Mark Klimek NCLEX Review 2

Pt med question: take each option and ask "if I didn't do this what's worse that could happen" choose the ____ outcome. Ex: which is highest priority for suicidal pt? Give tranquilizer, orientate to unit, put on suicide precautions, introduce to staff. If no suicide precautions they could die so best answer.

...

QRST: ventricular _____

...

Regular insulin: big "R" on bottle. Onset ____ hour, peak 2 hrs, duration 4 hrs. Its _____ so its a solution, can IV drip. Rapid short acting. R-rapid and ____ (in IV)

1, clear, run

DKA: high glucose. In type ___ diabetic. Diabetic coma can occur. Causes: too much ____, not enough exercise, not enough medication

1, food

Things always unstable regardless of whether its expected or not: hemorrhage, high fevers over ____, hypoglycemia, pulselessness or ____

105, breathlessness

Low fetal heart rate: below ___ do LION- this is bad. High fetal heart rate: above ____- not bad, monitor it and take moms temp, probably has ____

110, 160, fever

Unstable: acute illness, post op less than ___ hrs, general anesthesia, Newly ____- less than 24 hrs ago newly diagnosed, ____ assessment

12, admitted, changed

Rules for prioritization: ACUTE BEATS CHRONIC. Fresh post op- up to ___ hrs after beats medical or other surgical. 2 hr post op ___. UNSTABLE BEATS STABLE.

12, highest

Thyroidectomy post op: first ___ hrs top priority is airway, second is hemorrhage. 12-48 hrs after: totals can get ____ (larangeal) due to low calcium. Sub totals (partial): can get ____.

12, tetany, storms

Lispro and Humalog insulin: FAST ACTING. Onset ___ min, peaks 30 mins, duration 3 hrs. Give with ____.

15, meals

Hemoglobin: 12-____. If its 8-11 its low priority. If below 8 its ____ priority- assess for bleeding

18, high

Lithium: 0.6-1.2. ____ is toxic. Lanoxin (digoxin): treats A fib and congestive HF, range ____-2, toxic level is 2.

2, 1

Labor: Recovery (4th stage): first ___ hrs after placenta delivered. 4 things every 4 hrs in 4th stage: Vitals (look for signs of shock), Check fundus, Check ____, and Roll (to check bleeding under)

2, roll

Ph: 7.35-7.45. Bicarb (HCO3): ____-28. PACO2: 35-____

22, 45

Grave disease (hyperthyroidism): radioactive iodine- pt by themselves for ___ hrs, careful with urine (if spill call hazmat). PTU- "puts thyroid under", S/e: _____.

24, immunosuppresion

Stable: ready for discharge, admitted longer than ___ hrs ago, unchanged assessment, chronic illness, post op ___ than 12 hrs, local or regional anesthesia

24, longer

Pregnancy weight gain: total- ___ pounds, plus or minus 3. ___ trimester: 1 lb a month- 3 months so gain 3 lbs. 2nd and third trimester: 1 lb a ___

28, first, week

Heart sounds: Aortic- 2nd intercoastal space, right side, Pulmonic- ____ intercoastal space on left side, Tricuspid- 4th intercoastal space, Mitral (apical)- ____ intercoastal space, left side

2nd, 5th

Labor: Active phase: dilate 5-7 cm, every ___-5 min, lasts ____-60 sec. *Memorize this phase only, anything less=latent, anything more= transition.

3, 30

Heparin: works immediatly, cannot be given for longer than ___ weeks (except lovenox). Antidote- protamine sulfate. Lab test- ___. Can be given to ____ women.

3, PTT, pregnant

Creatinine: 0.6-1.2, not a priority. INR: coumadin level, 2-____. 4 or less is high priority. Hold med, ____ pt, prepare to give (antidote-vit k), then ____ doctor

3, assess, call

Insulin: peak= when pt can get hypoglycemia. Check expiration dates. Minute its opened expiration date is ____ days after- write on bottle when opened and date or when _____

30, expired

Pregnancy: urinary incontinence- 1st and ____ trimester, Not 2nd because the baby is up ___ of bladder. Need to void every ___ hrs

3rd, high, 2

No small toys for children under ___ yrs old. No metal (diecast) toys if O2 is in use- can spark. Stuffed animals harbor ____- non living object that harbors bacteria

4, fomites

Bicarb: 22-26. Not a priority. Co2: 35-____. In 50's= high priority- have pt do pursed ____ breathing (gets rid of Co2) In ____= highest priority- respiratory failure, prepare to intubate and ventilate.

45, lip, 60's

Sub Q: "S" looks like a "5" so pick answer with two ___'s in it. Ex: 25 guage 5/8 inch. Heparin: given ___ or sub q. Coumadin: given PO ONLY.

5, IV

WBC: total wbc 5,000- 11,000. ANC (absolute neurophil count): needs to be above ___. CD4: needs to be above ___- if below= AIDS, if above = ____. All WBC labs below levels= high priority

500, 200, HIV

Hematocrit: 36-____. Is hemoglobin x3, Ex: 12x3=36, 18x3=54. High= low priority, monitor pt for ____.

54, dehydration

Potassium: 3.5-5. Low or high potassium is high priority but if it get to ___ or more its highest priority

6

Whenever you don't know how long something restricted pick ____ weeks. Lamenectomy with fusion: bone ___ from ileac crest.

