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NCLEX Flashcards

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1
Q

normal sodium

A

135-145

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2
Q

normal potassium

A

3.5-5.0

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3
Q

normal calcium

A

9.0-10.5

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4
Q

normal magnesium

A

1.3-2.1

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5
Q

normal phosphorous

A

3.0-4.5

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6
Q

normal BUN

A

10-20

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7
Q

normal creatinine

A

0.6-1.2 (males)
0.5-1.1 (females)

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8
Q

normal glucose

A

70-105

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9
Q

normal HgbA1c

A

<6.5%

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10
Q

normal WBC

A

5,0000-10,000 / mm3

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11
Q

normal RBC men

A

4.7-6.1 million/mm3

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12
Q

normal RBC women

A

4.2-5.4 million/mm3

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13
Q

normal hemoglobin men

A

14-18 g/100 ml

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14
Q

normal hemoglobin women

A

12-16 g/100 ml

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15
Q

normal hematocrit men

A

42-52%

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16
Q

normal hematocrit women

A

37-47%

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17
Q

normal platelets

A

150,000-400,000 / mm3

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18
Q

normal ph

A

7.35-7.45

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19
Q

normal CO2

A

35-45 mm hg

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20
Q

normal PO2

A

80-100 mmhg

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21
Q

normal HCO3

A

21-26 mmol/L

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22
Q

normal PT

A

11-12.5 seconds

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23
Q

normal INR

A

0.7-1.8

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24
Q

normal PTT

A

30-40 seconds

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25
Q

digoxin normal levels

A

0.5 - 2.0 ng/ml

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26
Q

normal lithium

A

0.8-1.4 meq/l

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27
Q

normal phenytoin levels

A

10-20 mcg/ml

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28
Q

normal theophylline

A

10-20 mcg/ml

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29
Q

airborne precautions

A

measles
chicken pox
herpes zoster
TB

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30
Q

how to manage airborne diseases

A

neg pressure room
private room
n-95 for TB
mask

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31
Q

droplet precautions

A

-Sepsis
-Scarlet Fever
-Strep
-Pertussis
-Pneumonia
-Parvovirus
-Influenza
-Diphtheria
-Epiglottitis
-Rubella
-Mumps
-Adenovirus

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32
Q

droplet mgmt

A

private room
mask

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33
Q

contact precautions

A

MRSA
VRSA
RSV
skin infections (impetigo)
wound infections
enteric infections (c. diff)
eye infections

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34
Q

management for contact precautions

A

gowns
gloves
goggles
private room

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35
Q

what kind of drug is amitriptyline

A

tricyclic antidepressant
anticholingeric

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36
Q

how often do you apply a new transdermal nitrate patches

A

every morning to a new site

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37
Q

how is vanc administered

A

IV, slowly over 60 mins

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38
Q

what is alosetron used for

A

IBD in women

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39
Q

what kind of drug is famotidine

A

H2 receptor antagonist
suppress gastric acid secretion

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40
Q

what do bile acid sequestrants do

A

decrease LDL cholesterol

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41
Q

what is a complication of bile acid sequestrants (the coles)

A

constipation

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42
Q

how does leuprolide work

A

prevents release of LH and FSH to prevent testosterone production

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43
Q

adverse effects of thionamides (methimazole)

A

hypothyroidism
agranulocytosis
hepatits/liver injury

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44
Q

what drugs can delay progression of diabetic nephropathy

A

ARBS (sartans)

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45
Q

what is bethanechol used for

A

muscarinic agonist
used for nonobstructive urinary retention

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46
Q

should you take ferrous sulfate with food?

A

no - decreases absoprtion

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47
Q

nitrofurantoin: what is it used for

A

treat UTIs

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48
Q

how does ginger impact blood sugar

A

decreases blood sugar

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49
Q

activated clotting time normal range

A

70 to 120

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50
Q

what is ciprofloxacin used for

A

UTIs

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51
Q

side effects of ciprofloxacin

A

GI discomfort, tendon rupture, photosensitivity, suprainfection

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52
Q

4 Es for angina precipitating factors

A

exertion
eating
emotional distress
extreme temperatures

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53
Q

4 Ps of arterial occlusion

A

pain
pulselessness
pallor
paresthesia

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54
Q

how to treat CHG (MADD DOG)

A

morphine
aminophylline
digoxin
dopamine
diuretics
oxygen
gasses (monitor ABGs)

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55
Q

heart murmur causes

A

stenosis of valve
partial obstruction
aneurysm
septal defect
mitral regurgitation

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56
Q

signs of stroke

A

facial drooping
arm weakness
speech slurred
time to call 911

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57
Q

5 ps of compartment syndrome

A

pain
pallor
pulselessness
paresthesia
paralysis

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58
Q

signs of shock (CORD ITEM)

