NCLEX

Which insulin can be given IV?

ONLY regular

Chronic Kidney Disease: Leads to a decrease in the absorption of calcium in the gut, causing the secretion of _____ to increase. Calcium is then pulled from the?

PTH bones

These tasks belong to? -Clinical assessment -Initial pt assessment -Discharge education -Clinical judgement -Starting blood transfusion

RN

A client diagnosed with a ST-segment elevation myocardial infarction (STEMI) is receiving an intravenous thrombolytic infusion. In evaluating the client's response to treatment, which assessment finding by the nurse is the best indicator that reperfusion has occurred?

ST segment returns to baseline

Infant vaccinations: Hep B

0, 1 and 6 months

Digoxin therapeutic levels

0.5-2.0

Lab value: Creatinine

0.6-1.35

Lithium therapeutic levels

0.8-1.5

When does the babinski reflex disappear in an infant?

1 year

Lab value: LDH

100-190

When should you expect withdraw to occur in an infant born to a drug-using mother?

12-24 hr after birth

Lab value: Total Cholesterol

130-200

Lab value: Sodium

135-145

Infant vaccinations: MMR

15 months

Pregnancy weight gain: BMI- 25-29.9 Total gain? 1st trimester? 2nd/3rd trimester?

15-25lb 1.1-4.4lb 0.6 lb/week

Infant vaccinations: diphtheria, tetanus and pertussis

2, 4 and 6 months

The therapeutic INR level for a client receiving warfarin (Coumadin) to treat atrial fibrillation is?

2-3

Lab value: CVP

2-8

If the child has a sibling with a history of stroke, screening for hyperlipidemia is recommended in children ages?

2-8 yo

Normal pressure of an endotracheal tube?

20-30 mmHg

Lab value: Platelets

200K-400K

Pregnancy weight gain: BMI- 18.5-24.9 Total gain? 1st trimester? 2nd/3rd trimester?

25-35lb 1.1-4.4lb approx 1 lb/week

Lab value: Albumin

3.4-5.0

The nurse in the pediatric office observes the child in the waiting room. The child can walk up and down steps, has a steady gait, can stand on one foot momentarily, and jumps with both feet. Which does the nurse identify as the child's chronological age?

30 months

Newborns respiration rate?

30-60

Lab value: Hematocrit (male)

37-48%

Lab value: Triglycerides

40-50

Women who are planning on becoming pregnant should consume __________ mcg of folic acid daily.

400-800

When should you administer pyridostigmine to a pt with myasthenia gravis?

45 min before meals

Lab value: Hematocrit (female)

45-52%

Imitative behavior is commonly seen in _____ year olds

5

Lab value: WBC

5,000-10,000

1 week old infant should have how many wet diapers per day should they have?

6

Lab value: PAWP

6-12

How long is back up contraception needed when a pt starts oral birth control?

7 days

Lab value: BUN

7-22

Lab value: pH

7.35-7.45

Normal MAP

70-105

Lab value: Glucose

70-110

Peripheral IV sites should be changed no more frequently than every?

72-96 hours

Lab value: Calcium

8.5-10.9

Normal suction on trach?

80-120 mmHg

A pincher grasp appears at ____ months

9

Lab value: Chloride

98-107

Normal value for troponin T

<0.1

Normal value for troponin I

<0.5

Lab value: Bilirubin

<1.0

the 'nitro' group affects what vital?

BP but NOT HR

The 6-month-old infant has had all of the required immunizations for that age. The nurse knows this includes which immunizations?

DTaP

____________ is a congenital defect in which the urethral opening is on the underside of the penis

Hypospadias

The nurse is teaching a client diagnosed with end stage renal disease about hemodialysis. Which statement indicates that teaching has been effective?

I might have mm cramps after treatment

What is the tx for severe dehydration?

IV isotonic solution

Carbamazepine is contradicted within 14 days of ________ administration

MAOI

Q: Steps of the nursing process (4)

assess, analysis, planning, implementation

What is myasthenia gravis?

autoimmune disease decrease number of ach receptors at the nm jxn

The nurse is providing teaching to the parents of a child with Marfan syndrome. Which topic is the priority for the nurse to address?

avoid participating in contact sports

How should NTG be stored?

away from light and heat sources

Do not give tetracyclines at?

bed time

stages of labor: 3rd

birth of placenta

The nurse cares for clients in a drug rehabilitation facility. Which complication of IV drug abuse is the nurse most likely to observe?

cellulitis

A newborn is being evaluated for possible esophageal atresia with tracheoesophageal fistula. Which finding is the nurse most likely to observe?

choking and cyanosis during feeding

What is ordered during the evening before a IV pyelogram?

cleansing enemas

What food combo is not appropriate for a pt that is jewish?

dairy and meet

How to position a pt after a cardiac catheterization?

flat

Foods high in folic acid

fortified grain products

2 most common causes of acute pancreatitis?

gallstone movement alcohol abuse

The nurse cares for a client during an acute manic episode. The nurse identifies which client behaviors as most characteristic of mania? (3)

grandiose delusions difficulty concentration agitation

s/s of septic shock (5)

hyper or hypothermia hypotension tachycardia prolonged cap refill wbc >12,000

Which fluids do you NOT give to a pt with blood loss?

