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NCLEX: Saunders Comprehension Review > Mix 2 > Flashcards

Mix 2 Flashcards

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1
Q

Which is appropriate for preop MRI

A. Shave grion & insert catheter
B. Remove metal containing objects from patient
C. NPO 6 hrs before test
D. Teach inhale techniques for administration of radioscope

A

B: Remove metal containing objects from patient

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2
Q

Mag levels are usually between ____ - _____

What will be the effects if Higher or Lower

A

1.8 - 2.6

Lower = Increase everything
Higher = Decrease everything

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3
Q

NCSBN, ID 5 processes in the test plan that are fundamental to the practice of nursing

A

Caring
Communication & Documentation
Nursing Process ADOPIE
(Assess, Diagnosis, Outcomes, Planning, Implantation, Evaluation)
Culture & Spirituality
Teaching & Learning

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4
Q

Client with cast complains of pain when arm is passively moved. Which should be the first nursing action?

A. Elevate arm
B. Document findings.
C. Additional analgesic pain relief
D. Assess arm for paresthesia & paralysis

Which disease process is the scenario associated with?

What would be the procedure to correct this problem?

A

D.

Compartment syndrome

fasciotomy relieves pressure

Surgeon makes incisions in the
Fascia (the tissue surrounding the muscles) to release the pressure and allow blood flow to return to normal

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5
Q

Client hospitalized for angina pectoris begins to experience chest pain.

Nurse gives Nitroglycerin, sublingual, but the pain is unrelieved.

What is the next nursing action?

A. Reposition client
B. Call clients family
C. Contact HCP
D. Administer another Nitroglycerin tab

A

D. Administer another Nitroglycerin tab

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6
Q

How do / can you administrator Nitroglycerin tabs in the hospital as a nurse to relieve chest pain.

Administer (# of pills) ( minutes part)

A

Up to

3 pills, 5 minutes apart

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7
Q

Which action is taken before a CT scan.

A. NPO minium of 3 hrs before test
B. Only 2 cigarettes morning of the test
C. Clear liquid breakfast
D. Take all routine medication on morning of the test

A

A.

The rest are alike because they all say “morning of test”

You can eliminate Like results

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8
Q

Difference between:

Veracity & Fidelity

A

Veracity = obligation to tell the truth

Fidelity = duty to do what one promised

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9
Q

What is a tort in the law

A

Civil wrong, other than breach in contract, in which allows an injured person to seek damages

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10
Q

FEMA

What is highest disaster level

Lowest

A

Highest = level 1

Lowest = level 3

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11
Q

Triage color management

Red
Yellow
Green

“Black”

A

Red: Need immediate help or death
Yellow need help within 30 min - 2 hr
Green can wait atleast 2 hrs

“Black” Dead or close to death
Medical attention cannot help them

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12
Q

Which is the most appropriate assignment for AP

A. Client requiring a colostomy
B. Client receiving continuous tube feedings
C. Client who requires urine specimen collection
D. Client with difficulties swallowing

A

C. Client who requires urine specimen collection

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13
Q

Best way for a nurse to handle an AP who is resistant to new policy changes.

A. Ignore the resistance
B. Exert coercion on the AP
C. Positive rewards system
D. Confront AP to encourage verbalization of feelings regarding the change.

A

D. Confront AP to encourage verbalization of feelings regarding the change.

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14
Q

While giving a bed bath an AP informs you that another patient has requested pain meds.

How do you best handle this?

A. Finish bedbath and administrator medication afterwards
B. Ask AP to find out last time pain meds were issued
C. Ask AP to tell client that they will receive their pain meds as soon as bedabth is complete
D. Cover client, raise side rails, inform patient that to you leave breafly to give meds.

