MARK KLIMEK NCLEX ACTUAL FINALS
QUESTIONS AND ANSWERS SET A+
✔✔S/S: DKA = - ✔✔dehydration, ketones in their blood/kussmaul breathing (deep &
rapid)/K (high) potassium, acidosis (metabolic)/acetone breath/anorexia due to nausea
✔✔What do you do for DKA - ✔✔HYDRATE!! (IV fluids; fast!! 200ml/hour; regular
insulin; normal saline/D5?) D5 doesn't stay in veins; goes into the tissues.. won't cause
HYPERGLYCEMIA (D10 & D50 will!)
✔✔hyperglycemic hyperosmolar nonketotic coma HHNK (type 2) -
✔✔DEHYDRATION... HYDRATE them
✔✔*blank* is the most essential thing in treating DKA - ✔✔Insulin
✔✔long term complications of diabetes are related to: - ✔✔poor tissue perfusion &
peripheral neuropathy...
✔✔Lithium - ✔✔ANTImania drug for BiPolar.. Therapuetic level: 0.6-1.2 Toxic level: 2 &
>
✔✔Lanoxin (Digoxin) - ✔✔A-Fib & CHF Therapuetic level: 1-2... 2 can be toxic! Toxic
level: 2 & >
✔✔Aminophylline - ✔✔Airway Anti-Spasmodic *NOT a bronchodilator*
Therapuetic level: 10-20... 20 can be toxic! Toxic level: 20 & >
✔✔Dilantin: - ✔✔Used for Seizures Therapuetic level: 10-20... 20 can be toxic! Toxic
level: 20 & >
✔✔Bilirubin: - ✔✔Waste product from the breakdown of RBCs (only tested in
NEWBORNS on the NCLEX) Normal: 9.9 and < Elevated level: 10-20... 20 can be toxic!
14-15 *is when they need to be hospitalized* Toxic level: 20 & >
, ✔✔Jaundice: - ✔✔yellowing; bilirubin in the skin
✔✔Kernicterus: - ✔✔bilirubin the the brain... usually occurs when the level gets around
20..
✔✔Opisthotonus: - ✔✔a position the baby assumes when they have bilirubin on the
brain; HYPEREXTEND..
✔✔In what position do you place an opisthotonic child? - ✔✔On their side!
✔✔Hiatal hernia - ✔✔regurgitation of acid into the esophagus, because the upper part
of your stomach herniates upward through the diaphragm... *moves in the wrong
direction in the correct rate* (you want it to empty faster; so it doesn't reflux)
✔✔Hiatal hernia S/S - ✔✔GERD (heartburn & indegestion) *when lying down after
eating*
✔✔Hiatal hernia treatment - ✔✔play around with the head of the bed (raise), play
around with water content with the meal (flush faster) & you can play around with the
carbohydrate content of the meal (carbs go fast)... LOW protein!!
✔✔Dumping syndrome - ✔✔gastric contents dump too quickly into the duodenum...
*moves in the right direction, but at the wrong rate* (you want it to empty slower)
✔✔Dumping syndrome S/S - ✔✔*DRUNK* (staggering gait, slurred speech, impaired
judgement) & *SHOCK* (tachycardia, tachypnea, cold, clammy, pale) DRUNK +
SHOCK = HYPOGLYCEMIA *ACUTE ABDOMINAL DISTRESS* (cramping, pain,
doubling over, borborygmi *increased bowel sounds*, diarhhea, bloating, distension)
✔✔Dumping symdrome Treatment - ✔✔Eat with head low & turned to the side, low
fluids with meal and low carb content in the meals. HIGH protein!!
✔✔Kalemias do - ✔✔the SAME AS the prefix, except for heart rate & urine output!!
✔✔Calcemias do the - ✔✔OPPOSITE AS the prefix
(if it skeleton or nerve, blame it on calcium!)
✔✔Magnesiums do the - ✔✔OPPOSITE AS the prefix
(in a tie, DON'T pick magnesium!)
