MARK KLIMEK NCLEX COMPREHENSIVE
QUESTIONS AND ANSWERS SET A+
✔✔when to draw a tough - ✔✔b4 sub: 30 mins
b4 iv: 30 mins
b4 IM: 30 mins
b4 subQ: 30 mins
b4 PO: 30 mins
✔✔when to draw a peak - ✔✔after sub: 5-10 mins
after iv: 15-30 mins
after IM: 30-60 mins
after subQ: SEE Diabetes lecture
after PO: DON'T WORRY ABOUT IT
✔✔Calcium Channel Blockers: are like - ✔✔VALIUM for your ❤!!!
✔✔Calcium Channel Blockers - ✔✔negative inotropic, negative chronotropic, negative
dromotropic
*all are negative trops
✔✔what do calcium channel blockers treat? - ✔✔antihypertensives, anti-angina, anti-
atrial-aarrhythmia, SVT (atrial)
✔✔calcium channel blockers Side effects: - ✔✔HA, Hypotension
,✔✔Cardizem (can be continous IV) - ✔✔-Check BP: Hold CCB if SYSTOLIC is < 100!
✔✔normal sinus rhythm - ✔✔
✔✔v-fib - ✔✔
✔✔v-tach - ✔✔
✔✔asystole - ✔✔
✔✔QRS de-polarization = - ✔✔ventricular
✔✔P wave = - ✔✔atrial
✔✔-a lack of QRS's = - ✔✔asystole
✔✔-saw tooth = - ✔✔a flutter
✔✔chaotic =
*P wave - ✔✔atrial fibrilation (P wave)
✔✔chaotic =
*QRS - ✔✔ventricular fibrilation (QRS)
✔✔-QRS = - ✔✔ventricular tachycardia (bizzarre)
*bizzarre will always apply to tachy
✔✔periodic bizarre wide QRS - ✔✔PVC (low priority... can elevate to moderate: if there
are more than 6/min.. or more than 6 PVC's in a row.. or if the PVC falls on the T wave
of the previous beat) PVC's never reach HIGH
✔✔LETHAL arrhytmias.. (they will kill you in 8 minutes or less) - ✔✔asystole
v fib
*have in common: NO cardiac output (pulse).. NO brain perfusion.
✔✔Potentially life-threatening arrhythmias - ✔✔v-tach... (they have a cardiac output)
✔✔arrhythmias you can change by treatment - ✔✔PVCs/V-TACH: Ventricular... A
(amioderone)
, ✔✔Atrial: ABCD's - ✔✔adenocard (adenosine); push in <8 seconds... *asystole for
about 30 seconds!*
beta blockers (side effects: HA/HTN) *no asthma!*
calcium channel blockers...
digitalis (digoxin, lanoxin)
✔✔V FIB - YOU - ✔✔D FIB
✔✔Asystole treatment - ✔✔EPI and Atropine
✔✔pnemothorax - ✔✔air
✔✔hemothorax - ✔✔blood
✔✔pneumohemo - ✔✔air and blood
✔✔what do you expect from a hemo chest tube: - ✔✔drain blood
✔✔location of a chest tube - ✔✔APICAL (high; air)
BASILAR (bottom; blood)
✔✔unilateral pneumohemo tube placement - ✔✔apical for pneumo & basilar for hemo
✔✔bilateral pneumo tube placement - ✔✔2 apicals
✔✔do post op R pneumonectomy patients get chest tubes? - ✔✔no.
why? ECTOMY
✔✔TROUBLE SHOOTING chest tube errors - ✔✔Knocked it over... DON'T freak out!
set it back up
Water seal breaks...? CLAMP IT!!! (so nothing gets in).. CUT IT AWAY FROM BROKEN
DEVICE... SUBMERGE TUBE UNDER STERILE WATER!!! UNCLAMP IT...
✔✔What do you do if the chest tube gets pulled out? - ✔✔FIRST: takes a gloved hand
and cover the hole.. BEST: cover it with vaseline gauze!!
✔✔Bubbling, bubbling, bubbling... Where? Water seal.. When? Intermittent = -
✔✔GOOD! document it!