hypotonic

benztropine has what effect on the eyes?

increase intraocular pressure

A pt who is 24wks has a hemoglobin level of 9, what condition does this result suggest?

iron deficiency anemia

Q: Hypovolemia is also known as?

isotonic dehydration

Bumetanmide is what type of medication?

loop diuretic

Airborne precautions: "MY CHICKEN HAS TB" (4)

measles chicken pox herpes zoster tb

What are the early s/s of methadone toxicity? (2)

n/v lethargy

Ankylosing spondylitis treatment (4)

nsaids for pain stretching stop smoking take immunosuppressant and anti-inflammatory meds

Where can you auscultate aortic stenosis?

right sternal border, second intercostal space

The client has partial-thickness and full-thickness burns over 75% of the body. The nurse is most concerned if which symptom is observed?

tachypnea

The nurse is assisting the health care provider (HCP) with a client's chest tube removal. Just as the HCP prepares to pull the chest tube, what instructions should the nurse give the client?

take a breath in, hold it, and bear down

Q: EKG changes: Hyperkalemia (4)

tall peaked T waves, flat P waves, widened QRS complex, prolonged PR interval

What is a Cerebral Arteriovenous Malformation?

tangle of aa and vv in the brain

Where is Erb's point?

third intercostal space and the left lower sternal border

What type of medication is imipramine?

tricyclic antidepressant

What lab test is a highly specific cardiac marker for the detection of MI?

troponin

The nurse provides care for a client diagnosed with a severe ankle sprain. The client needs to be fitted with crutches. Which finding indicates to the nurse that the crutches are adjusted correctly?

two fingers fit between the top of the crutch and the axilla

Do not give MAOIs with ___________ containing foods

tyramine

Bureger's disease occurs in?

young men with a long hx of smoking

Why is bed rest needed for a pt with acute pancreatitis? (2)

decrease metabolic rate decrease secretion of pancreatic enzymes

Why does a pt need to valsalva during the removal of a chest tube?

decrease risk of pneumothorax

When giving loop diuretics, watch for?

decreased potassium

During pregnancy, the fetus stores large quantities of glycogen that are used during the transition to extrauterine life. How is the infants glucose levels effected in the first hour after birth?

decreased, stabilizes within 2-3 hours

How do pts with resilience cope with anxiety? (3)

deep breathing meditation mm relaxation

Common causes of metabolic acidosis? (4)

diarrhea starvation sepsis renal failure

The nurse is assessing a client with advanced amyotrophic lateral sclerosis. Which of the following assessment findings does the nurse expect? (3)

difficulty breathing difficulty swallowing mm weakness

"LION" pitocin treatment for: low FHR low baseline variability late decelleration

left side/lateral IV increase O2 notify doc

Where do the occlusions occur in a pt with Beurger's disease? What can this lead to?

legs gangrene

Administer __________ during alcohol withdrawal

librium

Common characteristics of Historinic personality disorder (3)

likes to be center of attention exaggerated emotional expression little tolerance for fustration

3 foods high in vitamin A?

liver sweet potatoes carrots

What medications are used to decrease fluid volume and preload?

loop diuretics

A client with massive trauma and possible spinal cord injury is admitted to the emergency department following a dirt bike accident. Which clinical manifestation does the nurse assess to help best confirm a diagnosis of neurogenic shock?

low apical heart rate

A client has potential radiation contamination from a disaster. The nurse should monitor for which of the following related to this contamination? (3)

low blood cell counts oral ulcerations vomiting and diarrhea

All macrolide antibiotics (eg, azithromycin, erythromycin, clarithromycin) can cause what irregularity on an EKG?

prolonged QT interval

Q: EKG changes: Hypocalcemia (2)

prolonged ST segment, prolonged QT interval

"PRE" eclampsia

proteinuria rising BP edema

Posterior fontanelle closes at ____ months of age.

2-3

Lab value: Phosphorus

2.5-4.5

At what rate should you put an IV infusion on to KEEP THE VEIN OPEN?

20 mL/hr

What size IV to use on an adult receiving blood?

20-24g

Meningococcal meningitis requires droplet precautions until?

24hr after start of effective tx

Pregnancy weight gain: BMI- <18.5 Total gain? 1st trimester? 2nd/3rd trimester?