6, graft

PVC: more than ___ pvc's per minute or more than 6 PVC's in a row or if the PVC falls on the T wave of the ____ beat= change priority from low to _____ priority

6, previous, moderate

Never pick infection before ____ hrs post op, as an answer. Deonate = long acting.

72

Po2: ____-100. In 70's= high priority, assess respirations, give o2. When hypoxic heart rate goes up ___ then when heart can no longer compensate respiratory rate goes up. In 60's= highest priority- respiratory ____

78, first, failure

NPH insulin: intermediate acting. Onset 6 hrs, peak ____ to 10 hrs, duration 12 hrs. Cloudy so its a _____, No IV drip. N= not fast acting and not hung (in IV)

8, suspension

Calculate ideal pregnancy weight gain: take week of gestation and subtract ___. Fundal height: NOT _____ until week 12. At umbilicus at ___-22 weeks

9, palpable, 20

Platelets: below ____= high priority. Below 40,000= highest priority. RBC's: 4-___ million. Abnormal= low priority

90,000, 6

Diabetes long term complications: Poor tissue ____ and peripheral neuropathy. Ex: eye damage, hurting ____ because can't feel pain, gang green

perfusion, self

Pre-op bowel surgery: give aminoglycoside _____ route to sterilize the bowel. PO kills bacteria in gut and doesn't get _____, or hurt liver. "Who can sterilize my bowels?" "Neo Can!" ______ and canimycin.

po, absorbed, Neomycin

QRST: ventricular _____. P wave = atrial. A lack of QRS segment= _____. Bizzar in question= tachycardia.

polarization, astystole

Acidosis: Ph goes down: everything goes down except ____ goes up. Hyporeflexia, lethergy, _____, etc. "As Ph goes down so goes my pt" Respiratory ____ can occur

potassium, bradycardia, arrest

Piaget: 12-15 yrs old: formal operations. ____ thinking, teach like an ____. They can manage care.

Abstract, adult

Lamenectomy: removal of spinous ____ of vertebrae. To relieve nerve root ____. S/s: pain, prastesias, paresis- muscle weakness. Location in any neuro problem will determine symptoms and ____

processes, compression, treatment

Toddlers 1-3 yrs old: push ____ toys. Gross motor skills- running, walking. No finger dexterity objects ie ____, scissors. Parallel play: play along side not with

pull, pencils

IN OB: check fetal heart ____ is answer that always wins. Delivery (stage 2): Goes alphabetical order- head, then ____, then nose. Then check for nuchal ___, deliver shoulders, then body

rate, mouth, cord

Can't learn reality: 1st acknowledge feelings, 2nd _____. Dementia: you can do reality orientation, ______ do PRESENTING REALITY.

re-direction, CANNOT

Non-psychotic: insight is ____ based, need good therapeutic communication, recognize their problem. Psychotic: no insight, don't think they have a ____, not reality based

reality, problem

Benzodiazepines: "zeps" Indications: mild tranquilizers, post- op to ____ so much anesthesia, muscle relaxer, ____ withdrawal, seizures, help people relax when fighting ____. Side effects: ABCD (see phenothiazines)

reduce, alcohol, ventilator

Wernicke's encephalopathy and Korsakoff's (psychosis) usually together, induced by vit _____ or thyamin deficiency. Extreme psychotic symptoms. Go _____, amnesia, confabulation. Usually permanent. Can't learn _____

B1, insane, reality

Methergine: causes high ___. Mag- "magnum ____ shot lowers bp" Meth- "methamphetamine raises BP"

BP, 45

Aneurysm: monitor ____- hypertension could cause it to enlarge or rupture

Bp

Truest, most positive sign of labor: the onset of _____ progressive contractions. Effacement: thinning of cervix, up to ____%. Station: fetal presenting part in relation to ischial ____

regular, 100, spines

Humulin 70 D30: 70% N, 30% ____. Top # Numerator- N (NPH) 70/30. Drawing up insulin: want to be RN= regular first then ____.

regular, NPH

DKA: treatment- regular insulin, IV. #1 cause: acute viral upper ____ infections within the last 2 weeks. After recovery they start going ____.

respiratory, downhill

Post op lamenectomy: log ___. any spinal cord injury pick log roll as an answer. Do not let ___ dangle. Do not let sit for longer than ____ min. May walk, stand, and lie down ____ restrictions

roll, feet, 30, without

Contact precautions: Private room or cohart- same disease same ____. Gloves, ____, handwashing, dedicated equipment, disposable ____.

room, gown, supplies

General guessing: rule out absolutes. If two answers say the ____ thing neither one is right. If two answers are ____, one of them is probably right.

same, opposite

Newborn complications: ____ succidana "CS= crosses suture" Cephalo hematoma doesn't ____ sutures. Physiologic jaundice appears after ___ hrs

Caput, cross, 24

Dilantin (phenytoin) for _____. Range: 10-20, 20 is toxic. Billirubin: newborn- range 10-20 and ____ is toxic. Level 10 or above need to come to hospital. Billirubin in _____- kernicterus.

seizures, 20, brain

Crutch gaits: 4 point- move everything _____. Swing through- for non- _____ bearing. "even for even, odd for odd" Use even numbered when have an even number of ____ messed up

separately, weight, legs

Postpartum: lochia- "real slimey accumulation" R- rubra, red color. S- ____- "rosa- rosey cheecks", pink. A- alba, (albino) ____ color

serosa, white

Draw trough 30 min before next ____. Draw peak: sublingual 5-10 min after drugs is _____. IV 15-30 min after drug is finished. IM 30-____ min

