ATI comprehensive predictor -Virtual Questions with Answers, Exams of Nursing

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ATI comprehensive predictor - Virtual Questions with

Answers

Do not delegate - CORRECT ANSWER-What you can EAT E-evaluate A-assess T-teach Addison's & Cushings - CORRECT ANSWER-Addison's = down down down up down Cushings= up up up down up hypo/hypernatremia, hypo/hypertension, blood volume, hypo/hyperkalemia, hypo/hyperglycemia Better peripheral perfusion? - CORRECT ANSWER-EleVate Veins, DAngle Arteries APGAR - CORRECT ANSWER-Appearance (all pink, pink and blue, blue (pale) Pulse (>100, <100, absent) Grimace (cough, grimace, no response) Activity (flexed, flaccid, limp) Respirations (strong cry, weak cry, absent) Airborne precautions - CORRECT ANSWER-MTV or My chicken hez tb measles, chickenpox (varicella) Herpes zoster/shingles TB Airborne precautions protective equip - CORRECT ANSWER-private room, neg pressure with 6-12 air exchanges/hr mask & respirator N95 for TB Droplet precautions - CORRECT ANSWER-spiderman! sepsis, scarlet fever, streptococcal pharyngitis, parvovirus, pneumonia, pertussis, influenza, diptheria, epiglottitis, rubella, mumps, meningitis, mycoplasma or meningeal pneumonia, adeNovirus

(Private room and mask) Contact precaution - CORRECT ANSWER-MRS WHISE protect visitors & caregivers when 3 ft of the pt. Multidrug-resistant organisms RSV, Shigella, Wound infections, Herpes simplex, Impetigo, Scabies, Enteric diseases caused by micro- organisms (C diff), Gloves and gowns worn by the caregivers and visitors Disposal of infectious dressing material into a single, nonporous bag without touching the outside of the bag PMGG= Private room/ share same illness, mask, gown and gloves Skin infection - CORRECT ANSWER-VCHIPS Varicella zoster Cutaneous diptheria Herpes simplez Impetigo Peduculosis Scabies Air or Pulmonary Embolism - CORRECT ANSWER-S/S chest pain, dyspnea, tachycardia, pale/cyanotic, sense of impending doom. (turn pt to LEFT side and LOWER the head of bed.) Woman in labor (un-reassuring FHR) - CORRECT ANSWER-(late decels, decreased variability, fetal bradycardia, etc) Turn pt on Left side, give O2, stop pitocin, Increase IV fluids! Tube feeding with decreased LOC - CORRECT ANSWER-Pt on Right side (promotes emptying of the stomach) Head of bed elevated (prevent aspiration)

After lumbar puncture and oil based myelogram - CORRECT ANSWER-pt is flat SUPINE (prevent headache and leaking of CSF) Pt with heat stroke - CORRECT ANSWER-flat with legs elevated during Continuous Bladder Irrigation (CBI) - CORRECT ANSWER-catheter is taped to the thigh. leg must be kept straight. After Myringotomy - CORRECT ANSWER-position on the side of AFFECTED ear, allows drainage. After Cateract surgery - CORRECT ANSWER-pt sleep on UNAFFECTED side with a night shield for 1- 4 weeks after Thyroidectomy - CORRECT ANSWER-low or semi-fowler's position, support head, neck and shoulders. Infant with Spina Bifida - CORRECT ANSWER-Prone so that sac does not rupture Buck's Traction (skin) - CORRECT ANSWER-elevate foot of bed for counter traction After total hip replacement - CORRECT ANSWER-don't sleep on side of surgery, don't flex hip more than 45 - 60 degress, don't elevate Head Of Bed more than 45 degrees. Maintain hip abduction by separating thighs with pillows. Prolapsed cord - CORRECT ANSWER-Knee to chest or Trendelenburg oxygen 8 to 10 L Cleft Lip - CORRECT ANSWER-position on back or in infant seat to prevent trauma to the suture line. while feeding hold in upright position.