28-40lb 1.1-4.4lb approx 1 lb/week

Lab value: Potassium

3.5-5.1

Lab value: Uric Acid

3.5-7.5

Magnesium toxicity: "BURP"

BP decrease urine output decrease RR <12 patellar reflex absent

The nurse assessing a 2-year-old should expect the child to be able to perform which actions? (3)

build tower with blocks say own name walk without help

Avoid grapefruits if taking these meds (4)

buspar veramapmil tegretol simvastatin

The clinic nurse is caring for a 3-year-old client. Which task, if not observed or reported by the parents as accomplished, will cause the nurse concern? a. catches ball 50% of the time b. copies a square with a pencil c. eats with a spoon d. hops on one foot

c

How to help reduce engorged breasts when a mother bottle feeds only?

cabbage leaves

Chronic Kidney Disease: Leads to a decrease in the activation of Vitamin D, decreasing the gut absorption of?

calcium

Do not let pts who take tetracyclines lay down because?

can cause gastric reflux

Why can prendisone increase the change of digoxin toxicity?

can increase k levels which increases risk

A client is in suspected shock state from major trauma. Which parameters best indicate the adequacy of peripheral perfusion? (2)

cap refill skin color and temp

What type of nutrient should the pt w/ respiratory failure avoid?

carbs

Troponin T is a myocardial mm protein that is released into circulation following?

cardiac injury

Dopamine treats ____________ shock

cardiogenic

Medications commonly prescribed for a client with an open fracture include? (5)

cefazolin cyclobenzaprine tetanus toxoid ketorolac opioids

The labor and delivery nurse is performing a vaginal examination to assess for cervical dilation and effacement. While palpating the presenting fetal part, the nurse feels a diamond-shaped structure that feels soft in the middle. What position should the nurse document?

cephalic

What diseases are common among african american women? (3)

cervical cancer ischemic stroke htn

stages of labor: 2nd

cervical dilation to birth

How to identify true labor?

cervix transitions into anterior postion

A client receiving total parenteral nutrition complains of nausea, abdominal pain, and excessive thirst. What is the best action for the nurse to take?

check BG

If a pt with cardio myopathy goes into v. tach, what is the initial action the nurse must preform?

check for a pulse

Highest priority when a mother give birth to a LGA baby?

check lochia

The nurse identifies a prolonged PR interval on the electrocardiogram of a client with acute kidney injury. The client reports fatigue and muscle weakness. Which action will the nurse take first?

check recent K levels

What is Sjögren's syndrome?

chronic autoimmune disorder in which moisture-producing exocrine glands of the body are attacked by white blood cells

Q: What causes hypotonic dehydration? (4)

chronic illness, excessive fluid replacement, kidney disease, chronic malnutrition

Normal appearance of CSF

clear and colorless

What is talipes equinovarus?

club foot

An increased CVP & PAWP can present as...?

coarse lung sounds

A newborn client at 32 weeks' gestation weighs 4 lb 10 oz (2.12 kg) and has mottling of the skin and acrocyanosis with irregular respirations of 60 breaths per minute. Which newborn problem does the nurse suspect this client is experiencing?

cold stress

Marfan syndrome is an autosomal dominant disorder affecting the?

connective tissues of the body

What are the two most common side effects of amitriptyline?

constipation dry mouth

The cardinal sign of impaction of the stool is?

continous oozing of liquid stool with no normal stool

A nulliparous client asks about being in "real" labor. The nurse should teach that which signs are most indicative of true labor? (3)

contractions that increase in frequency pain in back that moves to the lower abd progressive cervical effacement and dilation

What is the process of the myelogram?

contrast medium is injected into spinal subarachnoid space through a spinal puncture

When taking ramelton, what types of food should you avoid?

high fat

S/S of neuroleptic malignant syndrome (4)

high fever mm rigidity altered mental status autonomic dysfunction

If a pt is in hypovolemic shock, which position should you NOT put them in?

high fowler

Post-op appendectomy diet (3)

high protein high cal high vitamin c

S/S of infant withdrawl syndrome (4)

high shrill cry hyperrefelxia irritability tachypnea

What is pheochromocytoma?

hormone secreting tumor that can occur in the adrenal glands

How are the infants reflexes effected by a heroine-using mother?

hyper

Early s/s of alcohol withdrawal (3)

hyperalterness easily startled anorexia

A client is admitted with severe acute pancreatitis. While obtaining the client's blood pressure, the nurse notices a carpal spasm. What laboratory result would the nurse assess in response to this symptom?

hypocalcemia

What can alcohol cause in a pt with DM?

hypoglycemia

How does garlic effect glycemic levels and the actions of diabetic drugs?

hypoglycemia potentiate the actions

Q: Hyperinsulinism causes what electrolyte imbalance?

hypokalemia

_____________ can precipitate digoxin toxicity;

hypokalemia

When a pt is taking digoxin, side effects are more likely to occur if the pt is?

hypokalemic

_____________ is a major adverse effect of erythropoietin administration

hypotension

When ca-channel blockers are used with other anti-HTN meds what are the possible adverse effects? (2)

hypotension HF

When a pt is in v. tach, what are s/s of instability? (4)

hypotension altered mental status shock chest pain

The client receives a blood transfusion and experiences a hemolytic reaction. The nurse anticipates which assessment findings for this client? (3)

hypotension low back pain fever

Q: Replacement of isotonic fluid loss with hypotonic fluids can cause?

hypotonic overhydration

When should a pt call 911 when taking sublingual nitro?

if chest pain is unrelieved 5min after the first tab

A client with myocardial infarction (MI) underwent successful revascularization with stent placement, is now chest pain free, and will be attending cardiac rehabilitation as an outpatient. The client is embarrassed to talk to the health care provider (HCP) about resuming sexual relations after an MI. What teaching should the nurse initiate with this client?