Dose, dissolved, 60

Lamenectomy discharge teaching: do not ___ longer than 30 min. Lie flat or log roll. No _____ or lifting more than 5 lbs all of these for ___ weeks.

sit, driving, 6

Potassium imbalance treatment: Kayexalate: is full of ____ (if high sodium, potassium goes down) lasts longer but takes longer to achieve effects. "K exits late" D5W, Regular insulin: "K enters ____"

sodium, early

Goodell sign: cervical ____. Hegar sign: ____ softening. During pregnancy Hemoglobin will fall- thats ____. Morning sickness: dry carbohydrates before get out of ___.

softening, uterine, normal, bed

9-12 months old: ____ toys are best, purposeful activity. Never pick answers with these words before 9 months old: ____, sort, stack, make, construct.

speaking, build

Pharmacology: if you have no clue what the drug even is: If its po pick ____ side effect. Never tell children meds are ____.

GI, candy

Addison's treatment: _____ (glucocorticoids), end in "sone". Need to "add a son (sone)"

steroids

Hiatal hernia: regurgitation of acid into esophagus, upper part of ____ herniates into diaphragm. Dumping syndrome: gastric contents dump ____ quickly into duodenum

stomach, too

When alcohol pts ____ drinking alcohol within 24 hrs= withdrawal symptoms. Within ____ hrs= delirium tremors. Alcohol withdrawal syndrome- not life threatening. Not dangerous. Regular diet, up ad lib, no _____

stop, 72, restaints

In an OB crisis if pitocin is running ____ it. Do not give pain meds to woman in labor if baby is likely to be ____ when the med peaks

stop, born

Sub total thyroidectomy: thyroid ____. S/s: temp 105 and above, extremely high ____, severe tachycardias, psychotic delerium, _____- can cause brain damage

storm, BP, hypoxia

Calcium channel blockers: s/e- headache, _____. End in "dipine" "Dipping into the calcium ____. Also varapamil and cardizim. Monitor bp- if systolic is under ____ don't give.

Hypotension, channel, 100

Aminoglycosides: Give IM and ____, Not oral. Doesn't absorb! Hepatic encephalopathy- give oral aminoglycosides since it kills ____ in gut and reduces amonia levels- won't hurt ____ since it doesn't absorb.

IV, bacteria, liver

Potassium imbalance treatment: never push potassium ____. Not more than 40 K. Give D5W with regular ____, quick fix- drives potassium into the ____ out of the blood. Also kayexalate (mouth or rectum)

IV, insulin, cell

Do Not delegate these to LPN: starting an ___, hanging or mixing IV meds. IV ____ meds, administer blood or mess with central lines, No care planning, perform or develop ____ (can re-inforce), take care of unstable pts, can't do the ___ of anything.

IV, push, teaching, first

Inappropriate behavior from staff: are they doing anything illegal? if yes- tell ____. Is anyone in physical or psychological harm? if yes- ____ and take over. Is this legal, not harmful but simply inappropriate? if yes- talk later on with them. Never choose ____ it

supervisor, confront, ignore

Low fetal baseline variability: fetal heart rate stays the same- BAD, do ____. High baseline variability: fetal heart rate always ____- not bad

LION, changing

Med surge: first thing you assess- _____. First thing you do- establish an _____.

LOC, airway

Hypercalcemia: bradycardia, constipation, decreased ____, flaccid muscles +1 reflexes, bradypnea. Hypocalcemia: +3 +4 reflexes, tachycardia, ____, hyperactive, Chevosteck and trousseaus sign

LOC, diarrhea

Organ locations: liver- RUQ, gall bladder- RUQ, Spleen- ____, pancreas- LUQ, Appendix- ____

LUQ, RLQ

Ideas of reference: think people are ____ about them.

talking

HHNS: high glucose in type 2 diabetic. ___- ketonic. Symptom: ____.

Non, dehydration

Congenital heart defects: Trouble defects start with "T". No trouble: _____ life expectancy, can go home, etc. All congenital heart defects have a ____ whether trouble or not. Get echocardiograms.

Normal, murmur

Non reactive non stress test is ____ good. Reactive= reassuring

Not

Insulin: injecting air: into N first then ___ (drawing up is opposite-RN) Injections: "I" looks like a 1 (one) so pick answer that has ___ 1's. Ex: 21 gauge 1 inch ( has two ones)

R, two

Kalemias: do the _____ except for the heart rate and urine output. Hyperkalemia s/s: irritability, hyperactive, loud, aggitated, ____ heart rate, elevated ST, diarrhea, spasticity +3 +4 ____, low urine output

SAME, low, reflexes

Zapines: new major _____. Zoloft (sertraline): ____. Do not take St Johns ___ with this- can cause seritonin syndrome. On coumadin with SSRI's- increased ____ Zeps, Zines and Zaps= tranquilizers

SSRI, wort, bleeding

Normal sinus rhythm: p wave before every QRS. Vfib looks like ____ line. V tach- jagged, Sharp peaks, a ____. Saw tooth- A ____

Squiggly, pattern, flutter

Special filter mask for ____, negative air room. Always take PPE off in _____ order- Gloves, goggles, gown, mask. OFF ALPHABETICAL. On in _____ alphabetical for G's but mask is ____- Gown, mask, goggles, gloves (GMGG)

TB, alphebetical, reverse, second

Diabetics: need to eat carbs before exercise. When sick GLUCOSE GOES ____. Need to take insulin even though not ____. Take sips of water to prevent dehydration, stay active as possible

UP, eating

Calcium channel blockers: Are like ____ for your heart. Cardiac _____. Treat: AAA & AAA. Antihypertensives, anti _____, anti atrial arrhythmias.