A

Pain management is the priority proper

D. Cover client, raise side rails, inform patient that to you leave breafly to give meds.

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15
Q

Which is the priority for the nurse to assess first

A. Complaining of muscle aches, headaches, history of seizures
B. Client with twisted ankle
C. Minor laceration from a cooking accident
D. Chest pain after eating pizza with a spicy sauce

A

Chest pain after eating pizza with a spicy sauce

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16
Q

This system is used to express the combining activity of an electrolyte

A

mEq

1 mEq cation will always react with 1mEq of an anion

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17
Q

Generalized Edema, aka anasarca, is an excessive accumulation of fluid in the ______ space.

Causes: cardiac, renal, or liver failure

A

Interstitial

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18
Q

Most likely causes of

Hypertonic overhydration

Hypotonic overhydration

A

Hypertonic overhydration: Excessive Na consumption

Hypotonic overhydration: Water intoxication

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19
Q

Causes of

Hypertonic Dehydration

Hypotonic Dehydration

A

Hypertonic Dehydration: Excessive sweat, hyperventilation, ketoacidosis, prolonged fevers, Diarrhea, early-stage kidney disease, diabetes Insipidus

Hypotonic Dehydration: Chronic Illness, excessive hypotonic fluid replacement, kidney disease, chronic malnutrition

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20
Q

AKI, Chronic kidney disease, heart failure puts client at risk for…

(Fluid volume: Excess or Deficiency)

A

Excess

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21
Q

Increases secretions of Aldosterone, Cushings Syndrome, will have this affect _____ on the electrolyte _____

A

LOWER POTASSIUM <3.5

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22
Q

Which methods my K be given to a patient

A

IV (never Push) & Oral

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23
Q

Bananas, oranges, cantaloupes, honeydew, apricots, grapefruit (some dried fruits, such as prunes, raisins, and dates)
Cooked spinach.
Cooked broccoli.
Potatoes.
Sweet potatoes.
Mushrooms.
Peas.
Cucumbers.

Are foods high in this electrolyte

A

K

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24
Q

What does sodium polystyrene sulfonate do?

A

Cation-exchange resin

Promotes the gut to absorb Na and excretion of K

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25
Q

IV calcium or

Insulin with glucose

Maybe given to a patient with Hyperkalemia to solve the problem

T or F

A

True

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26
Q

Diuretics can cause

Hypo/Hypernatremia

A

Hyponatremia

Where water goes Na flows

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27
Q

Caution

If client is taking Lithium monitor it’s level if patient is (hyponatremic / Hypernatremic)

A

Hyponatremic

Hyponatremia can cause diminished Lithium excretion, resulting in toxicity

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28
Q

Corticosteroids
Cushing syndrome
Kidney disease
Hyperaldosteronism

(Hyponatremia/Hypernatremia)

A

Hypernatremia

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29
Q

Aluminum hydroxide (increases / reduces) Phosphorus levels, causing (higher / lower) calcium levels

A

Reduces phosphate

Increases calcium

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30
Q

Seizure precautions for

Hypo/Hypercalcemia

A

Hypocalcemia

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31
Q

Why would you move a client with a calcium imbalance carefully?

A

They are at a risk for fractures

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32
Q

_____ is the antidote for magnesium OD

A

Calcium Gluconate

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33
Q

Fluid is found in 3 compartments

Intercellular ___%
Interstitial ____%
Intravascular ____%

A

Intercellular 70%
Interstitial 22%
Intravascular 6%

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34
Q

Increased serum osmolality
Increased hematocrit
Increased BUN (Blood urea nitrogen)
Increased serum sodium
Increased Urine specific gravity

(Dehydration / Fluid Overload)

Decreased serum
Decreased hematocrit
Decreased BUN (Blood urea nitrogen)
Decreased serum sodium
Decreased Urine specific gravity

(Dehydration/ Fluid Volume Overload)

A

Increased serum osmolality
Increased hematocrit
Increased BUN (Blood urea nitrogen)
Increased serum sodium
Increased Urine specific gravity

Dehydration

Decreased serum
Decreased hematocrit
Decreased BUN (Blood urea nitrogen)
Decreased serum sodium
Decreased Urine specific gravity

