Things I didn't know from the review. NCLEX V1

  1. Raynaud's Phenomenon. Rememeber that microvascular doesn't work. So O2 sensor shouldn't be there.
  2. NG tube and the client vomits. What you thinking?
    Obstructed. Irrigate it.
  3. Giving meds with a GT, do you have to check placement?
    No. If it isn't in the stomach, it's in the bed. Can't be anywhere else.
  4. Why should prednisone and Dig concern you?
    Prednisone promotes K+ secretion. No K+ is dig toxicity.
  5. What kind of -tonic fluids do you give for person in shock?
  6. What is a complication of shock that looks like ecchymosis and petechiae?
  7. How do you know someone is getting better from an Adrenal Crisis?
    If they can better comprehend and function with other better.
  8. What herbs can increase chance with bleeding so you have to watch out with aspirin?
    Ginger, Garlic, Ginko.
  9. Why does taking tyelenol and aspirin concern you?
    Chronic use of tyelenol can increase bleeding.
  10. When taking care of a patient with a radiation implant, what is the priority you have to worry about?
    How long a person is next to them. The items in the room do not get "contaminated".
  11. What does Sinemet and eggs have to do with anything?
    Sinemet with protein reduces the effect.
  12. What is a lactovegetarian diet?
    no meat and eggs.
  13. When you have a client on TPN and develops a high urine output, what could be happening?
  14. You have a compound fx and the leg is spasing. Is that normal?
  15. How do we use a catheter with someone that has renal calculii?
    we don't.
  16. When you come across looking for the "most concerning", think about the non-expected findings. So someone with glomerulonephritis: you expect hematuria, proteinuria, reduced urine output. Even those are bad to have in the first place, think "of course they're going to have that, they have glomerulonephritis!". So if they have a fixed urine specific gravity, that's a complication (they're heading south), could be developing renal failure.
  17. When you calculate intake or I&O, dialysate is measured as "input" only and it's the amount in minus the amount out. For example, 2000ml in and 1900ml out is measured as 100ml input.
  18. When making a diet for a renal pt, you know low salt, potassium and protein. What's the problem with vegetables and beans for their protein?
    They don't have other amino acids that you can get from animals (eggs, meat, fish, milk). From them, you can get protein and the aminos.
  19. You got a pt that has a fever a day after surgery. Is that a priority?
    We EXPECT that after surgery, one or two days out, that they may have an elevated temp. It could be that they're dehydrated or something else. So they are not a priority.
  20. When assigning pts to an aide, if they have to make a judgement call (walk until he gets tired, ask them this, until they can't hold any more fluid) - eliminate it.
  21. Whenever you have a situation where the client is having everything done for them, it's wrong.
    So pick the one that has the client do something on their own (give them the bedside commode vs assisting them to the bathroom).
  22. When delegating assignments to aides or whomever, it's based on skill level and nothing else. If an aide asks to take care of a specific patient, you don't ask why because it doesn't matter why. You tell them their assignments. It has been made. You also don't need to owe them an explanation. Simply - you don't agree, you don't ask why and you don't explain why not.
  23. Your patient can't swallow. Why does an order for a gag reflex check concern you?
    They can't swallow their saliva. Aspirate.
  24. Can you give sxn ng tube to an aide?
    We don't give sterile procedures to aides.
  25. What concerns do you have for a client after a mastectomy?
    Unstable. Lots of drains. Lymphedema.
  26. What's the problem with the aide going into the TB pt's room with a mask on?
    It has to be an N95 mask, not a regular one.
  27. Stem cell transplant involves intense chemo.
  28. What is toxic hepatitis?
    Inflammation of the liver from alchy, chemicals. NOT bacteria.
  29. What are you thinking when you see a gest. DB mother with spontaneous, jerky movements?
    baby has hypoglycemia.
  30. What is a low temp from a baby mean?
    neonatal sepsis. They will have a low temp, not a high one.
  31. Should an elevated temp and WBC concern you after a delivery?
    No. Normal.
  32. Should a mother that is saturating peri pads after a delivery concern you?
    Yes. Bleeding, yes. Not saturating.
  33. What concerns you about a mother that suddenly gains a couple pounds over a day?
  34. What's the problem with playing along with a pt's delusion?
    It further enforces it. Don't agree to "check on the radioactive material in the basement". Reorient them. Tell them they are in the hospital.
  35. With an abuse client, don't remove others from the area. Deal with them directly.
  36. Remember to look for goals that are measureable.
  37. What do you do with a person that's having a seizure?
    Just protect their head. Turn them after they are done.
  38. Remember, when low blood sugar, don't immediately turn to glucagon. If they can, give them something to eat/drink.
  39. Why does multiple sex partners increase risk for cervical cancer?
    Cervical cancer comes from HPV - HPV spread through sex - people don't know they have HPV because it doesn't show.
  40. What's the problem with having milk to a renal patient?
    milk and carbonated stuff has lots of salt.
  41. Diabetes gives risk for infection so don't put them with other infections.
  42. How long do pneumonia vaccines last?
    6 years.
  43. When giving blood, you always start with NS and use T-tube. That way, you can flush when blood giving is interrupted.
  44. Remember, babies are fragile, loss of water and dehydration is big.
  45. Child spikes a temp after an MMR vaccine. Concern?
    None. Normal. It's a LIVE vaccine.
  46. What's the difference between the show they give a c-section pt and one going under general surgery?
    Narcotics are lower so it doesn't cross over to the baby.
  47. You need consent for a child. You only have the father's from the divorced parents. Is that ok?
    Yes. Just one is fine.
  48. What does a fixed a dilated pupil might mean to the brain?
    increased ICP. Notify the PCP.
  49. What does strabismus mean?
  50. How do you explain surgery to a school-aged child?
    Pictures and books (think, they do this in school so you can do it too).
  51. How do you explain a surgery to a preschooler?
    Toys (think, they do that in preschool, so you can do it too). 

