random things to know for the NCLEX

papule

A papule is a firm, inflammatory, raised lesion that's as long as 1/4″ in diameter and that may be pigmented or the same color as the client's skin — for example, acne papule and lichen planus.

plaque

A plaque is a circumscribed, solid, elevated lesion that's more than 3/8″, in diameter — for example, psoriasis

pustule

A pustule is a raised, circumscribed lesion that's usually less than 3/8″ in diameter and contains purulent material that gives it a yellow-white color — for example, acne pustule and impetigo.

A client arrives at the emergency department complaining of extreme muscle weakness after minimal effort. The physician suspects myasthenia gravis. Which drug will be used to test for this disease?

Edrophonium Edrophonium temporarily blocks the breakdown of acetylcholine, thus increasing acetylcholine level in the blood, and relieves weakness. Because of its short duration of action, edrophonium is the drug of choice for diagnosing myasthenia gravis. It's also used to differentiate myasthenia gravis from cholinergic toxicity. Ambenonium is used as an antimyasthenic. Pyridostigmine serves primarily as an adjunct in treating severe anticholinergic toxicity; it's also an antiglaucoma agent and a miotic. Carbachol reduces intraocular pressure during ophthalmologic procedures; topical carbachol is used to treat open-angle and closed-angle glaucoma.

Which of the following statements indicates that a client understands the need for routine screening to detect colorectal cancer?

The American Cancer Society (Canadian Cancer Society and Health Canada) recommends an annual digital examination after age 40 for the purpose of detecting colorectal cancer. The CEA test is performed on clients who have already been treated for colorectal cancer. It helps monitor a client's response to treatment as well as detect metastasis or recurrence. Proctosigmoidoscopy is recommended every 3 to 5 years for people older than age 50. A barium enema is not a screening test.

A nurse is palpating the fundal height of a pregnant woman at 40 weeks of gestation. Identify the area on the abdomen where the nurse would expect to feel the uterine fundus.

Uterine height is measured from the top of the maternal symphysis pubis to the top of the uterine fundus. By the 36th week, the uterine fundus would touch the xiphoid process. About 2 weeks before term (the 38th week), the fetal head settles into the pelvis to prepare for birth and the uterus returns to the height it was at 36 weeks.

A client in the postanesthesia care unit is being actively rewarmed with an external warming device. How often should the nurse monitor the client's body temperature?

every 15 mins In order to prevent burns, the nurse should assess the client's temperature every 15 minutes when using an external warming device.

A client with a large goiter is scheduled for a subtotal thyroidectomy to treat thyrotoxicosis. Saturated solution of potassium iodide (SSKI) is prescribed preoperatively for the client. The expected outcome of using this drug is that it helps:

reduce the vascularity of the thyroid gland. SSKI is frequently administered before a thyroidectomy because it helps decrease the vascularity of the thyroid gland. A highly vascular thyroid gland is very friable, a condition that presents a hazard during surgery. Preparation of the client for surgery includes depleting the gland of thyroid hormone and decreasing vascularity. SSKI does not decrease the progression of exophthalmos, and it does not decrease the body's ability to store thyroxine or increase the body's ability to excrete thyroxine.

vesicle

vesicles are raised, round, serous-filled lesions that are usually less than 1 cm in diameter. Examples of vesicles include chickenpox (varicella) and shingles (herpes zoster).

A client taking tranylcypromine sulfate for depression was treated in the emergency department for a headache, vomiting, and blood pressure of 190/100 mm/Hg following dinner at a restaurant. At discharge, the nurse evaluated the client's understanding of diet instructions. For what menu choice will the nurse provide further education?

When taking an MAO inhibitor, the client should avoid consuming high-tyramine foods, such as aged cheese, avocados, delicatessen meats (especially sausage), Chianti, anchovies, and fermented foods such as bean curd, pickled herring, and sauerkraut. These foods interact with the medication to cause a life-threatening hypertensive crisis. Therefore, a client who reports eating these foods requires additional teaching. The client may safely consume low-tyramine foods, such as poultry, whole grain bread, and fresh fish. Coffee, cottage cheese, cream cheese, spinach, tomatoes, and white wine are allowed in moderation.