MARK KLIMEK NCLEX PRACTICE EXAM
QUESTIONS WITH CORRECT ANSWERS
If the pH & the bicarb are both in the same direction... - Answer-metabolic
If the pH & the bicarb are in opposite directions - Answer-respritory
pH - Answer-7.35-7.45
HCO3 (bicarb) - Answer-22-26
(2+2+2=6)
CO2 - Answer-35-45
-when pH goes up; - Answer-patient goes up.. (everything gets irritable!)
when pH goes down; - Answer-patient goes down! (systems in your body shut down)
when pH goes up; potassium - Answer-potassium goes down
when pH goes down; potassium - Answer-potassium goes up
alkalosis s/s - Answer-(up) alkalosis: irritibility, hyper-reflexia (3 & 4), tachypnea,
tachycardia, borborygmi (increased bowel sounds), seizure, aspirate..
acidosis s/s - Answer-(down) acidosis: hypo-reflexia, bradycardia, lethergy (obtunded),
paralytic ileus (decreased bowel sounds), coma, respiratory arrest (ambu-bag!!)
Kussmaul breathing - Answer-deep and labored breathing pattern often associated with
severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney
failure
MAC Kussmaul (breathing) !! - Answer-Metabolic ACidosis
diarhhea will cause a ..
but once you get acidodic, it will shut your bowels down = - Answer-metabolic acidosis
paralytic ileus
over-ventilating = acidosis or alkalosis? - Answer-alkalosis
under-ventilating = acidosis or alkalosis? - Answer-acidosis
,if pt has prolonged gastric vomiting or suctioning... it's always ... why? - Answer-
metabolic alkalosis
losing acid = becomes basic.
high pressure alarm... triggered by increasure resistance to air flow.. (machine is
pushing too hard to get air into the lungs)..
what chemical imbalance? - Answer-respiratory alkalosis
3 ventilator obstructions and what to do for each - Answer-kink in tubing (get kink out),
water condensing within the tube (empty tube), mucus secretions in the airway (turn,
cough, deep breathe... then suction).. suction as needed!! *in that order*...
low pressure alarm.. decreased resistance (too easy for the machine..)
what chemical imbalance? - Answer-respiratory acidosis
Low pressure alarms are triggered by decreased resistance to airflow & can be caused
by disconnections of the main tubing or oxygen sensor tubing...
what should you do? - Answer-Tubing (reconnect it!) - oxygen sensor tube (reconnect it
UNLESS tube is on t the floor - bag them & call Respiratory therapist if this happens)
Respiratory alkalosis = ventilator setting may be too - Answer-high
Respiratory acidosis = ventilator setting may be too - Answer-low
what does wean mean in terms of ventilators - Answer-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 - Answer-C. hold
the order
MASLOW's Priorities (HIGHest - LOWest) - Answer-physiological safety
comfort psychological (problems within the person)
social (problems with other people) spiritual
alcohol (or any abuse) #1 problem is - Answer-denial
you treat denial by - Answer-confronting it
loss and grief - Answer-Denial
Anger
, Bargining
Depression
Acceptance
alcohol (or any abuse) #2 problem - Answer-dependency
dependency in regards to abuse - Answer-when the abuser gets the significant other to
do something
ex. "call my boss, im sick"
co-dependacy in regards to abuse - Answer-*calls boss* then has positive self esteem
how to treat dependency - Answer-set limits and enforce them
learn to say no
manipulation = - Answer-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 - Answer-wife buying alcohol for
husband
dangerous/harmful = manipulated example - Answer-kid buying alcohol for father
Wernicke-Korsakoff Syndrome (WKS) - Answer-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 - Answer-deficiency in the B1
vitamin thiamine.
primary symptom of Wernicke-Korsakoff Syndrome - Answer-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?!? - Answer-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 - Answer-It's preventable & arrestable (stop it from
getting worse) - Take vitamin B1 -Irreversible... *About 70%*
Antibuse (disulfiram) - Answer--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.
