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NCLEX Review Questions Flashcards

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1
Q

Best practice for confirming NG tube?

A

aspirating gastric contents and testing pH (should be below 5)

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2
Q

Procedure for neutropenic precautions

A
  • PPE
  • private room
  • visitor restriction
  • no raw vegetable or fruits
  • bathe daily
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3
Q

Team Nursing

A
  • Most common delivery system
  • team of nursing personnel provides total care to a group of clients
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4
Q

What endocrine disorder leads to dry scaly skin, muscle cramps, tingling of the lips, fingers and toes

A

Hypoparathyroidism

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5
Q

First Stage of Labor Transitional Phase lasts for

A

10-15 minutes

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6
Q

What medication is the only FDA approved med to treat PTSD

A

SSRIs

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7
Q

What is a priority for a patient after orchiectomy?

A

removll of testis for prostate cancer. PAIN MGMT

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8
Q

Diet for crohn’s disease

A

increased protien increase calorie. Low fat, Low Residue (fiber)

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9
Q

Hallmark Signs of tonsillitis

A

viral or bacterial. Difficulty swallowing, ear pain, fever/chills, headache, sore throat

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10
Q

What is the septum

A

a wall between the ventricles, there should be no opening

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11
Q

Which age range is at increased risk for poisoning?

A

Toddlers age 1-3 years b/c increasing mobility

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12
Q

Activity Lifestyle changes after MI

A

decrease physical activites. Need Cardiac Rehab

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13
Q

When is glucagon normally used?

A

If client is a ketoacidosis or coma. They are usually unconscious

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14
Q

What is the primary purpose of a transitional care program

A

reduce readmissions to the hosptial

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15
Q

What is always a concern with mysathenia gravis

A

airway

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16
Q

If a mother is RH negative and rbeastfeeding exclusively, what is a concern

A

hyperbilirubemia

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17
Q

What is the role of the MDS coordinator

A

interacts with health care staff to coordinate care processes of client assessment and care planning. Usually an RN

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18
Q

What type of diet does a patient with preeclampsia need?

A

protein. Lie on the left side, adequite fluids. Protein restores osmotic pressure

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19
Q

What patient is good to put next to a depressed patient

A

another depressed paitent or someone who’s condition is more stable. Matching roommates ages as closely as possible

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20
Q

If a patient has and SCI injury at C-5, what is his sexual functioning

A

sexual functioning may be possible, depends on severity of the injury, age of the client.

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21
Q

What is the algorithm for safe client handling and repositioning in bed

A
  • Use 2-3 Caregivers for a client that can partially assist & weights less tah 200 lbs
  • Use a friction reducing device
  • Move bed into flat position at comfortable height for caregivers
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22
Q

What is the glabellar reflex

A

tap the bridge of ose and baby will close both eyes

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23
Q

When a patient has a spinal cord injury what is the biggest risk

A

immobility. place client on pressure reducing support surface.

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24
Q

Heberden’s nodes are characteristic of

A

osteoarthritis nodules. Strongly inherited.

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25
Q

What is a major side effect of INH

A

peripheral neuropathy

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26
Q

Where is the apical pulse heard? (apex/mitral area)

A

4-5th intercostal space midclavicular line

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27
Q

PPE for Contact Precautions

A

Gown, Gloves

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28
Q

This GI issue Pain localizes to the right upper quadrant, but may radiate to the right shoulder or scapula

A

Cholecystitis

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29
Q

What is the 3rd stage of labor

A

placental separation and expulsions. Lasts 5-30 minutes

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30
Q
A
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31
Q

Therapeutic range for lithium

A

0.8 - 1.2 mEq/L

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32
Q

Why type of solution is lactated ringers?

A

isotonic

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33
Q

Fetal Attitude

A

the relationship of the fetall body part to one another

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34
Q

What is placenta previa

A

placenta is abnormally implanted in the lower uterine segment. No vaginal exams, IVs to restore blood volume.

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35
Q

Bright flashes of light; blurred vision; “floaters” in the eye

A

Retinal detachment

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36
Q

Procedures for after a newborn is delivered

A
  1. Asses infant’s airway and breating
  2. perform bulb suctioning if excessive mucus
  3. assess infants heart rate
  4. place id bands on mother and infant
  5. administer vit k
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37
Q

Priority action for pt with preeclmapsia

A

have the client turn to the left side

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38
Q

Who establihed the Standards of Practice

A

the nursing profession (ANA)

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39
Q

How is Scope of Practice determines

A

Stat’es nurse practice act

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40
Q

TB treatment

A

medication is taken daily with monthly visits to the clinic

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41
Q

Infectious diseaseas that require contact precautions

A

meningitis, Varicella (Gown, Gloves)

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42
Q

arrett’s esophagus is a complication of this condition

A

GERD

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43
Q

Things the nurse CANNOT delegate

A
  • assessment
  • evaluation of client date
  • nursing judgment
  • teaching and evaluation
  • nursing dx, or care planning
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44
Q

Fetal station means

A

the relationship between the presenting part of the baby with the mother’s pelvis

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45
Q

Why can’t a CNA shave a client after surgery

A

they probably have taken anticoagulants only an electric shaver can be used.

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46
Q

The most common healthcare associated infection

A

caused by staff

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47
Q

How much radiation in mammography is it equivalent to?

