MARK KLIMEK NCLEX ACTUAL EOC QUESTIONS
AND ANSWERS SET A+
✔✔Respiratory alkalosis = ventilator setting may be too - ✔✔high
✔✔Respiratory acidosis = ventilator setting may be too - ✔✔low
✔✔what does wean mean in terms of ventilators - ✔✔gradually decrease with the goal
of getting off altogether
✔✔Doc says wean off vent in AM... 6am ABG's show resp. acidosis... a) follow order b)
call respiratory c) hold order.. call doc d) begin to decrease the settings - ✔✔C. hold the
order
✔✔MASLOW's Priorities (HIGHest - LOWest) - ✔✔physiological safety
comfort psychological (problems within the person)
social (problems with other people) spiritual
✔✔alcohol (or any abuse) #1 problem is - ✔✔denial
✔✔you treat denial by - ✔✔confronting it
✔✔loss and grief - ✔✔Denial
Anger
Bargining
Depression
Acceptance
✔✔alcohol (or any abuse) #2 problem - ✔✔dependency
✔✔dependency in regards to abuse - ✔✔when the abuser gets the significant other to
do something
,ex. "call my boss, im sick"
✔✔co-dependacy in regards to abuse - ✔✔*calls boss* then has positive self esteem
✔✔how to treat dependency - ✔✔set limits and enforce them
learn to say no
✔✔manipulation = - ✔✔when the abuser gets the significant other to do things for him
or her... the nature of the act is dangerous or harmful
✔✔no harm = dependent / co-dependent example - ✔✔wife buying alcohol for husband
✔✔dangerous/harmful = manipulated example - ✔✔kid buying alcohol for father
✔✔Wernicke-Korsakoff Syndrome (WKS) - ✔✔is a neurological disorder. Wernicke's
Encephalopathy and Korsakoff's Psychosis are the acute and chronic phases,
respectively, of the same disease.
✔✔Wernicke-Korsakoff Syndrome (WKS) is caused by - ✔✔deficiency in the B1 vitamin
thiamine.
✔✔primary symptom of Wernicke-Korsakoff Syndrome - ✔✔amnesia with confabulation
(making up stories) *they believe the lie..*
✔✔Wernicke-Korsakoff Syndrome; you have a pt who believes he is Ronald Regan's
Natioal Security Officer... And they want to go to a cabinet meeting... :/ WHAT DO YOU
DO?!? - ✔✔Redirect!! ("well, why don't you get a shower and then we'll go watch CNN
and see what the news is in Washington D.C."
✔✔Wernicke-Korsakoff Syndrome is - ✔✔It's preventable & arrestable (stop it from
getting worse) - Take vitamin B1 -Irreversible... *About 70%*
✔✔Antibuse (disulfiram) - ✔✔-alcoholism medication *aversion therapy!* It can treat
problem drinking by creating an unpleasant reaction to alcohol. It's used in recovery
programs that include medical supervision and counseling.
✔✔how long does it take for Antibuse (disulfiram) to get into and out of their system? -
✔✔2 weeks!
✔✔patient teaching with Antibuse - ✔✔teach how to avoid NAUSEA, VOMITING &
DEATH NO: mouthwash, aftershaves, perfumes/colognes, insect repellants, -elixer
(Robitussin), alcohol-based hand santizers, un-cooked icings (vanilla extract)...
However, they CAN have RED WINE VINAGERETTE!
, ✔✔5 uppers that are abused - ✔✔caffiene, cocaine, PCP/LSD, methaphetamines,
adderall
✔✔uppers abuse s/s - ✔✔things go up... euphoria, tachycardia, restlessness, irritibility,
diarhhea, reflex 3/4, spastic - suction!!!
✔✔downers (135) - ✔✔heroin, alcohol, marijuana, etc.
*if its not an upper, its a downer
✔✔downer abuse s/s - ✔✔things go ↓ ~ lethargic, respiratory depression, bradycardia,
reflex 1/2, - ambubag!!!
✔✔2 steps for an abuse question - ✔✔Step 1: ask yourself, is it an Upper or Downer
Step 2: ask yourself, is it an Overdose (too much) or Withdrawal (not enough)
✔✔If they say: "overdosed on an upper" (too much upper)... pick - ✔✔↑ things!!
✔✔If they say: "downer & intoxication" (too much DOWNER)... pick - ✔✔↓ things!!
✔✔If they say: "withdrawal downer" - ✔✔(don't have enough downer; too little!)
✔✔Too little downer makes everything go - ✔✔up
✔✔Too little upper makes everything go - ✔✔down
✔✔Upper overdose LOOKS LIKE - ✔✔downer withdrawal
✔✔Downer overdose LOOKS LIKE - ✔✔upper withdrawal
✔✔2 situtions (highest priority) in abuse = - ✔✔Respiratory depression/arrest: Downer
overdose/upper withdrawal.. Seizure: Upper overdose/downer withdrawal...
✔✔Overdose on cocaine: UPPER/OVERDOSE.. (too much UPPER) *aka everything
goes ↑* What would you expect to see? - ✔✔-irritability, reflex 3/4, increased temp,
borborygmi (increased bowel sounds)
✔✔Withdrawing from cocaine.. - ✔✔Make sure the RR is above 12! Need NARCAN!!!