A

cold clammy skin
hypotension
oliguria
rapid, shallow breathing
drowsiness, confusion
irritability
tachycardia
elevated or reduced CVP
multi-organ damage

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59
Q

signs of hypoglycemia

A

TIRED
tachycardia
irritability
restlessless
excessive hunger
depression and diaphoresis

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60
Q

hypocalcemia signs (CATS)

A

CATS
convulsions
arrhythmia
tetany
stridor and spasms

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61
Q

hypokalemia signs (6 Ls)

A

lethargy
leg cramps
limp muscles
low, shallow, respirations
lethal cardiac dysrhythmias
lots of urine

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62
Q

early warning signs of cancer (CAUTION UP)

A

Change in bowel or bladder

A lesion that does not heal

Unusual bleeding or discharge

Thickening or lump in breast or elsewhere

Indigestion or difficulty swallowing

Obvious changes in wart or mole

Nagging cough or persistent hoarseness

Unexplained weight loss

Pernicious Anemia

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63
Q

leukemia signs and symptoms (ANT)

A

Anemia and decreased hemoglobin

Neutropenia and increased risk of infection

Thrombocytopenia and increased risk of bleeding

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64
Q

patients who require dialysis

A

Acid base imbalance

Electrolyte imbalances

Intoxication

Overload of fluids

Uremic symptoms

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65
Q

asthma mgmt

A

Adrenergics: Albuterol and other bronchodilators

Steroids

Theophylline

Hydration: intravenous fluids

Mask: oxygen therapy

Antibiotics (for associated respiratory infections)

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66
Q

pneumothorax signs

A

Pleuritic pain

Tracheal deviation

Hyperresonance

Onset sudden

Reduced breath sounds (and dyspnea)

Absent fremitus

X-ray shows collapsed lung

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67
Q

dysphagia mgmt

A

Modifying the texture of foods and the consistency of liquids may enable the client to achieve proper nutrition.

Place the client in an upright or high-Fowler’s position to facilitate swallowing.

Provide oral care prior to eating to enhance the client’s sense of taste.

Allow adequate time for eating, utilize adaptive eating devices, and encourage small bites and thorough chewing.

Avoid thin liquids and sticky foods

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68
Q

what is dumping syndrome

A

occurs as a complication of gastric surgeries that inhibit the ability of the pyloric sphincter to control the movement of food into the small intestine.

This “dumping” results in nausea, distention, cramping pains, and diarrhea within 15 min after eating

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69
Q

how to manage dumping syndrome

A

Small, frequent meals are indicated.

Consumption of protein and fat at each meal is indicated.

Avoid concentrated sugars.

Restrict lactose intake.

Consume liquids 1 hr before or after eating instead of with meals (a dry diet)

lie down after meals

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70
Q

how to manage peptic ulcer disease

A

Avoid eating frequent meals and snacks, as they promote increased gastric acid secretion.

Avoid alcohol, cigarette smoking, aspirin and other NSAIDs, coffee, black pepper, spicy foods, and caffeine

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71
Q

during acute diverticulitis do you want a low or high fiber diet

A

a low-fiber diet is prescribed in order to reduce bowel stimulation.

high fiber diet may prevent in the long term

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72
Q

what is an early sign of shock

A

narrowing pulse pressure
increase in diastolic BP

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73
Q

cleft lip nursing care plan

A

Crying, minimize

Logan bow

Elbow restraints

Feed with Brecht feeder

Teach feeding techniques; two months of age (average age at repair)

Liquid (sterile water), rinse after feeding

Impaired feeding (no sucking)

Position—never on abdomen

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74
Q

HELLP syndrome: what is it

A

complication of severe pre-eclampsia

Hemolysis

Elevated Liver enzymes

Low Platelet count

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75
Q

4Ps of labor

A

Powers

Passageway

Passenger

Psych

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76
Q

5 infections during pregnancy

A

TORCH

Toxoplasmosis

Other (hepatitis B, syphilis, group B beta strep)

Rubella

Cytomegalovirus

Herpes simplex virus

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77
Q

potential problems with an IUD

A

PAINS

Period (menstrual: late, spotting, bleeding)

Abdominal pain, dyspareunia

Infection (abnormal vaginal discharge)

Not feeling well, fever or chills

String missing

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78
Q

what does APGAR stand for

A

Appearance

Pulse

Grimace

Activity

Respiratory effort

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79
Q

GTPAL

A

Gravida

Term

Preterm

Abortions (SAB, TAB)

Living children

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80
Q

signs of problems with oral contraceptives

A

ACHES

Abdominal pain (possible liver or gallbladder problem)

Chest pain or shortness of breath (possible pulmonary embolus)