if the pt can walk 1 block or 2 flights of stairs, then sexual relations can be resumed

The nurse is admitting a client with a diagnosis of right-sided heart failure resulting from pulmonary hypertension. What clinical manifestations are most likely to be assessed? (3)

increased abd girth JVD lower extremity edema

S/S of PTSD (3)

increased anxiety reliving event feeling detachment from others

What does an increased PAWP indicate?

increased left ventricular preload

The nurse obtains the client's temperature of 103° F (39.4° C). The nurse knows body compensatory mechanisms include which mechanism? (2)

increased rr tachycardia

What does an increased CVP indicate? (2)

increased systemic circulation increased right ventricular preload

S/S of metabolic syndrome (5)

increased waist circumference htn triglycerides >150 HDL <40 for men and <50 for women fasting glucose >100

A pt on a ventilator is attempting to speak, how does this effect the peak inspiratory pressure?

increases

When sodium decreases lithium ____________

increases

What is Hirschsprung disease?

infant born with nn cells missing from parts of the distal large intestines

What are the 3 major concerns in a teenage male client with CF?

infertility vit A deficiency frequent resp infections

What is Beurger's disease?

inflammation and thrombosis in blood vessels

What is orchitis?

inflammation of one or both testes

What is Ankylosing spondylitis?

inflammatory disease that effects the spine

Instructions for pursed lip breathing? (2)

inhale 2s through nose with mouth closed exhale 4s through lips

What is priority when treating a pt experiencing an acute attack of Meniere disease (endolymphatic hydrops)?

initiate fall precautions

Dicyclomine (Bentyl) is an anticholinergic/antispasmodic drug prescribed to manage symptoms of ____________ in pts with irritable bowel syndrome?

intestinal hypermotility

S/S of cold stress in an infant (3)

irritability poor feeding weak cry

Which fluids do you give to a pt with blood loss?

isotonic

Q: Hypervolemia is also known at?

isotonic overhydration

Never give potassium ________?

iv push

S/S of hypoglycemia in a new born (6)

jittery irritable hypotonia apnea lethargy temp instability

Where would the fundus be at 12 weeks?

just above symphysis pubis

When a pt has a Cerebral Arteriovenous Malformation, what is the most crucial thing to control?

bp

Propanolol is contradicted in pts with?

bronchial asthma

Adverse effects of propanolol? (2)

bronchial constriction masks hyperglycemia

In a pt with acute glomerulonephritis, what is the most accurate indication of fluid loss or gain?

daily weights

Long term use of PPI's causes (2)

decrease bone density increased risk of c diff

Action of propanolol? (2)

decrease hr decrease co

Q: Isotonic dehydration results in? (2)

decrease in circulating blood and inadequate tissue perfusion

A pt is receiving oxytocin, the nurse should assess the uterine contractions every ____ during the 1st stage of labor and every ____ during the second stage?

15 min 5 min

When should aluminum hydroxide gel be taken?

1hr after meals

Infant vaccinations: inactive polio

2, 4, and 12-18 months

The health care provider prescribes intravenous fluid resuscitation for a client in hypovolemic shock. The nurse should anticipate the rapid infusion of which intravenous solution initially?

0.9% sodium chloride

Which assessment findings should the nurse anticipate in a child with suspected acute otitis media (AOM)? 1. frequent pulling on affected ear 2. refusal to eat 3. restless and irritable 4. retracted tympanic membrane 5. severe pain w/ pressure on the tragus

1 2 and 3

Lab value: Specific Gravity

1.010-1.030

Lab value: Magnesium

1.6-2.6

Theophylline therapeutic levels

10-20

How many mL is measured in one saturated peripad in a post-delivery mother?

100

Rate of compressions during a code?

100-120/min

Hemoglobin levels: 1st trimester 2nd trimester 3rd trimester

11 10.5 10.1

Pregnancy weight gain: BMI- >30 Total gain? 1st trimester? 2nd/3rd trimester?

11-20lb 1.1-4.4lb 0.5 lb/week

Lab value: Hemoglobin (male)

12-16

NPH is an intermediate-acting insulin with a duration of______?; it is generally prescribed how many times daily?

12-18 hours twice a day

Lab value: Hemoglobin (female)

14-18

Q: What is the most common earliest sign of digoxin toxicity?

GI symptoms

What are the expected s/s after a ECT? (3)

HA disruption of short/long term memory transient confusional state

These tasks belong to? -Monitoring RN findings -Reinforcing education -Routine procedures -Most meds admin -Ostomy care -Tube patency and enternal feedings -**assessments: lung sounds, bowel sounds, neurovascular checks

LPN

Prior to a brain surgery, the doctor most likely will prescribe what to prevent seizure development?

Levetiracetam

In a pt with coronary artery disease, which type of commonly used pain medication can increase the risk of thrombolytic events?