A

one hour of sun exposure

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48
Q

Foods to avoid if low WBCs

A

raw fruits and vegetables, undercooked meats, moldy cheeses, luch meat, salads things from the deli counter, brewed teas.

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49
Q

Common cause of aortic stenosis

A

aging heart, or rheumatic fever

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50
Q

What vegetarian foods are rich in

A

cereals and dried froot

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51
Q

What complication is at risk with Kawasaki Disease

A

Coronary artery aneurysm

Affects mucus membranes, lymph nodes and walls of the blood vessels. Can cause inflammation of the arteries, possible heart attack in child, fever lasting more than 2 weeks.

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52
Q

In a math equation requiring dilution factor, what should you watch for as potential trick

A

don’t get confused by the quantitiy of diluent. only the final concentration directs your answer

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53
Q

What is the rule for UAPs for documentation

A

they cannot document what they cannot assess

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54
Q

Responsibilities of UAP

A
  • No scope of practice
  • Non-invasive and non-sterile treatments
  • bathing, transferring, ambulating, feeding, toileting, Vital signs
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55
Q

What are minors known as if they are married

A

emancipated minors through marriage, pregnancy, high school graduation, independet living or service in the military (have the legal capacity of an adult)

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56
Q

A pt with BPH has a distended bladder due to acute urinary retention. What should nurse understand about care of this client

A

tx includes catheterization (starting w. smallest catheter size). Complete and rapid emptying of the bladder. Bladder irrigation is performed.

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57
Q

Total Client Care Case Method

A
  • RN is responsible for ALL aspects of care
  • May be seen in Critical care or PACU
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58
Q

Procedures with a patheint with bronchiolitis to RSV

A
  1. Assess for respiratory distress
  2. promote tissue ogyenation
  3. institute droplet isolation precautions
  4. administer medication
  5. promote desired fluid intake
  6. provide family teaching
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59
Q

What is the most common cause of diverticular disease

A

eating a low fiber diet

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60
Q

Pathophysiology of Pernicious Anemia

A

parietal cells of stomach fail to excrete intrinsic factor which is necessary for absorption of vitamin B12

sx: sore tongue(beefy red), anorexia, nausea, vomiting, diarrhea, abdominal pain

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61
Q

Clinical indicators for suctioning

A
  • course breath sounds
  • noisy breathing
  • increased/decreased pulse
  • increased/decreased respiration
  • prolonged expeiratory breath sounds
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62
Q

How many times should the fetus move per hour during 3rd trimester?

A

3x per hour. If it doesn,t drink a glass of juice and then start a new count

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63
Q

What are the 5 Stages of grief?

A
  1. Denial
  2. Anger
  3. Barganing
  4. Depression
  5. Acceptance
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64
Q

Procedure for child with ingestion of toxic substance

A
  1. Stabilize the child (ABCs)
  2. Start IV infusion (large bore needle)
  3. Obtain history of ingestion
  4. reverse or eliminate toxic substance
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65
Q

What is the most accuarete oxygen delivery method

A

venture mask mixes RA with 100% oxgyen max of 55%

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66
Q

Signs of Chronic Kidney Disease

A

Ecchymoses, hyperpigmentation, pruritus

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67
Q

What are you worried about with neuroleptic malignant syndrome

A

very high temperature

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68
Q

If a client has a blood glucose of 175 and reports being hungry and thirsty what should you do?

A

administer Humulin R- Insulin (short acting, regular). Will work in 30 mintues, pt should wait to eat breaskfost so insulin can begin working

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69
Q

Renal Encephalopathy signs pt with hemodlialysis

A

confusion irritability, elevated BUN and Creatnine

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70
Q

Nursing Consideration with Fentanyl patch

A
  • slowly absorped thru sub Q tissue, can take up to 12-24 hours before effective analgesia
  • short acting opioid can be given for breathrough pain
  • the pt can shower/bathe, but should not be exposed to hot tubs or heating pads. Speeds absorption of medication
  • throw them away but folding in half, not by cutting in half
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71
Q

What type of pain delivery system is well suited for pts with cancer

A

SubQ

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72
Q

What could be a cause at home for a child to have an astma attack

A

new pillow

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73
Q

What is the most important intervention when body iimage is a factor

A

touch

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74
Q

What is buck’s traction used for

A

to immobilize, position and align the lower extremity.

5-7 lbs is recommended for skin traction

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75
Q

What is a milkwakee brace used for?

A

scoliosis 1-2 years, during periods of growth

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76
Q

Who is the only employee from a health care organization that can be a lega withness of signing of an advance directive

A

clinical social worker

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77
Q

A child with burn is at risk for dehydration, what finding would indicate decrease in status

A

increased hematocrit and decrease in urine volume

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78
Q

In poison control when should you NOt induce vomiting

A

if contains alkaline or acid agents. I.E. lye, houseehold cleaners, oven cleaner, furniture polish, metal cleaners, battery acids, petroleum products

can neutralize using activated charcoal

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79
Q

What is the most accurate way of determining proper NG tube placement?

A

measure hte pH of aspirated gastric contents

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80
Q

Pediculosis capitis, signs

A

whitish oval specks sticking to the hair shaft. (Head lice)

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81
Q

When is a child ready for toilet training

A

when myelinationf of the spinal cord is completed this is when voluntary control of sphincter muscles occurs. (between 18 and 24 months). Child has to be walking without holdingo n.

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82
Q

Where is the Rinne Test administered using tuning forks?

