NCLEX QUESTIONS LATEST UPDATE 2024/2025 WITH 100% ACCURATE VERIFIED ANSWERS, Exams of Health sciences

Download NCLEX QUESTIONS LATEST UPDATE 2024/2025 WITH 100% ACCURATE VERIFIED ANSWERS and more Exams Health sciences in PDF only on Docsity! NCLEX QUESTIONS LATEST UPDATE 2024/2025 WITH 100% ACCURATE VERIFIED ANSWERS. What are signs and symptoms of hemorrhagic shock? Urinary output less than 30 cc/hr, dehydration, dizziness, fainting, fatigue, thirst What are the side effects of external radiation? - Dysgeusia (salty, rancid taste in mouth) - Stomatitis - Thrombocytopenia Where is the spleen palpated on the abdomen? RUQ "right upper quadrant" What is the highest priority care for pyelonephritis? -pyelonephritis: kidney infection Increase the patient's fluid intake to 3 liters daily. What is the difference between sterile and aseptic technique? Sterile - absence and continued protection against all microorganisms. Aseptic - used to prevent the SPREAD of microorganisms if a wound is already infected. Up to how many milligrams of caffeine can a pregnant women consume? 300 mg What is the edema scale? (1-4) 1 - 2cm 2 - 4cm 3 - 6cm 4 - 8 cm What screening tool is used for domestic violence? HITS "hurt, insult, threaten, scream" Where on an infants lips should they be latched on for proper sucking? areola What diet should a patient maintain for colorectal cancer screening? "colorectal cancer screening for colon or rectum" Avoid fish, cantaloupe, turnips, and red meats 48-72 hrs before the procedure. What are signs and symptoms of pernicious anemia? "Addison's anemia" - condition in which the body can't make enough healthy red blood cells because it doesn't have enough vitamin B12. Vitamin B12 is a nutrient found in some foods. The body needs this nutrient to make healthy red blood cells and to keep its nervous system working properly. Neuropathy of lower extremities, diarrhea, constipation, fatigue, lack of energy, light-headedness with exertion, swollen or red tongue, bleeding gums neuropathy - disease or dysfunction of one or more peripheral nerves "outside brain/spinal cord", typically causing numbness or weakness. What does the APGAR score assess? -given newborns after birth, given twice: once at 1 minute after birth, and again at 5 minutes after birth. Breathing effort, heart rate, muscle tone, reflexes, skin color What are symptoms of left sided heart failure? Cough - pink or frothy sputum, oliguria, fatigue, SOB, palpitations - Frothy sputum: Foamy white mucus "sometime signs of COPD/GERD" - Oliguria: Low urine output - SOB: shortness of breath "dyspnea" - Palpitations: noticeably rapid, strong, or irregular heartbeat due to agitation, exertion, or illness. What is worn for droplet precautions? Glove, gown, and mask What is a healthy total cholesterol to maintain? LDL? HDL? Total - <200 mg/dl HDL - >60 mg/dl "good" LDL - <130 mg/dl "bad" What is pulsation between the pubis and umbilicus indicative of? An aortic aneurysm - medical emergency Differentiate into macrophages to defend against infection. Normal % -2-8% What valvular disorder are syncope and dyspnea on exertion hallmark for? Aortic stenosis What does a spacer device do? May eventually lead to a decreased need in dosage or frequency of a medication What is a hepatobiliary scan used for? Used to evaluate the function of the gallbladder What is a erythrocyte sedimentation rate used for? Used to measure a non-specific measure of inflammation in the body - used to help diagnosed SLE, rheumatoid arthritis, and Kawasaki's disease What is a CBC used for? Used to detect anemia and thrombocytopenia What is an antinuclear antibody test for? To diagnose SLE What is Diltizazem used for? Used to treat arrhythimias and hypertension What is a normal range for lactate? 0.5-2.2mmol/L - it is a sign of spesis or tissue ischemia What causes an oxygen-hemoglobin dissociation curse to shift left? (oxygen uptake) Increased pH, decreased 2, 3-DPG, low temperature, increased CO, pCO2 decreased What causes an oxygen-hemoglobin dissociation curve to shift right? (oxygen release) Decreased pH, increased 2, 3-DPG, increased temperature, decreased CO, pCO2 increased What are Erikson's stages of psychosocial development? * Basic trust vs mistrust (0-2 yrs) *Autonomy vs shame and doubt (2-4 yrs) *Initiative vs guilt (4-5 yrs) *Industry vs inferiority (5-12 yrs) *Identity vs role confusion (13-19 yrs) *Intimacy vs isolation (20 - 24 yrs) *Generativity vs Stagnation (24-64 yrs) *Ego integrity vs despair (65-death) What are characteristic of autism? Over responsiveness to sensory stimuli (light or sound), impairment in communication, inability to name objects, and echolalia common What classifies a full thickness burn? 3rd degree - white/brown, dry, leathery, painless, no blanching What classifies a superficial burn? 1st degree - red, dry, painful What classifies a superficial partial thickness burn? 2nd degree - red, clear blisters, moist, painful, blanches What classifies a deep partial thickness burn? 2nd degree - red and white, bloody blisters, moist, painful, less blanching What classifies a 4th degree burn? Black, eschar, dry, painless, no blanching What is Kawasaki disease? An autoimmune disease involving the inflammation of blood vessels, lymph nodes, skin, and mucosa - initial symptom is a high fever, later symptoms include conjunctivitis, rash, peeling, and edema How far should an enema be inserted? 