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NCLEX: Saunders Comprehension Review > MIX > Flashcards

MIX Flashcards

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1
Q

Client complains of anorexia, N/V, which medication from home would you be most concerned about

A. Digoxin
B. Catopril
C. Losartan
D. Furosemide

A

Digoxin

Anorexia, N/V are common signs over digonxin OD

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2
Q

Which special population should be targeted for breast cancer screening via mammogram SATA

1.Male to Female
2. Female to male
3. Men who have sex with Men
4. Women who have sex with women
5. Women who have sex with men

A

1,2,4,5

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3
Q

Which medication should be determined that there is Need For Follow Up, if prescribed to a homeless person

A. Glipizide
B. Lisinopril
C. Metformin
D. Beclomethasone

A

A. Glipizide

It’s a Sulfonylureas (DM) amd can cause hypoglycemia

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4
Q

Female presents to ED with fatigue & SOB. WHICH FINDING REQUIRES FOLLOW UP

A. reddened sclera
B. Dry flaking on scalp
C. Reddish-purple mark on neck
D. Scaly rash on knees and elbows

A

C. Reddish mark on neck can be an indication of ABUSE

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5
Q

Caring for refugees which health care need is the priority

A. Housing
B. Clean water
C. Transportation
D. Mental health services

A

D. They are coming from places of violence & war

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6
Q

The nurse must follow guidelines identified in the ______ and agency’s ______ when delivering care

A

Nurse practice act

Policies

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7
Q

Legally, a nurse doesn’t have to accept a FLOAT assignment.

A

False

Nurse must accept a float assignment unless specific stated in Union Contract

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8
Q

Which organs can only be donated if the client is on mechanical ventilation

A

Heart, Lungs, liver

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9
Q

Jewish people can donate organs

Jewish people can accept donated organs

Can a jehova witness accept an organ

A

Jewish people can donate organs. FALSE

Jewish people can accept donated organs. TRUE

Can a jehova witness accept an organ
TRUE, but only if cleansed with non-blood solution before hand

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10
Q

What is usually the nurses role in informed consent for procedures

A

Witness the signing of the document

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11
Q

Which is consent not needed in a minor

A

Emergency
Substance Abuse
STD
Birth control / Pregnancy
Psychiatric services

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12
Q

After a fall, you (the nurse) & HCP determine that the patient was uninjured. After completing the occurrence report, what should be the next action?

  1. Reassess client
  2. Conduct staff meeting to describe the fall
  3. Contact nursing supervisor to update information regarding fall
  4. Document in nursing notes that an occurrence report was completed
A
  1. Reassess often after falls
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13
Q

Client needs you (the nurse) to serve as a witness to a document.

What is the most appropriate response to the client

A. I will sign as a witness to your signature
B. You will need to find a witness on your own.
C. Whoever is available at the time will sign as a witness for you
D. I will call the nursing supervisor and seek assistance regarding your request.

A

D. I will call the nursing supervisor and seek assistance regarding your request.

Often institutions dint want nurses acting as witnesses

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14
Q

Which are not necessary when amending a mistake in the documentation of “Wasted Morphine”

  1. Complete & File an occurrence report
  2. Right click & modify entry on MAR
  3. Document correct information & end with signature & title
  4. Obtain cosignature from RN who witnessed the “Wasting” of morphine
  5. Document in nurses notes the clients record detailing correct information
A

All correct except 1

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15
Q

Which are accurate nursing documentation: SATA

1.Client slept through the night
2. Abdominal wound dressing dry & intact, no drainage
3. Client seemed angry when awaked for VS @ 0500
4. Client appears anxious before respitory treatments
5. Client left lower medial leg wound is 3 cm in length, no redness, drainage, edema

A

3 & 4 INCORRECT
Don’t use opnion words like: SEEMES / APPEARS

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16
Q

Nurse calls HCP due to prescription being a higher dose than the recommended dose. Unable to get in contact with HCP. What to do next?

  1. Contact nursing supervisor
  2. Administer prescribed dose
  3. Hold meds until HCP is contactes
  4. Administer recommended dose until HCP can be located
A

Contact nursing supervisor

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17
Q

____ involves consultation and collaboration with interprofessional health care team

A

Case management

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18
Q

____ is a professional nurse who assumes responsibility for coordination of client care at admission & after discharge

A

Case manager

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19
Q

___ is a critical management care plan for providing client centered care

Planning & Monitoring progress within an established time frame

A

Critical pathway

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20
Q

____ is a written guideline & communication tool that IDs
Assessment Data
Problems & Nursing Diagnosis
Goals
Intervention
Outcomes

A

Careplan

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21
Q

Type of nursing where charge nurse delegates tasks to team members, rather than the whole client.

Crears lack of accountability by team members

A

Functional nursing

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22
Q

RN (Leader) assess clients, data, planning, and evaluation.