A

against the mastoid bone. Normal= air conduction is longer than bone conduction.

Abnormal= the reverse

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83
Q

Findings of pinworm

A

infection which includes intense perianal itching.

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84
Q

What can immunoglobulin therapy interfere with?

A

body’s ability to form appropriate amts of antibodies. Live attenuated immunizations should be delayed.

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85
Q

Droplet Precaution requirements

A

Mask, goggles

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86
Q

What intervention or advice does the nurse implement after instilling eye drop medication?

A

apply pressure for about minute to decrease systemic absorption of the medication

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87
Q

This condition may be caused by gallstones, chronic alcohol use, infections, medications, and trauma.

A

Pancreatitis

tx with IV fluids, antibiotics, pain relievers

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88
Q

What is the preferred site for ABG

A

radial. Apply firm pressure 5 min prior. Leave oxygen on. Sample should be cold on ice to minimize chemical reaction

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89
Q

what does stable eschar do for skin care?

A

serves as body’s natural cover

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90
Q

Hep A Precautions

A

wear gown and gloves during client contact

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91
Q

Probable changes in pregnancy

A
  • Chadwicks Sign- vaginal vascularity- blue cervix
  • Hepgar’s Sign- uterine vascularity
  • Goodell’s sign- cervical softening from estrogen and progesterone
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92
Q

What is the maximum dose of IM injection for infants and toddlers

A

1mL

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93
Q

Functioning Nursing

A
  • RN gives medications and UAP gives bed baths for one group of clients
  • Needs are broken down into tasks
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94
Q

Indications of Intenstinal obstruction

A

abdominal distention, chills fever (toxic megacolon), fitula formation

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95
Q

In relation to the heart what direction do veins go?

A

towards the heart, they have valves.

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96
Q

CNS infection examples

A

meningiits, encephalitis

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97
Q

What does the mitral valve control?

A

flow between the left atrium and left ventricle (Atrioventricular Valve)

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98
Q

Postpartum assessment, BUBBLE

A
  • Breasts
  • Uterus
  • Bowels
  • Bladder
  • Lochia
  • Episiotomy/C-section incision
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99
Q

What lab values indicate protein/malnutrtion

A

cholesterol, hemoglobin, Total Lymphocyte Count

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100
Q

Post Op Tracheostomy position

A

Elevate HOB and turn to one side until consciousness returns

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101
Q

The bubbling in a water seal chest tube chamber indicates

A

lung has not yet re-expanded

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102
Q

Classic findings of pulmonary stenosis

A

heaviy brathing, dyspnea, tachycardia, peripheral edema

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103
Q

What should you think when a patient states ““I went to the bathroom and my urine looked very red but it didn’t hurt when I went.””

A

painless gross hematuria. Urgent associated with bladder cancer or kidney problems.

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104
Q

Procedural order for administeral total parenteral nutrition through Central Line

A
  1. Check solution ofr cloudiness or sediment
  2. select & flush the correct tubing and filter
  3. thread the IV tubing thru an infusion pump
  4. use aseptic tech when handling injection cap
  5. connect the tubing to the central line
  6. set infusion pump at prescribed rate
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105
Q

Procedure for patient who is lethargic and slow to respond

A
  1. Attempt to elicit a response by physically shaking
  2. quick neurological assessment
  3. call rapid response team
  4. remain with pt, send another staff member to get list of medications and chart
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106
Q

What is MDS

A

Minimum Data Set. Standardized assessment of all residents in Medicare or Medicaid certified facilities. Completed for any individual staying more than 14 days. Does not measure outcomes.

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107
Q

What pain medication can induce asthma attacks

A

aspirin

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108
Q

Fetal adaptions during labor

A
  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • external rotation
  • expulsion
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109
Q

Infectious diseases that are airborne?

A

TB, Rubeola, Varicella

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110
Q

What needs to happen to prep a client for iv pyelogram

A
  • clean out gi tract
  • NPO 8-12 hours
  • administer laxative the evening before
  • enema morning of the test
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111
Q

What is an example of behavioral therapy

A

using positive and negative reinforcement. Assertiveness trainsing and desensitiization.

good for phobias, sexual dysfunction, eating disorders, etc.

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112
Q

Responsibilities of LPN/VN

A
  • implementation of a plan
  • assessing abnormal/normal
  • reinforce information given by RN
  • care for stable clients with predictable condition
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113
Q

early sign of intenstinal obstruction

A

hyperactive bowel sounds

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114
Q

How can over training in exercise increase risk with osteoporosi

A

can decrease estrogen levels in women and may increase risk

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115
Q

Normal range for neonate blood sugar

A

40-90

depending on weight of newborn, may need blood sugar checks q 2 hours

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116
Q

When does engagement of the fetus occur in pregnancy

A

2 weeks before birth

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117
Q

Risk factors for CT scan with contrast

A
  • history of asthma
  • positive pregnancy
  • Poor renal function
  • Beta blockers
  • heart, kidney, thyroid disease
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118
Q

What is always an intervention when puncturing the spine

A

need fluids

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119
Q

What other treatment options are there for an Afib clinet that does not respond to antiarrhythmics or cardioversion?

