NCLEX Random Flashcards
______ is used in myesthenia gravis to confirm the diagnosis.
Tensilon
Myesthenia gravis is caused by a d/o in the transmission of impulses from _____ to _____
nerve to muscle
ALS is a condition in which there is a degeneration of»_space;»>
Neurons in both the upper & lower motor neuron system
Esophagus doesn’t fully develop (surgically emergency)
transesophageal fistula
The 3 C’s of TEF.
1)
2)
3)
cough
choking
cyanosis
The MMR vaccine is given?
SQ
Mass-casulty
Red- unstable, occluded airway, actively bleeding, see first
Yellow- stable, can wait up to an hour for tx , ie burn see second
Green- stable, can wait even longer to be seen, “walking wounded”
Black-unstable clients that will probably not make it, need comfort measures
DOA-dead on arrival
They put an amulet or any other use of protective charms around their baby’s neck to avoid “evil eye” or envy of others.
greek heritage
Cannot interpret TIME. Need to explain time in relationship to a known COMMON event (Mom will be back after supper)
4 year olds
Name a contrainindication for Hep B vaccine.
Anaphylactic reaction to baker’s yeast.
Do you have an allergy to ___? (before flu shot)
eggs
Do you have an allergy to ____ or ____ before MMR?
eggs
neomycin
When on nitroprusside, monitor ______. Normal value should be __, over is heading towards toxicity.
thiocynate (cyanide)
Can you still give immunization if your child has a cold?
YES
SARS is ____ +____ , just like ?
airborne & contact … varicella
HEP A is _____
contact precaution
Tetanus, Hep B, HIV _____ _____
standard precautions
Williams position ?
semi fowler’s with knees flexed to relieve lower back pain.
External rotation, shortening, adduction !
signs of a fractured hip
Fat Embolism : ____ tinged sputum, (r/t inflammation), increase ___, ABGs?, HYPO_____, increased serum lipids, “snow storm” effect on chest x-ray
blood
serum lipids
respiratory alkalosis
HYPOcalcemia
Complications of mechanical ventilators
pneumothorax, ulcers
Allupurinal = NO ______
vitamin C
A localized disorder of bone remodeling that typically begins with excessive bone resorption followed by an increase in bone formation.
Paget’s disease
Name 3 s/s of Paget’s disease
tinnitus, bone pain, enlargement of bone, thick bones
An X-ray test that provides pictures of the kidneys, the bladder, the ureters, and the urethra.
Intravenous Pyelogram (IVP)
IVP requires ___ ___ so they can visualize the bladder better.
bowel prep
Acid Ash diet
cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread
Alk Ash diet
milk, veggies, rhubarb, salmon
Orange Tag is psych ?
non emergent
Greenstick fractures, usually seen in ___ bone breaks on one side and ___ on the other
kid
bend
___ is a side effect of thyroid hormones. Increased metabolism, your body is too busy to sleep as opposed to the folks with hypothyroidism who may report ____ (dec met rate, body is slow and sleepy)
Insomnia
Somoneolence
____ for strabisms. Patch the ___ eyes so that the weaker eye can get stronger.
botox
good
Tidal volume=
COPD patients : __LNC or less (hypoxic not hypercapnic drive), PaO2 of ___ and SaO2 of ___ is normal for them b/c they are chronic retainers
7-10 ml/kg
2, 60%, 90%
What to use to reverse the effects of pancuronium bromide ( a nondepolarizing muscle relaxant approved to induce skeletal muscle relaxation during anesthesia and to facilitate the management of patients undergoing mechanical ventilation)
atropine and neostigmine( a parasympathomimetic ,treats MG)
Amphotericin b will cause.. ____ (amongst many other things, gotta pre-medicate patient before giving). Most likely will get a ?
hypocalcemia
fever
Amphotericin B- antifungal
Test for ___ before the administration of ASPARAGINASE
sensitivity
a cancer drug that treats leukemia
Take Vermox with ? (increases absorption)
high fat diet
Vermox is used to treat infections caused by worms such as whipworm, pinworm, roundworm, and hookworm
Kidney Glucose threshold?
180
Amphogel and Renegal take with
meals
Stranger anxiety is greatest at which age?
Separation anxiety peaks in ______.
MMR is a ___ shot?
7-9
toddler
SQ
Lymes is mostly found in ?
Asthma and Arthritis (sport?)