Valium, depressants, anginas

Calcium channel blockers: Are like ____ for your heart. Cardiac _____. Treat: AAA & AS A. Antihypertensives, anti _____, anti atrial arrhythmias.

Valium, depressants, anginas

HA1C: best test for glucose. Need to be 6 or lower. 8 and ___ out of control. "<7 no ____, 8 see the gate" (of heaven)

above, heaven

Kusmals: "Mac Kusmal" (someones name) MAC= metabolic ______

acidosis

Stages of labor: stage 1: labor, phases- Latent, ____, transition. Stage 2: delivery of ____. Stage 3: delivery of placenta. Stage 4: recovery, lasts ___ hrs

active, baby, 2

Diabetes type 2: treatment: DOA, D- diet, O- oral hypoglycemic A- _____. Diet is most important, _____ restriction- best answer. Need ___ small meals a day.

activity, calorie, 6

Uppers: caffeine, coaine, pcp/lsd, meth, _____. Everything goes up- uphoria, restlessness, hyperreflexia +3, +4, ____, etc. Could arrest and cease. Need _____.

adderall, diarrhea, suction

Atrial: treat with ABCD. Treatment: A- _____ (IV push, FAST) B- beta blockers, C- calcium channel blockers, D- _____ (lanoxin, digoxin) "Adeno-______- calcium- Didge"

adenocard, digoxin, beta

Psych: Don't give or except gifts. Don't give _____ or guarantees in psych. Pick answers that keeps pt ____. Don't pick refer to social services even if appropriate.

advice, talking

Cholozaril (clozapine): for severe schizophrenia. S/e: _____. Geodone: prolongs QT interval and can cause cardiac ____

agranulocytosis, arrest

Antibuse and Revia (disulfiram): when drink ____ makes pt really sick. Onset ____ weeks. No mouthwash, aftershave, extracts, Nyquill etc.

alcohol, 2

ABG's: first thing you ask- Is it lung? Overventilating: ______. Underventilating: acidosis. Ventilation= gas exchange not respiratory ____. Ventilation= ______

alkalosis, rate, SAO2

Chadwick, goodell and hegar signs occur in ____ order. Chadwick sign: cervical color turns blue- from ____.

alphebetical, cyanosis

Benzodiazepines: anti- _____. Mild tranquilizers. "zep" in name. "Zzzzz"= sleep (tranquilized). Ex: diazepam- valium, lorazepam. Works ___ but shouldn't be on for longer than 2-____ weeks

anxiety, quickly, 4

Cervical vertebrae/neuro damage: affects diaphragm and ____. Monitor respirations. Thoracic: monitor cough and ____. Lumbar monitor bladder and ____.

arms, bowels, legs

Ex: pt withdrawing from cocaine: Respirations < 12, difficult to ____, etc. Need ____

arouse, narcan

V fib: you D fib (defibrillation). Asystole treatment: epinephrine first then _____.

atropine

Hallucinations: sensory, most common is ____- voices telling them to hurt self. Illusion: sensory, a referent in reality- something to which a person ____- actually something there

auditory, refers

Tyramine foods: "BAR" B- bananas, A- ____, R- raisins (or dried fruit). Also, aged ____, yogurt, alcohol, ____

avocado, cheese, chocolate

When stuck between two answers go ____ and read question. When you don't know what something is- Re- read question ____ what it is you don't know.

back, without

Hard plastic toys don't harbor ____, easy to clean. 0-6 months old: best toy is a mobile or something ____. 6-9 months: teaching object permanance, best toy- ____ uncover toys. Ex: jack in box, window books

bacteria, soft, cover

Chest tube: intermittent bubbling in suction control is ____, means suction is not high enough in container- turn suction ___. Never clamp a tube longer than ____ seconds without doctor order

bad, up, 15

Preschoolers: finger dexterity and ____. Cooperative play, ____ play. School age: 3 C's- creative (legos), _____, competitive (don't like losing). Adolescents: _____ and friends are main focus

balance, pretend, collective, socializing

OB: baby must have ID band on ____ leaves delivery area. Placental delivery (stage 3): make sure its ___ there, check for 3 vessel cord. "AVA"- two arteries one ____

before, all, vein

Pregnancy: positive station- presenting part is ____ ischial spines. Negative station- part is above spines. 0 station- part is at ischial spines. ___: the position of babys spine to mothers spine

below, Lie

Congenital heart defects: either trouble or no trouble. Remember TROUBLE- use consanants. T- trouble, R- right, B- ____, L- left. "Trouble, blue, shunts blood right to ____"

blue, left

Phenothiazines s/e: ABCDEFG. A-anticholingergic, dry mouth. B- _____ vision. C- constipation. D- drowsiness. E- ____. F- Fotosensitivity. G- agranulocytosis. At risk for ___

blurred, EPS, injury

Pharmacology: if you know what a med does but don't know s/e: pick side effect in same ____ system where the drugs working. Ex: GI drug- choose diarrhea

body

Wernickes, Korsakoff: Need B1 to metabolize alcohol so if not metabolized then goes to _____. Treatment: redirection. Is preventable and ______