QUESTIONS WITH CORRECT ANSWERS
If the pH & the bicarb are both in the same direction... - Answer-metabolic
If the pH & the bicarb are in opposite directions - Answer-respritory
pH - Answer-7.35-7.45
HCO3 (bicarb) - Answer-22-26
(2+2+2=6)
CO2 - Answer-35-45
-when pH goes up; - Answer-patient goes up.. (everything gets irritable!)
when pH goes down; - Answer-patient goes down! (systems in your body shut down)
when pH goes up; potassium - Answer-potassium goes down
when pH goes down; potassium - Answer-potassium goes up
alkalosis s/s - Answer-(up) alkalosis: irritibility, hyper-reflexia (3 & 4), tachypnea,
tachycardia, borborygmi (increased bowel sounds), seizure, aspirate..
acidosis s/s - Answer-(down) acidosis: hypo-reflexia, bradycardia, lethergy (obtunded),
paralytic ileus (decreased bowel sounds), coma, respiratory arrest (ambu-bag!!)
Kussmaul breathing - Answer-deep and labored breathing pattern often associated with
severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney
failure
MAC Kussmaul (breathing) !! - Answer-Metabolic ACidosis
diarhhea will cause a ..
but once you get acidodic, it will shut your bowels down = - Answer-metabolic acidosis
paralytic ileus
over-ventilating = acidosis or alkalosis? - Answer-alkalosis
under-ventilating = acidosis or alkalosis? - Answer-acidosis
,if pt has prolonged gastric vomiting or suctioning... it's always ... why? - Answer-
metabolic alkalosis
losing acid = becomes basic.
high pressure alarm... triggered by increasure resistance to air flow.. (machine is
pushing too hard to get air into the lungs)..
what chemical imbalance? - Answer-respiratory alkalosis
3 ventilator obstructions and what to do for each - Answer-kink in tubing (get kink out),
water condensing within the tube (empty tube), mucus secretions in the airway (turn,
cough, deep breathe... then suction).. suction as needed!! *in that order*...
low pressure alarm.. decreased resistance (too easy for the machine..)
what chemical imbalance? - Answer-respiratory acidosis
Low pressure alarms are triggered by decreased resistance to airflow & can be caused
by disconnections of the main tubing or oxygen sensor tubing...
what should you do? - Answer-Tubing (reconnect it!) - oxygen sensor tube (reconnect it
UNLESS tube is on t the floor - bag them & call Respiratory therapist if this happens)
Respiratory alkalosis = ventilator setting may be too - Answer-high
Respiratory acidosis = ventilator setting may be too - Answer-low
what does wean mean in terms of ventilators - Answer-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 - Answer-C. hold
the order
MASLOW's Priorities (HIGHest - LOWest) - Answer-physiological safety
comfort psychological (problems within the person)
social (problems with other people) spiritual
alcohol (or any abuse) #1 problem is - Answer-denial
you treat denial by - Answer-confronting it
loss and grief - Answer-Denial
Anger
, Bargining
Depression
Acceptance
alcohol (or any abuse) #2 problem - Answer-dependency
dependency in regards to abuse - Answer-when the abuser gets the significant other to
do something
ex. "call my boss, im sick"
co-dependacy in regards to abuse - Answer-*calls boss* then has positive self esteem
how to treat dependency - Answer-set limits and enforce them
learn to say no
manipulation = - Answer-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 - Answer-wife buying alcohol for
husband
dangerous/harmful = manipulated example - Answer-kid buying alcohol for father
Wernicke-Korsakoff Syndrome (WKS) - Answer-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 - Answer-deficiency in the B1
vitamin thiamine.
primary symptom of Wernicke-Korsakoff Syndrome - Answer-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?!? - Answer-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 - Answer-It's preventable & arrestable (stop it from
getting worse) - Take vitamin B1 -Irreversible... *About 70%*
Antibuse (disulfiram) - Answer--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.
