NCLEX RN Questions And Answers 2023 A+ Review Test

NCLEX RN Questions And Answers 2023 A+ Review Test when fusing packed red blood cells, which solution is hung with the Y tubing? - ANS0.9% sodium in water (NS) Severe Preeclampsia, what are expected findings? - ANS-proteinuria, facial edema, blurred vision DM and glucose monitoring, what will increase blood flow and decrease risk of infection, before taking the sample? - ANS-washing clients hands with soap and warm water What is an expecting finding of Hyperthyroidism? - ANS-Tremors What is an expected finding of Hypothyroidism? - ANS-Periorbital Edema Coping Strategies - ANSVerapamil - ANS-CCB, treats hypertension, angina, arrhythmia. Do not take with Grapefruit (may cause hypotension). what should be administered for a Benzodiazepine overdose? - ANS-Flumazenil Which side does a cane go on? Weak side or Strong side? - ANS-Strong side Na+ - ANS-Electrolytes, Sodium 136-145 K+ - ANS-Electrolytes, Potassium 3.5-5 Ca++ - ANS-Electrolytes, Calcium 9-10.5 pH - ANS-ABG, 7.35-7.45 PaCO2 - ANS-ABG, 35-45 HCO3 - ANS-ABG, bicarbonate, 21-28 PaO2 - ANS-ABG, oxygen, 80-100 SaO2 - ANS-ABG, Oxygen Saturation, 95%-100% Hgb - ANS-CBC, Hemoglobin, 12-16 (F) 14-18 (M) Hct - ANS-CBC, Hematocrit, 42-52% (M) 37-47% (F) RBC - ANS-4.7 (M) 6.1 (F) WBC - ANS-CBC, White Blood Cell, 5000-10,000 ESR - ANS-erythrocyte sedimentation rate, 20 mm/hr Cholesterol, Total - ANS- 200 (risk for cardiac or stroke 150) Platelets - ANS-150,000-400,000 PT - ANS-11-12.5 seconds therapeutic range is 1.5 - 2 times the normal aPTT - ANS-partial thromboplastin time, 30-40 seconds therapeutic range is 1.5 - 2 times the normal INR - ANS-0.7-1.8 (unless on drug, therapeutic range 2-3) Glucose, Fasting - ANS-Endocrine, 70-105 HbA1c, glycosylated hemoglobin - ANS-Endocrine, Hemoglobin A1c, 4-6% under 6% for normal under 7% for Diabetes Control BUN - ANS-GU, 10-20 Creatinine - ANS-GU, 0.6-1.2 (M) 0.5-1.1 (F) Creatinine Clearance Test - ANS-90 - 139 (M) 80 -125 (F) calculation of GFR best indicator of overall renal function What type of solution is TPN? - ANS-hypertonic How can TPN be given and when is it prepared? - ANS-Through a PICC line or tunneled catheter and prepared daily Which lab value is checked and how often, when TPN is initiated? - ANS-blood glucose, every 4-6 hours Every 24 hours a new TPN bag is hung with a new filter. True or False? - ANS-True Non-Pharmocological Interventions: HOT - ANS-on for 15min, off for 20min acts as an analgesia (pain relief) increase blood flow relaxes muscles diminishes muscles spasms eases muscles & joint stiffness Non-Pharmacological Interventions: COLD - ANS-on for 15min, off for 20min acts as an analgesia (pain relief) decreases/prevents swelling diminishes muscles spasms Diseases that need Private rooms? - ANS-varicella (chicken pox) herpes zoster (shingles) rubeola virus (measles) meningococcal disease pneumonia respiratory syncytial virus (RSV) rubella tuberculosis (TB) HIV/AIDS - ANS-Standard duration of illness blood & body fluids, including breast milk hand hygiene PPE if in contact with potential contaminated materials Varicella (chicken pox) - ANS-Standard, Airborne, Contact Private Room until lesions crust over leasions & respiratory secretions ppl who are pregnant or not had chicken pox of vaccine, should not care for client Clostridium difficile (C-diff) - ANS-Standard, Contact duration of illness feces hand hygiene PPE (enteric) if contact with potentially contaminated materials Hepatitis A (HepA) - ANS-Standard, Contact (if fecal incontinence) until 7 days after onset of jaundice Contact precautions used with clients wearing diapers or incontinent, min of 1 week depending on age Hepatitis B (HepB) - ANS-Standard duration of illness blood & body fluids hand hygiene contact for blood & body fluids Hepatitis C (HepC) - ANS-Standard (unless hemodialysis) duration of