MARK KLIMEK NCLEX RN EXAM STUDY

MARK KLIMEK NCLEX RN EXAM STUDY

ALREADY PASSED GUIDE

Acidosis: Ph goes down: everything goes down except ____ goes up. Hyporeflexia, lethergy, _____, etc. "As Ph goes down so goes my pt" Respiratory ____ can occur Correct -potassium, bradycardia, arrest

Alkalosis: ph goes up: everything goes _____ except potassium goes down. Can cease and ______. Correct -up, aspirate

Kusmals: "Mac Kusmal" (someones name) MAC= metabolic ______ Correct - acidosis

ABG's: first thing you ask- Is it lung? Overventilating: ______. Underventilating: acidosis. Ventilation= gas exchange not respiratory ____. Ventilation= ______ Correct -alkalosis, rate, SAO2

ABG's: if not lung its ______. Prolonged vomiting, or gastric ____= metabolic alkalosis."Alk, alk" noise when vomiting. If ph and bicarb are in same direction its _____ Correct -metabolic, suctioning, metabolic

Ph: 7.35-7.45. Bicarb (HCO3): ____-28. PACO2: 35-____ Correct -22, 45

Ventilators: high pressure alarm: when needs to pump ____. Could have a kink or ____.Low pressure alarm: could have _____. Respiratory alkalosis: ventilator setting too _____ Correct -more, blockage, disconnection, high

Denial treatment- _____ (for abuse) Don't say "you" say "I" Ex: I'm having trouble

interpreting this. Loss and grief: DABDA- denial, ____, bargaining, depression,

acceptance. Treatment- ______ Correct -confrontation, anger, support

Dependency: abuser gets significant other to do things for them or make _____ for

them. Co-dependency: when significant other derives _____ self esteem for doing

things for abuser Correct -decisions, positive

Dependency treatment: teach co-dependent person to say ____ and that they're a good person. Manipulation: the nature of the act is _____ or harmful. Treatment- set _____ and enforce them Correct -no, dangerous, limits

Wernicke's encephalopathy and Korsakoff's (psychosis) usually together, induced by vit _____ or thyamin deficiency. Extreme psychotic symptoms. Go _____, amnesia, confabulation. Usually permanent. Can't learn _____ Correct -B1, insane, reality

Wernickes, Korsakoff: Need B1 to metabolize alcohol so if not metabolized then goes to _____. Treatment: redirection. Is preventable and ______ Correct -brain, irreversible

Antibuse and Revia (disulfiram): when drink ____ makes pt really sick. Onset ____ weeks. No mouthwash, aftershave, extracts, Nyquill etc. Correct -alcohol, 2

Uppers: caffeine, coaine, pcp/lsd, meth, _____. Everything goes up- uphoria,

restlessness, hyperreflexia +3, +4, ____, etc. Could arrest and cease. Need _____.Correct -adderall, diarrhea, suction

Downers: everything goes down. Every drug not an upper is downer. Drowsiness,

_____, etc. Can go into respiratory ____. Correct -lethargy, arrest

Withdrawal from upper: not enough upper makes everything go ____. Not enough

downer makes everything go ___. Boroborigmy: increased bowel sounds Correct - down, up

Ex: pt withdrawing from cocaine: Respirations < 12, difficult to ____, etc. Need ____ Correct -arouse, narcan

Drug addiction in newborn: always assume intoxication not _____ at birth. After ____ hrs it can be withdrawal Correct -withdrawal, 24

When alcohol pts ____ drinking alcohol within 24 hrs= withdrawal symptoms. Within ____ hrs= delirium tremors. Alcohol withdrawal syndrome- not life threatening. Not dangerous. Regular diet, up ad lib, no _____ Correct -stop, 72, restaints

Delirium tremors: can be _____, unstable. NPO or clear ____, private room near nurses station. restricted bed ____, must be restrained. Very dangerous. Both Al with syndrom and delir trem get antihypertensive, tranquilizers and vit ____ Correct -fatal, liquids, rest, B1

Aminoglycosides (antibiotics): don's use unless _____ else works. "A mean old mycin" ALL END IN _____. Treat infections that are: serious, life threatening, resistant, gram _____. Correct -nothing, MYCIN, negative

Aminoglycosides: 3 drugs that end in mycin that are not these: arythromycin, ______ and clarithromycin. If it has "thro" in it, than throw it _____. Correct -zithromycin, out

Aminoglycosides: "mycin"- mice, mice have big ears. Ears- _____. Monitor pts hearing, ringing, dizziness. When you draw an ear connect it it looks like a ____- nephrotoxic, monitor ____ (best indicator of renal function), also a #8 fits in the ear drawing- cranial nerve ____ (hearing) and administer q8h Correct -ototoxic, kidney, creatinin, 8

