NCLEX study Review Questions and Answers from

NCLEX study Review Questions and Answers from Mark Klimek

Hyperthyroidism is also called - ANSWER Grave's disease or hypermetabolism Tip to remember Grave's disease s/s's - ANSWER "Run yourself into the Grave" - everything is up ... diarrhea, thin, hot, high BP, high HR, cold tolerance, hot intolerance Treatment for Grave's disease - ANSWER Radioactive Iodine, PTU (put thyroid under), surgically remove Total thyroidectomy ... totals get - ANSWER tetany, need lifelong hormone replacement After thyroidectomy patients are at risk for - ANSWER hypocalcemia, remember hypocalcemia is opposite of the prefix and anything to BP so tetany, parasthesia parathesia - ANSWER numbness and tingling, first sign of electrolyte imbalance Subtotal thyroidectomy ... subs get - ANSWER storm S/S of thyroid storm - ANSWER Extremely high vital signs, hyperpyrexia, psychotic delerium How to treat thyroid storm - ANSWER give o2, lower temp to spare brain Risks post op for total thyroidectomy - ANSWER airway, hemorrhage for 1st 12 hours then for 12-48 hours hypocalcemia leading to tetany Risks post op for sub total thyroidectomy - ANSWER airway, hemorrage for 1st 12 hours then for 12-48 hours thyroid storm Hypothyroidism is also called - ANSWER Myxedema or hypometabolism S/S of mydexema - ANSWER everything is down, constipation, heat tolerance, cold intolerance Treatment for mydexema - ANSWER give thyroid medications Where to put the 5 ice packs to cool a thyroid storm patient - ANSWER neck pits groin If you cool a patient too fast what might happen? - ANSWER Heart arrythmias Never hold the hormone for what patient? - ANSWER patient who is NPO with mydexema Addison's disease easy way to remember - ANSWER Add a Sone (sone = steroid) Adrenal Cortex diseases easy way to remember - ANSWER A in Adrenal stands for Addison's C in Cortex stands for Cushing's Addison's disease is - ANSWER undersecretion of adrenal cortex, not enough hormone,

BRONZE/tan, go into shock very easily. STRESS can trigger.Addison's disease treatment - ANSWER give a steroid, chronic steroid therapy Cushing's syndrome - ANSWER Over secretion of adrenal cortex, too much hormone, too much steroid.S/S of Cushing's syndrome - ANSWER same as steroid use ... moon face, think cushman "I'm mad I have an infection", high blood sugar, losing Potassium, Treatment for Cushing's syndrome - ANSWER Surgery, bi or uni lateral adrenalectomy (bilateral is worse) Donning PPE's order - ANSWER Gown, Mask, Goggles, Gloves Removing PPE's order - ANSWER alphabetically inside the room For airborne precautions the mask is removed where? - ANSWER outside of the room Avoid answers with what words for children 9 mths and younger? - ANSWER build, sort, stack, construct, make Toddlers (1-3) work on - ANSWER their gross motor skills (jump, hop, throw), NO fine motor, parallel play Preschoolers (3-6) work on - ANSWER fine motor, balance (tumbling, dance, tricycle), cooperative play, pretend School age (7-11) work on - ANSWER creative, collect, competitive Best default order for click and drag order questions? - ANSWER Hold ..... med Assess ..... what med does Prepare ...... the correction Call ..... or notify Rarely if ever answer ... - ANSWER call Doctor, NCLEX wants you to think critically Creatinine lab values - ANSWER same as lithium 0.6-1.2 Not a huge worry, not a dangerous lab to worry about INR lab values - ANSWER 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 - ANSWER 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!!pH lab values - ANSWER 7.35-7.45 if pH is in the 6;s VERY dangerous remember as the patient's pH goes so goes the patient If bad vitals, call rapid response team BUN lab values - ANSWER 8-30 check for dehydration if elevated not a big deal, just be concerned If a deadly or dangerous lab value is discovered AND they have symptoms call the - ANSWER rapid response team!HgB lab values - ANSWER 12-18 check for bleeding if low or high, if low prepare for tranfussion HCO3 lab values - ANSWER 22-26 if it is abnormal so what!CO2 lab values - ANSWER 35-45 if in the 50's assess respiratory status and have patient do pursed lip breathing, if in 60's considered deadly and respiratory failure, need intubated Hct lab values - ANSWER 36-54 thickness of blood if abnormal not too big of a deal, assess for dehydration PO2 lab values - ANSWER 78-100 this is only obtained from an ABG if low give O2 but if really low it is respiratory failure give O2, prepare for intubation, call resp therapy and call Dr O2 sat lab values - ANSWER 93-100 pulse ox, if under 93 assess resp status and give O2 BNP lab value - ANSWER less than 100 is normal, good indicator of CHF, edema, if elevated assess s/s of CHF

NA lab values - ANSWER 135-145, if a change in LOC then evaluate for fall/safety risk

WBC lab values - ANSWER 5000-11000 if low assess for infection

CD4 count less than 200 equals - ANSWER AIDS

Neutropenic precautions (low WBC) - ANSWER strict handwashing, avoid crowds, private room, low bacteria diet (no raw or undercooked), no water that has been standing longer than 15 min, vital signs Q4H

Platelets lab value - ANSWER 150000-400000 if lower than 90000 bad if lower than 40000

REALLY bad, if they sneeze they could die. Called thrombocytopenia

Bleeding precautions - ANSWER no venipuncture, injection or IV, if necessary use small guage, handle patient gently, use drawsheet, no razor, no toothbrush, blow nose gently, no aspriin, no rectal temp, no hard foods

RBC lab values - ANSWER 4-6 million abnormal doesn't really matter

Reason for laminectomy - ANSWER treat nerve root compression

S/S of nerve root compression - ANSWER Pain Parasthesia (numbness & tingling) Paresis (muscle weakness)

Cervical - ANSWER Diaphram and Arms affected, breathing, respiratory pattern

Thoracic - ANSWER Abd muscles and gut affected, ability to cough

Lumbar - ANSWER Bladder and legs affected, when did they last void, are they distended

#1 post op answer for spinal problems is - ANSWER log roll patient

Activity post op spinal issue - ANSWER do not dangle stand, walk, lie down w/o restricitons limit sitting to 30 min at a time

Post op complications for cervical spinal surgery - ANSWER pneumonia