A

radiofrequency catheter ablation. After ablation pt will need to take anticoagulatns

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120
Q

What action is benefical to prevent hypercalcemia

A

walking as much as possible keeps the calcium in the bone

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121
Q

What types of food can prevent kidney stones

A

high calcium, dairy products

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122
Q

What is a keyword to consider with a public health nurse

A

groups rather than invidivuals

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123
Q

Hallmark signs of Myasthenia Gravis

A

drooping eye lid, mouth weakness, difficulty chewing, swallowing or taking. Arm or Leg Weakness

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124
Q

Examples of urniraty tract infections

A

cystitis, pyelonephritis

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125
Q

Diagonal communication

A

staff from different levels work together on a project

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126
Q

When does the second stage of labor occur?

A

Complete dilation through birth (30-50 minutes for primipara)

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127
Q

What lab values can indicate pre-eclampsia

A

Magnesium will be low, Creatnine will be high

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128
Q

Symptoms of a Panic episode

A
  • Palpitations
  • Aabdominal distress
  • Nausea
  • Increased persiration
  • Chest pain
129
Q

Causes of myocarditis

A

mononucleuosis, parvovirus (5th disease), HIV

130
Q

What does downward communication mean?

A

used to relate organizationl policy such as position description and rules and regulations

131
Q

What is the main finding of pericardities

A

sharp, stabbing pain in the center or left side of chest.

132
Q

What is the treatment time with a halo vest?

A

12 weeks

133
Q

First Stage of labor Latent Phase

A

lasts 8 hours for primipara, 4-5 hours for multipara

134
Q

Hallmark signs of emphysema

A

carrel chest, chronic cough, SOB, wheezing, Weight loss

135
Q

What is upward communications?

A

staff meetings

136
Q

What is the most serious complication following gastric bypass surgery (bariatric surgery)

A

anastomotic leak. Monitor for back, shoulder, abdominal pain, restlessness, unexplained tachycardia, oliguria. Immediately report to surgeon. Do not manipulate NG tube. Elevate HOB.

137
Q

What should you NOT include in the chart in general

A

incident reports, abbreviations

138
Q

What is an early sign of diminished oxygenation

A

increasing pulse rate, compensatory mechanism.

139
Q

A client is in the third month of her first pregnancy. During the interview, she tells a nurse that she has several sex partners and is unsure of the identity of the baby’s father. Which of these nursing interventions is best at this time?

A

counsel the woman to consent to HIV screening

140
Q

Common findings in mitral valve regurgitation include

A

heart murmurs, SOB, fatigue, Paroxysmal noctural dyspnea

141
Q

What does justice mean?

A

fairness

142
Q

What is the antidote for metformin

A

acetylcestein (24-48 hrs after contrast)

143
Q

Positioning for pregnant woman

A

left side lying, prolasped cord (reverse trendelenburg)

144
Q

What is a common temporary side effect of Pepto Bismol (Bismuth Subsalicylate)

A

dark tint of the tongue

145
Q

What can cause false positive result on fecal occult test

A
  • eating red meat
  • NSAIDS
  • steroid use
  • bleeding gums
146
Q

Labs for a patient with hyperosmolar hyperglycemic nonketotic state?

A

ABGs, CBC with idfferential, urinalaysis, glucose, BUN, electrolytes, chem profile, and creatnine. Rapid infusion of IV fluids

147
Q

What does RACE stand for

A

Rescue clients, Activate fire alarm, Contain fire, Extinguis flames

148
Q

Does an RN have a legal duty to provide Good Samaritan care at a traffic accident?

A

No, not legally required

149
Q

Expected findings with inflammatory bowel disease

A

persistent diarrhea, ab pain, blood mucus in the stools

150
Q

in a psychiatric unit, which client should you see first typically

A

auditory hallucination, make sure they are not telling the lcient o harm self or others

151
Q

When is handwashing a requirement?

A
  • prior to eating
  • after cleaning a wound
  • after contact with inanimate object
  • before having direct contact with a client
  • C.Diff/soiled hands
152
Q

What is the biological response modifier for cancer therapy

A

stimulates bodys defense mecahnism. flu-like sx are common

153
Q

Practice Partnerships

A

partners work together on same schedule with same group of clients

154
Q

When is the safest time to offer analgesia during labor?

A

dilation is between 4-7 cm

155
Q

Charge nurse has received a call from ambulance of a multiple car accident with multiple casualties. What action should nurse take first

A
  • notify supervisor and request additional staff
  • prep the trauma room
156
Q

If a medication ends in these letter, what should you do?

CR, CD, LA, SR, XL, XR, XT

A

Do not crush

157
Q

What happens when medication are administered sub lingually or rectally and metabolism

A

avoids the first pass effect.

158
Q

Smallpox causative agent

A

variola virus

159
Q

What might excessive protein do to a patient with osteoporosis

A

may increase calcium loss in the urine

160
Q

Oral PAIN med admin consideratations

A
  • contraindicated with N/V
  • assess response 1 hour after administration
  • may require additional analgesic
161
Q

how often should trach be cleaned

A

every 4 hours

162
Q

Bubbling in a suction control chamber vs bubbling in water seal chamber?

A

Suction control bubbling is expected

Water seal, indicates air leak

notify HCP if draining is more than 100mL/hr

163
Q

What my an elderly patient with a hearing deficit exhibit

A

suspicious of others, because pt can’t communicate well with other people.

164
Q

What is Kawasaki disease, and what is the demographic?