Fluid Volume Overload

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35
Q

Infusion rate of K

A

5 - 10 mEq/hr

Never >20

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36
Q

Client with Addisons disease, hyperuricemia, or tissue damage is at risk for…

Hypokalemia/ Hyperkalemia

A

Hyperkalemia

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37
Q

Client taking corticosteroids, Hyperaldosteronism, or Cushings syndrome is at risk for…

Hyponatremia/ Hypernatremia

A

Hypernatremia

Cushings also creates hypokalemia/ Hypernatremia

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38
Q

Normal serum phosphate levels are ______

What factors contribute to Hypophosphatemia /Hyperphosphatemia

A

3 - 4.5 mg/dL

Hypophosphatemia = Malnutrition/ Aluminum hydroxide or Magnesium-based antiacids

Hyperphosphatemia:
Renal insufficiency, hypoparathoidism,
tumor lysis syndrome
( metabolic emergency that can occur when cancer treatment kills large amounts of tumor cells, causing them to break apart and release their contents into the bloodstream.)

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39
Q

Difference between

Insensible Loss
&
Sensible Loss

(Hydration Related)

A

Insensible= Skin & Lungs (Can’t notice)

Sensible = Urine, wound drainage, GI tract loss

40
Q

Cushings syndrome = hypo /Hyperkalemia

Addisons syndrome = hypo/ Hyperkalemia

A

Cushings syndrome = hypokalemia

Addisons syndrome = Hyperkalemia

The Oppsite is true for the Na values

41
Q

During Acidosis the body moves H ions into the cell (to lower the pH)

To make room for the H in the cell the cell kicks K out.

This creates Hypokalemia/ Hyperkalemia

During Alkalosis the cells pump H into the bloood stream and this forces K back into the cells.

Creating: Hypokalemia / Hyperkalemia

A

Hyperkalemia

Hypokalemia

42
Q

Adminsiter ____ for tetany

A

Calcium Gluconate

43
Q

______ is a medication usedto manage hypocalcemia, cardiac arrest, and cardiotoxicity due to hyperkalemia or hypermagnesemia

A

Calcium gluconate

44
Q

A diet low in ____ will lessen the Acidosis in DKA

A

Protein

45
Q

ABG

When _____ occurs the pH is within normal limits

But, the Co² & HCo³ will be out of normal limits

A

Full compensation

46
Q

ABG

Type of disorder that occurs when both Metabolic & Respiratory are either Acidosis/ Alkalosis

A

Mixed disorder

47
Q

Allen’s test

Apply pressure to ulnar and radial arteries simultaneously

Ask client to open & close fist

Release pressure from _____ while compressing the ____ artery

Assess color: Normal = color returns
Abnormal = Stay pallor

When is this preformed?

What action is taken immediately afterwards?

A

Release pressure from Ulnar while compressing the Radial artery

When is this preformed?
Before ABG blood draw

What action is taken immediately afterwards?
Apply pressure for 5 - 10 minutes

48
Q

What values equal death in ABG

A

6.8 Acidosis
7.8 Alkalosis

49
Q

Posistion of client for rectal temperature

A

Sims

50
Q

Nasal or oral surgery
Jaws wired shut
NG tube in place
Risk for seizures

All have temperature taken how

A

Rectal

51
Q

Apical pulse (Left side 5th intercostal space) is assessed for 1 full minute in patients with heart conditions before the administration of ___ or ____

A

Digoxin or Beta Blockers

52
Q

Difference between systolic & disystolic pressure is callled

A

Pulse pressure

Helps to predict cardiovascular complications (Heart attack / stroke)

Normal 40 - 60

53
Q

What is idiopathic pain?

