dressing is soiled or there are other abnormalities, wound healing should not be disrupted for a period as short as 2 days but no longer than 7 days, depending on client status and institutional protocols.

Foam dressings are left intact on chronic wounds for 48 hours unless otherwise indicated.

129
Q

The nurse inserts a nasogastric (NG) tube into a client and notes resistance when trying to advance the tube. Which action does the nurse take next?

A

Rotate the NG tube while in the nare

The NG tube may be against the wall of the nasal passage. Rotating the NG tube moves it off the wall and may allow the nurse to continue to advance the tube. This is the priority nursing action given the situation.

130
Q

The nurse provides care for a client experiencing a fever who also reports bone pain, redness, and swelling. The client asks the nurse which treatment will likely be prescribed by the health care provider (HCP). Which response from the nurse is the most accurate?

A

“Antibiotics will be prescribed for several weeks, which you can take at home.”

The client with acute osteomyelitis will be prescribed antibiotics. These medications can be started in an acute care facility and continued at home after discharge.

131
Q

zidovudine: type of drug?
ADR

A

Anti-retroviral for HIV

Anemia (look for low HgB)

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