Headache (possible hypertension, brain attack)

Eye problems (possible hypertension or vascular accident)

Severe leg pain (possible thromboembolic process)

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81
Q

anticipated problems with premature infants

A

Temperature regulation (poor)

Resistance to infections (poor)

Immature liver

Elimination problems (necrotizing enterocolitis [NEC])

Sensory-perceptual functions (retinopathy of prematurity [ROP])

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82
Q

VEAL CHOP

A

Variable decels => Cord compression (usually a change in mother’s position helps)

Early decels => Head compression (decels mirror the contractions; this is not a sign of fetal problems)

Accelerations => O2 (baby is well oxygenated–this is good)

Late decels => Placental utero insufficiency (this is bad and means there is decreased perfusion of blood/oxygen/nutrients to the baby).

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83
Q

postpartum assessment

A

B- Breasts
U- Uterus
B- Bladder
B- Bowel function
L- Lochia
E- Episiotomy
H- Hemorrhoids
E- Emotional Status
R- Respiratory System

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84
Q

placenta previa

A

low lying placenta

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85
Q

placenta abruptio

A

premature separation of the placenta

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86
Q

risk factors for placenta previa

A

Increased parity
Advanced maternal age
Past cesarean births
Past uterine curettage
Multiple gestation

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87
Q

risk factors for placenta abruptio

A

High parity
Advanced maternal age
A short umbilical cord
Chronic hypertensive disease
Pregnancy-induced hypertension
Direct trauma
Vasoconstriction from cigarette use
Thrombic conditions that lead to thrombosis such as autoimmune antibodies

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88
Q

does bleeding occur with placenta previa

A

always, bright red

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89
Q

does bleeding occur with placenta abruption

A

may or may not be present, will be dark red

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90
Q

is there pain during bleeding with placenta previa

A

never

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91
Q

is there pain during bleeding with placenta abrutpion

A

sharp, stabbing pain

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92
Q

can you perform pelvic or vaginal exams with placenta abruptions or previas?

A

NEVER

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93
Q

AEs of phenytoin

A

P - interactions

H irsutism

E nlarged gums

N ystagmus

Y ellow-browning of skin

T eratogenicity

O steomalacia

I nterference with B metabolism (hence anemia)

N europathies: vertigo, ataxia, headache

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94
Q

antiparksonian drugs (a cat does like milk)

A

A nticholinergic Agents

C OMT Inhibitors (catechol-O-methyltransferase); An enzyme involved in degrading neurotransmitters.

D opamine Agonists

L evodopa

M AO-B Inhibitors

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95
Q

what diet do patients with maternal PKU need to follow

A

low protein diet 3 months prior to pregnancy and throughout pregnancy

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96
Q

normal bilirubin levels for new born

A

24 hours: 2-6
48 hours: 6-7
3-5 days: 4-6

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97
Q

patent ductus arteriosus

A

the area between the pulmonary artery and aorta remains open, allowing the blood to flow through the patent ductus arteriosus and back to the pulmonary artery and lungs

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98
Q

signs of Intussusception

A

Normal comfort interrupted by periods of sudden and acute pain

  • Palpable, sausage-shaped mass in the right upper quadrant of the abdomen and/or a tender, distended abdomen
  • Stools that are mixed with blood and mucus that resemble the consistency of red currant jelly
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99
Q

conditions requiring droplet percautions

A

Hib, pertussis, mumps, rubella, plague, streptococcal pneumonia, meningococcal pneumonia

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100
Q

conditions requiring airborne precautions

A

measles, varicella, TB

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101
Q

what are 4 components of a mental status exam

A

Level of consciousness

Physical appearance

Behavior

Cognitive and intellectual abilities

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102
Q

classic symptoms of depression

A

change in sleep patterns,
indecisiveness,
decreased concentration,
or change in body weight

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103
Q

therapeutic lithium levels

A

0.8-1.4

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104
Q

cocaine intoxication symptoms

A

fevers, hallucinations, tachycardia, hypertension, chest pain, seizures, possible cardiac collapse and death

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105
Q

lithium AEs (therapeutic levels)

A

GI distress (nausea, diarrhea)

fine hand tremors

weight gain

polyuria

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106
Q

Assertiveness training

A

Teaches clients to express feelings and solve problems in a nonaggressive manner

Through therapy, this client can change their thinking to realize that they might have made some bad choices, but that they are not “a bad person.” The client learns to communicate in a more assertive manner in order to decrease psychological stressors. Therapy teaches the client to assert their feelings by describing a situation or behavior that causes stress, discussing feelings about the behavior or situation, and then making a change.