QUESTIONS AND ANSWERS SET A+
✔✔when to draw a tough - ✔✔b4 sub: 30 mins
b4 iv: 30 mins
b4 IM: 30 mins
b4 subQ: 30 mins
b4 PO: 30 mins
✔✔when to draw a peak - ✔✔after sub: 5-10 mins
after iv: 15-30 mins
after IM: 30-60 mins
after subQ: SEE Diabetes lecture
after PO: DON'T WORRY ABOUT IT
✔✔Calcium Channel Blockers: are like - ✔✔VALIUM for your ❤!!!
✔✔Calcium Channel Blockers - ✔✔negative inotropic, negative chronotropic, negative
dromotropic
*all are negative trops
✔✔what do calcium channel blockers treat? - ✔✔antihypertensives, anti-angina, anti-
atrial-aarrhythmia, SVT (atrial)
✔✔calcium channel blockers Side effects: - ✔✔HA, Hypotension
,✔✔Cardizem (can be continous IV) - ✔✔-Check BP: Hold CCB if SYSTOLIC is < 100!
✔✔normal sinus rhythm - ✔✔
✔✔v-fib - ✔✔
✔✔v-tach - ✔✔
✔✔asystole - ✔✔
✔✔QRS de-polarization = - ✔✔ventricular
✔✔P wave = - ✔✔atrial
✔✔-a lack of QRS's = - ✔✔asystole
✔✔-saw tooth = - ✔✔a flutter
✔✔chaotic =
*P wave - ✔✔atrial fibrilation (P wave)
✔✔chaotic =
*QRS - ✔✔ventricular fibrilation (QRS)
✔✔-QRS = - ✔✔ventricular tachycardia (bizzarre)
*bizzarre will always apply to tachy
✔✔periodic bizarre wide QRS - ✔✔PVC (low priority... can elevate to moderate: if there
are more than 6/min.. or more than 6 PVC's in a row.. or if the PVC falls on the T wave
of the previous beat) PVC's never reach HIGH
✔✔LETHAL arrhytmias.. (they will kill you in 8 minutes or less) - ✔✔asystole
v fib
*have in common: NO cardiac output (pulse).. NO brain perfusion.
✔✔Potentially life-threatening arrhythmias - ✔✔v-tach... (they have a cardiac output)
✔✔arrhythmias you can change by treatment - ✔✔PVCs/V-TACH: Ventricular... A
(amioderone)
, ✔✔Atrial: ABCD's - ✔✔adenocard (adenosine); push in <8 seconds... *asystole for
about 30 seconds!*
beta blockers (side effects: HA/HTN) *no asthma!*
calcium channel blockers...
digitalis (digoxin, lanoxin)
✔✔V FIB - YOU - ✔✔D FIB
✔✔Asystole treatment - ✔✔EPI and Atropine
✔✔pnemothorax - ✔✔air
✔✔hemothorax - ✔✔blood
✔✔pneumohemo - ✔✔air and blood
✔✔what do you expect from a hemo chest tube: - ✔✔drain blood
✔✔location of a chest tube - ✔✔APICAL (high; air)
BASILAR (bottom; blood)
✔✔unilateral pneumohemo tube placement - ✔✔apical for pneumo & basilar for hemo
✔✔bilateral pneumo tube placement - ✔✔2 apicals
✔✔do post op R pneumonectomy patients get chest tubes? - ✔✔no.
why? ECTOMY
✔✔TROUBLE SHOOTING chest tube errors - ✔✔Knocked it over... DON'T freak out!
set it back up
Water seal breaks...? CLAMP IT!!! (so nothing gets in).. CUT IT AWAY FROM BROKEN
DEVICE... SUBMERGE TUBE UNDER STERILE WATER!!! UNCLAMP IT...
✔✔What do you do if the chest tube gets pulled out? - ✔✔FIRST: takes a gloved hand
and cover the hole.. BEST: cover it with vaseline gauze!!
✔✔Bubbling, bubbling, bubbling... Where? Water seal.. When? Intermittent = -
✔✔GOOD! document it!