A

Pain in which the source of pain cannot be identified

54
Q

What is the TENS/PENS device used for

A

To deliver low electrical current to the skin in an attempt to block pain

55
Q

NSAIDS (Aspirin/ Ibuprofen) Contradictions

Acetaminophen (Tylenol) Contradictions

A

NSAIDS (Aspirin/ Ibuprofen) Contradictions

Bleeding Risk, Oral antidiabetic meds, CCB (Dipine)

Acetaminophen (Tylenol) Contradictions

Acetaminophen: Liver & renal problems

56
Q

Acetylcyseine

Function

A

Antidote to Acetaminophen

57
Q
  1. How does physical trauma without bleeding affect potassium levels?
  2. How do burns affect K levels
A
  1. Hyperkalemia. The cells break open releasing K into the blood stream
  2. If the burn causes oozing / Fluid loss Hypokalemia. The K will leave the body along with the fluid
58
Q

Elevated WBC & platelets will cause this condition of K

Hypokalemia/ Hyperkalemia

A

Hyperkalemia

59
Q

See deck on Coagulation

A

Ed’s class 1355 or something

60
Q

Affects of leafy green foods on Warfarin

A

Makes it less effective

Shortens the Pt time

61
Q

____ is the main component of erythroctes and serves as the vehicle for transportation of oxygen & carbon dioxide

A

Hemoglobin

62
Q

____ represent RBC % in blood and is an important measurement in the presence of anemia or polycythaemia

A

Hematocrit

63
Q

COPD, High altitudes, polycythaemia

Decreased /Elevated Hemoglobin

A

Elevated hemoglobin

64
Q

Dehydration, high altitudes, polycythaemia

Decreased/ Elevated hematocrit

A

Elevated

65
Q

Anemia, hemorrhage

Affected hemoglobin levels how?
(Part of the RBC that transports oxygen)

Anemia, hemorrhage, bone marrow failure, leukemia, overhydration

Affect hematocrit how?
(the ratio of the volume of red blood cells to the total volume of blood)

A

Both lower level

66
Q

Do clients take morning insulin/ oral antidiabetic medication before receiving a fast blood sugar test

How long do they fast before test

What are normal & abnormal values for this test

A

No

8 - 12 hrs

70 - 99 normal
100 - 125 pre-diabetic
125 + diabetes

67
Q

Affects on BS

Addisons disease / Cushings

Hyperthyroidism/ Hypothyroidism

A

Addisons disease: Lower
Addison crisis
life-threatening situation that results in low blood pressure, low blood levels of sugar and high blood levels of potassium.

Cushings: Higher
High level Cortisol makes Insulin Ineffective & produces more glucagon

Hyperthyroidism: Higher
Insulin resistance
Hypothyroidism: Lower
decrease in metabolism, which can lead to excess insulin in the body and low blood sugar episodes.

68
Q

Is fasting required before measuring A1c

A

No

69
Q

Avoid (2) before measuring Serum Creatinine

A

Exercise 8 hrs

Red Meat 24 hrs

70
Q

Below normal Values <0.8 in Serum Creatinine are seen in these types of diseases

A

Diseases with Decreases Muscle Mass

Muscular Dystrophy
Myasthenia gravis

71
Q

BUN LEVEL

Burns, dehydration, GI bleeding, Fever/ Stress, renal disease, UTI

Decreased / ELEVATED

Fluid Overload, malnutrition, severe liver damage, syndrome of inappropriate antidiuretic hormone

Decreases / Elevated

A

Burns, dehydration, GI bleeding, Fever/ Stress, renal disease, UTI

ELEVATED

Fluid Overload, malnutrition, severe liver damage, syndrome of inappropriate antidiuretic hormone

Decreased

72
Q

Stages of hypertension

Normal = less than 120/80
Elevated = Systolic ___ / Diastolic ___
Stage 1 = Systolic ___ / Diastolic ____
Stage 2 = Systolic ___/ Diastolic ____
Hypertensive Crisis = Systolic ___ / Diastolic ___

A

Elevated = Systolic 120 - 129/ Diastolic <80
Stage 1 = Systolic 130 - 139/ Diastolic 80 - 89
Stage 2 = Systolic 140 Min. / Diastolic 90 Min
Hypertensive Crisis = Systolic >180 / Diastolic >120

73
Q

WBC range

5,000 - 10,000 Normal

What does above and below mean

A

Below immune suppression (AIDS) - Neutropenic precautions

Above Fighting infection

74
Q

Normal platelets range

150,000 - 400,000

What does above and below signify

A

<150,000 bleeding risk

> 400,000 blood clot risk

75
Q

Caring for a client on a opiod PCA pump. Client appears to be sleeping

Vital signs: HR: 52, BP: 101/ 58, RR: 11, SpO² 93% @ 3 L oxygen via nasal Cannula

What action should take place next

A. Document findings
B. Attempt to arouse client
C. Contact HCP
D. Check med history on pump

A

B. Attemp to arouse

If successful, the vitals may normalize.