NSAIDs

What type of diet is assigned to a pt with CF? (3)

high cal high fat high protein

Q: EKG changes: Hypokalemia (3)

ST depression, shallow/flat/inverted T waves, prominent U wave

These tasks belong to? -ADLs -Hygiene -Linen changes -Routine stable VS -Document I/O -Positioning

UAP

The nurse is caring for a client admitted with incomplete fractures of right ribs 5-7. The nurse notes shallow respirations, and the client reports deep pain on inspiration. What is the priority at this time? a. admin IV morphine b. facilitate hourly incentive spirometry c. instruct to splint gently during coughing d. tell doc immediately

a

What is the life expectancy for a neonate with trisomy 18?

a few weeks

In a pregnant client, high serum alpha-fetoprotein values can indicate?

a neural tube defect

A pt with PVD with a sudden acute onset of abdominal pain that radiates to the lower back could indicate what?

abdominal aortic aneurysm

What is the earliest s/s of magnesium toxicity?

absent or decreased DTR

What is toxic hepatitis?

acetaminophen over dose

When are thrombolytic medications contradicted? (3)

active bleeding recent trauma uncontrolled htn

A nurse on the antepartum unit is caring for a pregnant client at 30 weeks gestation who was admitted with reports of vaginal bleeding. A diagnosis of placenta previa was confirmed by ultrasound. What should the nurse tell the client to anticipate? (3)

additional ultrasound at 36wk discharge if bleeding stops and fetus is stable c-section birth

Adverse effects of thiazide diuretics: How to treat hyperglcemica?

adjust DM meds

What is neuroleptic malignant syndrome?

adverse reaction to anti-psychotic meds

Clozapine is associated with a risk for which blood disorder?

agranulocytosis

What type of isolation is used for TB?

airborne

What are first-level priority problems? (4)

airway breathing circulation VS

Adverse effects of thiazide diuretics: How does hyponatremia present? (2)

altered mental status seizures

Which clinical manifestations would the nurse identify with severe anorexia nervosa? (4)

amenorrhea f/e imbalances lanugo extreme weight loss

For children younger than 7 months, where should shots been administered?

anterolateral thigh

Amantdaine is what type of drug?

antiparkinsons

When is the PKU test administered to an infant?

as soon as possible after birth, can be repeated 1-2 weeks after birth

A major side effect of angiotensin-converting enzyme (ACE) inhibitors is intractable cough. The nurse recognizes which ethnic group to be at highest risk for this side effect?

asians

When performing compression how deep should you go?

at least 2 in

Home diet care for a pt post op partial gastrectomy (3)

avoid fluid intake with meals low carb meals eat small frequent meals

Cerebellar deficits affect?

balance and equilibrium

Why should femoral lines be changed the earliest?

because they can be contaminated by urine/feces

what is normal during auscultation of the lungs in a new born (1 hour old)?

bilateral crackles

The nurse caring for a client with pulmonary edema responds to the mechanical ventilator high-pressure alarm. The nurse would assess for which conditions that can trigger the high-pressure alarm? (3)

biting endotracheal tube excessive airway secretions kinked ventilator tube

What is Hemarthrosis?

bleeding into joint spaces

What is homonymous hemianopsia?

blindness in the same half of each visual fields

What is hemophilia?

blood disorder caused of a deficit in coagulation properties

The nurse cares for an older client scheduled for a colon resection this morning. The nurse notes the client had polyethylene glycol-electrolyte solution and a soapsuds enema the previous evening. This morning the client passes a medium amount of soft brown stool. Which conclusion by the nurse is most accurate?

bowel prep is not complete

A nurse is teaching a parent of an infant about administration of an oral medication. What should be included in the teaching? (3)

direct med towards inside the cheek hold infant in semi-reclining measure/admin with oral syringe

The client is admitted with a tentative diagnosis of late stage AIDS dementia complex. The nursing assessment is most likely to reveal which finding?

disorientation to person, place, and time

what are the two most common s/s of cardiac tamponade?

distant heart sounds jugular v distension

s/s of Hirschsprung disease (4)

distended abdomen has not passed meconium stool difficulty feeding vomiting green bile

Therapeutic guidelines for a pt with Alzheimer disease include? (5)

distraction redirection simple yes or no questions visual cues complex tasks into steps

_____________ is given to alcoholics to curb impulsive drinking

disulfiram

In 6 months a baby's weight should? In 12 months?

double triple

The nurse is preparing to administer the fourth dose of vancomycin IVPB to a client with infective endocarditis. Which intervention does the nurse anticipate?

drawing a trough level prior to administration

Vancomycin and aminoglycosides (eg, gentamicin, amikacin, tobramycin) are strong antibiotics that can cause toxic reaction to?

ears kidneys

Which action is appropriate for the nurse to complete at the end of the assessment of an infant?

ears and mouth

S/S of graft leakage post-op repair of abdominal aortic aneurysm (6)

ecchymosis of groin tachycardia weak peripheral pulses decreased hct/hgb pain decreased uo

Q: Hypotonic dehydration occurs when?

electrolyte loss exceeds water loss

Which expected laboratory findings would help confirm the presence of a sickle cell crisis? (3)

elevated bilirubin hemoglobin <10 K <3.5

Pain associated with gastric ulcers becomes worse when? (2)

empty stomach at night

A nurse is reviewing the laboratory results of a client admitted for an asthma exacerbation. Elevation of which of these cells indicates that the client's asthma may have been triggered by an allergic response?