To prevent dumping syndrome - CORRECT ANSWER-(post operative ulcer/stomach surgeries) eat in reclining position. Lie down after meals for 20-30 min. also restrict fluids during meals, low CHO and fiber diet. small, frequent meals. AKA (above knee amputation) - CORRECT ANSWER-elevate for first 24 hours on pillow. position prone daily to maintain hip extension. BKA (below knee amputation) - CORRECT ANSWER-foot of bed elevated for first 24 hours. position prone to provide hip extension. detached retina - CORRECT ANSWER-area of detachment should be in the dependent position administration of enema - CORRECT ANSWER-pt should be left side lying (Sim's) with knee flexed. After supratentorial surgery - CORRECT ANSWER-(incision behind hairline on forhead) elevate HOB 30- 40 degrees After infratentorial surgery - CORRECT ANSWER-(incision at the nape of neck) position pt flat and lateral on either side. During internal radiation - CORRECT ANSWER-on bed rest while implant in place Autonomic Dysreflexia/Hyperreflexia - CORRECT ANSWER-S/S pounding headache, profuse sweating, nasal congestion, chills, bradycardia, hypertension. Place client in sitting position (elevate HOB) FIRST! Shock - CORRECT ANSWER-bedrest with extremities elevated 20 degrees. knees straight, head slightly elevated (modified Trendelenberg) Head Injury - CORRECT ANSWER-elevate HOB 30 degrees to decrease ICP Peritoneal Dialysis (when outflow is inadequate) - CORRECT ANSWER-turn pt from side to side BEFORE checking for kinks in tubing

Lumbar Puncture - CORRECT ANSWER-After the procedure, the pt should be supine for 4-12 hours as prescribed. Myesthenia Gravis - CORRECT ANSWER-worsens with exercise and improves with rest Myesthenia Gravis - CORRECT ANSWER-a positive reaction to Tensilon---will improve symptoms Cholinergic Crisis - CORRECT ANSWER-Caused by excessive medication ---stop giving Tensilon...will make it worse. Liver biopsy (prior) - CORRECT ANSWER-must have lab results for prothrombin time Myxedema/ hypothyroidism - CORRECT ANSWER-slowed physical and mental function, sensitivity to cold, dry skin and hair. Grave's Disease/ hyperthyroidism - CORRECT ANSWER-accelerated physical and mental function. Sensitivity to heat. Fine/soft hair. Thyroid storm - CORRECT ANSWER-increased temp, pulse and HTN Post-Thyroidectomy - CORRECT ANSWER-semi-fowler's. Prevent neck flexion/hyperextension. Trach at bedside Hypo-parathyroid - CORRECT ANSWER-CATS---Convulsions, Arrhythmias, Tetany, Spasms, Stridor. (decreased calcium) give high calcium, low phosphorus diet Hyper-parathyroid - CORRECT ANSWER-fatigue, muscle weakness, renal calculi, back and joint pain (increased calcium) give a low calcium high phosphorous diet Hypovolemia - CORRECT ANSWER-increased temp, rapid/weak pulse, increase respiration, hypotension, anxiety. Urine specific gravity >1.

Hypervolemia - CORRECT ANSWER-bounding pulse, SOB, dyspnea, rales/crackles, peripheral edema, HTN, urine specific gravity <1.010. semi fowler's Diabetes insipidus (decreased ADH) - CORRECT ANSWER-excessive urine output and thirst, dehydration, weakness, administer Pitressin SIADH (increased ADH) - CORRECT ANSWER-change in LOC, decreased deep tendon reflexes, tachycardia. N/V HA administer Declomycin, diuretics hypokalemia - CORRECT ANSWER-muscle weakness, dysrhythmias, increase K (rasins bananas apricots, oranges, beans, potatoes, carrots, celery) Hyperkalemia - CORRECT ANSWER-MURDER Muscle weakness, Urine (olig, anuria) Resp depression, decreased cardiac contractility, ECG changes, reflexes Hyponatremia - CORRECT ANSWER-nausea, muscle cramps, increased ICP, muscular twitching, convulsions. give osmotic diuretics (Mannitol) and fluids Hypernatremia - CORRECT ANSWER-increased temp, weakness, disorientation, dilusions, hypotension, tachycardia. give hypotonic solution. Hypocalcemia - CORRECT ANSWER-CATS Convulsions, Arrythmias, Tetany, spasms and stridor Hypercalcemia - CORRECT ANSWER-muscle weakness, lack of coordination, abdominal pain, confusion, absent tendon reflexes, shallow respirations, emergency! Hypo Mg - CORRECT ANSWER-Tremors, tetany, seizures, dysthythmias, depression, confusion, dysphagia, (dig toxicity) Hyper Mg - CORRECT ANSWER-depresses the CNS. Hypotension, facial flushing, muscle weakness, absent deep tendon reflexes, shallow respirations. EMERGENCY