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107
Q

what is true about an incident report
a. risk mgmt investigates
b. include description of incident and actions taken
c. it is confidential
d. document completion in nurses’s notes
e. include in client’s health record

A

a, b, c

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108
Q

what is an early sign of hemorrhage

A

increased HR

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109
Q

how long are is a pt on blood thinners after a surgery?

A

usually about a month

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110
Q

five rights of delegation

A

person
task
circumstance
directions
supervision

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111
Q

can a UAP get a urine specimen from a catheter

A

no because it is sterile! only RN and LPNs can do sterile procedures
bladder is sterile

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112
Q

what type of patients can LPNs receive

A

stable patients w/ predictable outcomes
patients that need reinforcing of education
data collection

*they do not hang first bag of anything

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113
Q

UAPs can care for

A

ADLs
vital signs
weight
is & os
safety

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114
Q

what two patients are weighed everyday

A

heart failure
renal patients

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115
Q

which medications are priority

A

scheduled

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116
Q

what strategy is implemented when nurse gives patient medications prior to family visit

A

maslow’s

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117
Q

can uncontrollable seizures disorders be disclosed to DMV

A

yes

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118
Q

three types of consent

A

general
implied
informed

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119
Q

if there is a fire, who would you evacuate first

A

most mobile

whoever needs the most help - evacuate last

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120
Q

which culture believes health is achieved by restoring balance

A

asian american

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121
Q

which culture believes you can speed healing with soups and herbal teas

A

hispanic

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122
Q

when would you apply a tourniquet (iv complication)

A

catheter embolus

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123
Q

when would you apply light pressure (iv complication)

A

hematoma

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124
Q

when would you elevate and apply cold compress (iv complication)

A

infiltration

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125
Q

when would you aspirate a drug if possible (iv complication)

A

extravasation

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126
Q

when would you apply a warm compress (iv complication)

A

phlebitis

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127
Q

4 complications with central venous catheters

A

pneumothorax
air embolism
occlusion
infection

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128
Q

what drug can cause angioedema

A

Ace inhibitors

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129
Q

what drug can increase HF

A

CCBlockers

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130
Q

which drug should be used in caution with asthma

A

beta blockers

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131
Q

what drugs can cause rapid drop in BP

A

vasodilators

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132
Q

which drugs are contraindicated with anticoags

A

alpha 2 agonists

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133
Q

can you take an oral hypoglycemic while pregnant

A

no, need to to switch to insulin

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134
Q

what increases iron absorption

A

vit C

135
Q

what decreases iron absorption

A

Ca and tannin

136
Q

liquid iron: how should pts take?

A

use straw and rinse mouth

137
Q

which 2 antibiotics are nephrotoxic

A

vancomycin
gentamicin

138
Q

CIs for levodopa

A

MAOIs
narrow angle glaucoma

139
Q

how far should someone be from someone with radiation therapy

A

6 ft
for a max of 30 mins

140
Q

what are the steps of turning an immobile patient to right side

A
  1. place bed supine and move to side of the bed
  2. flex left knee and roll toward nurse
  3. place pillow under head and neck
  4. move right shoulder forward
  5. position pillows to maintain alignment
  6. position arms
141
Q

what does the acrononym PRESSURE stand for

A

preventable
risk assessment
early skin observation
set up appropriate mattress
seat cushions
use wound assessment tools
reposition regularly
evaluate effectiveness

142
Q

when using a cane, do you hold it on the side of weakness or stronger/unaffected side

A

use cane on stronger side to provide support

143
Q

when using the cane do you move the cane with the stronger or weaker leg

A

w/ the weaker leg

144
Q

when walking up stairs with crutches, do you move the unaffected or weaker leg first

A

unaffected , then crutches with weaker leg

145
Q

when walking down the stairs, do you move unaffected or weaker leg first

A

weaker leg first with crutches then unaffected leg

146
Q

what is the most effective spill mgmt technique for someone with AIDS

A

disinfect area with 10% bleach solution after initial cleaning

147
Q

what lab values will elevate if a patient is dehydrated secondary to vomiting

A

serum ph
hct
urine osmolarity
urine specific gravity

148
Q

therapeutic signs of KCL infusion for someone who was hypokalemic

A

reports leg cramps are no longer present
serum potassium is higher

149
Q

peaked t waves - hypo or hyperkalemia

A

hyperkalemia

150
Q

if you know patients weight, what is desired urine output

A

0.5 ml/kg/hr

151
Q

would decreased insulin cause metabolic acidosis or alkalosis

A

acidosis

152
Q

if you have diarrhea, are you losing acid or base

A

base - losing bicarb
will be metabolic acidosis

153
Q

match symptoms:

chronic bronchitis
emphysema
asthma
lung cancer
TB
pneumonia

night sweats
pleuritic pain
pursed lip breathing
hemoptysis
bronchospasm
tenacious sputum