3-4 inches What foods have tyramine in them? Caffeine, dairy products, alcohol, ginseng, and aged meat, What are signs and symptoms of psoriasis? It is a chronic inflammatory diseased caused by hypersensitivity of the immune system - symptoms include lesions with red and white scales that appear on the extensor surfaces of joints (elbows and knees) What is a safe Troponin-1 level? <0.01 ng/ml What is, and what are signs and symptoms of systemic scleroderma? it is an autoimmune disorder that causes inflammation and sclerosis of the skin, muscles, joints, kidneys, and heart - others, weakness, pruritus, Raynaud's phenomenon, difficulty swallowing, edema, tight skin, shortness of breath, fatigue, and hypertension How is idiopathic thrombocytopenia purpura treated? First line of treatment is corticosteroids to dampen immune response and increase platelet count - will raise BG levels, need to be monitored. How is Lyme disease diagnosed? Blood test - not reliable until 6-8 weeks after exposure - treated with antibiotics (Doxycycline) What are signs and symptoms of Lyme disease? Bullseye rash, fever, malaise, muscle soreness, and headache What do lesions in Kaposi's sarcoma look like? They are papular, nonpruritic, bilater, and pink, brown, or violet. What factors increase the risk of prostate cancer? *African american race *Folic acid supplementation *Increased levels of dihydrotestosterone *Hormones *Age What is Sjogren's syndrome? A systemic autoimmune disease that affects exocrine galnds - causes a deficiency in saliva, tears, skin lubrication, and other exocrine secretions - moisture replace usually the is treatment of choice. How does Theophylline work? Relaxes bronchial smooth muscles and stimulates the CNS and skeletal muscles What is the onset, peak, and duration of rapid-acting insulin? (insulin aspart, lispro) *Onset - 15 min *Peak 1-3 hours *Duration 3-5 hours What test is used to diagnose SLE? Antinuclear antibody What are risk factors for endocarditis? Small head and brain, sunken nasal bridge, thin upper lip, small teach, and an upturned nose - it can also cause vision difficulties, intellectual disability, short attention span, delayed mental development, and poor impulse control What are symptoms of Down's syndrome? Short stature, short wide neck, slanted eyes, low set ears, hypotonia, intellectual disability, and learning disabilties What are symptoms of Klinefelter's syndrome? Present in males - less facial and body hair, reduced muscle mass, and strength, broad hips, gynecomastia, and hypogonadism What are signs and symptoms of mercury posions? Peripheral neuropathy, skin discoloration (pink), swelling, shredding of the skin, tremors, visual changes, hearing impairment, and fatigue. What are appropriate nursing interventions for a patient with emphysema? Postural drainage, chest physiotherapy, low-flow oxygen, high fowlers position, and increased fluid intake. What is a unit a measure of? A measure of effect. What is pertussis? A highly contagious bacterial infection - it causes whooping cough, and vomiting that can last 6 weeks - can be prevented with Dtap, once contracted, it is treated with antibiotics. What are a few blood transfusions that would work? Rh negative blood can donate to Rh positive of same type. O negative is universal donar AB patients can recieve both A and B, as long as there is Rh compatibility. What is involved with Thromboangitis obliterans (buerger's disease)? It is inflammation and thrombosis of the vessels of the hands and feet, strongly associated with smoking. - patient should inspect skin regularly for signs of tissue ulceration and necrosis. When should levothyroxine be taken? In the morning, before breakfast. What increases a patients risk of digitalis toxicity? *Hypothyroidism *Hypomagnesemia *Hypokalemia *Hypoxemia *Advanced heart disease What is a patient at risk for after parathyroidectomy? Hypocalcemia What is a Myxedema coma? it occurs from a low thyroid production - occurs after acute illness, rapid discontinuation of thyroid medication, or hypothermia What are signs and symptoms of Myxedema coma? Hypotension, coma, hypoglycemia, edema, bradycardia, and respiratory failure. What are the symptoms of high blood pressure? - rarely has any, but can have headache, tinnitus, blurred vision, and dizziness. What is a normal PKU level? What occurs if level is elevated? Normal is <2 mg/dl, can result in seizures, albinism, microcephaly, and cerebral impairment. What is the most common side effect of brain tumors? Headache, followed by vomiting, and lastly vision changes. What causes Addisonian crises (adrenal crisis)? It is caused by severe adrenocortical insufficiency How is Addisonian crisis treated? It is treated with hydrocortisone, saline, and dextrose What can Addisonian crisis cause? *Hypotension *Hypoglycemia *Hyperkalemia *Hyponatremia *Weakness, weight loss, and abdominal pain What is Naloxone used for? Opioid overdose What is Naltrexone used for? Opioid