Addison's - CORRECT ANSWER-Hypo Na, Hyper K, Hypoglycemia, dark pigmentation, decreased resistance to stress fx, alopecia, weight loss. GI stress. Cushings - CORRECT ANSWER-Hyper Na, Hypo K, hyperglycemia, prone to infection, muscle wasting, weakness, edema, HTN, hirsutism, moonface/buffalo hump Addesonian crisis - CORRECT ANSWER-N/V confusion, abdominal pain, extreme weakness, hypoglycemia, dehydration, decreased BP Pheochromocytoma - CORRECT ANSWER-hypersecretion of epi/norepi. persistent HTN, increased HR, hyperglycemia, diaphoresis, tremor, pounding HA; avoid stress, frequent bathing and rest breaks, avoid cold and stimulating foods (surgery to remove tumor) Tetrology of Fallot - CORRECT ANSWER-DROP (Defect, septal, Right ventricular hypertrophy, Overriding aortas, Pulmonary stenosis) Autonomic Dysreflexia - CORRECT ANSWER-(potentially life threatening emergency!) HOB elevate 90 degrees, loosen constrictive clothing, assess for full bladder or bowel impaction, (trigger) administer antihypertensives (may cause stroke, MI, seizure) FHR patterns for OB - CORRECT ANSWER-Think VEAL CHOP! V-variable decels; C- cord compression caused E-early decels; H- head compression caused A-accels; O-okay, no problem L- late decels; P- placental insufficiency, can't fill what to check with pregnancy - CORRECT ANSWER-Never check the monitor or machine as a first action. Always assess the patient first. Ex.. listen to fetal heart tones with stethoscope. Position of the baby by fetal heart sounds - CORRECT ANSWER-Posterior --heard at sides Anterior---midline by unbilicus and side

Breech- high up in the fundus near umbilicus Vertex- by the symphysis pubis. Ventilatory alarms - CORRECT ANSWER-HOLD High alarm--Obstruction due to secretions, kink, pt cough etc Low alarm--Disconnection, leak, etc ICP and Shock - CORRECT ANSWER-ICP- Increased BP, decreased pulse, decreased resp Shock--Decreased BP, increased pulse, increased resp Cor pumonae - CORRECT ANSWER-Right sided heart failure caused by left ventricular failure (edema, jugular vein distention) Heroin withdrawal neonate - CORRECT ANSWER-irritable, poor sucking brachial pulse - CORRECT ANSWER-pulse area on an infant lead poisoning - CORRECT ANSWER-test at 12 months of age Before starting IV antibiotics - CORRECT ANSWER-obtain cultures! pt with leukemia may have - CORRECT ANSWER-epistaxis due to low platelets when a pt comes in and is in active labor - CORRECT ANSWER-first action of nurse is to listen to fetal heart tones/rate for phobias - CORRECT ANSWER-use systematic desensitization

NCLEX answer tips - CORRECT ANSWER-choose assessment first! (assess, collect, auscultate, monitor, palpate) only choose intervention in an emergency or stress situation. If the answer has an absolute, discard it. Give priority to the answers that deal with the patient's body, not machines, or equipment. ARDS and DIC - CORRECT ANSWER-are always secondary to another disease or trauma In an emergency - CORRECT ANSWER-patients with a greater chance to live are treated first Cardinal sign of ARDS - CORRECT ANSWER-hypoxemia Edema is located - CORRECT ANSWER-in the interstitial space, not the cardiovascular space (outside of the circulatory system) the best indicator of dehydration? - CORRECT ANSWER-weight---and skin turgor heat/cold - CORRECT ANSWER-hot for chronic pain; cold for accute pain (sprain etc) When pt is in distress....medication administration - CORRECT ANSWER-is rarely a good choice pneumonia - CORRECT ANSWER-fever and chills are usually present. For the elderly confusion is often present. before IV antibiotics? - CORRECT ANSWER-check allergies (esp. penicillin) make sure cultures and sensitivity has been done before first dose. COPD and O2 - CORRECT ANSWER-with COPD baroreceptors that detect CO2 level are destroyed, therefore, O2 must be low because high O2 concentration takes away the pt's stimulation to breathe. Prednisone toxicity - CORRECT ANSWER-Cushings (buffalo hump, moon face, high blood sugar, HTN) Neutropenic pts - CORRECT ANSWER-no fresh fruits or flowers

