NCLEX-RN EXAM REVIEW QUESTIONS AND ANSWERS GRADED A

NCLEX-RN EXAM REVIEW QUESTIONS AND ANSWERS GRADED A Acetaminophen (Tylenol) is what type of drug? What is the maximum recommended dosage? What should you monitor? - ANS -Nonopioid Analgesics. Max dose: 4000 mg (4 g) in 24 hrs Monitor liver function Aldosterone attracts what? - ANS -Sodium aminoglycosides (mycins) - ANS - Angiotensin II in the lungs is a potent? - ANS -vasodialator At what pain level should an Opioid Analgesic be considered? - ANS -Pain level of 6 or greater. Opioids are used for moderate to severe pain. Define fluid volume excess: Hypervolemia - ANS -too much fluid in the vascular space (first). Vascular equals the vessels --> veins, arteries, capillaries, heart chambers, etc. DO NOT delegate what you can EAT - ANS -E = evaluate A = assess T = teach EPI is always given in what type of syringe - ANS -TB syringe HIV Nursing and Collaborative Management includes... - ANS -- Monitor disease progression and immune function -Initiate and monitor (ART) antiretroviral therapy: to decrease viral load and increase T cell count -prevent development of opportunistic diseases -detect and treat opportunistic diseases -manage symptoms -prevent or decrease complications of treatment -prevent transmission of HIV How do you convert Centigrade to Fahrenheit - ANS -C+40, multiply 9/5 and subtract 40 How do you convert Fahrenheit to Centigrade - ANS -F+40, multiply 5/9 and subtract 40 How do you test for the Chvostek sign and what happens if there is a positive response? - ANS -Elicitation: Tapping on the face at a point just anterior to the ear and just below the zygomatic bone Postitive response: Twitching of the ipsilateral facial muscles, suggestive of neuromuscular excitability caused by hypocalcemia How do you test for the Trousseau's sign and what happens if there is a positive response? - ANS -Elicitation: Inflating a sphygmomanometer cuff above systolic blood pressure for several minutes Positive response: Muscular contraction including flexion of the wrist and metacarpophalangeal joints, hyperextension of the fingers, and flexion of the thumb on the palm, suggestive of neuromuscular excitability caused by hypocalcemia How do you treat fluid volume deficits? - ANS -Strict I&O Replace with isotonic fluids monitor Bp weight daily How does atrial natriuretic peptide (ANP) work? - ANS -It is the opposite of aldosterone, so it causes excretion of Nas and H2O How often is nitroglycerine administered and when should you not give it? - ANS -up to 3 times (every 5 minutes) do not give when BO is less than 90/60 How should you address questions related to Maslow's Hierarchy of Needs - ANS -Address physiological needs first, followed by safety and security needs, love and belonging needs, self esteem needs and finally self actualization needs. *When a physiological need is not addressed in the question, look for the option that addresses safety. How would you treat fluid volume excess? - ANS -Give Diuretics (Lasix), fluid restrictions, weigh daily, monitor K+ If a question is related to the nursing process, read the question to determine the step of the nursing process. What are the steps in the nursing process and what kind of question might be related to that step. - ANS -Assessment question address the gathering and verification of data. Analysis questions require the nurse to: interpret data, collect additional information, identify and communicate nursing diagnoses and determine the health team's ability to meet the pts needs. Planning questions ask about determining, prioritizing, and modifying outcomes of care. Implementation questions reflect the management and organization of care and the assignment and delegation of tasks. Be prepared for questions on client teaching. Evaluation questions focus on comparing the actual outcomes of care with the expected outcomes and on communicating and documenting findings. If PVC's are left untreated what can it lead to? - ANS -Ventricular fibrillation Name 3 Invasive non-pharmacological pain relief techniques. - ANS -Nerve blocks Interruption of neural pathways Acupuncture Name 3 types of IV fluids - ANS -Isotonic: 0.9% NS, LR, and D5w Hypotonic: 0.5% NS, 0.45% NS Hypertonic: d5 0.45% NS, D5LR, D5NS Name 4 types of Nonopioid Analgesics - ANS -1. Acetaminophen: Tylenol 2. Salicylates: Aspirin, Trilisate 3. NSAIDS: ibuprofen, Indomethacin, Ketorolac, Diclofenac 4. COX-2 inhibitors: Celebrex Name 5 non-invasive non-pharmacological pain relief techniques (1st choice of pain relief) - ANS -Ten's heat and cold application message therapy relaxation techniques guided imagery biofeedback techniques Never IV push what electroylte - ANS -K+ Nursing assessment r/t HIV - ANS --Positive result on enzyme-linked immunosorbed assay (ELISA) - CONFIRMED WITH WESTERN BLOT TEST -Polymerase chain reaction (PCR) - used with neonate - OraQuick In-Home HIV Test: positive result is only preliminary; it must be confirmed by a healthcare professional. **Ongoing assessment, interaction with the client, and client education and support are required.*** - NCLEX testing - never choose abstinence, choose educate! Related to mental Health, how long can an involuntary admission last? - ANS -72 hours To much CO2 causes what? - ANS -vasoconstriction What are low risk therapies - ANS -Low-risk therapies are therapies that have no adverse effects and, when implementing care, can be used by the nurse who has training and experience in their use. Low-risk therapies include meditation, relaxation techniques, imagery, music therapy, massage, touch, laughter and humor, and spiritual measures, such as prayer. What are nosocomial infections - ANS -Infections acquired as a result of exposure to a microorganism in the hospital setting What are nurses responsible for related to the standards of care? - ANS -Nurses are responsible for performing procedures correctly and exercising professional judgment when implementing healthcare providers prescriptions. What are some examples of Non-opioid Analgesic pain medications - ANS -Acetaminophen (Tylenol) Salicylates: - Aspirin - Choline magnesium trisalcylate (Trilisate) NSAIDs: - Ibuprofen - Indomethacin - Ketorolac - Diclofenac K Cyclooxygenase-2 (COX-2) inhibitors - Celecoxib What are some HIV Medications - ANS -Nucleoside reverse transcriptase inhibitors (NRTIs) -zidovudine (AZT, ZDV, Retrovir) -lamivudine -abacavir -emtricitabine Nucleotide reverse transcriptase inhibitor (NtRTI) - Tenofovir DF (Viread) What are some symptoms of fluid volume deficit - ANS -weight loss oliguria (not enough urine) postural hypotension What are some types of Analgesics (used for moderate to severe pain)? - ANS -Mu agonists - Morphine