eosinophils

How often to rinse the bag and change the formula for a pt who is receiving continuous tube feeding?

every 4 hours

Meniere disease (endolymphatic hydrops) results from?

excess fluid accumulation inside the inner ear

What is polycythemia vera?

excessive amounts of rbcs, wbcs, and platelets

Risk factors of breast cancer (4)

exposure to radiation increased abd fat hx of colon, endometrial, and ovarian cancer first degree relatives breast cancer

Aphasia syndrome: Broca is _________ and Wernicke is _________

expressive receptive

What is the phlebostatic axis?

external anatomical point on the chest at the level of the atria of the heart

s/s of B12 deficiency (4)

fatigue constipation sore tongue diarrhea

Adverse effects of imipramine (5)

fever dry mouth increased fatigue vomiting and diarrhea sore throat

A client diagnosed with chronic obstructive pulmonary disease (COPD) has chronic hypoxemia. Which finding does the nurse expect when assessing this client?

finger clubbing

Initial s/s of steven johnson syndrome

flu like symptoms painful purple rash mucus membrane resemble a third degree burn

Aphasia syndrome: Wernicke- Spontaneous speech: Comprehension:

fluent but lacks meaning greatly diminshed

To treat left sided heart failure you need to decrease? (2)

fluid volume preload

Diazepam antidote?

flumazenil

A client receives intermittent bolus enteral feedings through a nasogastric tube. Which are appropriate nursing actions prior to starting the feeding? (3)

flush before and after the feeding place pt in semi fowlers start feeding after <100mL of residual is obtained

s/s of Duchenne muscular dystrophy (4)

frequent trips and falls pushes on thighs to stand walks on tip toes unproportioned calf mm

The client diagnosed with bipolar disorder is in a manic phase with combative behavior. Which is the initial priority nursing action?

gain control

Which herbal supplements pose an increased risk for bleeding in surgical clients and should be discontinued prior to major surgery? (3)

garlic ginger ginkgo biloba

What are CN IX and CN X?

glossopharyngeal vagus

Memory trick for pts ambulating with signal sided weaknees

good goes up bad goes down

How to position a pt with pneumonia?

good lung down

Can NAP suction nasotracheal tubes?

hell the fck no

When is recombinant human erythropoietin initiated as treatment in a pt with chronic kidney disease?

hemoglobin <10

Hemarthrosis is commonly caused by?

hemophilia

A nurse is caring for a client on a mechanical ventilator. The ventilator is sounding an alarm and displaying an alert about low tidal volumes. The nurse has checked all connections and the endotracheal tube, but the alarm persists and the client's oxygen saturation is dropping. What should the nurse do next?

manually ventilate the pt with a bag

The nurse notes muffled heart tones in a client with a pericardial effusion. How would the nurse assess for a pulsus paradoxus?

measure the difference btwn korotkoff sounds during expiration and resp cycle

Do not give _________ to a pt receiving procedures with contrast dye

metformin

S/S of fetal alcohol syndrome (5)

microencephaly short palpebral fissures flat mid face smooth philtrum thin upper lip

What is common among women with IBD?

mild to moderate anemia

The client is admitted to the hospital for a hemiglossectomy with lymph node dissection. The client's preoperative care includes frequent oral hygiene with normal saline. The nurse knows the purpose of this treatment includes which reason?

minimize bacterial count in mouth

Adverse effects of thiazide diuretics: How does hypokalemia present?

mm cramps

The nurse is caring for a client admitted with serotonin syndrome after taking citalopram and tramadol. Which assessment findings does the nurse expect to find? (3)

mm rigidity restlessness sinus tachycardia

What s/s are the early indicators of rhabdomyolysis?

mm weakness or aches

The nurse administers Rho(D) immune globulin to prevent complications in which type of client situation? (3)

mom is Rh negative baby is Rh positive negative direct coombs

The nurse provides care for a client with a serum sodium level of 120 mEq/L. Which nursing action is a priority?

monitor for neuro changes

Admin diuretics in the ____________

morning

Contact precautions: "MRS WEE" (6)

multi drug resp infection skin infection wound infection enteric (c diff) eye infections (pink eye)

A nurse is assessing a 1-month-old infant with an atrial septal defect (ASD). Which assessment finding does the nurse expect?

murmur

The nurse is performing a cardiac assessment on a client. The nurse auscultates a loud blowing sound at the second intercostal space, right sternal border. How should the nurse document this finding?

murmur heart at aortic area

Naloxone will cause signs and symptoms of opioid withdrawal (4)

nausea vomiting restlessness abd cramping

What do plantar creases indicate in an infant?

neonatal age

Stopping the seizure activity is priority over?

neuro assessment

Dietary changes for a pt w/ cirrhosis (3)

no alcohol high carb high cal

A client with a newly casted lower leg reports to the nurse that the foot feels numb. Which action will the nurse take first?

notify doc possible compartment syndrome

What is physiological anorexia?

occurs when the very high metabolic demands of infancy slow down to keep pace with the moderate growth of toddlerhood