A

chronic bronchitis - tenacious sputum
emphysema - pursed lip breathing
asthma - bronchospasm
lung cancer - hemoptysis
TB - night sweats
pneumonia - pleuritic pain

154
Q

what do you need to do before and after a bronchoscopy

A

assess gag reflex

155
Q

is bubbling in suction chamber good or bad

A

good

156
Q

what should you observe in the water seal chamber

A

tidaling with inspiration and expiration

157
Q

if tidaling in the chamber stops, what might that indicate

A

kinks/obstruction
lung might have re-expanded

158
Q

diet recommendation for acute cholecystitis

A

low fat diet with food rich in HDL
fats will cause more bile

159
Q

how are meds given through NG tube

A

one at a time and flushing in between

160
Q

what would be included in a low fiber and low residue diet

A

cream of wheat
puffed rice cereal
canned green beans

161
Q

colostomy care instructions

A

clip hair around peristomal site
empty when 1/3 full
add cranberry juice and yogurt to your diet (help with odor)

162
Q

match the symptom

cirrhosis
hepatitis
pancreatitis
pancreatic cancer

malnutrition
fatigue and anorexia
bleeding
flu like symptoms

A

cirrhosis - bleeding
hepatitis - flu like symptoms
pancreatitis - malnutrition
pancreatic cancer - fatigue and anorexia

163
Q

fat emoli are most common with fractures in which types of bones

A

pelvis and long bones

164
Q

s/s of fat emboli

A

confusion
tachycardia
chest pain
tachypnea
hemoptysis
petechiae over neck, upper arms, chest and abdomen (late sign)

165
Q

6 ps of compartment syndrome

A

pain
pallor
pressure
paresthesia
paralysis
pulselessness

166
Q

what are the levels of phosphorous and calcium in hypoparathyroidism

A

hyperphosphatemia
hypocalcemia

167
Q

normal phosphorous

A

3.0-4.5

168
Q

left sided HF manifestations (4)

A

left = lungs

dyspnea
frothy sputum
crackles
cough

169
Q

right sided HF

A

right = rest of the body

JVD
weight gain
edema

170
Q

what is the primary cause of right sided HF

A

left sided HF

171
Q

s/s of venous insufficiency

A

painless ulcers
lower leg edema
hyperpigmentation

172
Q

s/s of arterial insufficiency

A

claudication
delayed CRT
hair loss on legs
cyanotic extremities

173
Q

early s/s of shock

A

pallor
tachypnea
confusion
tachycardia

174
Q

late s/s of shock

A

cold, moist skin
weak/thready pulse
anuria
metabolic acidosis
hypotension

175
Q

s/s of DKA

A

confusion
tachycardia
hematocrit level increased
decreased LOC

176
Q

s/s of HHS

A

confusion
tachycardia
increased HCT
gradual sympton onset
decreased LOC

177
Q

s/s of hypoglycemia

A

confusion
tachycardia
decreased LOC

178
Q

what do you do if only half the dialysate is returned after PD

A

reposition client by turning side to side

179
Q

actions to prevent autonomic dysreflexia

A

promote high fiber diet and use of stool softeners
monitor patency of indwelling bladder catheter

180
Q

which procedure tells the type of CVA

A

Ct scan

181
Q

teaching for patients wtih WBC of 1000

A

rinse toothbrush in bleach solution
wash dishes in hot, soapy water or dishwasher
report fever over 100.0
avoid fluids that have been unrefrigerated more than 1 hour

182
Q

what would indicate effective response to therapy for ADIS patient

A

lack of pulmonary infiltrates

183
Q

parkland formula

A

LR
4 ml x kg x % TBSA
1/2 of that total goes in first 8 hours
1/2 in remaining 16 hours

184
Q

sickle cell priorities

A

HOP

hydrate
oxygenate
treat pain

185
Q

valerian root

A

used to prevent insomnia or reduce anxiety related restlessness
additive when combined with barbs or benzos

186
Q

how does garlic impact cholesterol

A

lowers triglycerides and LDL
raises HDL

*increases risk for bleeding

187
Q

benefits of ginko biloba

A

increases blood flow to brain
improve memory
decrease pain

188
Q

black cohost

A

estrogen substitue
shouldn’t be taken for more than 6 months

189
Q

which 5 herbal supplements interfere with anticoagulants/bleeding risk

A

garlic
ginger
ginkgo
ginseng
saw palmetto

190
Q

what kind of drug is olanzapine

A

atypical / SG antipyschotic

191
Q

early signs of lithium toxicity

A

lethargy
dehydration
slurred speech

192
Q

late signs of lithium toxicity

A

blurred vision

193
Q

normal lithium levels

A

0.4-1.4

194
Q

cluster A personality disorders

A

paranoid
schizoid
schizotypal

195
Q

cluster B personality disorders

A

antisocial
borderline
narcisstic
histrionic

196
Q

cluster c personality disorders

A

dependent
ocd
avoidant

197
Q

what can bupropion be used for

A

nicotine
amphetamines

198
Q

manifestations of opioid withdrawal

A

yawning
insomnia
panic
diaphoresis
cramps
N/V
chills
fever
diarrhea

199
Q

sources of b 12

A

animal products
(yogurt, liver)