A

boys younger than 5 and asian descent. Red eyes (conjuctivitis), rash on the body and genital area, strawberry tongue. Red skin on palms of hands. Last 2-12 wks without treatment

165
Q

Fetal Lie

A

the relationship between the head to tailbone axis for both the fetus and the mother

166
Q

In relation to the heart, what direction do arteries go?

A

away from the heart

167
Q

What 4 things does the nurse practice act define?

A

scope of practice, nursing titles, qualification for licensure, actions taken if nurse does not follow the law.

168
Q

What do variable decellerations in a fetus represent

A

prolapsed cord, reposition client, apply oxygen and notify HCP

169
Q

What does veracity mean

A

telling the truth

170
Q

What will a patient experience with placenta previa

A

painless vaginal bleeding (painful bleeding indicated abruptio placenta)

171
Q

what discomforts should be noted for a laparscopy exam

A

carbon dioxide is trapped in the abdomen and may cause shoulder pain

172
Q

to assess for patency in a dialysis fistula or graft, the nurse should..

A
  • auscultate for a bruit and
  • palpate for a thrill (you feel this)
173
Q

What can excessive diarrhea do to ABGs?

What about excessive vomiting?

A

d: lead to metabolic acidosis.
v: metabolic alkalosis

174
Q

What are pre-surgery procedures to ensure safety

A
  • surgical site is marked by the surgeon
  • client is asked to state his/her name and birthdate
  • the client is asked to confrim the correct surgical site
175
Q

What are contraindications for a halo crown

A

skull fractures, chest trauma, obesity and avadanced age

176
Q

What is a good handoff report technique

A
  • Introduction (yourself)
  • Patient name, identifiers,
  • Assessment, chief complaint, Vital signs/sx, Dx
  • Situation (code status, recent changes, response to tx)
  • Safety concerns (lab values, socioeconomic factors, allergies, falls
  • Background (comorbidities, currend meds, family hx
  • Actions (what did you do)
  • Timing (level of urgency and explicit timing, priotixation actions
  • Ownerhip (who is responsible)
  • Next (blocking discharge, plan)
177
Q

What is the rooting reflex

A

touching or stroing cheek beside mouth causes baby to turn head to the side and suck (stops at 3-4 months

178
Q

Where my patient report pain if they have pancreatitis?

A

sharp pain in the epigastric area, above the belly button. Pt might report upper back pain, nurse needs to assess correct location regardless of how the client identifies it verbally.

179
Q

Left sided heart failure signs

A

orthopnea, cough

180
Q

What type of communication technique is best for patient with Wernicke’s Aphasi

A

non verbals, actions, movements, props. Wernicke have no understanding of language. They can speak, but it makes no sense

181
Q

What drug should not be given with Lithium

A

diuretics (furosemide)

additional side effects include polyuria, polydipsia

182
Q

What are early findings of shock?

A

Increase RR, Inc HR, Oxygen is the most critical intervention

183
Q

When does a pregnant women need to increase insulin dosage

A

during first 3 months of pregnancy

184
Q

If you notice a mass in the umbilica area, which assessment should you NOT perform?

A

palpate/percuss b/c risk of rupture. Auscultate, bruit would confirm an aneurysm

185
Q

How do you protect against extravasation in vesicant drugs for cancer?

A

aspirate positive blood return prior to use

186
Q
A
187
Q

early sign of diabetic nephropathy

A

albumin in the urine

188
Q

How can you tell a patient is taking lithium

A

shaky hands

189
Q

Why might a patient be asked to bear down during a central venous catheter insertion?

A

IV pressure must exceed astmospheric pressure to prevent air from entering the catheter and traveling to the heart and lungs

190
Q

What solution should be used to clean around the pins in skeletal traction?

A

saline or sterile water (not alcohol or iodine which can cause corrosion)

191
Q

Why does a client lie in prone position prior to amputation

A

stretch hip flexor muscles.

192
Q

Signs of True Labor

A
  • contractions regular pace,
  • continue despite change of position
  • start in the lower back and move to the front of the abdomen
  • effacement and dilation
193
Q

When is an electronic blood pressure machine contraindicated?

A

irregular HR, peripheral vascular disease, seizure, tremors, and shivering

194
Q

When is it NOT the time to have client Turn Cough and Deep Breathe

A

immediately after srugery

195
Q

Signs of False Labor

A
  • Irregular contractions
  • Diminish with activity
  • Contractions get weaker
  • Felt in the front of the abdomen or pelvic region
  • membranes in tact, no cervical changes
196
Q

What is a contraindication for receiving influenza vaccine

A

allergy to egg proteins b/c grown on egg embryos

197
Q

A harrington rod is used for scoliosis, what do you want to assess

A

neuro checks b/c of spine

198
Q

If nurse makes a medication error, what are the appropriate actions to take?

A
  • Monitor vital signs
  • notify HCP
  • Document the administration
  • Notify nurse manager
199
Q

What is the consequence if a nurse attempts to resuscitate a client with a DNR

A

committing battery

200
Q

S1 Auscultation

A
  • closing of the mitral valve.
  • heard best at apex
  • after long diastolic pause, before short systolic pause
201
Q

What is the biggest concern with first time dosing effect

A

orthostatic hypotension

202
Q

Steps to using a peak flow meter

A
  1. move the indicator to the bottom of the numbered scale
  2. stand up
  3. take deep breath
  4. place in mouth and close lis around it
  5. blow out hard and fast
  6. record number achieved on the indicator
  7. Repeat 2x more (3 attempts
203
Q

What is important to know for all anti-infective drugs

A

decrease effectiveness of oral contraceptives

204
Q

When are hemovac or jackson pratt’s removed after total kneww surgery

A

the morning after

205
Q

If client wishes to die, who should be the one to report that to the family

A

the client, not the nurse. encourage pt to discuss with HCP and family.