dependence What is Flumazenil used for? benzodiazepine overdose What is methadone used for? Opiod analgesic often used for opioid dependecy What are the symptoms of iron-deficiency anemia? Pallor, dyspnea, tachycardia, malaise, fatigue, and palpitations. What are symptoms of sinusitis? Headaches that are worse in the morning, purulent nasal discharge, stuffiness, cough, and loss of smell What is Duloxetine used for? Depression, generalized anxiety disorder, neuropathy, and fibromyalgia What are some things about multiple sclerosis? Bladder dysfunction common - constipation common, fatigue should be managed, and patient should avoid heat and cold. What are some physical characteristics of Thalassemia? Change in shap of skull - frontal bossing and upper teeth protrusion. Hypogonadism, pallor, and a protruding abdomen due to hepatomegaly also can occur What are several complications of pancreatic cancer? Weight loss, blood clots, depression, infections, jaundice, pain. How would a nurse assess involution? The nurse should palpate the fundus to see if it is firm and well contracted. What is lochia rubra? Postpartum vaginal discharged consisting of blood - there are small particles of deciduas and mucus 3 days postpartum What are signs and symptoms of pneumonia? *Fever Productive cough *dyspnea *Increased respiratory rate *Chills Starts from the onset of regularly perceived uterine contracts and ends with full cervical dilation What characterizes the third stage of labor? Follows the expulsion of the infant and ends with the delivery of the placenta. What characterizes the fourth stage of labor? Follows placental expulsion to 1-4 hours postpartum What characterizes the second stage of labor? Starts with full cervical dilation, and ends with birth of baby. What are physical findings of an inhalation injury? *Stridor *Dyspnea *Singed nasal or mucosal burns *Soot in the sputum *Facial burns *Wheezing What is Prinzmetal's angina? also known as variant angina - characterized by cyclic chest pain that often occurs at rest (night0, caused by vasospams, leading to the narrowing of the coronary arteries What could trigger Prinzmetal's angina (Variant angina)? Cold, stress, tobacco use, medications, and activity. What are complications of mitral stenosis? Pulmonary hypertension, edema, right-sided heart failure, and reduced cardiac output. What characterizes peritoneal pain? Well-localized pain that causes rigidity of the abdominal muscles where pain increases with any pressure or motion. What characterizes renal pain? Begins in the flank area and may radiate to the lower abdomen, back, and groin. What characterizes biliary pain? occurs in the right upper quadrant and may radiate to the right shoulder. What characterizes meningeal pain? Headache, nuchal rigidty, and photophobia. Pain is increased when the neck is flexed toward the chest. What are characteristics of ADHD? *Inattention *Hyperactivity *Impulsiveness What are signs and symptoms of multiple sclerosis? Visual disturbances, impaired sensation, mood swings, impaired motor function, cerebellar functions, impaired urination, constipation, and sexual impotance in males. What are signs and symptoms of Parkinson's disease? masklike appearance to the face, presence of drooling, slow speech, and shuffling gait. What are signs and symptoms of Myasthenia gravis? Weakness, fatigue, drooling, and ptosis. What are signs and symptoms of ALS? Muscle weakness, atrophy, fasciculations, dysphagia, and spasticity of the flexor muscles. What is Rosiglitazone used for? Used to treat type 2 DM by improved insulin sensitivity. What are 3 things done for a myocardial infarction Nitroglycerin given, telemetry done, and TPA ordered. Should bubbling occur in the water-seal chamber? Yes, intermittent bubbling is expected - it will fluctuate with respirations - called tidaling, if tidaling stops, chest tube may be kinked or obstructed. Should bubbling occur in the suction chamber? It should bubble gently - if not, check to see if the tubing is connection and the suction source turned on. What do different APGAR scoes mean? <4 - critical, may need resusicitation 5 - guarded and may need clearing of airways or supplemental oxygen 7-10 - good, baby is safe When is the APGAR score done? 1 and 5 minutes after birth. What does Aldosterone do? Angiotensin 2? Responsible for sodium and water retention. Angiotensin 2 causes potent vasoconstriction. - Blocking both allows vasodilation and the excretion of sodium and water, lowering BP. What are the different risk factor scores for the Braden scale for pressure ulcer development? *<10 - Very high *10-12 - High risk *13-15 - Moderate risk *16-23 - Mild risk What does Nitroglycerin do to the body? Increases heart rate, and decreases blood pressure - helps maintain cardiac output. What should a nurse asses before giving heparin to a child? Wight - dosages are calculated based on the patient's weight. What are common characteristics of most personality disorders? Impulsivity, abnormal moral development, maldaption in social situations, altered interpersonal functioning, and abnormal way of interpreting self and others. What is a delusion of reference? When a person believes that insignificant events or objects in the environment have personal meaning What can occur from a C1-C8 spinal cord injury? C1-C8 - Quadriplegia, Respiratory paralysis in lesions above C6 How is the appearance section of APGAR scored? 