brain, irreversible

Cushings s/s: are also side effects of steroids. Moon face, gynocomastia, striae, ____, atrophy, high ____ sugar, full of sodium and water, _____ hump, hirsutism, immunosuppression. (draw moon man)

bruises, blood, buffalo

Functional psychotic: ___ function in ADL's. "skeezo skeezo major manics" Schizophrenia, schizo effective disorder, major ____, manic

can, depression

Transverse lie: babys spine is diagonal to moms. Presentation: part of baby that enters birth ____ first. ROA and LOA most ____

canal, common

Hypoglycemic shock treatment: rapidly metabolized ____- sugar, starch or protein. Ex: fruit juice, pop, candy, ____, honey, icing, jelly, crackers, cheese. If unconscious give ____ IM or IV dextrose

carbs, milk, glucogon

V tach: potentially life threatening, has _____ output. Ventricular: treat with ____ and amioderone.

cardiac, lidocaine

Labor 4th stage: Boggy fundus: massage. Displaced fundus: _____. Check perineal pad: if bleeding excessively will saturate 100% of pad in ___ minutes or less. Roll her over and check for bleeding

catheterize, 15

Chevosteck sign: rub ____ go into spasm. Trousseaus sign: hand spasm when put BP ____ on. Gay French Guy named Trousseo doing gay wrist flick.

cheek, cuff

Painful back labor: position her in knee ____- on hands and knees with butt up. Push your hand into sacrum. Prolapse cord: push the head up off ___, put her in knee chest position.

chest, cord

Nutrition: In a tie pick ____ (not fried), if not an answer then pick fish (not shellfish). Never pick casserole for ____. Never mix meds in childrens food.

chicken, children

Chest tubes: surgery- always assume bilateral. If drain container comes open: 1st ____, 2nd cut broken container off, 3rd put end of tube under ____ water, then unclamp. Use rubber tipped double clamps.

clamp, sterile

Obtunded: almost _____. Calcemias do the _____

comatose, opposite

Piaget: 7-11- ____ operations. Rule oriented, teach ___ ahead. Teach what your going to do plus ____, with age appropriate reading and demonstration.

concrete, days, skills

Denial treatment- _____ (for abuse) Don't say "you" say "I" Ex: I'm having trouble interpreting this. Loss and grief: DABDA- denial, ____, bargaining, depression, acceptance. Treatment- ______

confrontation, anger, support

Flight of ideas: ideas all other the place, phrases are coherent but not tightly ____. By themselves they are coherent but together ____ coherent.

connected, not

Late decelerations: heart rate slows down near the end or after _____- BAD. Do LION. Early decels: fetal heart rate slows ____ or at beginning of contraction- not bad

contraction, before

Sub total thyroidectomy/ thyroid storm treatment: get temp down- ice and ____ blanket. O2 at 10 liters. ____ with patient, wait till come out of it.

cooling, stay

Variable decels: VERY BAD. Prolapse ____- push baby head up, put mom in knee chest position. Fetal HR tracings that begin with letter "L" do ____, they are bad

cord, LION

VEAL CHOP- write vertical, next to each other. V- variable= ____ compression. E- Early decel= H- head compression. A- acceleration (high fetal HR)= O-___. L- Late decels= P-_____ insufficiency

cord, OK, placental

General guessing: When want to answer all of the above- choose an answer that ____ all others.

covers

Psychosis of dementia: brain is _____. Functional psychotic: has potential to learn ____. If not psychotic pick best _____ communication as answer

damaged, reality, therapeutic

Coumadin: PO only, takes a few ____ to a week to work. Can be given for rest of ___. Antidote- vitamin K. Lab test- ___ (INR). Not given to pregnant women.

days, life, PT

Dependency: abuser gets significant other to do things for them or make _____ for them. Co-dependency: when significant other derives _____ self esteem for doing things for abuser

decisions, positive

Lamenectomy post op complications: Cervical- trouble breathing _____, ie pneumonia. Thoracic- pneumonia and ____. Lumbar- urinary retention and leg problems

deeply, ileus

Diabetes: don't metabolize glucose. Insipidus: polyuria, polyphagia, polydipsia,- leading to _____ due to low adh

dehydration

Diabetes melitus type 1: insulin ____, ketosis prone. If don't get treatment could DIE. D-diet, I- _____, E- exercise.

dependent, insulin

MAOI's: anti-____. Beggining of names are Mar, Nar and Par- brand names. Pt must avoid tyramine ____.

depressants, food

Prioritization: questions will always have age, gender, ____ and modifying phrase. Don't need age and gender.

diagnosis

Sesame street rule: only when NO other way. Right answer tends to be ____ than others. Wrong answers are similiar. When something really ____ right it probably is- go with your gut

different, feels

LPN cannot do these assessments: admission, ____, transfer, first assessment after there's been a ____

discharge, change

Pediatric dose: always _____ by 2.2. Crutches: length of crutch- 2 to ____ finger-widths below the anterior ____ fold to a point lateral or slightly in front of the ____. Hand grip- elbow will be about ___ degrees

divide, 3, axillary, foot, 30

Aminophylline: airway antispasmotic. When bronchodilator _____ work give a phylline then bronchodilator. Range: 10-20. ____ is toxic

doesn't 20

Magnesium sulfate: hypermagnesemia- does opposite, everything goes ____- heart rate, BP, Respirations, ____ and reflexes. Want +2 reflexes, if +1 need to ____ magnesium down, if + 3 need to increase it.