    Don't use time ("in one hours"), they don't know what that means.
  52. Gestational Diabetes is a complication. Address it.
  53. You want to assess nutritional status? Albumin is a good indication of long-term nutritional status.
  54. What is priority in sickle cell crisis?
  55. How do you prevent dumping syndrome?
    Lie down, fluids between meals, no spicy.
  56. What is bleeding with no pain? Previa or preeclampsia?

    Think preeCLAMPsia. It's going to hurt.
  57. What's wrong with a person on bedrest with gout?
    You want to move it. not immobilize it.
  58. I got a second degree burn. Can I put ointment on my blister?
  59. What color is bile?
  60. Patient coming out of surgery needs a high residue diet (to prevent consti), may be positioned on the affected side after the incision heals, and need to cough and deep breathe to prevent complications from surgery.
  61. Is decerebrate posturing a late or early sign of ICP?
  62. Are grand mal seizures a late or early sign of ICP?
  63. What is the first thing you're expecting with ICP?
  64. What do you have to remember to tell the pt about breathing with splinting and coughing?
    breathe in 3 times.
  65. What does ESR measure?
  66. What does ABGs measure?
  67. What labs do you look at for liver function?
  68. Giving blood: pt has fever, chills, nausea?
    Febrile rx.
  69. Giving blood: N/V, hematuria
  70. Giving blood: neck vein distention
    circulatory overload
  71. Self-cath a clean or sterile technique?
  72. What kind of drug was the guy witih lack of coordination on?
  73. You have constricted pupils. What drugs are you abusing?
  74. What does a meth withdrawal look like?
    depressed. can't sleep. restless.
  75. What does a cocaine withdrawal look like?
    cravings. fatigue.
  76. You give hot or cold to rheumatoid arithitis?
  77. What is myxedema?
    Hypothyroidism. Everything slows. (HR, BP)
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Things I didn't know from the review. NCLEX V1