0 - pale or blue all over 1 - blue at the extremites 2 - body and extremities are pink How is pulse rate scored in APGAR? 0 - pulse is absent 1 - heart rate below 100 2 - heart rate above 100 How is Reflex irritability score in APGAR (Grimace)? 0 - absence of response to stimulation 1 - feeble cry or grimace after stimulation 2 - cry or pulls away from stimulation How is muscle tone scored in APGAR? an absence of ganglionic innervation to the smooth muscle of the bowel - results in no peristalic waves - results in chronic constipation or ribbonlike stools What is megacolon? abnormal dilation of the colon (large intestines) - can be confirmed with barium enema. What is Trendelenburg position? What is Trendelenburn position used for? For pelvic surgery, and to treat shock. What position should a patient be placed in after cleft palate repair? Lying on side to facilitate drainage and maintain patent airway What is used to diagnose acute lymphoblastic leukemia? Bone marrow biopsy What is involved with schizoid personality disorder? A lack of interest in social relationships, lack of pleasure, and introspection. When is it safe for a child to be out in the sun? Not until 6 months of age. What is true about an immunoassay done shortly after conception? Highly accurate 8-10 days after conception - detects human chorionic gonadotropin - hormone that is secreted by the developing placenta. What is Clopidogrel (Plavix) used for? it is an antiplatelet medication (anticoagulant) - used to prevent MI, stroke, or peripheral arterial disease during an acute myocardial infarction. What are the 3 stages of separation anxiety? Protest, Despair, Detatchement What happens during the protest stage of separation anxiety? Crying and making a scene - usually will refuse comfort from anyone What happens during the despair stage of separation anxiety? Child begins to accept parents are not going to be around - they act sad, apathetic, and depressed What happens during the detachment stage of separation anxiety? Child begins to adjust and becomes more interested and active in surroundings What are common complications of influenza? Pneumonia, COPD exacerbations, sinusitis, bronchitis, and ear infections What is Kussmaul's breathing? is a compensation to eliminate CO2 in the body due to metabolic acidosis - described as hyperventilation with an increased rate and depth. What is Cheyne-Stokes respirations? Occurs in patients with CHF, increased ICP and drug overdose - breathing becomes progressively deeper and faster, followed by periods of apnea - cycle repeats. What is cluster breathing (Biot's respiration)? Characterized by groups of quick, shallow breaths followed by periods of apnea - usually seen in patients with medulla damage and indicates poor prognosis. What is Sitagliptin used for? Increases insulin secretion and contributes to less weight gain then other oral antihyperglycemics. How should a patient with pericarditis sit to relieve pain? To lean forward - will pull the heart away from the lungs, preventing pericardial irritation caused by friction and contact with the lungs. What is sarcoidosis? It is an abnormal collection of inflammatory cells that for nodules in multiple organs, including lungs. What are signs and symptoms of pleurisy? Causes a sharp knifelike pain that intensifies with pain - caused by pleural friction rub. What is a huge risk factor for the development of bladder cancer? Smoking What is used to diagnose a DVT? D-dimer, venous ultrasound, or venography. What is distraction? Shifting the patients attention and energy to a more neutral topic. What is reality orientation? It is when the patient is continuously reminded of their name, date and current events. What is the client self-determination act of 1990? Require all hospitals to inform patients about patients advance directives. What are signs and symptoms of hypoparathyroidism? Paresthesia, muscle cramps and spams, fatigue, bone pain, abdominal pain, and muscle cramps. What are signs and symptoms of serotonin syndrome? Hypertension, tachycardia, myoclonic jerking, tremor, sweating, nausea, diarrhea, confusion, and agitation. What are signs and symptoms of pleurisy? Causes a sharp knifelike pain that intensifies with pain - caused by pleural friction rub. How long is each box on the EKG? 0.04 seconds What does SMART stand for for patient goals? Specific Measurable Attainable Reasonable Time-oriented What is accelerated silicosis? Raidly progressing symptoms and x-ray changes What is simple silicosis? The patient was exposed to low concentrations of silica and is usually asymptomatic - abnormalities are often detected on x-ray What is complicated silicosis? Severe scarring and fibrosis of the lung tissue. What is acute silicosis? Develops with a few years after exposure to silica dust - characterized by rapid onset of dyspnea, cough, and weight loss. - E-ray reveals a ground-glass appearance. How should a cane be used? On the unaffected