NCLEX Common Topics

NCLEX Common Topics:

Leave the first rating Students also studied Terms in this set (119) Science MedicineNursing Save NCLEX Questions 59 terms kdelagardelle Preview

NCLEX EXAM PREVIEW

110 terms kandykat1012Preview Concepts for Nursing Practice Teacher 185 terms Fredrick_Ochieng808 Preview Test Ba Teacher Sha Vitamins (A,B,C,D,E) - know what each vitamin benefits Vitamin A - eyes, immune system, and reproduction Vitamin B - make energy from food Vitamin C - helps your body heal - immune deficiency Vitamin D - Helps your bones Vitamin E - Healthy skin and eyes

KNOW SIDE EFFECTS OF COMMON MEDIC ATIONS

Nsaids (ibuprofen):should be taken with food - do not give to a patient who has not eaten FlagylMetronidazole - treats various of infections may discolor urine. Also pyridum makes urine orange (medicine for UTI to reduce burning) Levadopacommon side effect is discoloration of urine GI medicationsknow that antacids (Maalox, Mylanta) are used to keep the PH of gastric contents above 3.5. They DO NOT reduce gastric secretions.H2 blockersreduce gastric secretions - pepcid or prilosec Steroids and immunosuppresantselevate blood sugar, be careful with diabetics.Also, there usually are questions regarding steroid use. Always taper off of steroids to avoid addisons disease. Steroids should always be taken with food.

MetoprololLopressor - It can treat high bp, heart failure, and chest pain. check patients apical heart rate before admin. Hold medication if HR less than 60 or SBP less than 90.Contact physican.Which IV medication can be used if a patient is in a hypertensive crisis with a heart rate of 50?Hydrazine (Apresoline) ANGIOEDEMA- swelling of tongue, lips, or face. Usually caused by ace inhibitors. This is a medical emergency. Pril (enalapril, lisinopril)

• There is almost always a question on this.
• First priority is airway. Most patients present as an allergic reaction (swollen face,

lips, tongue) but are awake. A good way of checking if the patient has a patent airway is if they are speaking complete sentences. In severe cases, a patient will have respiratory symptoms (stridor, wheezing, SOB). GIVE EPI! If this is the case, get a physician immediately and prepare for intubation. There are rare cases where the doctor cannot pass the ET tube and the patient will require an emergency cric.Most often medication used for treatment is IV BENADRYL, SALUMEDROL

(STEROIDS), PEPCID (HISTAMINE BLOCKER), AND IV FLUIDS.

In the most severe case, a patient may be in anaphylactic shock (low blood pressure) and require 2 large bore IV's and a lot of IV fluids and possibly pressors

INSULIN:

Know the difference of short acting and long acting

insulin:

Insulin regular - 15-30 minutes, fast acting Humalog (lispro) - given with meals (short acting), usually smaller unit amount (1-5 unit) Levemir (lantus) - given at night, long acting, usually large unit amount (10-20 units) There almost always is a select all that apply question about mixing insulin, even though in clinical practice we NEVER mix insulin. Remember, inject air into cloudy, then inject air into clear, draw clear, then draw cloudy. They try to trick you with these questions and one of the answers will not include (use an alcohol wipe) and that will not be one that you will select.TIC BITESFor some reason NCLEX focuses a lot on tic bites.

• Know the signs and symptoms of tic bite/lyme disease.

Bullet eye rash (look up other symptoms) Also know what type of clothing to wear when walking in the forest (you want to wear light colored clothes so the tic does not mistake you for a tree)

The camp nurse prepares to instruct a group of children about Lyme disease. Which of the following information would the nurse include in the instructions? 1. Lyme disease is caused by a tick carried by deer.

• Lyme disease is caused by contamination from cat

feces.

• Lyme disease can be contagious by skin contact with

an infected individual.

• Lyme disease can be caused by the inhalation of

spores from bird droppings.

Answer: 1

Rationale: Lyme disease is a multisystem infection that results from a bite by a tick carried by several species of deer. Persons bitten by Ixodes ticks can be infected with the spirochete Borrelia burgdorferi. Lyme disease cannot be transmitted from one person to another. Toxoplasmosis is caused from the ingestion of cysts from contaminated cat feces. Histoplasmosis is caused by the inhalation of spores from bat or bird droppings.The client is diagnosed with stage I of Lyme disease. The nurse assesses the client for which characteristic of this stage? 1. Arthralgias

• Flu-like symptoms
• Enlarged and inflamed joints
• Signs of neurological disorders