Phototherapy used to prevent SAD should begin in? and last until?

october spring

stages of labor: 1st

onset of labor to full dilation

What is the tx for mild dehydration?

oral rehydration

What is the tx for moderate dehydration?

oral rehydration

Rifampin turns the urine __________

orange

What food has no vitamin K?

oranges

Swimmers ear is what type of ear infection?

otitis externa

Sodium bicarbonate is only given if

pH is 6.9 or lower

What should the interventions for a pt with incomplete rib fractures be based on? (2)

pain management pulmonary hygiene

A client takes a beta 2 adrenergic agonist. Which finding indicates to the nurse that the client is experiencing an adverse reaction?

palpations

What are Epstein's pearls?

pearl like cysts on gum margins seen in an infant. disappear within a few weeks

Q: What causes hypertonic dehydration? (7)

perspiration, hyperventilating, ketoacidosis, prolonged fever, diarrhea, ESKD, DI

When using a gravity drip, how should you place the bags?

piggyback higher than primary infusion

Potassium is an erosive substance that can cause?

pill-induced esophagitis

stages of labor: 4th

placental delivery to stability

What vaccination is necessary for pts over 65yo?

pneumococcal

What is Torsades de pointes?

polymorphic v tach coupled with prolonged QT invertval

Chronic Kidney Disease: Leads to a decrease in GFR which decreases the secretion of? (2)

potassium phosphate

What is refeeding syndrome?

potentially fatal complication of nutritional rehab in a chronically malnourished pt

Warfarin in generally contradicted in which type of pts?

pregnant

Furosemide can decrease L/R sided...?

preload

Q: EKG changes: Hypermagnesemia (2)

prolonged PR interval, widened QRS complex

The client has metastatic cancer, and a living will on record indicates that the client does not want cardiopulmonary or pharmacologic resuscitation. The client is brought to the emergency department with respirations of 4/min and a heart rate of 20/min. How should the nurse handle the situation at this time?

provide comfort measures

Which port is used when administering oxytocin?

proximal

What are the most common s/s of myasthenia gravis? (3)

ptosis bulbar sign diff breathing

Which parameter is measured by the CVP?

r atrium

rifampin and rifapentine effect oral contraceptives how?

reduce the efficacy

The nurse learns that a client with heart failure has an ejection fraction of 28%. Which outcome will the nurse identify as being the most appropriate for this client?

reduced preload and afterload

What is the function of a Miller-Abbott tube?

removes fluid and gas from the small intestines

The nurse cares for a client with a diagnosis of Guillain-Barré syndrome. Which symptoms support this diagnosis? (3)

resp failure flaccid paralysis urinary retention

What should a pt do post-op billroth II procedure regarding meals and fluids? (2)

rest after meals drink 1hr after meals

Q: What is the earliest sign of hypovolemic shock?

restlessness

A serious complication associated with statin medication is?

rhabdomyolysis

How to position a pt after a percutaneous liver biopsy?

right side laying

5 rights of delegation

right task right circumstances right person right direction right supervision

A child is brought to the school nurse after having a permanent tooth knocked out during gym class. Which action by the nurse is appropriate?

rinse tooth with sterile saline and reinsert

What temp should insulin be given?

room temp

Which glands are most commonly affected in pts with Sjögren's syndrome? (2)

salivary lacrimal

cooperative play occurs in which aged children?

school aged

The client is returned to the unit after surgery with a cuffed tracheostomy tube in place. The nurse knows the purpose of the cuff on the tracheostomy tube includes which reason?

seals trachea, prevents aspiration

What types of medications can exacerbate obstructive sleep apnea?

sedating meds

An elderly client with a history of stable chronic obstructive pulmonary disease, alcohol abuse, and cirrhosis has a serum theophylline level of 25.8 mcg/mL (143 µmol/L). Which clinical manifestation associated with theophylline toxicity should worry the nurse most?

seizure activity

What is Levetiracetam used to tx?

seizures

Cerebral Arteriovenous Malformation can cause? (3)

seizures ha neuro deficits

Droplet precautions: "SPIDERMAN" (7)

sepsis scarlet fever streptococcal pharyngitis parovirus pneumonia influenza diptheria

The hospitalized client with anorexia nervosa is started on nutrition via enteral and parenteral routes. Which client assessment is the most important for the nurse to check during the first 24-48 hours of administration? (2)

serum potassium serum phosphate

The nurse is caring for a client who had a near-drowning accident in cold weather. The pt's toes are facing straight down, what does this indicate?

severe brain injury

What is Anencephaly?

severe neural tube defect resulting in little or no brain

What is the most common side effect of SSRIs?

sexual dysfunction

Q: EKG changes: Hypercalcemia (2)

shortened ST segment, widened T wave

The nurse provides care to a client who fell. Which assessment finding indicates to the nurse that the client fractured the hip as a result of the fall?

shortened and externally rotated leg

The nurse cares for the client who has just had a prosthetic hip implant. The nurse places the client in which position?

side lying w affected hip abducted

Feedings specifications for an infant with tetralogy of fallot? (2)

sit up high-flow soft nipple

A client with a hip fracture is placed in Buck's traction. Which nursing intervention is most important when caring for this client?