When sleeping vitals decrease

76
Q

Amenorrhea…

A

Absence of period

77
Q

Longterm protien status can be determined by evaluating this protein…

A

Serum albumin

78
Q

Limit Na intake to …

A

<2300 mg

79
Q

This type of diet is used for clients with dsyphagia, surgery of head or neck, dental problems

A

Mechanical soft

80
Q

This diet maybe used as a transition diet after full clear liquid.

Includes

Ice cream
Breakfast drinks
Fruit / veg juices

Foods that are liquid at body temperature

A

Full liquid diet

81
Q

This diet is used as Initial feeding after Complete Bowel Rest
Feeding after Malnourishment
Bowel prep / Post op

A

Clear liquid diet

82
Q

T or F

All foods are allowed on a Soft Diet

Liquid, chopped, or pureed foods are tolerated best

A

True

83
Q

Which client would get a

High Fiber Diet (how many grams)

Low Fiber Diet

A

High Fiber Diet: Constipation, IBS (Alternating Diarrhea & Constipation), Asymptomatic diverticulitis

20 - 35

Low Fiber Diet IBS, partially obstructed intestines, gastroenteritis, Diarrhea

84
Q

Who is the DASH Diet used for

What does it consist of…

A

Atherosclerosis, DM, Hyperlipidemia, hypertension, MI, Nephrotic syndrome/ renal failure

Normal healthy foods

85
Q

Fat restricted diet is used in which clients…

A

Malabsorption disorder, pancreatitis, gallbladder disease, GERD

86
Q

High calorie/ High protein diet

Used for…

A

Severe stress, burns, wounds,Cancer, AIDS, COPD, Respitory failure,

87
Q

Type of diet for
DM, Hypo/Hyperglycemia, obesity

A

Carbohydrate-consistent diet

88
Q

Type of client on a protein restricted diet

A

Renal disease/ end stage liver disease

89
Q

Low-purinenl diet is indicated for..

Types of patients

Types of food to avoid

A

“Purine is a precursor for Uric Acid, which forms stones & crystals “

Gout: Inflammatory arthritis
Caused by a buildup of uric acid in the bloodstream, Forms needle-like crystals which Hurt

Kidney Stones

Elevated Uric Acid levels

Anchovie & similar small fish
Organ meats, gravies, wild game

90
Q

High Iron Diet

Which type of patients…

Special consideration

A

Anemia

Concurrent intake of Vitamin C will enhance absorption

91
Q

Pregnancy nutrition considerations

(4)

A

Increase:
Calcium (fetal bones)
Iron (Increase Blood Volume),
Folic Acid (DNA synthesis & RBC production)

60g protein

92
Q

Breastfeeding considerations

Nutrition

A

Increase: Protein, calcium, Vitamins A,B,C

Addition 500 calories daily

Avoid alcohol, caffeine, drugs

93
Q

Bouillon, carbonated beverages, gelatin, hard candy, lemonade, ice pops, regular & decaf coffee

Are this type of food

A

Clear liquid diet

94
Q

Meats & Dairy products are high in these vitamins

A

B

95
Q

Parathyroid hormone regulates calcium, magnesium, and phosphorus levels in the blood.

When PTH production is low, calcium levels in the blood ( drop / raise ), and phosphorus levels (drop / rise)

A

Low PTH = Low calcium

Low calcium = High phosphorus

NCLEX: Saunders Comprehension Review (2 decks)

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