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NCLEX RN ACTUAL STUDY GUIDE WITH LATEST QUESTION AND
ANSWERS AS PER MARKING SCHEME 2023.
1 DO NOT DELEGATE WHAT YOU CAN EAT!
Evaluate Assess Teach
Don’t delegate Unstable patients Initial Assessment, Teaching, IV drips, Evaluations only RN
AIRBORNE TRANSMISSION -BASED PRECAUTIONS: MTV
Measles TB Varicella-Chicken Pox/Herpes Zoster-Shingles
Private Room: Negative pressure with 6-12 air exchanges/hr
Mask: N95 for TB
DROPLET TRANSMISSION -BASED PRECAUTIONS: Think of SPIDERMAN!
Sepsis Scarlet fever 1 / 4
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Streptococcal Pharyngitis (Streptococcus group A/ Strep Throat): Can Lead to
Glomerulonephritis & Rheumatic
Fever.
Pneumonia
Pertussis Influenza/ Haemophilus influenza type B
Diphtheria (Pharyngeal): Serious bacterial infection.
Epiglottitis: Medial Emergency! No Throat Inspection.
2 Rubella/ German measles
Mumps
Meningitis/ Neisseria Meningitidis Mycoplasma/ Meningeal Pneumonia An - Adenovirus Private Room or Cohort Surgical mask PRN for Procedures Mask 3ft Distance
CONTACT PRECAUTION TRANSMISSION -BASED PRECAUTIONS: MRS.WEE
Multidrug resistant organism/ MRSA/ VRE
Respiratory infection Skin infections Wound infection Enteric infection - Clostridium Difficile
Eye infection – Conjunctivitis
*MRSA - Contact precaution ONLY. Use Chlorhexidine Wipe!
*VRSA - Contact & Airborne precaution (Private room, door closed, negative pressure)
Parvovirus
B19 2 / 4
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*SARS (Severe Acute Resp Syndrome) Airborne & Contact (just like Varicella)
SKIN INFECTIONS- VCHIPS- CONTACT
Varicella Zoster
Cutaneous Diphtheria (Bacteria Infection in the Wound)
Herpes Simplex
Impetigo (Bacterial Skin Infection)
Pediculosis (Lice)
Scabies (Itchy Skin condition. Burrowing Trail of the Scabies Mite) 3
Middle East Respiratory Syndrome (MERS): Viral respiratory illness caused by Coronavirus (MERS-CoV).S/S: Fever, Cough, SOB, and Death. The Incubation Period is 5-6 days but can range from 2-14 days.CDC: Standard (Gloves), Contact (Gown), Eye Protection (Goggles), Airborne Precautions (N95)
Negative room: Negative disease (TB, Disseminated Herpes Zoster)
Positive room: Protect the Patient (HIV, Cancer)
= hyponatremia, hypotension, decreased blood vol, hypoglycemia, hyperKalemia, HyperCalcemia.
= HyperNatremia, HyperTension, Incr. Blood Vol, HyperGlycemia, hypokalemia, hypocalcemia.
Managing Stress in a patient with Adrenal Insufficiency (Addison’s) is paramount, because if the Adrenal glands are stressed further it could result in Addisonian Crisis.Addison’s: Remember BP is the most Important assessment parameter, as it causes Severe Hypotension.
Addison’s Cushing’s 3 / 4
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Addison’s: (need to "add" hormone): Hypoglycemia, Dark pigmentation, Decr.Resistance to Stress, fractures, Alopecia, Weight Loss, GI distress. Vitiligo. Mood swings (Normal) Need to Report S/S of Infection/ Fever (Addisonian Crisis)
Tx: Mineral Corticoids.
Addisonian Crisis: Hypoglycemia, Confusion, n/v, Abd Pain, Extreme Weakness, Dehydration, Decr. BP.
Cushings: (have extra "Cushion" of Hormones): Hyperglycemia, prone to Infection, Muscle Wasting, Weakness, Edema, HTN, Hirsutism, Moonfaced/Buffalo Hump Cause: Excessive production of Corticotropin (Hyperplasia of the Adrenal Cortex) & Cortisol-secreting Adrenal Tumor.Prednisone Toxicity: Cushing’s syndrome- Buffalo Hump, Moon face, Hyperglycemia, Hypertension.
Acetaminophen: 10-20. Max 4000mg per day.
4 Acetaminophen Poisoning: Possible Liver Failure for about 4 days. Close observation required.
Tx: (Antidote) n-AcetylCysteine/Mucomyst
AcetylSalicyclic Acid (ASA): Metabolic Acidosis.
S/S: Tinnitus, Coffee Ground Emesis (Old Blood), Black tarry stools (Melena), Bruising, Tachycardia,
Hypotension, GI Ulcers. Tx: Activated Charcoal, then IV Na+ Carbonate.
Acromegaly: Coarse Facial feature. Assess Cardiac Problems (eg. S3, S4).
Acute Respiratory Distress Syndrome (ARDS):
The 1st Sign is Incr. Respirations. Later comes Dyspnea, Retractions, Air Hunger, Cyanosis.Cardinal sign is Hypoxemia (Low O2 level in tissues).
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