skin assessment every 2-4 hours

Tamazepam adverse effects (3)

sleep driving incoordination amnesia

Where should the nurse preform compressions on a pt who is 32 weeks pregnant?

slightly higher on the sternum

Excretion of lithium depends on normal __________ levels

sodium

Q: Hypertonic overhydration occurs when there is an excessive of _______ ingestion

sodium

The health care provider prescribes lithium carbonate 300 mg PO QID for the adult client. The nurse in the outpatient clinic instructs the client about the medication. The nurse encourages the client to maintain an adequate intake of which substance?

sodium

Aphasia syndrome: Broca- Spontaneous speech: Comprehension:

sparse and nonfluent relatively preserved

Anticholinergic effect- won't be able to...

spit, pee, poop or see

A 15-month-old begins to seize during assessment for a high-grade fever. What is the most appropriate nursing action?

stay with pt and monitor o2

A 2-year-old in the emergency department is suspected of having intussusception. Which assessment finding concerning the pt stools should the nurse expect?

stools mixed with blood and mucus

Several hours after an oxytocin infusion is started, a client 's contractions are sustained over 2 minutes. Which nursing action is most important for the nurse to take?

stop oxytocin

The nurse provides care for a client with a history of chronic urinary tract infections who is experiencing urolithiasis. Which type of urinary stone does the nurse suspect the client has developed?

struvite

If a pt has a Cerebral Arteriovenous Malformation, which s/s are CRUCIAL? (2)

sudden severe ha n/v

Pt with the CN IX and CN X affected, which precautions are necessary?

swallow precautions

The health care provider (HCP) has told a client to take over-the-counter (OTC) supplemental calcium carbonate 1000 mg/day for treatment of osteoporosis. Which instruction should the clinic nurse give the client?

take calcium in divided doses with food

The following should be taught to clients taking tetracyclines (eg, tetracycline, doxycycline, minocycline)? (4)

take on empty stomach avoid antacids/dairy take with full glass of water photosensitivity

Q: EKG changes: Hypomagnesemia (2)

tall T waves, depressed ST segment

The supervisor observes the nurse delegate a dressing change on a client with a fever, positive blood cultures, and a blood pressure of 86/42 mm Hg to the LPN/LVN. Which action will the supervisor take next?

tell nurse the lpn cannot perform the change

What is rhabdomyolysis?

the breakdown of muscle tissue that leads to the release of muscle fiber contents into the blood

A nurse is discussing parallel play with parents of toddlers. Which statement should be included in the discussion?

they play without group goals

When taking valporic acid, what labs need to be done periodically? (3)

thrombocyte count amylase liver fxn tests

Q: Oral birth control is contradicted in these types of female patients (8)

thrombophlebitis, cardiovascular issues, cerebrovascular issues, estrogen dependent cancer, malignant liver tumors, impaired liver fxn, HTN, DM with vascular involvement

The nurse cares for the client admitted with a diagnosis of acute hypoparathyroidism. It is most important for the nurse to have which item available?

trach set

Where would the fundus be at 20-22 weeks?

umbilicus

The nurse helps the health care provider perform a thoracentesis at the bedside. In which position does the nurse place the client to facilitate needle insertion and promote comfort?

upright leaning forward on a bedside table

The primary health care provider prescribes a 24-hour urine collection for a client with suspected Cushing syndrome. Which instructions should the nurse give the client regarding this test? (3)

urine collection container should be kept in the fridge record time collection is started then empty bladder dark plastic jug is given to the pt with powder that absorbs the urine

A 24-year-old female client has been prescribed isotretinoin for severe nodulocystic acne that has been resistant to other therapies. Which instruction is most important for the nurse to reinforce with this client?

use 2 forms of contraception

Torsades de pointes can develop quickly into?

v fib

Hypomagnesemia causes prolonged QT interval which increases a pt's susceptibility to?

v tach

What two rhythms are most commonly shocked?

v tach v fib

"VEAL CHOP"

variable early acceleration late cord compress head compress OK, no prob placental insufficiency

Positive pressure applied to the lungs via a ventilator causes a decrease in? (3) Which leads to?

venous return ventricular preload CO hypotension

What complication is common directly after an acute MI?

ventricular dysrhythmias

Q: Hypotonic overhydration is also known as?

water intoxication

Q: Hypertonic dehydration occurs when?

water loss exceeds electrolyte loss

Cushing's syndrome s/s (5)

weight gain moon face buffalo hump hyperglycemia hypernatremia

What s/s is most concerning when a pt is taking propanolol?

wheezing

How to take potassium chloride tablets?

with a glass of water and stay sitting up afterwards

How should tetracyclines be taken?

with full glass of water at least 1 hour before or 2 hours after meals

The health care provider prescribes simvastatin for a client with hyperlipidemia. The nurse instructs the client to take this medication in which manner?

with the evening meal

Adverse effects of thiazide diuretics: How does hyperuricemia present?

worsen gout attacks

Where would the fundus be at 36 weeks?

xiphoid process