down, loc, slow

Crutches and stairs- up with the good, ____ with the bad. Hold cane on ____ side. Advance cane and bad leg at same time. Walkers- pick them up and set them down, then ____ to them.

down, strong, walk

Withdrawal from upper: not enough upper makes everything go ____. Not enough downer makes everything go ___. Boroborigmy: increased bowel sounds

down, up

Hiatal hernia s/s: GERD only when lay down after ____. Dumping syndrome s/s: shock and "drunk": staggering, slurred ____ etc. Also, abd cramping, _____, boriborigmy. Decreased cerebral blood flow, all blood is going to the ___.

eating, speech, diarrhea, gut

Sao2: o2 sat. 93-100. Less than 93= high priority. Anemia falsely ____ o2 sat. ____ procedure in last 48 hrs falsely elevates it.

elevates, dye

Timing contractions: frequency: begining of one to beginning of next. Duration: beginning to ____ of one contraction. Intensity: the ____ of contraction. Teach to palpate with one hand over ____ with pad of fingers

end, strength, fundus

Stable: pt experiencing typical ____ signs and symptoms of the disease with which they were diagnosed. Unstable: ____ signs and symptoms

expected, unexpected

Hiatal hernia treatment: you want the stomach to empty _____ so it doesn't regurgitate. Dumping syndrome treatment: want stomach to empty _____.

faster, slower

Delirium tremors: can be _____, unstable. NPO or clear ____, private room near nurses station. restricted bed ____, must be restrained. Very dangerous. Both Al with syndrom and delir trem get antihypertensive, tranquilizers and vit ____

fatal, liquids, rest, B1

Contact precautions: for anything interic- _____, oral. C-diff, Hep A (anus) and ____ infections, herpes. RSV is a droplet but kids touch everything so its ____.

fecal, staph, contact

Teach reality: 1st acknowledge ____. 2nd present reality, 3rd set a limit. Last ____ the limit. Ex: presenting reality- "I know that you see that demon but I don't see that demon" Setting a limit- "we're not gonna talk about that"

feelings, enforce

Chest tubes: if tube comes out: 1st put gloved ____ over hole on patient. 2nd cover hole with vaseline ____.

finger, gauze

Nutrition: Toddlers- ____ foods even if not healthiest answer. Preschoolers- 1 meal a day is ____, leave them alone

finger, ok

Aids/ UAP's can do: ADL's but never the ____. Do Not delegate ____ responsibilities to family

first, safety

3 things for black tags in un-witnessed accident: pulselessness, breathlessness, ____ dilated pupils. Unless there when happened, unwitnessed at scene of death= ____ priority

fixed, lowest

Lithium: #1 intervention is ___ intake. Need normal sodium for lithium.

fluid

SIADH is opposite of diabetes insipidus. Retain ____ and not thirsty. If urine output goes down, specific gravity goes ____.

fluid, up

Hiatal hernia: elevate HOB, high _____- to go through stomach faster, high carbs- digested fast. Dumping syndrome: HOB ____, lay on side to eat, low fluids- 1 to 2 hrs before or after ____, low carbs

fluids, flat, meals

Chest tube: intermittent bubbling in water seal is ____, just document it. Continuous bubbling in water seal is bad, it means a ____. Like buying a bottle of pop- don't want broken ____

good, leak, seal

Paranoid delusion: believe people are out are out to ____ them. Grandios delusion: believe they are _____. Somatic delusion: false belief about _____ part

harm, superior, body

BNP (brain naturetic peptide): best indicator of congestive ____ failure. Sodium: 135-145. If abnormal= low priority. If sodium abnormal and pt has decreased ____= high priority.

heart, LOC

Thyroidism= metabolism. Hyperthyroidism: hyperactivity, ___ intolerance, cold tolerance, weight ____, exopthalmous, high pulse and BP, skinny. This is graves disease

heat, loss

Postpartum assessment: "BUBBLE HEAD": B- breasts, U- uterine fundus- check ____ and firmness, B- bladder, B- bowel. L- ____. E- episiotomy, H- hemoglobin, hematocrit, E- ____ check, A- affect (emotion), D- discomforts

height, lochia, extremity

Asytole: _____ priority. V fib: high priority. Both have no cardiac ____ which equals no brain perfusion. Patient dead in ____ minutes.

high, output, 8

Total thyroidectomy: lifelong ____ replacement. At risk for hypocalcemia- impossible to spare ____ during procedure

hormone, parathyroid

Piaget: 3-6 yrs- preoperational. _____, teach shortly before or after. Teach what you are ____ to do. Use ____

imaginative, going, play

Prozac: s/e: ABCDE. Causes ____- do not give at bedtime. Adolescents and young adults watch for ____ ideation when change dose

insomnia, suicidal

Complications of diabetes: low sugar (glucose)- hypoglycemic shock. Causes: not enough food or too much ____ and too much exercise.

insulin

Exercise does the same thing as ____. In questions- replace exercise with insulin. Ex: pt went to store and exercised- Pt went to store and got another shot of insulin. More exercise ____ insulin, less exercise more insulin

insulin, less

Graves disease (hyperthyroidism): " your gonna run yourself into the grave" Treatment: radioactive ____, PTU (proplethyouricil) and ______

iodine, thyroidectomy

Hypoglycemic shock s/s: "drunk in shock" slurred speech, staggering gait, poor ____, delayed reaction time, labile mood (all over place), ____, loud. Shock- low blood pressure, tachycardia, tachypnea, cold, ____, clammy skin

judgement, obnoxious, pale

DKA s/s: 1 D, 3 K's, 3 A's: D- dehydration. K- _____ (in blood). K- kusmauls (deep rapid breathing) K- high K (potassium) A- ____ (due to nausea), A- acidotic (metabolic) A- acetone ____

ketones, anorexia, breath

Oxytoxics: stimulate ____. Ex: pitocin and _____. Pitocin- can cause uterine hyperstimulation, is longer than ___ seconds and closer than 2 minutes.