Conneticut
swimming
Irreversible, involuntary movements of the tongue , face & extremities, may happen after…
Tardive Dyskinesia
may happen after prolonged use of antipsychotics
Motor restlessness , need to keep going, tx with antiparkinson’s meds, can be mistaken for agitation
akathisia
When drawing ABGs put blood in a ____ tube, make sure there are no ____, put on ___ immediately after drawing, with a label indicating if the patient was on….
heparinized
bubble
label
room air, how many L of O2
What test should you do before ABG to check for significant blood flow?
Allen’s test
Before going to the PFT , a pts_____withheld and they are not allowed to….
bronchodilator
smoke for 4 hours prior
For a lung biopsy , position patient…. have patient breath in mid-expiration, chest x-ray done immediately afterwards to check for complications of pneumothorax, ___ dressing applied
lying on the side of the bed or with the arms raised up on the pillows over the bedside table
sterile
For a lumbar puncture, pt is position in _______, keep pt FLAT for ___ hours afterwards, sterile dressing, frequent ___ assessments
lateral recumbent fetal position
2-3 hours
neuro
EEG hold med for _____ prior, no caffine or cigarettes for __ hours prior , PT CAN EAT, pt must stay awake night before exam, pt. may be asked to ____ and watch a bright flashing light, after EEG, assess pt for ____ because the will be at an increased risk
24-48
24
hyperventilate
seizures
A test that detects electrical activity in your brain using small, flat metal discs (electrodes) attached to your scalp.
An electroencephalogram (EEG)
Diamox used for ____ can cause _____
glaucoma, hypokalemia
Dexedrine used for ___ may alter ___ needs, avoid taking with ____, take in the ____. What is a possible side effect
ADHD insulin MAOis morning insomnia
Cytovene used for ____ caused by cytomegalovirus, pt will need regular eye exams. REPORT (3 things immediately!)
retinitis
dizziness
confusion
seizures
INH used to treat and prevent ____, do not give with ____, can cause ____ toxicity, monitor LFT’s, give with ___, what will occcur initially and then resolve?
TB Dilantin phenytonin B6 hypotension
What for TB dues bodily fluids orange
Rifampin
If mixing antipsychotics (Haldol, Throazine, Prolixin) with fluids, med is incompatible with two liquids?
Apple Juice and caffine
Preferred antipsychotic in the elderly? But high risk for ________ monitor for early sign of reaction and give with ?
Haldol
extrapyramidal S.E: (dystonia, TD, tightening of jaw, stiff neck, swollen tongue, later on swollen airway)
Benadryl IM
First line anti-psych drug for children? Doses over 6 MG can cause?
risperdal
TD
Lavodopa for ______ , contraindicated in patients with ____, avoid ___
Parkinsons
Glaucoma
B6
Sinemet for _____ , contraindicated with ?
MAOIs
Hydroxurea for ____, report ____symptoms immediately could be signs of toxicity
sickle-cell
GI
Zocor for _____, take on _____ to enhance absorption, report any unexplained ….. especially if there is a ?
hyperlipidemia
empty stomach
muscle pain
fever
Decorticate is toward the __ and Decerbrit is the other way (out)
CORD!
BOTOX (Botulin toxin) can be used with ____ also to ____ in spasmodic dysphonia
strabismus
relax vocal cord
A psychiatric d/o that causes an individual to self-inflict injury or illness or to fabricate symptoms, of physical or mental illness, in order to receive medical care or hospitilization.
Munchausen syndrome
An individual typically a mother, intentionally causes or fabricates illness in a child or other person under her care.
Muchausen by proxy
A chronic, progressive disease with demyelinating lesions in the CNS which affect the white matter of the brain and spinal cord
Motor:
Sensory:
Cerebral:
MS
Motor: limb weakness, paralysis, slow speech
Sensory: numbness, tingling tinnitus
Cerebral: nystagmus, ataxia, dysphagia, dysarthia
Chorea: 50% genetic, autosomal dominant d/o
s/s: ___,___, movements of the face, limb, body. __ deteriorates to …..
No cure! Just palliative care
writhering, twisting
gait, no ambulation
WBC shift to the ____ with pyelonephritis (neutrophils kick in to fight infections)
left
Definitive dx for AAA->
CT scan
Uremic fetor->
smell urine on the breath; a urine-like odor on the breath of persons with uremia.The odor occurs from the smell of ammonia, which is created in the saliva as a breakdown product of urea
Don’t use Kayexalate if ?
hypoactive bowel sounds
Bile is lower obstruction , no bile is upper obstruction, ribbon-like stool
Hirschsprung’s
Pancreatic enzymes are…
taken with each meal, not before or after
A person should not have ___ & ___ before an occult blood test?
cantaloupe and fish, cantaloupe is high in Vit C which causes a false + for occult blood
Hypospadius: Abnormality where the ____ ___ is located on the ___ surface of the penis from the corona to the perineum.
urethral meatus , ventral back , remember hypo(low)- for the lower side or the underside
Opening of the urethra on the dorsal front surface of the penis
Epispadias
Painful erection lasting longer than 6 hours.