QUESTIONS AND ANSWERS SET A+
✔✔S/S: DKA = - ✔✔dehydration, ketones in their blood/kussmaul breathing (deep &
rapid)/K (high) potassium, acidosis (metabolic)/acetone breath/anorexia due to nausea
✔✔What do you do for DKA - ✔✔HYDRATE!! (IV fluids; fast!! 200ml/hour; regular
insulin; normal saline/D5?) D5 doesn't stay in veins; goes into the tissues.. won't cause
HYPERGLYCEMIA (D10 & D50 will!)
✔✔hyperglycemic hyperosmolar nonketotic coma HHNK (type 2) -
✔✔DEHYDRATION... HYDRATE them
✔✔*blank* is the most essential thing in treating DKA - ✔✔Insulin
✔✔long term complications of diabetes are related to: - ✔✔poor tissue perfusion &
peripheral neuropathy...
✔✔Lithium - ✔✔ANTImania drug for BiPolar.. Therapuetic level: 0.6-1.2 Toxic level: 2 &
>
✔✔Lanoxin (Digoxin) - ✔✔A-Fib & CHF Therapuetic level: 1-2... 2 can be toxic! Toxic
level: 2 & >
✔✔Aminophylline - ✔✔Airway Anti-Spasmodic *NOT a bronchodilator*
Therapuetic level: 10-20... 20 can be toxic! Toxic level: 20 & >
✔✔Dilantin: - ✔✔Used for Seizures Therapuetic level: 10-20... 20 can be toxic! Toxic
level: 20 & >
✔✔Bilirubin: - ✔✔Waste product from the breakdown of RBCs (only tested in
NEWBORNS on the NCLEX) Normal: 9.9 and < Elevated level: 10-20... 20 can be toxic!
14-15 *is when they need to be hospitalized* Toxic level: 20 & >
, ✔✔Jaundice: - ✔✔yellowing; bilirubin in the skin
✔✔Kernicterus: - ✔✔bilirubin the the brain... usually occurs when the level gets around
20..
✔✔Opisthotonus: - ✔✔a position the baby assumes when they have bilirubin on the
brain; HYPEREXTEND..
✔✔In what position do you place an opisthotonic child? - ✔✔On their side!
✔✔Hiatal hernia - ✔✔regurgitation of acid into the esophagus, because the upper part
of your stomach herniates upward through the diaphragm... *moves in the wrong
direction in the correct rate* (you want it to empty faster; so it doesn't reflux)
✔✔Hiatal hernia S/S - ✔✔GERD (heartburn & indegestion) *when lying down after
eating*
✔✔Hiatal hernia treatment - ✔✔play around with the head of the bed (raise), play
around with water content with the meal (flush faster) & you can play around with the
carbohydrate content of the meal (carbs go fast)... LOW protein!!
✔✔Dumping syndrome - ✔✔gastric contents dump too quickly into the duodenum...
*moves in the right direction, but at the wrong rate* (you want it to empty slower)
✔✔Dumping syndrome S/S - ✔✔*DRUNK* (staggering gait, slurred speech, impaired
judgement) & *SHOCK* (tachycardia, tachypnea, cold, clammy, pale) DRUNK +
SHOCK = HYPOGLYCEMIA *ACUTE ABDOMINAL DISTRESS* (cramping, pain,
doubling over, borborygmi *increased bowel sounds*, diarhhea, bloating, distension)
✔✔Dumping symdrome Treatment - ✔✔Eat with head low & turned to the side, low
fluids with meal and low carb content in the meals. HIGH protein!!
✔✔Kalemias do - ✔✔the SAME AS the prefix, except for heart rate & urine output!!
✔✔Calcemias do the - ✔✔OPPOSITE AS the prefix
(if it skeleton or nerve, blame it on calcium!)
✔✔Magnesiums do the - ✔✔OPPOSITE AS the prefix
(in a tie, DON'T pick magnesium!)