labor, methergine, 90

Diuretics: Semides end in X. Ex: fourosemide- ____. Baclofen: muscle relaxer. S/e- fatigue, muscle ____. Don't drink, don't ___, don't operate heavy machinery. "Back loafin' " Flexeril: muscle relaxer

lasix, weakness, drive

Woman's due date: 1st day of ____ menstrual period, add 7 days and 1 yr and subtract ___ months.

last, 3

Tetrology of fallot (trouble): "varied pictures of a ranch" use the first and ___ letter of each word. VD: ventricular defect, PS: pulmonary ____, OA: overriding _____, RH: right hypertrophy

last, stenosis, aorta

If its not back pain or prolapse cord treat with: LION. L- turn on ____ side. I- increase IV. O- oxygen. N- notify ___.

left, doctor

Downers: everything goes down. Every drug not an upper is downer. Drowsiness, _____, etc. Can go into respiratory ____.

lethargy, arrest

Psych: Don't use slang- they take everything ____. Empathy: nurse excepts the pts ____. Never say "I know how you feel" Empathy questions always have a ___ in question part.

literally, feelings, quote

Chest tube questions: look at reason for why it was placed and _____. Pneumothorax: tube removes ____. Hemothorax: removes blood. Apical: up high, removes air. ____: bottom, removes blood

location, air, Basilar

Lantis and Glargine insulin: _____ acting. So slowly absorbed has no peak. Little risk for hypoglycemia. Can give at ____. Duration 12- _____ hrs

long, bedtime, 24

Contractions should not be ____ than 90 seconds or closer than every ___ minutes. If they are than can= problems. Can be a sign of uterine ____ or uterine hyperstimulation- would need to turn down or stop ____

longer, 2, tetany, pitocin

Psychotic delirium: temporary sudden dramatic secondary ____ of reality. From meds or _____ imbalances. Acknowledge feelings and re-_____ that its temporary.

loss, chemical, assure

Lithium and lanoxin: go _____= 2 (toxic levels) all others go high= _____ (toxic level)

low, 20

Hiatal hernia: "everything high". Dumping syndrome: "when you wanna go slow make everything ____." High carbs= low ____

low, protein

Trough level: drug at ____. Peak level: drug at _____. "TAP" levels: T- check trough level, A- administer drug, P- draw ____. Draw when drug has a _____ therapeutic window

lowest, highest, peak, narrow

OB meds: Tocolytics- stop labor Ex: turbutaline, and ____ sulfate. Turbutaline: ____ maternal heart rate

magnesium, increases

Haldol: is a deconate (long acting) S/e: ABCDE. Can cause NMS- neuroleptic ____ syndrome, high fever, medical emergency.

malignant

Lithium: for bi-polar disorder. Decreases ____. S/e: peeing, pooping, parasthesia, ____, metallic taste, severe diarrhea.

mania, tremors

Do not delegate these to an AID (UAP): charting about the pt- can chart what they did. Give ____- except for topical OTC skin barriers. Assessments- except vitals and ____. Treatments- except ____. Cannot evaluate

meds, accuchecks, enemas

Droplet precautions: ____, H flu. Private room. Mask, gloves, handwashing. Pt wear ____ when leaving room, dedicated equipment, disposable supplies.

meningitis, mask

ABG's: if not lung its ______. Prolonged vomiting, or gastric ____= metabolic alkalosis. "Alk, alk" noise when vomiting. If ph and bicarb are in same direction its _____

metabolic, suctioning, metabolic

NSSRI's: ____ elevators. Ex: elevil, toprodil, avotil, desoril. Elevil- elevate. S/E: anticholingergic, blurred vision, constipation, drowsiness, ____. Take for 2-___ weeks to achieve full effects.

mood, euphoria, 4

Ventilators: high pressure alarm: when needs to pump ____. Could have a kink or ____. Low pressure alarm: could have _____. Respiratory alkalosis: ventilator setting too _____

more, blockage, disconnection, high

Fetal lung meturing meds: betamethasone- given to ___, IM, before baby is born. Servanta- surfactant- given to neonate, trans tracheal (blown into trachea), after baby is ____

mother, born

Piaget: stages of thinking: 0-2 yrs old- sensory ____. Present oriented. Teach them ____ you to it. Teach what you are doing, verbally

motor, while

Airborne precautions: measles, ____, rubella, TB and ____ (chicken pox). Private room, mask, gloves, handwashing.

mumps, varicella

Hypothyrothyroidism: another name is _____. Treatment: thyroid hormone- ____, levothyroxin. Do not ____, can put into a coma ie ambien. Do Not hold thyroid ____ before surgery.

myxedema, synthroid, sedate, med

Chest tube: creates _____ pressure in pleural space, this is good and lets lung ____ while chest wall moves.

