Jodi- NCLEX Practice

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Jodi- NCLEX Practice

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What should nurse teach patient with peripheral arterial occlusive disease?
Avoid sunburn Wear extra socks in winter wear clean, loose cotton socks Larger shoe size  
Peripheral arterial occlusive disease is caused from what?
atherosclerosis and/or blocked artery
Signs and symptoms of Cardiogenic shock are?
Low BP rapid, weak pulse decrease urine output confusion restlessness  
Which antibiotic may cause thrombocytopenia?
If patient on Priloprim, should be advised to report what?
any unusual bleeding or bruising.   Periodic blood counts should be done  
Acts directly on bronchial smooth muscle to relax, and dilate the bronchi and relieve bronchial constriction and spasms?
Theophylline ethylenediamine  
what is theophylline used for?
patient with COPD
What are the therapeutic levels of Theophylline and what are desired effects of drug?
10-20mcg Dyspnea and SOB should decrease  
What is assessed on newborn for the Apgar score?
Heart rate Resp rate Muscle tone Reflex irritability Color
Valproic Acid (Depakene)
Adjunct therapy for patients with seizures or for bipolar disorders
MAOI inhibitor used for treatment of depression?
phenelzine( Nardil)
If patient on Nardil, report palpitations immediatetly. could indicate what?
Hypertension crisis due to ingesting tyramine rich foods
what are considered tyramine rich foods?
Aged meats and cheeses yeast dried fruit hot dogs
What does the P-wave represent on an ECG?
Depolarization of the left and right Atria.
0.11sec or less
normal duration of P-wave
action potential or contractions of the heart
Resting state of the heart.
common side effects of Lithium Carbonate?
nausea, dry mouth, thirst.   Will decrease or go away after 6 weeks
Treatment for manic episodes of Bipolar?
Lithium Carbonate
What levels of Lithium Carbonate may indicate toxicity?
levels over 1.5mEq
Primary action of Nitroglycerin tablets?
To prevent platelet fromation and block prostiglandin synthesis.
What is correct dosage for Nitro tablets?
1 tab every 5 min TIMES 3 doses
What may be the result of thickening of the heart muscle b/c of increased workload of the heart such as high BP?
Left ventricular enlargement (enlarged heart)
How is left ventricular enlargement detected?
physical exam, x-ray or other imaging test.
Where is the normal apical pulse found?
over the apex of the heart and auscultated in left 5th intercostal space in the midclavicular line.
What are activity orders for a pt with internal radium implant for cervical cancer?
strict bed rest, flat in bed.  
Why is movement limited for pt with a internal radium implant?
To prevent accidental dislodgement or displacement of implant
What is the proper procedure for wound irrigation?
Using a 35ml syringe and 19- french angiocatheter, Irrigating with about 8lbs of pressure, wearing a mask, gown, goggles, gloves
What are the adverse reactions caused from tetnus, mmr, pertussis and polio vaccines?
redness at injection site, rash(7-10 days after), anorexia, low grade fever, malaise, fussines
Antidiabetic agent Observe clients for S&S of hypogylcemia
What are the S&S of an adolescent with severe weight loss assoc with anorexia nervosa?
bradycardia, hypotension, cold sensitivity
ventriculoperitoneal shunt for an infant?
Done to relieve pressure inside skull.  Pressure is caused by too much CSF on the brain.  Pressure is drawn from the brain into the abdominal cavity.
What should be monitored very carefully post-op for an infant with a ventriculoperitoneal shunt?
intake & output- to prevent fluid overload that can lead to ICP
What are the effects of chlamydial infection during pregnancy?
preterm labor, low-birth weight, preterm rupture of membranes.
What drug is assoc with bone marrow suppresion and toxic doses could cause anorexia, n/v, diarrhea? 
mercaptppurine( Purinenthol)
Recovery from what may take weeks to months and cause pt to become very depressed and bored from fatigue?
Hep A
S&S of Hep A?
Dark urine, fatigue, itching, loss of appetite, N/V, clay colored stools, jaundice
A distended bladder is most common cause for what?
Autonomic Dysreflexia- Which occurs from a sympathetic response to autonomic nervous system stimulation.
Nursing considerations for pt with autonomic dysreflexia?
Place client in high fowlers and check patency of urinary catheter.
Normal TSH level?
Drug used for Hypothyroidism?
Levothyroxin( Synthroid)
Loss of brain function as a result of severe low thyroid level?
myxedema coma
S&S of possible overdose when pt on Synthroid?
sweating, insomnia, rapid pulse, dyspnea, irritable, fever, weight loss
What is a closed pneumothorax?
chest wall is punctured and air leaks from a ruptured bronchus and eventually ruptures into pleural space.
What is an open pneumothorax?
A penetrating chest wound enables air to rush in and cause lungs to collapse.
S&S of a pneomothorax?
SOB, dry cough, cyanosis
Most reliable indicator of renal function?
serum creatinine
Normal serum creatinine levels?
Potters Syndrome?
Kidneys fail to develop properly as the baby is growing in the womb as a result of not enough amniotic fluid. Without amniotic fluid the infant is not cushioned from the walls of the uterus. Infant will have unusual facial appearance, and widely seperated eyes.
