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NCLEX EXAM PREVIEW

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- provide 1:1 support and engage in concrete tasks

• acknowledge experience, present reality
• DO NOT directly debate psychotic content Choose an answer

Psychosis communication The nurse is teaching a client with anemia who is newly prescribed *ferrous sulfate.* Pyridostigmine/neostigmine a new nurse reparing to administer aspirin as needed to treat a child with varicella zoster's fever SHOULD

REQUIRE FOLLOW UP

Don't know?

The nurse is teaching a client with anemia who is newly prescribed *ferrous sulfate.*

• take on an empty stomach and/or with orange juice to increase absorption
• avoid taking with calcium or large meal
• may make stool black and tarry

--- ferrous sulfate is an iron supplement--- Three Point Gait

• extend both crutches and injured leg *FIRST*
• place 2-3 fingers below axilla; DO NOT REST ON AXILLA
• elbows bent

If throat seems injured...

DO NOT STICK ANYTHING IN MOUTH OR THROAT

i.e. thermometer or throat culture who is at *highest* risk for developing hypoglycemia?

• T2DM and takes metformin
• has RA and takes prednisone
• T1DM and takes scheduled insulin
• has pancreatitis, NPO, receiving IV fluids
• T1DM and takes scheduled Insulin
• taking insulin always increases hypoglycemia risk. this patient might skip meals, engage in strenuous activity, or accidentally take too much.

a new nurse reparing to administer aspirin as needed to treat a child with varicella zoster's fever SHOULD REQUIRE FOLLOW UP *aspirin should NEVER be given to a child with a viral illness* -- reye syndrome instead, administer acetaminophen or ibuprofen Coarctation of the Aorta (CoA) narrowed aorta causing high BP and bounding pulses in *UPPER extremities. Lower BP and weak pulses in LOWER* extremities.

• RF for falls
• Impaired mobility
• Impaired balance
• Impaired mental status
• Impaired sensory perception
• Impaired bladder/bowel function
• environmental hazards
• chronic conditions (pain, diabetes, dementia)

Sickle Cell Disease (crisis) sickle-shaped, rigid RBC

• can aggregate and block blood vessels causing decreased perfusion and tissue damage.

ssx: pain, itching, elevated bilirubin

mgmt: iv fl, O2, analgesics

Atypical Angina -- MI

ssx: indigestion, shoulder pain, arm pain, asymptomatic

mgmt: IMMEDIATELY CALL HCP, assess for other ssx, perform dx

Preeclampsia-- HELLP syndrome

• Hemolysis
• Elevated Liver enzymes (epigastric pain, continuous heartburn
• Low Platelets

Preeclampsia teaching

• report continuous epigastric pain
• headaches and blurred vision can indicate worsening HTN and cerebral edema
• take BP daily

Digoxin

• decreases HR

- NORMOKALEMIA IS CRUCIAL BEFORE ADMIN

• review potassium levels BEFORE administering
• hypokalemia increases digoxin toxicity risk

Pyridostigmine/neostigmine

• antimyasthenic, inhibits acetylcholinesterase

- can cause toxicity: "wet" symptoms

=> SLUDGE: salivation, lacrimation, urination, diaphoresis, gi distress, emesis

• take 30min before meals for life

Psychosis communication

- provide 1:1 support and engage in concrete tasks

• acknowledge experience, present reality
• DO NOT directly debate psychotic content

MI teaching

• regular physical activity
• medication adherence
• avoid NSAIDs (naproxen, ibuprofen)
• resume sexual activity once able to climb two flights of stairs/walk one block without chest pain

Pertussis (whooping cough)

HIGHLY CONTAGIOUS

• airborne and droplet precautions
• private room (can be placed with other pertussis pts)

Airborne Isolation private, airtight, negative air pressure rooms, HEPA filter

--- PREVENTS AIR FROM LEAVING PT ROOM ---

• TB, measles (rubeola), chickenpox (varicella), disseminated herpes zoster

Positive Pressure Airflow prevents potentially contaminated outside air from entering the room

• immunocompromised pt who require a protective environment

Insulin timing insulin should be administered NO EARLIER than the DURATION OF ONSET of action i.e. rapid-acting insulin has an onset of 15-30 minutes, admin the insulin lispro 15-30 minutes before meals Appendicitis

ssx: abdominal pain, n/v, abdominal guarding, fever

-- McBurneys point (RLQ)

=> if pain is randomly better, it busted :(

Nonrebreather Mask

• one way expiration valves that open during expiration and close on inspiration
• require 10-15L/min flow rate to inflate reservoir bag
• bags should remain partially inflated

stoma

• visible intestinal tissue on the abdomen
• shiny, red, slightly edematous at first

-- gray, dark red, blue, purple indicates ischemia--> REPORT!!

• slight serosenguineous drainage is normal
• should protrude 1-2cm