Answer: 2

Rationale: The hallmark of stage I is the development of a skin rash within 2 to 30 days of infection, generally at the site of the tick bite. The rash develops into a concentric ring, giving it a bullseye appearance. The lesion enlarges up to 50 to 60 cm, and smaller lesions develop farther away from the original tick bite. In stage I, most infected persons develop flu-like symptoms that last 7 to 10 days; these symptoms may reoccur later. Neurological deficits occur in stage II.Arthralgias and joint enlargements are most likely to occur in stage III.A female client arrives at the health care clinic and tells the nurse that she was just bitten by a tick and would like to be tested for Lyme disease. The client tells the nurse that she removed the tick and flushed it down the toilet.Which of the following nursing actions is appropriate? 1.Refer the client for a blood test immediately.

• Inform the client that there is not a test available for

Lyme disease.

• Tell the client that testing is not necessary unless

arthralgia develops.

• Instruct the client to return in 4 to 6 weeks to be

tested, because testing before this time is not reliable.

Answer: 4

Rationale: A blood test is available to detect Lyme disease; however, the test is not reliable if performed before 4 to 6 weeks following the tick bite. Antibody formation takes place in the following manner: immunoglobulin M is detected 3 to

• weeks after Lyme disease onset, peaks at 6 to 8 weeks, and then gradually

disappears; immunoglobulin G is detected 2 to 3 months after infection and may remain elevated for years. Options 1, 2, and 3 are incorrect.A Cub Scout leader who is a nurse is preparing a group of Cub Scouts for an overnight camping trip and instructs the scouts about the methods to prevent Lyme disease.Which statement by one of the Cub Scouts indicates a need for further instructions? 1. "I need to bring a hat to wear during the trip."

• "I should wear long-sleeved tops and long pants."
• "I should not use insect repellent because it will attract

the ticks."

• "I need to wear closed shoes and socks that can be

pulled up over my pants."

Answer: 3

Rationale: In the prevention of Lyme disease, individuals need to be instructed to use an insect repellent on the skin and clothes when in an area where ticks are likely to be found. Long-sleeved tops and long pants, closed shoes, and a hat or cap should be worn. If possible, one should avoid heavily wooded areas or areas with thick underbrush. Socks can be pulled up and over the pant legs to prevent ticks from entering under clothing.

THERAPEUTIC COMMUNICATION

What is the best nursing response?- These are usually pretty straight forward but the questions are usually regarding psychiatric patients.Ex - the monsters are going to get me!

• Bring the patient back to reality and say I am a nurse and you are in the hospital.

Ex - a mom is in the lobby of a clinic and her children (age 2 and 4) are running around the waiting room screaming and playing. Best nursing response "children can be tough to handle at that age". Don't say something stupid like "control your children" or something like that.Pretty much never say anything that can offend someone. If you don't know the answer, get someone who does.CHEST TUBESIt is ok to milk a chest tube, all that means is you raise the tubing (like a foley) and drain the drainage into the device.When a chest tube is connected to suction, there should be no bubbles or fluctuation When a chest tube is connected to gravity (no suction), bubbles and fluctuation (rise and fall of the little ball) are expected.Sample question - a patient with a chest tube develops sudden shortness of breath. After applying oxygen via NRB and contacting the physician, the nurse should anticipate what? Stat portable chest xray to check for pneumothorax VENTILATORSOnce you have a few patients on a vent they are really easy, but for students they seem confusing. The best way to remember is by using the DOPE pneumonic.When dealing with an intubated patient, when something suddenly changes, that change is usually not a positive change. When the intubated patient suddenly becomes worse, we need to identify and correct the problem quickly. The patient is somehow suffocating.DOPED - DISLODGED - the ET tube is not in the right place. Either the patient pulled the tube or somehow it became dislodged. In this case you would immediately use bag valve mask and call a rapid response O - OBSTRUCTED - the tube is either kinked or the patient has a mucus plug.Suction the patients ET tube.P - PNEUMOTHORAX - this is scary because usually it is a tension pneumo. The patient will not have breath sounds on the affected side. If it is a tension, that means the air pressure is so high from the collapsed lung that it is pushing the heart, major blood vessels, and trachea to the other side. Call a doctor immediately. Treatment is needle decompression or chest tube.E - EQUIPMENT - either the ventilator is not working or the ventilator unhooked from the patients tube. If the vent isn't working right or becomes unhooked, bag the patient with high flow oxygen.OB - Monitor is showing late decels, what do you do first This question is always asked

• Reposition to left lateral position
• Apply high flow O2 (NRB)
• IV fluid bolus
• Contact physican
• If the patient is getting IV pitocin, you would first stop the infusion