Assigns staff members specif clients based on their skills

This type of nursing

A

Team nursing

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23
Q

This type of nursing is concerned with keeping the nurse at the bedside and actively involved in patient care

Individualized care

A

Primary nursing (Relationship-based) Nursing

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24
Q

(Leadership or Management)

Accomplishment of tasks or goals by oneself or by direction of others

Interpersonal process that involves influencing others to achieve goals

A

Accomplishment of tasks or goals by oneself or by direction of others (Management)

Interpersonal process that involves influencing others to achieve goals (Leadership)

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25
Q

Laissez-faire leadership is…

A

When the leader takes a passive role

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26
Q

Bureaucratic leadership assumes that team members are motivates by …

A

External forces

Polices & Procedures

27
Q

This leadership style focuses on

Building relationships
Staff members have a shares vision
Encourage and praises staff members

A

Transformational leadership

28
Q

This leadership style

Build relationships
Develop skills of team members
Meet needs of team mates

A

Servant leadership

29
Q

_____ are guidelines that define an organization directives on course of action

____ are based on policy and define methods for tasks

_____ prescribe a specific course of action for a specific type of client of problem

A

Policies

Procedures

Protocols

30
Q

Maslows hierarchy of needs

Start with most basic

(5)

A

Physiological needs
Safety / Security
Love & Belonging
Self-esteem
Self-Actualization

31
Q

FEMA has 4 disaster management phases

A

Mitigation, preparedness, response, recovery

32
Q

Which pulses to check during CPR

How long?

A

Carotid or femoral

5 - 10 seconds

33
Q

Non-invasive interventions, skin care, ROM exercises, ambulation, grooming, hygine

Delegated to this team member

A

Assisting personal

34
Q

Dressing changes, suctioning, urinary Catheterization, Med Administration (Oral, SQ, intramuscular, SELECT IVPB)

Collect Data & Review teaching plans initiated by RN

Delegated to this team member

A

LPN

35
Q

This health care team member

Responsible for assessment & planning care
Initiating teaching
Administration IV meds

A

RN

36
Q

Can an LPN care for unstable clients

A

No

Only, an RN

37
Q

Nurse Management

Which nurse manger:

A

unit manager/ Supervisor

Prepares work schedule, write & implementation of polices for client care and unit operations, maintain quality of client services.

Charge nurse
Supervision of multi departments and works closely with administration.

DON
Supervisory role of client care and may temporarily assume client care role

38
Q

List in order of priority

Hysterectomy the following day

24-HR Post-op had wedge resection (removal small part of lung- less than a lobectomy) and client has a chest tube

Absent bowel sounds

Heart failure with a 4 lb weight gain in 24 hrs, SOB

A
  1. Heart failure with a 4 lb weight gain in 24 hrs, SOB
  2. 24-HR Post-op had wedge resection (removal small part of lung- less than a lobectomy) and client has a chest tube
  3. Absent bowel sounds
  4. Hysterectomy the following day
39
Q

What contains the following information

  1. Clients name, age, HCP, diagnoses
  2. Current health status & plan of care
  3. Clients needs and priority for care
  4. Lab test, med administration, dressing changes needed
  5. Need for special equipment
  6. Allergies, resurrection status, precautions considerations, cultural/ religious issues, family issues.
A

Transfer report

40
Q

List 6 parts of a transfer report

A
  1. Clients name, age, HCP, diagnoses
  2. Current health status & plan of care
  3. Clients needs and priority for care
  4. Lab test, med administration, dressing changes needed
  5. Need for special equipment
  6. Allergies, resurrection status, precautions considerations, cultural/ religious issues, family issues.
41
Q

Describes the following

  1. How to admin prescribed medication
  2. SE & Adverse reaction that need to be reported to HCP
  3. Prescribed dietary & activity measures
  4. Complications that need to be reported to HCP
  5. How to preform prescribed treatments
  6. How to use special equipment
  7. Schedule home care services
  8. How to access community resources
  9. When to obtain follow-up care
A

Discharge teaching

42
Q

Discharge teaching (9)

A
  1. How to admin prescribed medication
  2. SE & Adverse reaction that need to be reported to HCP
  3. Prescribed dietary & activity measures
  4. Complications that need to be reported to HCP
  5. How to preform prescribed treatments
  6. How to use special equipment
  7. Schedule home care services
  8. How to access community resources
  9. When to obtain follow-up care
43
Q

How can prioritizing be different in a disaster situation for a nurse.

A

Action may need to be taken before assessment

44
Q

Which should the nurse evaluate first.

  1. Client ambulatory demonstrating steady Gait.
  2. Post-op client just recieved morphine
  3. Client scheduled for first PT crutch walking session
  4. Client with WBC 14,000 and fever of 101.
A
  1. Client with WBC 14,000 and fever of 101.

