NCLEX MARK KLIMEK PHARMACOLOGY

NCLEX MARK KLIMEK PHARMACOLOGY

EXAM QUESTIONS AND ANSWERS.

Never hold the hormone for what patient? Correct - patient who is NPO with myxedema

Addison's disease easy way to remember Correct - Add a Sone (sone = steroid)

Best default order for click and drag order questions? Correct - Hold ..... med Assess ..... what med does Prepare ...... the correction Call ..... or notify

Rarely if ever answer ... Correct - call Doctor, NCLEX wants you to think critically

INR lab values Correct - 2-3, critical value if off, potential for patient to bleed. Use default order for order ?'s (hold all coumadin, assess for bleeding, prepare Vit K (antidote for Coumadin), Call or notify

Potassium lab values Correct - 3.5-5.3 If low it is a critical lab to worry about assess the heart and then prepare to give K if high, hold all K, assess heart (EKG), give D5W and reg insulin, call if really high, hold, assess, prepare, call STAT Get someone else involved! Dangerous!!

If question says there is pitocin running and there are complications Correct - stop pit first then LIONpit

Pain meds in labor Correct - know your peaks for IV, IM, PO, Subling. If baby is likely to be born when the pain med is peaking don't give! Why? Respiratory depression in baby

OB medications tocolytics Correct - stop contractions, Brethine causes maternal tachycardia, Nifedipine (dipine - CCB) causes Hypotension and headache

OB medications oxytocics Correct - makes labor more intense, Pitocin, Methergine, Cervidil

OB medications Fetal/Neonatal Lung meds Correct - Betamethasone, speeds the development of the baby's lungs, given to Mom before baby is born, given IM, will increase the blood sugar of Mom

Survanta (surfactant) Correct - given to baby after baby is born given trastracheal through the airway develops lungs

Med hints for IM injections Correct - Look for 1's in both parts (the 1 looks like an I), guage and length, 21 g, 1 inch means IM

Med hints for SQ injections Correct - look for 5's in both parts (the 5 looks like an S), guage and length, 25 g, 5/8 inch means SQ

Drawing up Insulin rules Correct - R then N, Draw up R then N, NRRN the whole process

Pressurizing Insulin rule Correct - put air into N then R , NRRN the whole process

If 70/30 insulin it is Correct - 70% N and 30% R, may have to make your own on boards, no 70/30 on the floor

Heparin is given IV or SQ NOT PO, info re: Heparin Correct - works immediately, labs Ptt or any clotting or bleeding time, antidote: protamine sulfate, course: 21 days,

pregnancy: YES (Class C pregnancy drug, use caution)

Coumadin is given PO, info re: Coumadin Correct - takes days to work, labs ONLY PT-INR, antidote: Vit K (think Koumadin), course: forever, prengancy: NO (never use)

If a diuretic ends in the letter X it is a potassium Correct - wasting drug plus Diurel

Baclofen/ Flexoril Correct - muscle relaxant, think on your back loafin'! makes a patient drowsy, weak muscles, don't drink, don't drive, don't care of kids under 12 Piaget's stage Sensorimotor age 0-2, totally

When can a child give themselves their own insulin shot? Correct - 7

What 2 parts are always irrelevant in a prioritization question? Correct - age and gender (NCLEX is testing discrimination against agism), age only important for peds

All psych drugs cause Correct - low BP and weight change (usually gain)

Phenothiazines Correct - all end in 'zine Ex: Thorazine, Compazine, they are major tranquilizers so think safety

'Zines for the Correct - Zanny

In large doses Phenothiazines are Correct - anti-psychotics

In small doses Phenothiazines are Correct - anti-emetics

Side effects of Phenothiazines Correct - Anticholinergic (dry mouth), Blurred vision, Constipation, Drowsiness, Extrapyramidal syndrome (parkinsons), Fotosensitivity, aGranulocytosis (low WBC's)

#1 problem or concern for patient taking Phenothiazines Correct - SAFETY

Deconoate drug is Correct - a long acting IM form given to non compliant patients

Tricyclic Antidepressants are Correct - mood elevators to treat depression

Examples of Tricyclic anti depressants Correct - Elavil, tofranil, aventyl desyrel

Side effects of Tricyclic medications Correct - Anticholinergic(dry mouth), Blurred Vision, Constipation, Drowsiness, Euphoria HInt: Elavil starts with E so this group goes through E

How long does a tricyclic need to be taken before results are seen? Correct - 2-4 weeks

Benzodiazepines are for Correct - anti anxiety, they are minor tranquilizers, have

'zep in the name, EX: Diazepam (Valium), plus Xanax, Often given pre op, muscle

relaxant, alcohol withdrawal, seizures, facilitates mechanical ventilation

Benzodiazepines works Correct - quickly, must not take for 6 weeks, keep on Valium until Elavil kicks in

Side effects for Benzodiazepines Correct - Anticholinergic (dry mouth), Blurred Vision, Constipation, Drowsiness

Number one nursing concern for patient taking Benzo's is Correct - also safety

MAOI's Correct - antidepressants, happy pills

Depression is caused by a deficiency of Correct - norepinephrine, dopamine and serotonin in the brain

Names of MAOI's Correct - MAR, NAR, PAR: Marplan, Nardil, Parnate

Side effects of MAOI's Correct - Anticholinergic (dry mouth), Blurred vision, Constipation, Drowsiness

How long can a person be on MAOI's and how long before they work? Correct - rest of life, 2-4 weeks

MAOI's interact with LOTS Correct - Avoid all foods containing Tyramine, causes fatal hypertension

Tyramine foods Correct - Fruits and Veggies are okay except remember salad BAR, avoid Banannas, Avacados, Raisins, Grains are okay except for active yeast, no organ

meats, no preserved meats, no dairy, no alcohol, tinctures, caffiene, chocolate, licorice, soy sauce

Lithium Correct - for bipolar disorder (manic depression) it decreases mania

Side effects of Lithium Correct - peeing, pooping, parasthesia

Lithium Toxicity Correct - 2 or greater, tremors, metallic taste, severe diarrhea, number one intervention, give fluids, if sweating give electrolytes too

Lithium monitor what levels Correct - sodium, low sodium levels prolong lithium's half-life, causing lithium toxicity, high sodium levels decrease the effectiveness of lithium

Prozac Correct - it an SSRI, similar to Elavil so same info as Tricyclic's

Prozac causes Correct - insomnia, so give before noon, so if BID, give at 6A and 12N NOT at bedtime

When changing the dose of Prozac for an adolescent or young adult, watch for Correct - suicide

'zine, 'zep, 'zap Correct - all tranquilizers

a good guess about psych med weening Correct - decrease the dose of the old drug

Haldol Correct - just like the Thorazine's, also has a deconoate form

Dose of Haldol for elderly patient should be Correct - half of usual adult dose

Clozaril (Clozapine) Correct - 'zap's, for schizophrenia

'zap's, for schizophrenia Correct - aGranulocytosis

How often should WBC be drawn when pt is taking 'zap's for schizo? Correct - 1 time per week for 1 month, 1 month every month for 6 months then every 6 months

Zoloft (sertraline) Correct - also a SSRI like prozac, antidepressant, doesn't cause insomnia so it can be taken at bedtime.

Zoloft interacts with other medications like Correct - St John's wart (causes serotonin syndrome) - sweating, apprehension (impending sense of doom), dizziness (vertigo), headache, also with Coumadin so watch for bleeding

Zoloft with Coumadin? Correct - Question the order if the coumadin dose wasn't lowered