side - with the base about two feet from the little toe. Patient should step with the affected leg and bring the can forward at the same time - move the can and affected leg forward together. What is somatrem used for? Standing - accomplished by age 13 months Run - 14-22 months Say 3 words - 12-20 months Put on clothing - 20-30 months Check Denver 2 Developmental Screen What can occur with a tracheoesophageal fistual? pneumonia can develop from leakage of stomach secretions into the lungs or an electrolyte imbalance from lack of oral intake. - can also lead to aspiration Where can an Austin Flint murmur be assessed where? By listening near the apex of the heart What is an Austin Flint murmur? It is described as low-pitched and rumbling and can be heard during mid to late diastole. This murmur is associated with severe aortic regurgitation. What can be heard over the second intercostal space, on the left sternal border? Best location for hearing pulmonic stenosis What can be heard over the second intercostal space on the right sternal border? Best location for hearing aortic stenosis. What can be heard over the carotid arteries? Can hear a bruit What is an axillofemoral bypass used for? It is a surgical revascularization procedure used to treat symptomatic aortoiliac occulsive disease who cannot undergo aortofemoral intervention. - The axillary artery is connected to the femoral artery via an artifical graft in order to restore perfusion to the lower extremity. - Patient should avoid belts What is Ethosuximide (Zarontin) used for? It is used to treat petit mal seizures or absence seizures. How is a cerebral arteriogram done? Arterial access is obtained via the femoral artery. What should be done after a cerebral arteriogram? Pressure should be applied to the dressing site for 4 hours, patient should be placed on bed rest for 4 - 24 hours in a flat position, and the extremity should be kept straight for the length of bed rest. What causes neuroleptic malignant syndrome? An adverse reaction to antipsychotic medications within 4-14 days after beginning the drug or after a dose increase. What are early signs of neuroleptic malignant syndrome? Muscle stiffness, fever, sweating, and tremors. Where can candidiasis occur? Adheres to the surfaces of the mucosa and tongue, occurs on the genitalia, and anus - can cause bleeding if patches are removed, will not occur if scraped with a tongue blade. What are risk factors for hypertension? High salt and fat intake, obesity, stress, alcohol consumption, inactivity, caffeine, and vitamin D deficiency. What are risk factors for secondary hypertension? Renal disease, Cushing's syndrome, hyperthyroidism, hyperaldosteronism, pheochromocytoma, hormonal contraceptives, and diabetes. How should a nurse reduce pruritus? Patient should keep house cool, wear loose clothing, use tepid water for bathing, use mild soaps, and take antihistamines. What are causes of urinary incontinence? Pelvic organ prolapse, decrease in urethral closure pressure, diabetes, CVA, Parkinson's and cancer. What is Buspirone used for? Acts on serotonin receptors - effective in treating anxiety but does not have sedative effects. What is Ropinirole (Requip) used for? To treat Parkinson's disease What is a requirement of the Omnibus Reconciliation Act of 1986? All hospitals are mandated to establish protocols for identifying potential tissue and organ donors. How is insulin affected during pregnancy? Increasing glucose demands of the fetus may cause the amount of insulin needed to be increased - usually after the first trimester. What should a patient do during the removal of a chest tube? Use the valsalva maneuver - patient should exhale slowly and bear down - will increase intrathoracic pressure and reduce the risk of air entering the pleural space. What are symptoms of drug addicted newborns? Low birth weight, nervousness, irritability, tremors, seizures, poor feeding, piercing cry, and respiratory distress. What is the first line of defense against increasing ICP? The patient should be hyperventilated - decreases ICP by decreasing carbon dioxide levels. What is a complication of using a crutch to ambulate? Forearm muscle weakness. What lab value would indicate a corticotropin-secreting pituitary adenoma? High cortisol and high ACTH levels What value would indicate adrenal tumors + hyperplasia? High cortisol levels, and low ACTH levels. What is diphenhydramine? Antihistamine What is methylergonovine (Methergine) used for? used to prevent postpartal hemorrhage. - can cause hypertension, should check BP before administering. Usually given up to 8 hours after birth to promote uterine contractions to prevent postpartal hemorrhage. Where to adenocarcinomas of the large intestine most commonly occur? In the rectosigmoid colon What gauge of needle should be used for subcutaneous injection? 