illness blood & body fluids hand hygiene contact for blood & body fluids Herpes Simplex Virus (HSV) - ANS-Standard, Contact recurrent oral, skin, genital until lesions crust over fluid from lesions horizontal transmission: skin & secretions vertical transmission: mother to child utero or birth Carbapenam-resistant enterobacteriacease (CRE) - ANS-Standard, Contact high mortality rate blood & body fluids, feces hand hygiene contact precautions Herpes Zoster (shingles) - ANS-Standard. Airborne, Contact Private Room disseminated or localized in immunocompromised duration of illness or visible lesions lesions ppl who never had chicken pox or vaccine should not care for client Rubeola virus (measles) - ANS-Standard, Airborne Private Room duration of illness respiratory secretions virus can live on infected surfaces up to 2 hours Meningococcal disease - ANS-Standard, Droplet Private Room until continuous 24 h therapy respiratory secretions postexposure prophylaxis to control outbreaks What is the antidote for Magnesium Sulfate? - ANS-Calcium Gluconate What is the number one complication after insertion of an epidural catheter and what should the nurse do? - ANS-HTN and nurse should infuse isotonic IV solution Specific Gravity (urine) - ANS-Urinalysis, 1.005 - 1.025 Protein (urine) - ANS-Urinalysis, 0.8 Glucose (urine) - ANS-less than 0.5 g/day Ketones (urine) - ANS-Urinalysis, none pH (urine) - ANS-4.6 - 8 WBC (urine) - ANS-0-3 (M) and 0-5 (F) What type of fluid am I? treatment of vascular system fluid deficit concentration equal to plasma prevent fluid shift between compartments 0.9% NS LR D5W - ANS-Isotonic Stays where "I" put it! What type of fluid am I? treatment of intracellular dehydration lower osmolality than ECF shifts fluid from ECF to ICF 0.45% NS 2.5% D in 45% NS - ANS-HypOtonic Go "O"ut of the vessel! and into cells What type of fluid am I? used only when serum osmolality is critically low osmolality higher than ECF shifts fluid from ICF to ECF D10W (10% dextrose in water) D50W (50% dextrose in water) D5NS (5% dextrose in NS) D5W in 0.45% NaCl (5% dextrose in 1/2 NS) D5LR (5% dextrose in LR) - ANS-HypErtonic "E"enter the vessel! nasal cannula - ANS-1-6 L/min 24-44% simple face mask - ANS-6-8 L/min 40-60% partial rebreather mask - ANS-8-11 L/min 50-75% non-rebreather mask - ANS-12 L/min 80-100% venturi mask - ANS-4-8 L/min 24-40% aerosol mask / face tent - ANS-8-10 L/min 30-100% T-piece - ANS-8-10 L/min 30-100% Hypokalemia - ANS-low K+ (potassium) give K+ **NEVER give IV push **"No P = No K+" risk factors: -adverse affects of medications (steroids, diuretics, digitalis, laxative abuse) -body fluid loss (vomit, diarrhea, wound drain,NG suction) -excessive diaphoresis -kidney disease -dietary deficiency -alkalosis Manifestations: -muscle weakness, cramping -fatigue -n/v -dysrhythmias -flat or inverted T waves confusion, irritable decreased bowel mobility paresthesia interventions: -monitor: respiratory, ECG, I&Os, HCO3 and pH, -initiate and monitor K+ replacement (oral, IV) -fall precautions -dietary -client education Hyperkalemia - ANS-high K+ (potassium) risk factors: -renal failure -adrenal insufficiency -acidosis -excessive K+ intake -medications (K+ sparing diuretics, ACE inhibitors) manifestations: -peaked T waves -ventricular dysrhythmias -increased bowl motility -muscle twitching (early) -muscle weakness (late) interventions: -monitor: ECG, bowel sounds -initiate dialysis -administer (kayexalate, 50% glucose with insulin,calcium gluconate, bicarbonate, loop diuretics) Hyponatremia - ANS-low Na+ (sodium) **risk of cerebral edema with hypertonic solutions risk factors: -GI loss -SIADH -adrenal insufficiency -water intoxication -excessive diaphoresis -medications (diuretics, anti-convulsants, SSRIs, lithium) manifestations: -muscle cramps, twitching -weakness -confusion -lethargy -seizures -headache Continues...