negative, expand

Dependency treatment: teach co-dependent person to say ____ and that they're a good person. Manipulation: the nature of the act is _____ or harmful. Treatment- set _____ and enforce them

no, dangerous, limits

Peds: always give child more time (to grow and develop), don't rush. When in doubt- call it ___. Ex: 6 yr old can't read- call it normal. When in doubt pick the ____ task. Ex 6 month old rolling over or sitting up- rolling over is easier to do

normal, easier

Aminoglycosides (antibiotics): don's use unless _____ else works. "A mean old mycin" ALL END IN _____. Treat infections that are: serious, life threatening, resistant, gram _____.

nothing, MYCIN, negative

Magnesemias do the _____. In a tie don't pick magnesemias. Skeletal muscle or nerve= _____. Heart = potassium.

opposite, calcium

Crutch gaits: 2 point gait- move a foot and ____ crutch together, moving two together. 3 point- move two ____ and bad leg together. 2 point mild problem, 4 point- _____ problem

opposite, crutches, severe

Tie breaker only: the more vital the ____ the higher the priority- organ of the modifying phrase. Order of organ vitality: Brain, ___, heart, liver, ____, pancrease

organ, lung, kidney

Aminoglycosides: "mycin"- mice, mice have big ears. Ears- _____. Monitor pts hearing, ringing, dizziness. When you draw an ear connect it it looks like a ____- nephrotoxic, monitor ____ (best indicator of renal function), also a #8 fits in the ear drawing- cranial nerve ____ (hearing) and administer q8h

ototoxic, kidney, creatinin, 8

Labor: Stage 1: dilate and efface. Stage 2: purpose of contractions- push baby ____. Stage 4: contractions to stop ____.

out, bleeding

Hypernatremia= dehydration. Hyponatremia= fluid _____. Earliest sign of electrolyte disorder is numbness and ____(parasthesia). Circumoral parasthesia: numbess, tingling around _____

overload, tingling, lips

Psych questions: best answer- nurse will examine her ___ feeling about it. Also, establishing ____ relationship

own, trust

Hypothyroidism (myxedema): s/s: cold intolerance, heat _____, flat affect, tired over weight, low ___ and pulse, longer thinking times, slow.

tolerance, BP

Cushings syndrome: if you have a cushy couch or cushy tushy you have ____ much. Over secretion of adrenal cortex. Treatment: ____

too, adrenalectomy

St johns wart (not with SSRI's) can increase drug ____ cause it doesn't allow meds to be broken ____. Seritonin syndrome s/e: "SAD head" S- sweating, A- apprehension, D- ____, head ache.

toxicity, down, drowsiness

Pregnancy: difficulty breathing- 2nd and 3rd trimester. Teach _____ position- flat with arms on table, leaning forward. Back pain- 2nd and 3rd trimester. Treatment- pelvic ___ exercises to tilt pelvic forward.

tripod, tilt

Bruit: swooshing sound. AAA: hear a bruit over peri _____ area

umbilical

Adrenal cortex: disorders begin with "A" or "C". Addison's: ____ secretion of adrenal cortex. S/S: hyperpigmented, don't adapt to ____. If don't have adequate adrenal cortex when in stress can go into ____

under, stress, shock

Alkalosis: ph goes up: everything goes _____ except potassium goes down. Can cease and ______.

up, aspirate

Word salad: babble random words. Neologism: making ____ words. Narrowed self concept: psychotic refused to ____ room or change clothes. Believe clothes define who they are.

up, leave

Probable and presumptive signs of pregnancy: are maybes. All ____ and blood tests. Positive pregnancy test is ___ a positive sign of pregnancy.

urine, not

PH: 7.35-7.45. Ph in 6's= highest priority. Assess ____, and call doc asap. BUN: 8-____. If high assess for ____

vitals, 25, dehydration

Lamenectomy permanent restrictions: NEVER lift object by bending at ___. Cervical- no allowed to lift anything over ____. No off trail biking, carnival rides, jerking motions, etc.

waist, head

Neutropenic precautions: don't drink ____ been sitting longer than 15 mins- no pitchers. ____ bottles of water good for 1 hr, unopened good for 4 hrs.

water, opened

Hypokalemia s/s: bradypnea, tachycardia, polyuria, flaccid, +1 reflexes. (+2 is normal), _____, lethargy, decreased _____, constipation

weakness, LOC

All psych drugs cause low bp and ____ changes. Phenothiazines: "we use zines for the zanny" In large doses= anti-psychotics. In small doses= anti-____. They are major ____, the "big guns"

weight, emetics, tranquilizers

Drug addiction in newborn: always assume intoxication not _____ at birth. After ____ hrs it can be withdrawal

withdrawal, 24

Empathy: Do not choose answer that reflects their ____, choose one that reflects what pt FELT. Ex: "your killers, you killed my mom" she feels scared, pick answer about her being scared.

words

If your not interrupting patients meal to give Lispro your doing it ____. Do not give it before, only with meals

wrong

PTT: draw two lines on TT and it makes an "H" for heparin. Diuretics: any diuretic ending in letter __ exes out potassium= wastes potassium. And Diurill included. Diurill sounds like "die you will" when your dying- ____ away.

x, wasting

Positive signs of pregnancy: fetal skeleton on ____, fetal presence on ultrasound, auscultation of fetal heart ____-hear it between 8-12 weeks. Examiner ____ fetus

xray, rate, palpates

Aminoglycosides: 3 drugs that end in mycin that are not these: arythromycin, ______ and clarithromycin. If it has "thro" in it, than throw it _____.

zithromycin, out