206
Q

If a toddler does not want to take medication, what is the correct method or intervention to take?

A

leave the room and return five minutes later and give the medicine. Nurse must comply with child’s choise to build trust. Toddlers to not have an accurate sense of time.

207
Q

What does a cisternography assess

A

ciculation of cerbrospinal fluid within the skull or subarachnoid spaces

208
Q

What does crepitus mean?

A

air in sub q space (usually due to pneumothorax)

209
Q

How much water must pt drink prior to ultrasound of urinary bladder

A

32 ounces

210
Q

Nursing considerattions with Vincristin (Oncovin)

A
  • Used for ALL (Acute Lymphocytic Leukemia)
  • IV use only
  • Intrathetcal admin can be fatal
  • Vesicant can cause local damage if extravasation occurs
    • Tx includes warm compresses
  • Peripheral neuropathy is a major side effect
  • monitor for decreased hepatic functining b/c gets metabolized in the liver
211
Q

What is the extrusion reflex

A

touch or depress the tongue and it is forced outward. Stops by 4 months of age

212
Q
A
213
Q

Acronym OLD Cart for Pain scale

A
  • Onset
  • Location
  • Duration
  • Characteristics
  • Attributes
  • Related findings
  • therapy and timing
214
Q

GI infections

A

staph food poisoning, botulism

215
Q

What is the pathogen of peptic ulcer disease

A

heliobacter pylori

216
Q

How do you relieve flatus from a patient with an ostomy pouch

A

open the bottom of the pouch in privacy will cause odor.

217
Q
A
218
Q

Client with Irritable Bowel Syndrome is having problems with fiber, what should you do

A
  • increase fiber gradually 2 - 3 mg per day, help to reduce gas and bloating
  • Dairy products can contribute to gas formation
  • small frequent meals to reduce gas

goal is to reduce gas and bloating

219
Q

How might restrains without consent or sufficient justification be interpreted?

A

false imprisonment

220
Q

what does an elevated d-dimer test indicate following aprution of placenta

A

concern for DIC. Notify HCP right away.

221
Q

Where can you find standard of care?

A

institutional policy and procedure documents

222
Q

Can CNAs collect urin specimens

A

yes

223
Q

What is the most common and life threatening metabolic complication of renal failure?

A

hyperkalemia

224
Q

Hallmark Signs of Tensions Pneumothoraz

A

chest pain, muffled heart/lung sounds. medistinal shift, respiratory distress.

225
Q

Findings of Endocarditis

A
  • Red spots on palms/soles (Janeway lesions)
  • Red painful sores on fingetips and tes (Osler’s Nodes)
  • fever, night sweats muscle aches.
226
Q

Causes of Pericardities

A

infection, heart attack, injury to the chest esophagus or heart (MI)

227
Q

Guthrie Bacterial Inhibition test (PKU)

A
  • Can be done after 6 weeks of age
  • Mandatory in the U.S.
  • identifies an inherited disease
  • Best results occur after baby has been breast feeding or drinking formula for 2 full days
  • Test is delays if baby is less than 5 lbs
  • positive test require dietary control for prevention of brain damage
228
Q

Russells sign is observed with this disorder

A

bulimia nervosa

will have scraped or raw areas on the knuckles.

229
Q

When you see the word thrombophlebitis, what should you think

A

embolism DVT/VTE

230
Q

Actions for nurse to take after administration of restraints

A
  • explain rationale for restraints
  • tie using quick release
  • thorough assessment
  • document which alternative interventions were attempted
231
Q

Why is pain med a priority for MI

A

pain wil increase oxygen demand

232
Q

How do you reduce risk of lead contamination in tap water

A

let water run for 2 minutes

233
Q

What is the first sign of worsening asthma

A

a fall in peak flow rates. Feeling tired, sneezing, stomach ache, poor appeptite, night time cough.

234
Q

What indicates child has swallowed something corrosive

A

irritation of tissues. Mout would be burning and throat pain.

235
Q

Which organ is most susceptible to damage during a hypertensive crisis

A

the brain due to rupture of cerebral blood vessels. Monitor neuro.

236
Q

5Ps Factors affecting Pregnancy

A
  • Passageway bony pelvis, soft tissues
  • Passenger (fetus)
  • Power (uterine contractions, bearing down)
  • Position of laboring woman
  • Psyche of birth
237
Q

How do you know if IV pump is not functioning

A

calculate how much is left, more than expected amount would be left in the container

238
Q

Fire Rescue plan, what does PRC stand for

A

Protect clients, Report the Fire, Contain the Fire

239
Q

Normal therapeutic range for PTT

A

1.5-2 times normal

Normal: 20-25

Upper: 32-39

240
Q

What is the safe action for removing an NG tube

A

ask the client to hold breath until tube is completely out. Closes the epiglottis and helps prevent aspiration. When inserting it is easier of the pt swallows.

241
Q

What is a sign and risk when infant is receiving ventriculoperiotneal shunt?