200
Q

signs of cold stress in baby

A

cool, cyanotic extremities with warm trunk

201
Q

what is important when admitting a child to a hopsital

A

knowing their routines and rituals

202
Q

who can sit unsupported with crude pincer grasp

A

8 months

203
Q

how old: solid foods introduced and separation anxiety begins

A

4 months

204
Q

posterior fontanel closes: when

A

6-8 weeks

205
Q

receives first flu vaccine

A

6 months

206
Q

when does anterior fontanel close

A

12-18 months

207
Q

how old: birth weight doubles and rolls from front to back

A

5 months

208
Q

when does birth weight triple and they can walk with help

A

12 months

209
Q

how old: ritualism and separation anxiety peaks

A

toddler (1-3 yrs)

210
Q

how old: rides a tricycle and alternates feet going up and down steps

A

3 years

211
Q

how old: can jump rope and tie shoelaces

A

5 years

212
Q

how old: pretend play and magical thinking

A

preschooler (3-6 years)

213
Q

how old: walks independently and can use a cup well

A

15 months

214
Q

how old: skips and hops, throws ball over head, catches ball reliably

A

6 years

215
Q

tet spells triggers

A

upon awakening
during feeding
after crying
during painful procedures

216
Q

what is the best way to measure hydration?

A

weight

217
Q

a loss of 0.5kg body weight is equal to ____ of water

A

500 ml

218
Q

a nurse assess a toddler who has a 36 hour history of vomiting and diarrhea. what should be reported to provider?

A

absence of tears
skin cool and clammy
6% loss of body weight
blood pressure 78/52

219
Q

tonsillectomy sign of hemorrhage

A

frequent swallowing
frequent throat clearing
hematemesis

220
Q

tonsillectomy: when is hemorrhage most likely to occur

A

first 2 days and again approx one week

221
Q

what is the most common mode of transmissoin

A

airborne

222
Q

what is the desired effect of pancrelipase powder

A

steady weight/height gain

223
Q

can an lpn administer albumin

A

no considered a blood product

224
Q

can an lpn hang the first bag of fluids/meds

A

no

225
Q

what is the triad of fat embolism syndrome

A

hypoxemia
neurological symptoms
petechiae

226
Q

how do steroids impact serum calcium levels

A

decreases GI absorption of Ca

227
Q

why does corticosteriods cause hypervolemic hypernatremia

A

aldosterone - helps retain Na (and water)

228
Q

causes of hypernatremia

A

MODELS

medications (corticosteriods)
osmotic diuretics
diabetes insipidus
excessive H2O loss
low H2O intake
sodium intake too high

229
Q

hypernatremia s/s (fried & salted)

A

fever (low grade)
restlessness & agitation
increased fluid retention
edema
dry mouth

skin flushed
altered loc & confusion
low UO
thirst
elevated BP
decreased energy (lethargy)

230
Q

mgmt of hypernatremia - FLAG

A

free water
loop diuretics
agent causing (remove)
give fluids IV

231
Q

causes of hyponatremia (MOBS FAIL)

A

meds (diuretics)
oral gastric tube suctioning
burns
SIADH
failure: heart, kidney, liver

232
Q

s/s of hyponatremia (LOW SODIUM)

A

LOC altered
orthostatic hypotension
weak muscles

seizures
osmolality low
diarrhea
increased ICP
urine osmolality high
more bowel sounds

233
Q

normal chloride levels

A

96-108

234
Q

what medications elevate K+

A

ace inhibitors
K+ sparing diuretics

235
Q

causes of hyperkalemia (MACHINE)

A

medication
acidosis
cellular destruction
hypoaldosteronism
intake
nephrons failure
excretion impaired

236
Q

hyperkalemia s/s (MURDER)

A

muscle cramping
urine abnormalities
resp distress
decreased cardiac contractility
ekg changes
reflexes (depressed/ absent)

237
Q

3 tx that drive potassium into cells

A

d5w with regular insulin
albuterol
bicarb

238
Q

3 tx that reduce total body potassium

A

kayexalate
diuretics
dialysis (only in severe cases)

239
Q

hyperkalemia management (CRIED)

A

calcium IV
remove sources of K+
increase K+ secretion
enhance K+ uptake into cels
dialysis

240
Q

casues of hypokalemia (DITCH)

A

drugs (diuretics, corticosteroids)
inadequate K+ intake
too much water
cushing’s disease
heavy fluid loss

241
Q

EKG change with hypokalemia?