25 or 27 gauge needle. What is Doxepin used for? It is an antidepressant used for depression and anxiety - should not be abruptly stopped, can caused flu- like symptoms, dizziness, fatigue, and insomnia - dizziness is common side effect. What are early signs of hypoxia? Restlessness, headache, fatigue, SOB, and cyanosis. What are signs of dehydration? Skin tenting, weight loss, sunken eyes, hypotension, tachycardia, lethargy, and headache. What should a nurse asses for a patient whom is post-operative for a total thyroidectomy? Check for signs of latent tetany due to calcium deficiency - tingling of toes, fingers, and lips, muscular twitches, positive Chvostek's and Trousseau's signs, and decreased serum calcium levels. Tetany can occur 1-7 days after thyroidectomy. Asses for signs of hemorrhage - exam back of neck and shoulders for bleeding, blood tends to drain posterior in a client with thyroidectomy. What is a symptom of chronic renal failure? Uremia - build up of nitrogenous waste products due to the kidneys inability to excrete. What are complications of hypercortisolism? Bacterial or funal infections, diabetes, hypertension, obesity. How is Hepatitis A transmitted? Fecal-oral route - usually through contaminated food. How is Hepatitis B transmitted? Through body fluids such as blood, sexual fluids, and saliva How is Hepatitis C transmitted? Through body fluids, primarily blood. How is Hepatitis D transmitted? Through body fluids such as blood, sexual fluids, and saliva. Causes infection only in the presence of Hepatits B. What are modifiable risk factors for heart failure? Diabetes, sedentary lifestyle, and obesity. What are non-traditional risk factors for heart failure? Metabolic Syndrome - refers to a cluster of CVD risk factors that increase the risk of CVD including obesity, increased triglycerides, low HDL cholesterol, hypertension, and elevated fasting glucose. C-reactive Protein - independent risk factor for CVD Homocysteine - an amino acid that has been shown to be increased in people with atherosclerosis. Where is the least painful spot to inject heparin? Administered at least 2 inches from the umbilicus - on the left or right side of the abdomen. What is sinus tachycardia? It is defined as a sinus rhythm with a rate of greater than 100 BPM. What are causes of sinus tachycardia? fever, emotional and physical stress, heart failure, fluid volume loss, hyperthyroidism, hypercalcemia, caffeine, nicotine, exercise, and medications. How does Docusate work? It is a surfactant laxative (stool softener) - it facilitates admixture of fat and water in the stool to reduce surface tension. What is Rifampin used for? Used to treat TB. What are signs and symptoms of chronic hepatitis? Muscle wasting, weakness, fatigue, weight loss, increased bleeding, decreased body hair, and peripheral edema, and Jaundice. What may build up in severe liver disease? Ammonia - can cause hepatic encephalopathy. What are signs and symptoms of a bulimia nervosa? Frequent vomiting causes hypertrophy of the parotid glands and puff cheeks. Also has binge eating, inappropriate compensatory behavior present to weight gain, and excessive concern about body weight, brittle hair, and hair loss common, hypotension, electrolyte imbalances, metabolic alkalosis. How is meningeal infection assessed? Positive Brudzinski's and Kernig's sign, and an inability to flex the neck forward (nuchal rigidity) What is Brudzinski's sign? After forced flexion of the neck there is a reflex flexion of the hip and knee and abduction of the leg. What is Kernig's sign? After flexing the hip and knee at 90 degree angles, pain and resistance are noted. What is Cullen's sign? It is the presence of superficial edema and bruising around the umbilicus - it is suggestive of acute pancreatitis or an intraabdominal bleed. What is Ortolani's sign? It is a distinctive "clunk" heard after flexing and abducting a newborns hips - indicative of hip dysplasia. What is McBurney's sign? It is a deep tenderness or pain at McBurney's point, one-third the distance from the right anterior iliac spine and the navel. This is indicative of acute appendicitis. What is a normal sodium level? 135-145 mEq/L What is a normal Potassium level? 3.5-5.0 mEq/L What is a normal Magnesium level? 1.3-2.1 mEq/L What is a normal Phosphorus level? 3-4.5 mg/L What is used to confirm a diagnosis of infection mononucleosis? Epstein Barr virus antibody test is used to confirm if the Monospot test is negative and the patient has symptoms of mononucleosis. The monospot test, or heterophile antibody test, is a quick test used by mononucleosis, but may produce false negatives. What might be auscultated when assessing a patient with paralytic ileus? Hypoactive bowel sounds Hyperactive may indicate a mechanic obstruction. What is Fi02? It is a fraction of the amount of oxygen a patient is inhaling produced by an oxygen device such as a nasal cannula. When administering a SQ injection, the nurse disinfects the injection site and waits how long before administering? 