A

ICP, sign is irritability, bulging fontanel, high pitched cry, continual crying when held.. Variable pulse. Slow respirations

242
Q

What is the normal range for prothrombin time?

What is the normal range for Warfarin

A

10-14 seconds

20-28 seconds

243
Q

Name an example of a hypotonic solution

A

0.45% sodium chloride

244
Q

pregnancy and type 1 insulin requirements

A

increase during pregnancy and decrease after delivery

245
Q
A
246
Q

What intervention is crucial for pt with NG tube

A

frewuent oral care (ice chips/mints could be contradindicated)

247
Q

Priorities if a patient has fallen out of bed

A
  1. Obtain Vital Signs
  2. Assist client back to bed (if does not appear injured)
  3. Call HCP to report Incident
  4. Incident Report
248
Q

What is the first principle of safe assignments?

A

match skills with the task. New nurses should not be assigned task for which they are not competent

249
Q

What is Most important to note while a patient is having a seizure

A

observe the sequence and types of movements

250
Q

What does the nurse challenge rule refer to?

A

assertively voice concerns at least 2 times to ensure that it has been heard. If not heard contact supervisor or the attending physician.

251
Q

What form of medication is best for a client on suicide precautions

A

liquid

252
Q

Positive Signs of pregnancy

A
  • presence of fetus
  • fetal heart tones, visualization of fetus, plpating fetal movements
253
Q

What is Total Lymphocyte count used for?

A

to assess immune function and is below 1500 when pt is malnourished (protein)

254
Q

What is raynaud’s phenonemon

A

cold temperatures or strong emotions cause blood vessel spasms. Block blood flow to fingers, toes, ears and nose

255
Q

What fluid and electrolyte imbalance happens with vomiting?

A

loss of acid in the stomach. Metabolic Alkalosis

256
Q

Who should nurse manager consult with regarding bad behavior by a nurse?

A

human resources to determine procedures for documenting and reporting behavior

257
Q

Symptoms of Cardiogenic shock

A

oliguria, jugular vein distention, crackles in bilateral bases, pitting sacral edema, weight gain

258
Q

When doing an abdominal assessment, what quardant do you start in?

A

Right Lower Quadrant

259
Q

What can cause mitral valve regurgitation

A

any disease or porblem that weakens the valve or heart tissue.

260
Q

What should be done if a physician yells at a nurse in front of a client

A

nurse manager should request an immediate private meeting with HCP and staff nurse

261
Q

Broca’s Area affects expressive aphasia or receptive aphasia?

A

Expressive Aphasia

262
Q

What is lateral communication

A

between staff members i.e. coordinate activities

263
Q

precautions with a fistula

A

never take blood pressure or draw blood from arm with fistula

264
Q

Primary clients for C. Difficile

A

hospitalized, receiving antibiotic therapy- Ampicillin, amoxicillin and cephalosporins (Cephalexin)

265
Q

Acute bacterial, viral gastroenteritis infections

A

salmonella, gastroentereitis, viral hepatitis, C. difficile

266
Q

Normal Newborn Blood Pressure

A

50-75

267
Q

What do you do if outer cannula of trach gets expelled?

A

ventilate the chest using a manual resuscitation bag

268
Q

First Stage of Labor Active Phase

A

lasta 4 hours for primipara, discuss regional anasthesia

269
Q

Malabsorption syndrome and Wernicke-Korsakoff syndrome are associated with which disorder

A

Chronic Alcoholism

malabsorb fat, nitrogen, sodium, water, thiamine, folic acid and vitamin b12. Wernicke’s is caused by a lack of thiamine.

270
Q

Complications with cold stress

A

metabolic acidosis, hypoglycemia, reduced partial pressure of oxygen in arterial blood

271
Q

If pt is experiencing chest pain and nausea and dizziness what lab values should you request

A

CBC, Cardiac Enzymes. R/t MI or Angina

272
Q

How long before anginal client can resume sexual activity

A

1 week

273
Q

If the dose of med exceeds 1 ml For infants receiving an IM injection. How should it be administered?

A

2 separate doses

274
Q

Naegeles Rule for confirmng pregnancy date

A

first day of last period + 7 days - 3 months + 1 year

Example: June 10th is first day of last period = March 17 due date

275
Q

Priority action for client with hypovolemia

A
  1. increase IV rate
  2. elevate lower extremities
  3. assess surgical dressing for bleeding
  4. reassess vital signs
276
Q

What is the casative agent for the plague

A

yersinia pestis. Deteriorating pneumonia, fever, chest pain, bloody or watery sputum.

277
Q

What should clients expect after transurethral resection of the prostate

A

3 way indwelling has a large diamtere, will continuously feel the urge to void for 24-48 hours

278
Q

Fetal Presentation

A

portion of the fetus that enters the pelvic inlet first (cephalic, breech, shoulder)

279
Q

What is the common cause of old age related drug absorption

A

decrease in lean body mass and increase in body fat.

280
Q

Chancres, flu-like symptoms, hair loss, palmar rash signs of

A

syphyillis

281
Q

Gout Diet

A

low purine. Organ meats, anchovies, mushrooms, spinach, dried beans, peas.

282
Q

IM pain med administration consideration

A
  • assess for response to therapy 30 minutes after admin
  • avoid with hypothermia and vasoconstriction
283
Q

Normal Newborn Respiration

A

30-60

284
Q

What is a risk when the membranes rupture

A

increased risk fo cord prolaspe if head is at a minus level

285
Q

Sucking Reflex

A

slowly relaced by voluntary sucking by 2 months of age.