Aminoglycosides: Give IM and ____, Not oral. Doesn't absorb! Hepatic encephalopathy- give oral aminoglycosides since it kills ____ in gut and reduces amonia levels- won't hurt ____ since it doesn't absorb. Correct -IV, bacteria, liver

Pre-op bowel surgery: give aminoglycoside _____ route to sterilize the bowel. PO kills bacteria in gut and doesn't get _____, or hurt liver. "Who can sterilize my bowels?" "Neo Can!" ______ and canimycin. Correct -po, absorbed, Neomycin

Trough level: drug at ____. Peak level: drug at _____. "TAP" levels: T- check trough level, A- administer drug, P- draw ____. Draw when drug has a _____ therapeutic window Correct -lowest, highest, peak, narrow

Draw trough 30 min before next ____. Draw peak: sublingual 5-10 min after drugs is _____. IV 15-30 min after drug is finished. IM 30-____ min Correct -Dose, dissolved, 60

Calcium channel blockers: Are like ____ for your heart. Cardiac _____. Treat: AAA & AS A. Antihypertensives, anti _____, anti atrial arrhythmias. Correct -Valium, depressants, anginas

Calcium channel blockers: s/e- headache, _____. End in "dipine" "Dipping into the calcium ____. Also varapamil and cardizim. Monitor bp- if systolic is under ____ don't give. Correct -Hypotension, channel, 100

Normal sinus rhythm: p wave before every QRS. Vfib looks like ____ line. V tach- jagged, Sharp peaks, a ____. Saw tooth- A ____ Correct -Squiggly, pattern, flutter

QRST: ventricular _____ Correct -...

Draw trough 30 min before next ____. Draw peak: sublingual 5-10 min after drugs is _____. IV 15-30 min after drug is finished. IM 30-____ min Correct -Dose, dissolved, 60

Calcium channel blockers: Are like ____ for your heart. Cardiac _____. Treat: AAA & AAA. Antihypertensives, anti _____, anti atrial arrhythmias. Correct -Valium, depressants, anginas

Calcium channel blockers: s/e- headache, _____. End in "dipine" "Dipping into the calcium ____. Also varapamil and cardizim. Monitor bp- if systolic is under ____ don't give. Correct -Hypotension, channel, 100

Normal sinus rhythm: p wave before every QRS. Vfib looks like ____ line. V tach- jagged, Sharp peaks, a ____. Saw tooth- A ____ Correct -Squiggly, pattern, flutter

QRST: ventricular _____. P wave = atrial. A lack of QRS segment= _____. Bizzar in question= tachycardia. Correct -polarization, astystole

PVC: more than ___ pvc's per minute or more than 6 PVC's in a row or if the PVC falls on the T wave of the ____ beat= change priority from low to _____ priority Correct -6, previous, moderate

Asytole: _____ priority. V fib: high priority. Both have no cardiac ____ which equals no brain perfusion. Patient dead in ____ minutes. Correct -high, output, 8

V tach: potentially life threatening, has _____ output. Ventricular: treat with ____ and amioderone. Correct -cardiac, lidocaine

Atrial: treat with ABCD. Treatment: A- _____ (IV push, FAST) B- beta blockers, C- calcium channel blockers, D- _____ (lanoxin, digoxin) "Adeno-______- calcium- Didge" Correct -adenocard, digoxin, beta

V fib: you D fib (defibrillation). Asystole treatment: epinephrine first then _____.Correct -atropine

Chest tube: creates _____ pressure in pleural space, this is good and lets lung ____ while chest wall moves. Correct -negative, expand

Chest tube questions: look at reason for why it was placed and _____. Pneumothorax: tube removes ____. Hemothorax: removes blood. Apical: up high, removes air. ____: bottom, removes blood Correct -location, air, Basilar

Chest tubes: surgery- always assume bilateral. If drain container comes open: 1st ____, 2nd cut broken container off, 3rd put end of tube under ____ water, then unclamp. Use rubber tipped double clamps. Correct -clamp, sterile

Chest tubes: if tube comes out: 1st put gloved ____ over hole on patient. 2nd cover hole with vaseline ____. Correct -finger, gauze

Chest tube: intermittent bubbling in water seal is ____, just document it. Continuous bubbling in water seal is bad, it means a ____. Like buying a bottle of pop- don't want broken ____ Correct -good, leak, seal

Chest tube: intermittent bubbling in suction control is ____, means suction is not high enough in container- turn suction ___. Never clamp a tube longer than ____ seconds without doctor order Correct -bad, up, 15

Congenital heart defects: either trouble or no trouble. Remember TROUBLE- use

consanants. T- trouble, R- right, B- ____, L- left. "Trouble, blue, shunts blood right to ____" Correct -blue, left