A

prominent u-wave (after t wave)

242
Q

hypokalemia mgmt (POD)

A

potassium IV (never IV PUSH)
oral potassium
diet rich in potassium

243
Q

causes of hypercalcemia (MD spied)

A

malignancy
diuretics

steroids (causes bone breakdown –> Ca released into blood)
parathyroid (hyper)
immobilization
endocrine (Addison’s)
vitamin D

244
Q

causes of hypocalcemia CHAMP

A

celiac, crohn’s
hypoparathyroid, hyperphos
alcoholism
malnutrition, malabsorption
pancreatitis

245
Q

hypocalcemia s/s (CATS)

A

convulsions (irritable)
arrythmias
tetany
spasms

246
Q

causes of hyperphosphatemia

A

malnutrition
alcoholism
TPN
tumor lysis syndrome
hyperparathyroidism –> hypercalcemia –> hypophosphatemia

247
Q

s/s of hypercalcemia

A

sedated! it slows things down
weakness
flaccidity
decreased peristalsis
hypoactive bowel sounds
bradycardia
decreased LOC

248
Q

causes of hypomagnesemia

A

alcoholism
malnutrition
malabsorption
hypoparathyroidism
hypocalcemia
diarrhea

249
Q

what electrolyte imbalance can cause torsade de pointes

A

hypomagnesemia

250
Q

does renal failure increase or decrease magnesium

A

increase – causes retention of magnesium

251
Q

normal urine specific gravity

A

1.005-1.030

252
Q

what is simethicone and what is it used for

A

relives cramping and promotes gas release

253
Q

what happens to progesterone and estrogen when the placenta is delivered

A

decrease –> results in increase in prolactin

254
Q

risk factors for ovarian cancer

A

nulliparity
advancing age
family history
early menarche
BRCA variants

255
Q

when should you take corticosteroids

A

morning with food

256
Q

s/s of hepatitis A

A

nausea, vomiting, abdominal pain, fever, anorexia, dark urine, scleral icterus, pale stools, jaundice, and pruritus

257
Q

what is scleral icterus

A

yellowing of sclera

258
Q

what is the most accurate way to determine if a patient is infectious with TB

A

sputum culture

259
Q

what does a quantiferon gold test do?

A

serum test that results in approximately 24 hours. This also would determine if the client was exposed and not an active infection

260
Q

what kind of foods are high in PKU

A

foods with protein or dairy

261
Q

what is Isosorbide

A

nitrate medication

262
Q

what is therapeutic aPtt on heparin

A

1.5-2.5x normal which is 30-40 seconds

263
Q

normal INR

A

0.9-1.2

264
Q

therapeutic INR on warfarin

A

2-3

265
Q

normal alaklinezymes increase when there is an issue

A

alkaline phosphatase
asparatate aminotransferance (AST)
alanine aminotransfer (ALT

266
Q

normal alkaline phosphatase

A

30-120

267
Q

normal AST

A

0-35

268
Q

normal ALT

A

4-36

269
Q

normal albumin

A

3.5-5

270
Q

normal ammonia

A

15-110

271
Q

normal residual from NG tube

A

<500 ml in an adult

272
Q

first, second and third line medications in shock

A

dopamine

phenylephrine

vasopressin

273
Q

do you perspire in heat stroke or heat exhaustion

A

both!

274
Q

how is heat stroke different from heat exhastuion

A

heat stroke has temp above 104 + lethargy and confusion

275
Q

5 signs of transfusion reaction

A

low back pain

SOB

apprehension

chills

itching

276
Q

side effect of amphotericin b

A

hypokalemia

nephrotoxic

277
Q

what two conditions are associated with reye syndrome

A

influenza

varicella

278
Q

3 lab values to monitor with lithium

A

creatinine (d/t being nephrotoxic)

TSH (can cause hypothyroidism)

sodium (hyponatremia can lead to lithium toxicity)

279
Q

what is Sevelamer

A

a phosphate binder indicated for individuals with chronic kidney disease (CKD).

This medication inhibits phosphorus absorption, thereby increasing the calcium level.

280
Q

what is the target for H1Ac for diabetcis

A

less than 7%

281
Q

what is macewan’s sign

A

Macewen’s sign is an indication of hydrocephalus. This sign is positive when the nurse percusses the skull bones and hears a ‘cracked-pot’ sound. This sound is due to thin, widely separated skull bones with hydrocephalus.