Chest tubes are placed - CORRECT ANSWER-in the pleural space Preload/Afterload - CORRECT ANSWER-Preload affects the amount of blood going into Right ventricle. Afterload is the systemic resistance after leaving the heart. CABG - CORRECT ANSWER-Great Saphenous vein in leg is taken and turned inside out (because of valves inside). Used for bypass surgery of the heart. Unstable Angina - CORRECT ANSWER-not relieved by nitro PVC's - CORRECT ANSWER-can turn into V fib. 1 tsp - CORRECT ANSWER-5 mL 1 oz - CORRECT ANSWER-30 mL 1 cup - CORRECT ANSWER-8 oz 1 quart - CORRECT ANSWER-2 pints 1 pint - CORRECT ANSWER-2 cups 1 g (gram) - CORRECT ANSWER-1000 mg 1 kg - CORRECT ANSWER-2.2 lbs I lb - CORRECT ANSWER-16 oz

centigrade to Fahrenheit conversion - CORRECT ANSWER-F= C+40 multiply 5/9 and subtract 40 C=F+40 multiply 9/5 and subtract 40 Angiotenson II - CORRECT ANSWER-In the lungs...potent vasodialator, aldosterone attracts sodium. Iron toxicity reversal - CORRECT ANSWER-deferoxamine S3 sound - CORRECT ANSWER-normal in CHF. Not normal in MI After endoscopy - CORRECT ANSWER-check gag reflex TPN given in - CORRECT ANSWER-subclavian line pain with diverticulitis - CORRECT ANSWER-located in LLQ appendicitis pain - CORRECT ANSWER-located in RLQ Trousseau and Chvostek's signs observed in - CORRECT ANSWER-Hypocalcemia never give K+ in - CORRECT ANSWER-IV push DKA is rare - CORRECT ANSWER-in DM II (there is enough insulin to prevent fat breakdown) Glaucoma patients lose - CORRECT ANSWER-peripheral vision. Autonomic dysreflexia - CORRECT ANSWER-patients with spinal cord injuries are at risk for developing autonomic dyreflexia (T-7 or above) Spinal shock occurs - CORRECT ANSWER-immediately after injury

multiple sclerosis - CORRECT ANSWER-myelin sheath destruction. disruptions in nerve impulse conduction Myasthenia gravis - CORRECT ANSWER-decrease in receptor sites for acetylcholine. weakness observed in muscles, eyes mastication and pharyngeal musles. watch for aspiration. Gullian - Barre syndrome - CORRECT ANSWER-ascending paralysis. watch for respiratory problems. TIA - CORRECT ANSWER-transient ischemic attack....mini stroke, no dead tissue. CVA - CORRECT ANSWER-cerebriovascular accident. brain tissue dies. Hodgkin's disease - CORRECT ANSWER-cancer of the lymph. very curable in early stages burns rule of Nines - CORRECT ANSWER-head and neck 9% each upper ext 9% each lower ext 9% front trunk 18% back trunk 18% genitalia 1% birth weight - CORRECT ANSWER-doubles by 6 months triples by 1 year if HR is <100 (children) - CORRECT ANSWER-Hold Dig early sign of cystic fibrosis - CORRECT ANSWER-meconium in ileus at birth

