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