NCLEX KELSEY DAY 1

A client newly diagnosed with diabetes mellitus asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond?

"Ketones will tell us if your body is using other tissues for energy." Explanation: The nurse should tell the client that ketones are a byproduct of fat metabolism and that ketone testing can determine whether the body is breaking down fat to use for energy. The spleen doesn't release ketones when the body can't use glucose. Although ketones can damage the eyes and kidneys and help the physician evaluate the severity of a client's diabetes, these responses by the nurse are incomplete.

IM injection angle

90 degrees

As she tries to decide on a birth control method, a client requests information about medroxyprogesterone. Which statement represents the nurse's best response?

: Medroxyprogesterone needs to be administered every 12 weeks.

CONTAGIOUSNESS OF TB ENDS WHEN

A client with drug-resistant tuberculosis is not contagious when the client has had a negative acid-fast test.

CLONAPINE TX

A sore throat and fever are indications of an infection caused by agranulocytosis, a potentially life-threatening complication of clozapine therapy. Because of the risk of agranulocytosis, white blood cell (WBC) counts are necessary weekly, not monthly. If the client's WBC count drops below 3,000/μl, the medication must be discontinued.

Direct-acting beta-active agent

After extensive cardiac bypass surgery, a client returns to the intensive care unit on dobutamine, 5 mcg/kg/minute I.V. Which classification best describes dobutamine?

A child has been prescribed a 3-day treatment of gentamicin sulfate. Which of the following manifestations would indicate that the child is developing toxicity?

Decreased renal output

BEFORE AN EPIDURAL....

Give a fluid bolus of 500 ml.

Metoprolol inhibits the action of sympathomimetics at beta1-receptor sites. Where are these sites mainly located?

HEART

Meningococcal infections PCN

Meningococcal infections are spread through close mucous membrane or respiratory contact with large respiratory droplets. Meningococcal infections are not spread by small airborne organisms or contact with a person's skin or contaminated items. Standard precautions, used when touching body fluids, are not sufficient to prevent the spread of meningitis.

phases of arf

Oliguric phase Diuretic phase Recovery phase

A sudden gush of dark blood occurs

PLACENTA IS ABOUT TO SEPERATE

FLUCTUATION IN THE WATER CHEST TUBE WITH EACH BREATH INDICATES

PROPER FUNCTIONING

ENDING NURSE PATIENT TALK SHOULD BEGIN WHEN

Preparation for ending the nurse-client relationship should begin during the orientation phase, when realistic limits of the relationship are established.

An older client reports episodes of severe anxiety resulting in shortness of breath, palpitations, chest pain, dizziness, and nausea. The physician prescribes lorazepam. What effect of this medication would be most important for the nurse to monitor on this client?

SEDATION MOST COMMON S/E

Non-estrogen contraception should be used for:

Smokers, age over 35, HTN, Vaginal bleeding, DM with vascular complications or more than 20 years, DVT/PE, Heart disease, HA/Migraine, Breast CA, Liver disease, breast feeding, Immobilization, Cholestasis

The health care provider prescribes sulfasalazine for the client with ulcerative colitis. Which instruction should the nurse give the client about taking this medication?

Stop taking it if urine turns orange-yellow. Avoid taking it with food. Take it with a full glass (240 mL) of water. Take the total dose at bedtime.

Team nursing is efficient and less costly to implement than primary or case management systems. Because staff members know each other well, they can function effectively as a team. Although functional nursing is the most cost-effective, care is commonly fragmented and clients are less satisfied. Case management and primary nursing require more registered nurses than are available.

TYPES OF NURSING MANAGEMENT

LPN SCOPE

To delegate nursing care effectively, a nurse must know the client's condition, the competence and scope of practice of all nursing team members, and the level of supervision needed for the delegated nursing care task. The nurse must also consider the training, cultural competence, and experience of the delegate. Delegating nursing care requires critical thinking and professional judgment to ensure that the delegated nursing care task is the right task for the right person, the task is delegated under the right circumstances, the delegate receives the right directions and communication, and the performance of the task is properly supervised and evaluated. An experienced LPN/LVN would monitor and report vital signs to the RN. The paracentesis tray can be obtained by the unit clerk or unlicensed assistive personnel (UAP). The admission assessment and teaching require the RN's expertise and education.

PATIENT WITH MS AT BEDSIDE MUST BE

To ensure a patent oral airway, the nurse should keep a suction machine and suction catheters at the bedside.

WHEN IS AN INGUINAL HERNIA REPAIR READY TO D/C

Urinary elimination in the first 8 hours postoperatively is a requirement before the client who has had an inguinal hernia repair can be discharged from same-day surgery.

PREDNISONE SHOULD BE TAKEN

WITH MEALS

pediculosis corporis

an infestation with body lice

dorsal recumbant position

lithotomy

A female client is receiving chemotherapy and is experiencing pancytopenia. Which laboratory result most warrants that the nurse immediately contact the health care provider (HCP)?

platelet count of 12,000/mm3 Explanation: Pancytopenia means a decrease in all blood components. Because a platelet count of less than 15,000/mm3 can result in spontaneous bleeding, the nurse notifies the HCP of this laboratory result. Neutrophils are a type of WBC. An absolute neutrophil count between 1,000 and 1,800/mm3 suggests mild neutropenia and represents a low risk of infection. Although references vary, normal range for WBC counts are 5,000 to 11,000/mm3, and a female's normal hemoglobin (Hgb) value is roughly 12 to 16 g/100 ml. Therefore, the WBC count and Hgb levels are a bit low, but not critical.

PIG SKIN GRAFTS GOOD BECAUSE....

promote the growth of epithelial tissue.

Planes of the body

sagittal, frontal, transverse

ECT before, administer...?

the neuromuscular blocking agent