Post-op will be best to evaluate when medication takes effect

45
Q

Match

  1. Each staff member is assigned specific task for a group of clients
  2. Determine clients needs at home and begin discharge planning
  3. Single RN is provides care to 6 patients with help of an AP
  4. RN leads 2 LPNs & 3 AP provide care to 12 members

Team-based, Functional, Case Management, Primary/ Task based

A

Functional
1. Each staff member is assigned specific task for a group of clients

Case Management
2. Determine clients needs at home and begin discharge planning

Primary
3. Single RN is provides care to 6 patients with help of an AP

Team
4. RN leads 2 LPNs & 3 AP provide care to 12 members

46
Q

Which factors should a nurse be mindful of when delegating assignments

  1. Acuity level of client
  2. Specific request from staff
  3. Clustering rooms in the unit
  4. Number of anticipated discharge
  5. Clients needs and workers needs and abilities
A
  1. Acuity level of client
  2. Clients’ needs and workers’ needs and abilities

Guidelines for delegación include: Safety, appropriate task based on nurse practice act and posistion of designee, provide clear,concise, accurate, complete instructions.

Staff request, convenience as in clustering rooms, and anticipate change in unit census are NOT specific Guidelines when delegating tasks.

47
Q

Hypertonic Dehydration/ Hypotonic Dehydration

Water loss exceeds electrolyte loss

Electrolyte loss exceeds Water loss

Fluid moves from intracellular compartment into plasma, causing shrinkage of cell

Fluid moves from plasma & interstitial Fluid into the cell

A

Hypertonic Dehydration
Water loss exceeds electrolyte loss
Fluid moves from intracellular compartment into plasma, causing shrinkage of cell

Hypotonic Dehydration
Electrolyte loss exceeds Water loss
Fluid moves from plasma & interstitial Fluid into the cell

48
Q

Causes of Hypertonic/ Hypotonic Dehydration

Diaphoresis, hyperventilation, DKA, fever, diarrhea, early kidney disease, diabetes insipidus

Chronic illness, Kidney disease, Chronic malnutrition

A

Hypertonic Dehydration
Diaphoresis, hyperventilation, DKA, fever, diarrhea, early kidney disease, diabetes insipidus

Hypotonic Dehydration
Chronic illness, Kidney disease, Chronic malnutrition

49
Q

Hypo/Hypernatremia precipitates Lithium toxicity

A

Hyponatremia

50
Q

Hyponatremia/ Hypernatremia

Corticosteroids
Cushings syndrome
Kidney disease
Hyperaldosteronism

Diuretics
Vomiting
Diarrhea
Wound drainage
Kidney disease

A

Hypernatremia
Corticosteroids
Cushings syndrome
Kidney disease
Hyperaldosteronism

Hyponatremia
Diuretics
Vomiting
Diarrhea
Wound drainage
Kidney disease

51
Q

Aluminum hydroxide reduces ____ levels & increases ____ levels

A

Aluminum hydroxide reduces phosphorus levels & increases calcium levels

52
Q

Provide quiete environment and reduce stimuli

Initiate seizure precautions

Move client carefully and monitor for signs of pathological fractures

Describes this electrolyte imbalance

A

Hypocalcemia

53
Q

____ is the antidote for magnesium overdose

A

Calcium Gluconate

54
Q

ECG & ELECTROLYTES

ST depression
Shallow,flat, inverted T waves
Prominent U wave

A

Hypokalemia

55
Q

ECG & ELECTROLYTES

Tall T wave
Flat P wave
Widened QRS
Prolonged PR interval

A

Hyperkalemia

56
Q

ECG & ELECTROLYTES

Prolonged ST segment
Prolonged QT interval

A

Hypocalcemia

57
Q

ECG & ELECTROLYTES

Shortened ST
Widened T wave
Heart block

A

Hypercalcemia

58
Q

Give potassium via these routes

A

Oral / IV

NEVER IV PUSH, IM, SQ

59
Q

Max infusion rate for potassium

A

5 -10 mEq/hr

Never more than 20

60
Q

Hyponatremic patient has flat neck veins, generalized muscle weakness, diminished tendon reflexes.

Which of the following is also a sign of Hyponatremia

  1. Muscle twitching
  2. Decrease urine output
  3. Hyperactive bowel sounds
  4. Increased specific gravity urine
A
  1. Hyperactive bowel sounds
61
Q

Client has 1.8 Phosphate. Which condition most likely caused this serum phosphorus (phosphate) level?

  1. Malnutrition
  2. Renal insufficiency
  3. Hypoparathoidism
  4. Tumor lysis syndrome
A

Malnutrition

2.5 to 4.5 mg

62
Q

Dilution of no more than 1 mEq/10 mL is recommended before giving this electrolyte

A

K

63
Q

Ibuprofen (NSAID) may have this affect if taken with a oral diabetic agent?

Ibuprofen (NSAID) & CCB together will have this effect?

A

Hypoglycemia

Increased BP / Kidney Damage

64
Q

DKA sodium / K levels

A

Hyponatremia / Hyperkalemia

NCLEX: Saunders Comprehension Review (2 decks)

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