282
Q

when is hospice offered

A

when life expectancy is less than 6 months

283
Q

kubler stages of grief

A

denial
anger
bargaining
depression
acceptance

284
Q

is NPO appropriate on palliative care

A

yes

285
Q

what does black triage tag mean

A

expectant
deceased or not likely to survive

agonal breathing or brain matter exposed

286
Q

what does red triage tag mean

A

see first! needs immediate intervention

287
Q

what does yellow triage tag mean

A

see second
delayed attention

288
Q

what does green triage tag mean

A

see last
non-urgent
can send to urgent care, lacerations, anxious

289
Q

what is performance improvement

A

establishes a system of formal eval for job performance and recommends ways to improve perf

290
Q

what is quality mgmt

A

act of overseeing all activities and tasks needed to maintain excellence

291
Q

can you delegate obtaining pt history

A

yes

292
Q

what is licorice extract used for

A

ulcers, bronchitis

293
Q

what are risks associated w/ licorice extract

A

acts like aldosterone

HTN
hypokalemia

294
Q

what does resonance mean for percussion

A

dullness, hollow

should hear over air in the lungs

295
Q

what goes tympany indicate for percussion

A

fluid

usually over abdomen

296
Q

s1

A

mitral and tricuspid valves close
systole

297
Q

s2

A

aortic and pulmonic valves close
diastole

298
Q

when does s3 occur

A

after s2
volume overload like CHF

299
Q

when does s4 occur

A

before s1
due to stiff failing hypertrophic left ventricle

300
Q

how do you assess visual acuity

A

snellen chart

301
Q

what does a snellen chart score of 20/200 mean

A

can read at 20 feet what normal people can read at 200 feet
poor vision

302
Q

what is hyphema

A

bleeding in anterior chamber of the eye

303
Q

does nulliparity increase risk for breast cancer

A

yes

304
Q

what culture would require wrapped plastic utensils and would want to unwrap their own

A

jewish

305
Q

when do living wills go into effect

A

when client is terminally ill

306
Q

what is battery

A

unconsented physical contact

307
Q

assault

A

act that threatens physical harm even when actual harm is not done

308
Q

what is andexanet

A

antidote to apixaban

309
Q

which vaccines can you not get while pregnant

A

MMR

✓ Varicella

✓ Zoster

✓ HPV

✓ Polio

✓ Any live vaccine

310
Q

what is the major ae of isoniazid (INH)

A

peripheral neuropathy

tx with b complex vitamin

311
Q

how do you give ear drops to a child

A

For a child younger than the age of three, pull the pinna down and back

312
Q

what is akathisia and how do you treat it

A

sense of motor restlessness and is one of the most common EPS

tx with propanolol

313
Q

what is Presbycusis

A

ensorineural hearing loss associated with aging

314
Q

what fluid should be used for hypernatremia

A

d5w

315
Q

who should not receive bupropion

A

anorexics - causes weight loss
pts with epilepsy

316
Q

what is Variant angina (Prinzmetal’s angina)

A

occurs at about the same time every day, usually at rest. Variant angina is treated with calcium channel blockers

317
Q

what increases risk for DIC

A

infection/injury
sepsis

318
Q

what does warfarin prolong

A

INR & PT

319
Q

what could lead to labor dystocia

A

Maternal fatigue
Uterine overdistention such as with multiple gestation
Maternal inactivity
Uncontrolled maternal pain
Fluid and electrolyte imbalance
Hypoglycemia
Excessive analgesia or anesthesia

320
Q

can LPNs do sterile dressing changes

A

yes

321
Q

what vitamin do vegans need to supplmement

A

b12

322
Q

what is Oprelvekin

A

stimulates platelet production

indicated to prevent chemotherapy-induced severe thrombocytopenia and avoid the need for platelet transfusions

323
Q

how long can troponin be elevated after MI

A

2 weeks

324
Q

do platelets require ABO compatability?

A

no

325
Q

is inhalation anthrax spread from person to person

A

no! so no need for a mask

326
Q

are loop diuretics nephrotoxic

A

yes

327
Q

does enoxaparin (LMWH) require monitoring aptt

A

no!
would be more concerned about platelets for HIT

328
Q

what type of precautions is mono

A

standard

329
Q

what would help a patient with dailysate that won’t come out during peritoneal dialysis

A

encourage bowel mvmt

330
Q

what position would you put a pt in for removal of IJ central cath?

A

supine or trendelenburg to avoid air embolism

331
Q

how to treat hyper parathyroidism / hypercalcemia

A

0.9% saline infusion followed by furosemide

332
Q

who should not receive beta blockers

A

cardiogenic shock

333
Q

How do you prevent fat embolism

A

Immobilization!

334
Q

D dimer

A

Indicates if you have a blood clot or blood clotting problem

NCLEX Prep (20 decks)

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