Priapism
Anticholinergic effects: assessment
- Four cant’s !
can’t spit- dry mouth
cant’s piss- urinary retention
can’t shit- constipation
can’t see- blurred vision
When you see coffee Brown emesis think?
Anytime you see fluid retention think?
An answer that delays tx is ALWAYS wrong
peptic ulcer
haert problems
PVD-> DAVE
Dependent for arterial, Venous elevated
NCLEX tip
When choosing an answer think in this manner, if you can only do ONLY on thing to help this patient what would it be? Pick in the most important intervention
NCLEX tip
If two answers are the exact opposite. For example bradycardia & tachycardia, one is probably the answer
NCLEX tip
If two or three answers are similar or alike, none is correct
NCLEX tip
When asking questions,never use WHY
NCLEX tip
If you have never heard of it don’t pick it
NCLEX tip
Never release traction unless you have an order from the MD to do so
NCLEX tip
Questions about halo? Remember safety first, have a screwdriver nearby
Compartment syndrome is an emergency. Top two classic symptoms. other P’s.. Neuromuscular damage is irreversible __
Pain and paresthesias( pallor, pulselessness, paralysis, poikilothermia)
4-6 hours after onset
NCLEX tip
Always deal with actual problems or harm before potential problems
NCLEX tip
Always select a patient focused answer
NCLEX tip
An answer that states reassess in 15 mins is probably wrong
Interpersonal Model
Infancy (0-18 months) others will…
satisfy needs
Interpersonal Model
Childhood (>6)- learn to delay…
delay need gratification
Interpersonal Model
Juvenile (6-9)-learn to relate
to peers
Interpersonal Model
Preadolescence(9-12)-learns to relate to ___
friends of opposite sex
Interpersonal Model Early adolescence(12-14)-
learn independence and how to relate to opposite sex
Interpersonal Model Late adolescence(14-21)- develop...
intimate relationship with person of opposite sex
Fetal alcohol syndrome- What’s up with this babies nose? size? lip?
upturned nose
flat nasal bridge
thin upper lip
SGA
Where to admin IM for 6 month infants?
Vastus lateralis
Where to admin IM for toddler if 18 months and older
Ventrogluteal
Two IM sites appropriate for children?
deltoid and gluteus maximus
Quick Abbreviations
OU-
OS-
OD-
both eyes
left eye
right eye (dominant right eye)
COAL !
cane, opposite, affected, leg
RED- IMMEDIATE !
injuries are life threatening but survivable with minimal intervention. EX- hemothorax, tension pneumothorax, unstable chest and abdominal wounds, INCOMPLETE amputations , open fx’s of long bones, and 2nd/3rd degree burns with 15-40% body surface
Yellow- DELAYED!
Injures are significant and require medical care, but can wait hrs w/o threat to life or limb. Ex: stable and wounds without evidence of hemorrhage, fx requiring open reduction, debridement, external fixation , most eyes and CNS injuries
Green-MINIMAL !
Injuries are minor tx can be delayed to hrs or days, Individuals in this group should be moved away from main triage area. Ex: upper extremity fx, minor burns, sprains, sm lacerations, behavior d/o
BLACK-EXPECTORANT
Injuries are extensive and chance of survival are unlikely. Seperate but don’t abandoned, comfort measures if possible. Ex- unresponsive, SCI, wounds with anatomical organs, 2nd/3rd degree burn with 60% of body surface area, seizures, profound shock with multiple injuries, no pulse, b.p, pupils fixed and dilated
Thoracentesis prep- Take v.s, shave area needle insertion, how to position patient, no more than _______ at a time, Post-procedure…
position patient with arms on pillow on over bed table or lying side, listen for bilateral breath sounds, vs, check leakage , sterile dressing
NCLEX TIP
CT- assess for allergies
MRI- claustrophobia, no metal, assess pacemaker
Cardiac cath: NPO___, ____ bladder, check pulses, tell pt that they may feel??or a desire to cough with dye injection. Post-op : vital signs, keep legs straight, bedrest for 6-8 hours
8-12 hours
empty
palpitations
Cerebral angio prep- well hydrated, lie ___, pulses marked !. Post- keep flat for ___ hours, check site, pulses, force fluids
flat
12-14 hours
Lumbar puncture: __ position, POST- neuro assessment 15-30 mins until stable, flat for 2-3 hours, encourage fluids, what to take for HA?? observe dressing.
flat
oral analgesics
EEG- the night before? meals ? tranquilizers. stimulants? may be asked to ? 3-4 mins with ?