Meningitis--check for - CORRECT ANSWER-Kernig's/ brudinski's signs wilm's tumor - CORRECT ANSWER-encapsulated above kidneys...causes flank pain hemophilia is x linked - CORRECT ANSWER-passed from mother to son when phenylaline increases - CORRECT ANSWER-brain problems occur buck's traction - CORRECT ANSWER-knee immobility russell traction - CORRECT ANSWER-femur or lower leg dunlap traction - CORRECT ANSWER-skeletal or skin bryant's traction - CORRECT ANSWER-children <3 y <35 lbs with femur fx eclampsia is - CORRECT ANSWER-a seizure perform amniocentesis - CORRECT ANSWER-before 20 weeks to check for cardiac and pulmonary abnormalities Rh mothers receive Rhogam - CORRECT ANSWER-to protect next baby anterior fontanelle closes by...posterior by.. - CORRECT ANSWER-18 months, 6-8 weeks caput succedaneum - CORRECT ANSWER-diffuse edema of the fetal scalp that crosses the suture lines. reabsorbes within 1 to 3 days pathological jaundice occurs:

physiological jaundice occurs: - CORRECT ANSWER-before 24 hours (lasts 7 days) after 24 hours placenta previa s/s placental abrution s/s - CORRECT ANSWER-there is no pain, but there is bleeding there is pain, but no bleeding (board like abd) bethamethasone (celestone) - CORRECT ANSWER-surfactant. premature babies milieu therapy - CORRECT ANSWER-taking care of pt and environmental therapy cognitive therapy - CORRECT ANSWER-counseling five interventions for psych patients - CORRECT ANSWER-safety setting limits establish trusting relationship meds least restrictive methods/environment SSRI's - CORRECT ANSWER-take about 3 weeks to work patients with hallucinations patients with delusions - CORRECT ANSWER-redirect them distract them Thorazine and Haldol - CORRECT ANSWER-can cause EPS Alzheimer's - CORRECT ANSWER-60% of all dementias, chronic, progressive degenerative cognitive disorder.

draw up regular and NHP? - CORRECT ANSWER-Air into NHP, air into Regular. Draw regular, then NHP Cranial nerves - CORRECT ANSWER-S=sensory M=motor B=both Oh (Olfactory I) Some Oh (Optic II ) Say Oh (Oculomotor III) Marry To (trochlear IV) Money Touch (trigeminal V) But And (Abducens VI ) My Feel (facial VII) Brother A (auditory VIII) Says Girl's (glossopharyngeal IX) Big Vagina (vagus X) Bras And (accessory XI) Matter Hymen (Hypoglossal XII) More Hypernatremia - CORRECT ANSWER-S (Skin flushed) A (agitation) L (low grade fever ) T (thirst) Developmental - CORRECT ANSWER- 2 - 3 months: turns head side to side 4 - 5 months: grasps, switch and roll 6 - 7 months: sit at 6 and waves bye bye 8 - 9 months: stands straight at 8 10 - 11 months: belly to butt 12 - 13 months: 12 and up, drink from a cup

Hepatitis A - CORRECT ANSWER-Ends in a vowel, comes from the bowel Hepatitis b - CORRECT ANSWER-B= blood and body fluids (hep c is the same) Apgar measures - CORRECT ANSWER-HR RR Muscle tone, reflexes, skin color. Each 0-2 points. 8-10 ok, 0-3 resuscitate Glasgow coma scale - CORRECT ANSWER-eyes, verbal, motor Max- 15 pts, below 8= coma Addison's disease: Cushing's syndrome: - CORRECT ANSWER-"add" hormone have extra "cushion" of hormone Dumping syndrome - CORRECT ANSWER-increase fat and protein, small frequent meals, lie down after meal to decrease peristalsis. Wait 1 hr after meals to drink Disseminated herpes zoster localized herpes zoster - CORRECT ANSWER-Disseminated herpes=airborne precautions Localized herpes= contact precautions. A nurse with localized may take care of patients as long as pts are not immunosuppressed and the lesions must be covered! Isoniazid - CORRECT ANSWER-causes peripheral neuritis Weighted NI (naso intestinal tubes) - CORRECT ANSWER-Must float from stomach to intestine. Don't tape right away after placement. May leave coiled next to pt on HOB. Position pt on RIGHT to facilitate movement through pyloris Cushings ulcers - CORRECT ANSWER-r/t brain injury