Result of a problem with girls chromosomes?Born with only 1 x chromosome.
Turners Syndrome
What are effects of child with Turnes Syndrome?
growth problems, infertile, webbed neck (extra folds of skin)
Functions only when HR falls below a set level?
Demand pacemaker
Used to induce labor, increase force of contractions in labor, contract uterine muscle, control post-partum hemorrhage, stimulate milk ejection
For a client with uncontrolled atrial fibrillation, the nurse will assess for what?
Client is at risk for low cardiac output, so nurse will assess for: palpitaions, chest pain and discomfort, hypotension, fatigue, weakness, dizziness, SOB, distended neck veins.
If experiencing unstable ventricular tachycardia, nurse would instruct client to do what?
Inhale deeply and cough forcefully every 1-3 sec. known as cough CPR. May terminate ther dysrythmia or sustain coronary circulation for a short time until other measures can be implemented.  
Clients post cardiac surgery...
At risk for acute renal injury from poor perfusion, hemlysis and low cardiac output.
Renal injury in clients post cardiac surgery is signaled by?
decreased urine output and increased BUN and creatinine.
On an adult pt receiving CPR the sternum in depressed how much?
11/2 to 2 in
Drug of choice for heart failure. Normal levels= 0.5 to 2.0
Cardiac marker for pt with signs of MI?
Troponin- Regulatory protein found in heart muscle. Levels higher than 0.1 to 0.2  "think MI"
Ambiguous genetalia?
Enlarged clitoris with fusion of the posterior labia majora. Ultrsound will reveal whether ovaries are present.
Instructions involving gavage feeding for a newborn?
First lubricate the catheter with sterile water before introduction so that if the catheter  inadverdently goes into the lungs, damage would not occur.
terbutaline (Brethine)
Tocolytic med which inhibits uterine activity by suppressing contractions.
Adverse effects of terbutaline therapy include what?
Pulmonary edema. Increased plasma volume is indicative of fluid overload. Decreased H & H levels are indicators of increase in blood plasma volume.
S & S of pulmonary edema?
chest pain, SOB, resp distress, wheezing, crackles, blood tinged sputum.
Infection that occurs in testicle alone?
Acute epidiymitis
S & S of acute epidiymitis?
pain in scrotum, tenderness in epididymus first then scrotum.
What are S &S of venous leg ulcers?
Pink ulcer bed, uneven edges of ulcer, granulation tissue is evident, skin has a brown pigmentation, and clients exhibit peripheral edema.
To ensure accurate measurement of BP, nurse should implement what measures?
Have pt. seated with arm bared, supported and arm at heart level, legs on floor with feet uncrossed. Cuff should encircle at least 80% of limb being measured. Client should have not smoked or taken caffeine 30 min preceding test. 2 or more BP readings should be measured.
Persantine thaliium -201 scan?
Persantine dilates the coronary arteries just like excercise would. An alternative test to the excercise thallium 201 scan.
Before the Persantine thallium 201 scan, what should be withheld?
Caffeine and bronchodilators (Theophylline)
An ECG taken DURING an episode of chest pain shows what?
Captures ischemic changes which includes ST segment elevation or depression.
Pulmonary embolism?
A life-threatening complication of DVT and thrombophlebitis.
What are S &S of a pulmonary embolism?
sudden, onset of chest pain, dyspnea, cough, diaphoresis, apprehension
When would carotid sinus massage be used?
A maneuver used for vagal stimulation to decrease a rapid HR and possibly terminate a tachydysrythmia.
Automatic internal cardioverter-defibrillation (AICD)?
Detects and delivers an electrical shock to terminate life-threatening episodes of ventricular tachycardia and v. fib.
Automatic internal cardioverter- defibrillator devices are implanted in what kind of pts.?
High risk pts who survived sudden cardiac death unrelated to MI, refractive to medication therapy, and who have syncopal episodes R/T ventricular tachy.
Which VS should be assessed following admin of nitroglycerin?
BP, cause nitroglycerin can cause hypotension
How should nurse assess the Ortolani's maneuver for pt with congenital hip dysplasia?
Flex the knees while holding thumbs at midthigh and fingers over the greater trochantors. If a "click" is heard, that is bad.
What is the normal range for WBC's and and what actions should be taken if range is extremely low?
3000-5000 Place in isolation and limit visitors and others who are sick.
Term used to describe the discomfort (pain) a person experiences when oxygen demand is greater than the supply?
Buergers Disease?
An inflammation of the intermediate small arteries and veins. Affecting mostly hands and fingers.
What are the S & S of Beurgers Disease?
claudication, cyanosis, coldness and pain at rest.
Variant Angina (Prinzmetals) is diagnosed using what symptoms?
prolonged, severe pain and occurs same time each day often at rest.
What type of angina is induced by exercise and relelieved by rest or nitroglycerin tablets?
Stable Angina
What are the S & S of unstable angina?
Occurs at lower and lower levels of activity or at rest. Less predictable and often a precurser of MI.
Blood urea nitrogen. Normal levels= 7-20 Increased levels suggest impaired kidney function.