NO SLEEP
not withheld
held 24-48 hours before
hyperventilate, bright flashing light
Myelogram: How long NPO? allergy hx, Phenothiazines, CNS depressants, and stimulants withheld ? table will be moved to various positions during the test. Neuro checks , water soluble = ? oil soluble =? oral analgesics for HA, encourage po fluids, assess for distended bladder, inspect site
4-6 hours, 48 hours, HOB up, HOB down,
A diagnostic imaging procedure done by a radiologist. It uses a contrast dye and X-rays or computed tomography (CT) to look for problems in the spinal canal, including the spinal cord, nerve roots, and other tissues.
Myelogram
Liver biopsy: Admin(2 thing) ____, NPO morning of exam , Teach patient that he will be asked to …. position ? Post-procedure: position ? frequent vs, repost severe abdominal pain stat, no heavy lifting for a week
Vitamin K and sedative
hold breath 10-15 sec, supine position lateral with upper arm elevated. Post- RIGHT side
Laparoscopy: __ used to enhance visual, general anesthesia, Foley! Post- what to do with patient to decrease __ build up from procedure
CO2
CO2
walk with patient
Paracentesis : Position? empty bladder ! Post- vs, report elevated temp, observe for signs of ?
semi fowlers, or upright on edge of bed
hypovolemia from pulling off too much fluid
A form of imaging of the renal pelvis and ureter. Types include: Intravenous pyelogram In which a contrast solution is introduced through a vein into the circulatory system.Assess for ?
pyelogram, allergies
Sengstake blakemore tube used for the tx of ? keep what at the bedside?
esophageal varices, keep scissors
Hemovac- used after mastectomy, empty when full or Q8hr, remove contents, place on flat surface, cleanse opening and plug with sponge. How to remove air? , release plug, check system for operation
compress evacuator completely to remove air
S/S: Pulmonary tuberculosis : afternoon?
low-grade fever
S/S: Pneumonia -> sputum color
rusty
S/S: Asthma-> wheezing on?
expiration
S/S: Emphysema-> chest?
barrel
S/S: Kawasaki syndrome?
strawberry-tongue
S/S: Pernicious anemia-> tongue?
red-beefy
S/S: Down-syndrome-> tongue?
protruding
S/S:Cholera-> stool?
rice,watery stool: A bacterial disease causing severe diarrhea and dehydration, usually spread in water.
S/S:Malaria-> stepladder like ___ with ___
fever w/ chills
S/S:Typhoid-> abdomen?
rose-spots: symptomatic bacterial infection due to Salmonella Typhi
S/S: Diptheria->______ formation
psuedo membrane : infection of the nose and throat : due to an infection caused by the bacterium Corynebacterium diphtheriae.
S/S:Measles-> ____ spots
kopliks
S/S:SLE-> rashes
butter-fly
Liver cirrhosis -> spider-like ___
varices
Leprosy- face?
lioning face
Bulimia- face?
chimpmunk
Appendicitis…
rebound tenderness
Dengue: A mosquito-borne disease occurring in tropical and subtropical areas. S/S
petechiae or (+) Herman’s sign
Meningitis
1) Leg flex then leg pain on extension
2) Neck flex=lower leg flex
Kernig
Brudzinski
Tetany: _____ (+) Trousseau’s sign /carpopedal spasm; Chvostek sign (facial spasm)
hypocalcemia
Risus sardonicus occurs in-> a highly characteristic, abnormal, sustained spasm of the facial muscles that appears to produce grinning
tetanus
Cullen’s sign(ecchymosis of umbilicus) and Grey turners spots( bruising of the flanks)
pancreatitis
Olive like mass.
pyloric stenosis
Machine like murmur
PDA
Bronze like skin pigmentation..
Addison’s disease
Moon face appearance and buffalo bump
Addison’s disease
Exopthlamus
Grave’s disease/hyperthyroidism
Sausage shaped mass, dance sign (empty portion of RLQ)
Intussusception
Ms-Charcot’s Triad=SIN
- Nystagmus (the uncontrolled movement of the eyes from in a lateral motion)
- Intention tremor
- Staccato speech
Descending muscle weakness.
MG
Ascending muscle weakness
GB
Homan’s sign?