286
Q

Hallmark Signs of Severe Acute Respiratory Distress Syndrome

A

cough, difficulty breathing, fatigue, fever > 100.4, headache, myalgia.

287
Q

S2 Auscultation

A
  • closing of the aortic valve
  • after short systolic pause, before long diastolic pause
  • heard best over aorta, secon right interspace
  • high pitched dull in quality
288
Q

Newborn Apical Heart Rate Normal

A

110-160

289
Q

What is the best technique for improving patient outcomes

A

involve the client in making healthcare decisions. More motivated to adhere to recommendations when involved in the process

290
Q

Most common areas affected by scabies

A

hands and feet

291
Q

Typical symptoms of a client with Hyperosmolar Nonketotic State

A
  • blood glucose above 600 mg/dL
  • profound dehydration
  • No ketones
  • alkalosis
292
Q

What happens to nitrogen balance in burns, infections, injuries, fever or starvation

A

negative nitrogen balance. Protein is the body’s only source of nitrogen. Must be balanced by excretion of urea wastes.

293
Q

How is Hep A transmitted

A

fecal oral route, or someone w/ virus hands food without washing hands. Or drinking contaminated water, eating raw shellfish from polluted water

294
Q

What is the only fuel source that neurons cannot store

A

glucose. Only fuel used by brain cells

295
Q

Other than hypertension and mental health. What can beta blockers be used for?

A

essential tremors

296
Q

Infectious Diseaseas that are droplet

A

rubella, meningitis

297
Q

Prioriy procedures for patient with pneumonia and sepsis

A
  1. Oxygen administration
  2. Blood & Sputum (prior to admin of antibx)
  3. IV initiation of normal saline
  4. Administer antibiotics
  5. Fingerstick before each meal
298
Q

What are signs of Wilms tumor in an 2 year old?

A

urinary output less. Malignant tumor of the kidney. Increase girth

299
Q

Airborne precaution PPE

A

Mask, N95 Mask

300
Q

Common reasons older adults get readmitted to the hospital

A
  • inadequate primary care
  • poor care coordination
  • poo skilled nursing facility
  • poor communication among providers
  • family preferences
301
Q

What is the term when a nurse causes unintended harm to a patient?

A

Negligence

302
Q

he client is informed that the ultrasound suggests the baby is small for gestational age (SGA). An earlier ultrasound indicated normal growth. What causes this change?

A

maternal hypertension. Common cause of late pregnancy fetal growth restriction. Vasoconstriction reduces placental exchange of oxygen and nutrients.

303
Q

General Guide for serving size for children

A

one tables spoon per year of age.

304
Q

a disease that causes inflammation and sores (ulcers) in the lining of the rectum and colon (large intestine)

A

Ulcerative colitis

305
Q

What is the appropriate dressing for a stage II pressure ulcer

A

Hydrocolloid or foam dressing (duoderm). Eliminate answer choices that have the word “dry” in them

306
Q

What is wander band used for

A

a sensor bracelet allows patients to roam around (dementia pt) trips an alarm system if they decide to leave.

307
Q

How many wet diapers per day for infants and newborns?

A

6-8 wet diapers

308
Q

Primary Nursing

A
  • Primary nurse designs, implements and is accountable for nursing care of clients during entire stay on the unit
  • continuity of care, not feasible with varying schedules
  • greater nurse satisfaction, more personalized care, less turn over
  • fewer negative outcomes for patients
309
Q

What does coconut oil contain

A

caprylic acid, no scientfici evidence says it is safe and effective for cognitivie decline

310
Q

right sided hf signs

A

anorexia, nausea, ab discomfort, peripheral edema

311
Q

Abnormal vital sigs and taking fish oil garlic and naproxen

A

all thos medication increase risk for bleeding. check color of bowel, bruising, frequency of medication use

312
Q

What is the priority action prior to getting a sputum sample

A

oral hygiene without the use of mouthwash (alchol can alter the spututm . Then pt should take deep breaths and cough

313
Q

Requirements for 24 hr urine sampling

A
  • container must be kept cool
  • can help doctor confirm a diagnosis r/t kidneys
  • how much creatnine clears thru kidneys
314
Q

What is charcot’s join

A

degenerative condition. Joint instability, and hpermobility. Along with numbness and tingling. Tx includes casting for 12 weeks. No weight bearing acivity

315
Q

10 year old cognitive capabilities

A

able to think logically in the organization of facts

316
Q

How is metformin used for Type 2 Diabetes

A

it lowers the amount of glucose absorbed from food, lowers the amount of glucose produced by the liver and increases body’s response to insulin

317
Q

Actions to take with sudden drop in BP and pulse

A
  1. Simultanously check apical and radial pulse manually
  2. Assess for chest pain, dyspnea, low oxygen sat, restlessness
  3. nofity HCP
  4. anticipate EKG, oxygen admin, and mergency pacing
318
Q

Presumptive Signs of Pregnancy

A

subjective/objective reported by women

amenorrhea, fatigue, N/V, breast changes, elevation of basal body temperature, skin changes.

findings can be caused by conditions other than pregancy

319
Q

What is most valuable tool for school aged children and physical assessment

A

weight and heigh compared to standard tables

NCLEX Review (4 decks)

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