✔✔You are caring for an infant born to a equaline (pain killer) addicted mother... It is 24
hours after the birth... What do you expect to see? - ✔✔difficult to console, exaggerated
startle reflex, seizure risk,
shrill high pitch cry
AND ANSWERS SET A+
✔✔Respiratory alkalosis = ventilator setting may be too - ✔✔high
✔✔Respiratory acidosis = ventilator setting may be too - ✔✔low
✔✔what does wean mean in terms of ventilators - ✔✔gradually decrease with the goal
of getting off altogether
✔✔Doc says wean off vent in AM... 6am ABG's show resp. acidosis... a) follow order b)
call respiratory c) hold order.. call doc d) begin to decrease the settings - ✔✔C. hold the
order
✔✔MASLOW's Priorities (HIGHest - LOWest) - ✔✔physiological safety
comfort psychological (problems within the person)
social (problems with other people) spiritual
✔✔alcohol (or any abuse) #1 problem is - ✔✔denial
✔✔you treat denial by - ✔✔confronting it
✔✔loss and grief - ✔✔Denial
Anger
Bargining
Depression
Acceptance
✔✔alcohol (or any abuse) #2 problem - ✔✔dependency
✔✔dependency in regards to abuse - ✔✔when the abuser gets the significant other to
do something
,ex. "call my boss, im sick"
✔✔co-dependacy in regards to abuse - ✔✔*calls boss* then has positive self esteem
✔✔how to treat dependency - ✔✔set limits and enforce them
learn to say no
✔✔manipulation = - ✔✔when the abuser gets the significant other to do things for him
or her... the nature of the act is dangerous or harmful
✔✔no harm = dependent / co-dependent example - ✔✔wife buying alcohol for husband
✔✔dangerous/harmful = manipulated example - ✔✔kid buying alcohol for father
✔✔Wernicke-Korsakoff Syndrome (WKS) - ✔✔is a neurological disorder. Wernicke's
Encephalopathy and Korsakoff's Psychosis are the acute and chronic phases,
respectively, of the same disease.
✔✔Wernicke-Korsakoff Syndrome (WKS) is caused by - ✔✔deficiency in the B1 vitamin
thiamine.
✔✔primary symptom of Wernicke-Korsakoff Syndrome - ✔✔amnesia with confabulation
(making up stories) *they believe the lie..*
✔✔Wernicke-Korsakoff Syndrome; you have a pt who believes he is Ronald Regan's
Natioal Security Officer... And they want to go to a cabinet meeting... :/ WHAT DO YOU
DO?!? - ✔✔Redirect!! ("well, why don't you get a shower and then we'll go watch CNN
and see what the news is in Washington D.C."
✔✔Wernicke-Korsakoff Syndrome is - ✔✔It's preventable & arrestable (stop it from
getting worse) - Take vitamin B1 -Irreversible... *About 70%*
✔✔Antibuse (disulfiram) - ✔✔-alcoholism medication *aversion therapy!* It can treat
problem drinking by creating an unpleasant reaction to alcohol. It's used in recovery
programs that include medical supervision and counseling.
✔✔how long does it take for Antibuse (disulfiram) to get into and out of their system? -
✔✔2 weeks!
✔✔patient teaching with Antibuse - ✔✔teach how to avoid NAUSEA, VOMITING &
DEATH NO: mouthwash, aftershaves, perfumes/colognes, insect repellants, -elixer
(Robitussin), alcohol-based hand santizers, un-cooked icings (vanilla extract)...
However, they CAN have RED WINE VINAGERETTE!
, ✔✔5 uppers that are abused - ✔✔caffiene, cocaine, PCP/LSD, methaphetamines,
adderall
✔✔uppers abuse s/s - ✔✔things go up... euphoria, tachycardia, restlessness, irritibility,
diarhhea, reflex 3/4, spastic - suction!!!
✔✔downers (135) - ✔✔heroin, alcohol, marijuana, etc.
*if its not an upper, its a downer
✔✔downer abuse s/s - ✔✔things go ↓ ~ lethargic, respiratory depression, bradycardia,
reflex 1/2, - ambubag!!!
✔✔2 steps for an abuse question - ✔✔Step 1: ask yourself, is it an Upper or Downer
Step 2: ask yourself, is it an Overdose (too much) or Withdrawal (not enough)
✔✔If they say: "overdosed on an upper" (too much upper)... pick - ✔✔↑ things!!
✔✔If they say: "downer & intoxication" (too much DOWNER)... pick - ✔✔↓ things!!
✔✔If they say: "withdrawal downer" - ✔✔(don't have enough downer; too little!)
✔✔Too little downer makes everything go - ✔✔up
✔✔Too little upper makes everything go - ✔✔down
✔✔Upper overdose LOOKS LIKE - ✔✔downer withdrawal
✔✔Downer overdose LOOKS LIKE - ✔✔upper withdrawal
✔✔2 situtions (highest priority) in abuse = - ✔✔Respiratory depression/arrest: Downer
overdose/upper withdrawal.. Seizure: Upper overdose/downer withdrawal...
✔✔Overdose on cocaine: UPPER/OVERDOSE.. (too much UPPER) *aka everything
goes ↑* What would you expect to see? - ✔✔-irritability, reflex 3/4, increased temp,
borborygmi (increased bowel sounds)
✔✔Withdrawing from cocaine.. - ✔✔Make sure the RR is above 12! Need NARCAN!!!
✔✔You are caring for an infant born to a equaline (pain killer) addicted mother... It is 24
hours after the birth... What do you expect to see? - ✔✔difficult to console, exaggerated
startle reflex, seizure risk,
shrill high pitch cry