DVT:A positive sign is present when there is pain in the calf on forceful and abrupt dorsiflexion of the patient’s foot at the ankle while the knee is extended
Vesicular Rash (central to distal) drew drop on rose petal
Chicken Pox
Crushing stubbing pain relived by NTG
Anginia
MI- crushing stubbing pain which radiates to _____ shoulder, neck, arms, unrelieved by NTG.
left
Inspiratory Stridor
Croup
TEF (Tetralogy of Fallot )
Coughing
Chocking
Cyanosis
Continous Drooling
Epiglottis - 3 D’s
drooling, dysphonia , dysphagia: A flap that is made of elastic cartilage tissue covered with a mucous membrane, attached to the entrance of the larynx.
Painless, progressive enlargement of spleen & lymph tissues, Reedstenberg cells
Hodgekin’s DSE/Lymphoma
Hallmarks of mononucleosis… (3 things)
sore throat, CERVICAL lymph adenopathy, fever
Pill-rolling tremors
Parkinsons
Fibrin Hyalin(Respiratory distress syndrome): ____ grunt
expiratory grunt
Salty Skin
Cystic fibrosis
Polyuria, Polydispia, Polyphagia
DM
Kussmauls breathing (deep & rapid)
DKA
Bladder cancer-> painless?
hematuria
Reduced size and force of urine
BPH
Pemphigus Vulgaris: Nikolksky’s sign-> separation of? caused by?
Separation of epidermis caused by rubbing of the skin.
Immune d/o: chronic blistering skin disease with skin lesions that are rarely pruritic, but which are often painful
Retinal detachement: (3 things)
visual floaters, flashes of light, curtain vision
Painful vision loss, tunnel/gun barrel/halo vision (peripheral vision loss)
Glaucoma
Painless vision loss, opacity of the lens, blurred vision
Cataracts
Retino Blastoma - Cat’s eye reflex (color?)
grayish discoloration of the pupils
Coarse facial feature..
acromegaly: Acromegaly is a hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood. When this happens, your bones increase in size, including those of your hands, feet and face. Acromegaly usually affects middle-aged adults.
Gower’s sign (use of hands to push one’s self from the floor)
Duchenne’s muscular dystrophy
Barrets esophagus (erosion of the ___ portion of the esophageal mucosa)
lower, GERD
Flapping, temors
hepatic encephalopathy
Increase ICP vs Shock
ICP- hypertension, brachypnea, bradycardia
Shock- hypotension, tachypnea, tachycardia
Meniere’s Disease ( 2 things)
vertigo, tinnitus : Meniere’s disease is a disorder of the inner ear that causes spontaneous episodes of vertigo — a sensation of a spinning motion — along with fluctuating hearing loss, ringing in the ear (tinnitus), and sometimes a feeling of fullness or pressure in your ear. In many cases, Meniere’s disease affects only one ear.
Cystitis - ____ during urination
burining
Chvostek & Trosseaus Sign
HYPOcalcemia
Recurrent bloody diarrhea
Ulcerative colitis
Lyme’s disease - what kind of rash ?
Bull’s rash
Ottorhea(An infection of the air-filled space behind the eardrum) = ___ fracture
Signs of orbital fracture?
Basilar
racoons eyes, battles sign
Take iron elixir with 1) and 2) NEVER With ?
juice and water, MILK
Kawasaki’s leads to ?
cardiac problems
Dilantin
10-20
Theophyline
10-20
Acetaminophen
10-20
Lithium
0.5-1.5
Digoxin
0.8-2.0
Osteomyletitis is an ______ bone disease. Give _____ cultures, _____, then if necessary surgery to drain abscess.
infectious, blood cultures, antibiotics
Nephrotic syndrome s/s 1)_______ 2)_____ . Turn and reposition (risk of impaired skin integrity)
edema, HYPOtension
NCLEX Tips
To access role relationship pattern focus on image and relationships with others.
Renal impairment: Serum creatine ______ Urine Clearance______
elevated, decreased
Norm.Serum creatinine: ___(men), _____(women)
Norm. Urine clearance -> _____ (lab values)
0.8-1.8(men), 0.5-1.5 (women)
85-135
Atropine
Hot as a Hare (TEMP) , Mad as a Hatter (LOC), Red as a beet (flushed face), and dry as a BONE (thirsty)
Hemoglobin levels
Neonates 18-17
3 months 10.6-16.5
3 yrs 9.4-15.5
10 yrs 10.7-15.5
Glomerulonephritis : Take vs q__hrs + daily weights
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