Cushing's triad - CORRECT ANSWER-r/t ICP (HTN, bradycardia, irritability, sleep, widening pulse pressure) Thyroid storm - CORRECT ANSWER-HOT (hyperthermia) Myxedema coma - CORRECT ANSWER-COLD (hypothermia) Glaucoma - CORRECT ANSWER-No atropine Non Dairy calcium - CORRECT ANSWER-Rhubarb sardines collard greens Koplick's spots - CORRECT ANSWER-prodomal stage of measles. Red spots with blue center, in the mouth--think kopLICK in the mouth INH can cause peripheral neuritis - CORRECT ANSWER-Take vitamin B6 to prevent. Hepatotoxic pancreatitis pts - CORRECT ANSWER-put them in fetal position, NPO, gut rest, Prepare anticubital site for PICC, they are probably going to get TPN/Lipids Murphy's sign - CORRECT ANSWER-Pain with palplation of gall bladder (seen with cholecystitis) Cullen's sign - CORRECT ANSWER-ecchymosis in umbilical area, seen with pancreatitis Turner's sign - CORRECT ANSWER-Flank--greyish blue. (turn around to see your flanks) Seen with pancreatitis McBurney's point - CORRECT ANSWER-Pain in RLQ with appendicitis LLQ - CORRECT ANSWER-Diverticulitis RLQ - CORRECT ANSWER-appendicitis watch for peritonitis

Guthrie test - CORRECT ANSWER-Tests for PKU. Baby should have eaten protein first shilling test - CORRECT ANSWER-Test for pernicious anemia Peritoneal dialysis - CORRECT ANSWER-Its ok to have abd cramps, blood tinged outflow and leaking around site if the cath (tenkoff) was placed in the last 1-2 weeks. Cloudy outflow is never ok Hyper reflexes absent reflexes - CORRECT ANSWER-upper motor neuron issue (your reflexes are over the top) Lower motor neuron issue Latex allergies - CORRECT ANSWER-assess for allergies to bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes and peaches Tensilon - CORRECT ANSWER-used in myesthenia gravis to confirm diagnosis ALS - CORRECT ANSWER-(amyotrophic lateral sclerosis) degeneration of motor neurons in both upper and lower motor neuron systems Transesophageal fistula - CORRECT ANSWER-esophagus doesn't fully develop. This is a surgical emergency (3 signs in newborn: choking, coughing, cyanosis) MMR - CORRECT ANSWER-is given SQ not IM codes for pt care - CORRECT ANSWER-Red- unstable, ie.. occluded airway, actively bleeding...see first Yellow--stable, can wait up to an hour for treatment Green--stable can wait even longer to be seen---walking wounded Black--unstable, probably will not make it, need comfort care DOA--dead on arrival

Contraindication for Hep B vaccine - CORRECT ANSWER-anaphylactic reaction to baker's yeast what to ask before flu shot - CORRECT ANSWER-allergy to eggs what to ask before MMR - CORRECT ANSWER-allergy to eggs or neomycin when on nitroprusside monitor: - CORRECT ANSWER-cyanide. normal value should be 1. William's position - CORRECT ANSWER-semi Fowler's with knees flexed to reduce low back pain S/S of hip fx - CORRECT ANSWER-External rotation, shortening adduction Fat embolism - CORRECT ANSWER-blood tinged sputum r/t inflammations. Increase ESR, respiratory alkalosis. Hypocalcemia, increased serum lipids. complications of mechanical ventilation - CORRECT ANSWER-pneumothorax, ulcers Paget's disease - CORRECT ANSWER-tinnitus, bone pain, elnargement of bone, thick bones with allopurinol - CORRECT ANSWER-no vitamin C or warfarin! IVP requires - CORRECT ANSWER-bowel prep so bladder can be visualized acid ash diet - CORRECT ANSWER-cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread alk ash diet - CORRECT ANSWER-milk, veggies, rhubarb, salmon orange tag in psych - CORRECT ANSWER-is emergent psych