30 seconds - allows site to dry. Upon suspicion of an acute appendicitis diagnosis, a nurse should check when the child last did what? Ate - surgery is done immediately to prevent complications. What are early signs of increased intracranial pressure? headache, nausea, vomiting, decreased LOC, and blurred vision. What is a factor that can affect drug absorption when doing an IM injection? Blood flow to that area. What are several complications that could occurs with scoliosis? Shortness of breath or dyspnea, and lower back pain In case of an emergency situation, what should be kept near a patient's bed that is on mechanical ventilation due to respiratory failure? A resuscitation bag, as well as a yankauer suction tip. Curvature of the spine exceeding 65 degrees in what region of the spine can lead to serious complications? The thoracic area - can cause cardiopulmonary problems due to impaired chest expansion. What foods should be avoided in a patient with Crohn's disease? Foods high in fiber, and milk products that may increase diarrhea should be avoided. What are signs and symptoms of acute pancreatitis? Elevated temperature, weight loss, abdominal pain, nausea, and vomiting What are common finding in a patient with atrial septal deficit? Murmur heard over the pulmonic area, dyspnea and fatigue, and a second heart sound that is split and fixed. What is atrial septal deficit? An abnormal communication between the two atria, allowing blood to shift from the left and right atrium. What is Chvostek's sign? It occurs when the nurse taps the facial nerve at the angle of the jaw, resulting in the facial muscles contracting and twitching - indicative of hypocalcemia. What would be included in an early stage pregnancy class? Warning signs and complications, nutrition, anatomy and fetal development. What are ways to reduce acne vulgaris? Patient should be instructed to use lotion, makeup, and other products labeled noncomedogenic, use oil-free moisturizer, and dont touch face. What are symptoms of chronic renal failure? Hypertenison, anemia, fluid and electrolyte imbalances, Why should a dialysis patient avoid milk and soft drinks? It puts them at risk for hyperphosphatemia and hypocalcemia. What are foods that are high in phosphate? Milk, eggs, chocolate, soft drinks, organ meats, dried beans, bran cereal, and beer. What should be included in the care for a patient with acute decompensated heart failure? Administer oxygen as ordered, administer loop diuretics, monitor O2 sat, vitals, and cardiac rhythm, and encourage the patient to sit in an upright position What is a normal pO2 value? 80-100 mmHg What is a normal pCO2 value? 35-45 mmHG What is a normal bicarbonate (HCO3) level? 22-30 What is a hiatal hernia? It is when a portion of the stomach herniates through the diaphragm, into the thorax. What most commonly causes cellutitis? Streptococcus pyogenes and Staphylococcus aureus What are risk factors for skin disorders? Exposure to chemicals, radiation, and the sun, corticosteroid use, cosmetics and harsh soaps, infection, nutritional deficiencies, poor hygiene, and emotional stress. What position is used for Tetralogy of fallout? Knee to chest How can a pregnant lady reduce nausea from a prenatal pill? Take it at night + with food. What type of diet should a patient with gout avoid? Should have a diet low in purines - high purine foods include organ meats, seafood, alcohol, sardines, aged cheese, lentils, spinach, and cod. What are purines? They metabolize into uric acid, which crystallizes in the joints. This causes the local immune-mediated inflammatory reaction seen in gout. What is a common finding of an osteogenic sarcoma? A palpable mass that is large in size. What are signs and symptoms of a COPD exacerbation? Airway inflammation, mucous gland hyperplasia, mechanical loading, fibrosis, mechanical loading, fibrosis and an increased number of goblet cells. What is mechanical loading? It refers to external resistance due to pathological changes, which the lungs must work against to breath - in COPD patients, the diaphragm muscle works against increased mechanical loads due to airflow limitation and geometrical changes of the thorax from pulmonary hyperinflation. What are signs and symptoms of myasthenia crisis? Occurs when the breathing muscles become too weak - they include an increase in heart rate, blood pressure, respiratory rate, cyanosis, increased secretions, or urinary and bowel incontinence. What are lab findings reflective of fluid overload? Plasma osmolarity of less than 275 mOsm/kg from hemodilution, hematocrit less than 45%, specific gravity of less than 1.010, BUN level of less than 8mg/dl, and a plasma sodium level of less than 135 mEq/L. What are characteristics of Hodgkin's lymphoma? Localized lymph node involvement, spreads continuously (from node to node), the mesenteric nodes and Waldeyer ring are rarely involved, and extra-nodal presentation is rare. What are characteristics of non-Hodgkin's lymphoma? Multiple lymph node involvement, spreads non-continguously, mesenteric nodes and Waldeyer ring often are involved, and extra-nodal presentation is common. What should a patient do during a laryngoscopy procedure to reduce gagging? Breath in and out through the nose. What are signs and symptoms of hypoglycemia? Shakiness, anxiety, nervousness, diaphoresis, palpitations, coldness, and a headache - late signs include seizures, loss of consciousness, and death. What are signs and symptoms of hyperglycemia? It is the blood pressure ration between the lower legs and the arms - blood pressure int he lower legs is normally higher than the arms, and abnormalities indicate narrowing of arteries. - S/S include Hx of angina with activity, intermittent claudication, and abormal (weak or absent) pedal pulses. What is the formula for an ankle brachial index? It is the systolic blood pressure of the ankle (measured at the doralis pedis or posterial tibial) divided by the systolic pressure in the arms - it is measured on both sides, a ration under 1.0 indicates PVD. What position should a patient be in after a lumbar fusion? Patient should be placed flat on bedrest and be repositioned every 2 hours - using logrolling method. A nurse is informing a patient about postural drainage - to facilitate clearing of the lungs, the nurse should position the patient based on what assessment? Auscultation - it will help determine which areas need to be drained. What does a hypertonic solution do to fluid? It raises serum osmolarity and pulls fluid into the vascular space What does a hypotonic solution do to fluid? It lowers serum osmolarity and pulls fluid out of vascular space. What would a nurse monitor to asses hypothalmic function? Urinary output and temperature. What should a nurse do if uterine atony is suspected/ Control hemorrhage by attempting uterine massage to encourage contraction - this will compress the vessels and reduce blood flow. How long should a child use a front facing care seat for? Until the age of 2, or until the child weighs 40 pounds. How long should a booster seat be used for? Until the child outgrows a car seat and until they are 4 foot 9 inches talls. What are signs and symptoms of scarlet fever? They begin abruptly and include fever, sore throat, rash, and a bright red tongue - rash appears 12 to 72 hours after the onset of a fever, tonsils are inflamed and often covered with a white coating. What are signs and symptoms of diphtheria? Purulent nasal discharge, brassy cough, and bluish skin coloration. What is the most common cause of hyperaldosteronism? Adrenal adenoma What is an expected reaction after a DTaP vaccine? A slight fever and pain at the injection site. What test is used to diagnose infants with HIV? PCR - polymerase chain reaction test What is a postive Murphy's sign indicative of? A gall bladder infection - cholecystitis. What is it important for a patient with hyperparathyroidism to do? Exercise regularly to increase bone resorption What is flail chest? It is a life-threatening condition that involves two or more fractures of adjacent ribs - This causes a flail segment to move in the opposite direction of the other ribs, causing trauma and contusions. What are signs and symptoms of a pulmonary embolism? Sudden chest pain - most common symptoms, others include dyspnea, increased respiratory rate, hemoptysis, tachycardia, anxiety, fever, and diaphoresis. How would shingles be diagnosed? Microscopic smear test. What should be done for a patient with gout? Encourage gradual weight loss, encourage the client to limited alcohol and red meat, administer regular NSAIDS as prescribed until symptoms are gone, and apply ice over the inflamed joints. What is a Miller-Abbott tube used for? It is inserted through the nose and advanced past the pyloric valve into the small intestine. it is used to diagnose and treat small bowel obstructions How would you confirm that a tube is located in the small intestines? Aspirate that should have a pH of 7. What oxygen rate should a patient with emphysema be set at? Not past 2 LPM What are the ranges for a nasal cannula? 1-6LPM at 4LPM, approx 32% O2 is provided. What are the ranges for a simple face mask? 6-10 LPM, 40-60% O2, must be over 5 lpm to flush expired C02 from mask. What are the ranges for a Venturi "Venti" mask? 4-8LPM at 24-40% at low flow or 10-12 LPM at 50% o2 at high flow What are the rages for a nonrebreathing mask? 6-12 LPM, provides 95% O2 with flow rate of 10-12 LPM What are symptoms of malinger? They have no real physical symptoms or grossly exaggerate relatively minor symptoms - their purpose is an external incentive or outcome such as financial compensation, obtaining drugs, avoiding work, or to gain sympathy. People who malinger can stop the physical symptoms as soon as they have gained what they wanted. What are signs and symptoms of peripheral kidney disease? Flank or lower back pain, frequent UTIs, hematuria, proteinuria, calculi, and hypertension. What is a normal range for serum amylase? 25-120 U/L What serum amylase level is indicative of acute pancreatitis? Levels 3x the normal range. When does separation anxiety generally occur? When a child is between the ages of 8 months and 3 years. Where are chest tubes that are used to drain fluid or blood usually place? At the lateral chest wall, near the fourth to sixth intercostal space. What occurs in patients with hyperosmolar hyperglycemia nonketotic syndrome? They are often dehydrated by up to 12 L and require rapid fluid infusion to maintain cardiovasular integrity. - 6 L of fluid are given over the first 12 hours, isotonic fluid is used (normal saline) What deformities occur in clubfoot? Inversion, adduction, and equinus (plantar flexion) of the foot and ankle What is a laminectomy? Surgical removal of one more more vertebrae from the spine. What type of dressing should be used to cover a fasciotomy site?