thyroid med side effects - CORRECT ANSWER-insomnia. body metabolism increases Tidal volume is - CORRECT ANSWER- 7 - 10 ml/kg COPD patients and O2 - CORRECT ANSWER-2LNC or less. They are chronic CO2 retainers expect sats to be 90% or less Kidney glucose threshold - CORRECT ANSWER- 180 Stranger anxiety is greatest at what age? - CORRECT ANSWER- 7 - 9 months..separation anxiety peaks in toddlerhood when drawing an ABG - CORRECT ANSWER-put in heparinized tube. Ice immediately, be sure there are no bubbles and label if pt was on O Munchausen syndrome vs munchausen by proxy - CORRECT ANSWER-Munchausen will self inflict injury or illness to fabricate symptoms of physical or mental illness to receive medical care or hospitalization. by proxy mother or other care taker fabricates illness in child multiple sclerosis - CORRECT ANSWER-motor s/s limb weakness, paralysis, slow speech. sensory s/s numbness, tingling, tinnitis cerebral s/s nystagmus, atazia, dysphagia, dysarthia hungtington's - CORRECT ANSWER-50% genetic autosomal dominanat disorder.. s/s uncontrolled muscle movements of face, limbs and body. no cure WBC left shift - CORRECT ANSWER-pt with pyelo. neutrophils kick in to fight infections pancreatic enzymes are taken - CORRECT ANSWER-with each meal! infants IM site - CORRECT ANSWER-Vastus lateralis

Toddler 18 months+ IM site - CORRECT ANSWER-Ventrogluteal IM site for children - CORRECT ANSWER-deltoid and gluteus maximus Thoracentesis: - CORRECT ANSWER-position pt on side or over bed table. no more than 1000 cc removed at a time. Listen for bilateral breath sounds, V.S, check leakage, sterile dressing Cardiac cath - CORRECT ANSWER-NPO 8-12 hours. empty bladder, pulses, tell pt may feel heat, palpitations or desire to cough with injection of dye. Post: V.S.--keep leg straight. bedrest for 6-8 hr Cerebral angio prep - CORRECT ANSWER-well hydrated, lie flat, site shaved, pulses marked. Post--keep flat for 12-14 hr. check site, pulses, force fluids. lumbar puncture - CORRECT ANSWER-fetal position. post-neuro assess q15-30 until stable. flat 2-3 hour. encourage fluids, oral analgesics for headache. ECG - CORRECT ANSWER-no sleep the night before, meals allowed, no stimulants/tranquilizers for 24- 48 hours before. may be asked to hyperventilate 3-4 min and watch a bright flashing light. watch for seizures after the procedure. Myelogram - CORRECT ANSWER-NPO for 4-6 hours. allergy hx phenothiazines, cns depressants and stimulants withheld 48 hours prior. Table moved to various positions during test. Post--neuro assessment q2-4 hours, water soluble HOB UP. oil soluble HOB down. oralanalgesics for HA. No po fluids. assess for distended bladder. Inspect site Liver biopsy - CORRECT ANSWER-administer Vitamin K, NPO morning of exam 6 hrs. Give sedative. Teach pt to expect to be asked to hold breath for 5-10 sec. supide position, lateral with upper arms elevated. Post--position on RIGHT side. frequent VS. report severe ab pain STAT. no heavy lifting 1 wk Paracentesis - CORRECT ANSWER-semi fowler's or upright on edge of bed. Empty bladder. post VS-- report elevated temp. watch for hypovolemia

laparoscopy - CORRECT ANSWER-CO2 used to enhance visual. general anesthesia. foley. post--ambulate to decrease CO2 buildup PTB - CORRECT ANSWER-low grade afternoon fever pneumonia - CORRECT ANSWER-rusty sputum asthma - CORRECT ANSWER-wheezing on expiration emphysema - CORRECT ANSWER-barrel chest kawasaki syndrome - CORRECT ANSWER-strawberry tongue pernicious anemia - CORRECT ANSWER-red beefy tongue downs syndrome - CORRECT ANSWER-protruding tongue cholera - CORRECT ANSWER-rice watery stool malaria - CORRECT ANSWER-stepladder like fever--with chills typhoid - CORRECT ANSWER-rose spots on the abdomen diptheria - CORRECT ANSWER-pseudo membrane formation measles - CORRECT ANSWER-koplick's spots sle (systemic lupus) - CORRECT ANSWER-butterfly rash

pyloric stenosis - CORRECT ANSWER-olive like mass Addison's - CORRECT ANSWER-bronze like skin pigmentation Cushing's - CORRECT ANSWER-moon face, buffalo hump hyperthyroidism/ grave's disease - CORRECT ANSWER-exophthalmos myasthenia gravis - CORRECT ANSWER-descending musle weakness gullian-barre syndrome - CORRECT ANSWER-ascending muscle weakness angina - CORRECT ANSWER-crushing, stabbing chest pain relieved by nitro MI - CORRECT ANSWER-crushing stabbing chest pain unrelieved by nitro cystic fibrosis - CORRECT ANSWER-salty skin DM - CORRECT ANSWER-polyuria, polydipsia,polyphagia DKA - CORRECT ANSWER-kussmal's breathing (deep rapid) Bladder CA - CORRECT ANSWER-painless hematuria BPH - CORRECT ANSWER-reduced size and force of urine retinal detachment - CORRECT ANSWER-floaters and flashes of light. curtain vision glaucoma - CORRECT ANSWER-painful vision loss. tunnel vision. halo

retino blastoma - CORRECT ANSWER-cat's eye reflex increased ICP - CORRECT ANSWER-hypertension, bradypnea,, bradycarday (cushing's triad) shock - CORRECT ANSWER-Hypotension, tachypnea, tachycardia Lymes disease - CORRECT ANSWER-bullseye rash intraosseous infusion - CORRECT ANSWER-often used in peds when venous access can't be obtained. hand drilled through tibia where cryatalloids, colloids, blood products and meds are administered into the marrow. one med that CANNOT be administered IO is isoproterenol, a beta agonist. sickle cell crisis - CORRECT ANSWER-two interventions to prioritize: fluids and pain relief. glomuloneprhitis - CORRECT ANSWER-the most important assessment is blood pressure children 5 and up - CORRECT ANSWER-should have an explanation of what will happen a week before surgery Kawasaki disease - CORRECT ANSWER-(inflammation of blood vessles, hence the strawberry tongue) causes coronary artery aneurysms. ventriculoperitoneal shunt - CORRECT ANSWER-watch for abdominal distention. watch for s/s of ICP such as high pitch cry, irritability and bulging fontanels. In a toddler watch for loss of appetite and headache. After shunt is placed bed position is FLAT so fluid doesn't reduce too rapidly. If presenting s/s of ICP then raise the HOB 15-30 degrees 3 - 4 cups of milk a day for a child? - CORRECT ANSWER-NO too much milk can reduce the intake of other nutrients especially iron. Watch for ANEMIA MMR and varicella immunizaions - CORRECT ANSWER-after 15 months!

cryptorchidism - CORRECT ANSWER-undescended testicles! risk factor for testicular cancer later in life. Teach self exam for boys around age 12--most cases occur in adolescence CSF meningitis - CORRECT ANSWER-HIGH protein LOW glucose Head injury or skull fx - CORRECT ANSWER-no nasotracheal suctioning otitis media - CORRECT ANSWER-feed upright to avoid otitis media! positioning for pneumonia - CORRECT ANSWER-lay on affected side, this will splint and reduce pain. However, if you are trying to reduce congestion, the sick lung goes up! (like when you have a stuffy nose and you lay with that side up, it clears!) for neutropenic pts - CORRECT ANSWER-no fresh flowers, fresh fruits or veggies and no milk antiplatelet drug hypersensitivity - CORRECT ANSWER-bronchospasm bowel obstruction - CORRECT ANSWER-more important to maintain fluid balance than to establish a normal bowel pattern (they cant take in oral fluids) Basophils reliease histamine - CORRECT ANSWER-during an allergic response Iatragenic - CORRECT ANSWER-means it was caused by treatment, procedure or medication Tamoxifen - CORRECT ANSWER-watch for visual changes--indicates toxicity post spelectomy - CORRECT ANSWER-pneumovax 23 is administered to prevent pneumococcal sepsis Alkalosis/ Acidosis and K+ - CORRECT ANSWER-ALKalosis=al K= low sis. Acidosis (K+ high)