UWorld NCLEX-PN Rationale-based Questions and Answers 100% Correct

UWorld NCLEX-PN Rationale-based Questions and Answers 100% Correct B/P Medication side effects? - fatigue - erectile dysfunction - dizziness Angina pectoris risk factors? - Smoking - Extreme temperatures - Physical exertion (including sex) - Intense emotion - Coronary artery narrowing - Stimulants (cocaine, amphetamines) Define angina pectoris Chest pain due to myocardial ischemia (decreased blood flow to heart). Purpose of an ICD (implantable cardioverter defibrillator)? - sense and defibrillate life-threatening dysrhythmias. - overdrive pacing for rapid heart rhythms - back-up pacing for bradycardia that may occur after defibrillation. Postoperative teaching for ICD? Don't lift arm of affected side above the shoulder unless cleared by the health care provider. Where is an ICD placed? In the endometrium via the subclavian vein. Home care instructions for discharging a patient with heart failure following myocardial infarction? - How to take own pulse - Monitoring weight daily - Reduction of sodium in diet - Take blood pressure and keep record of it - Avoid temperature extremes - Increase walking, but plan for rest periods Chronic Venous Insufficiency (CVI) s/sx? - Brownish skin discoloration on lower extremities - Chronic edema - Inflammation - Leathery skin - Venous leg ulcers inside of ankle How to improve pain due to acute pericarditis? Sit up and lean forward Pericarditis treatment? NSAIDs or aspirin plus colchicine. Pericarditis is characterized by what symptom? Pleuritic chest pain. Pericarditis is known to be aggravated by what actions? Inspiration and coughing. Normal urinary output? 30 mL/hr Urinary output below 30 ml/hr may signify what? - low vascular volume - decreased renal perfusion - intrinsic kidney injury - urine outflow obstruction A client with heart failure with decreased urine output, what action is the priority? Auscultate for lung sounds to assess for crackles due to decreased cardiac function and buildup of fluid in the lungs. Anticipated treatment for a client with decreased urine output r/t to heart failure? Loop diuretics. Critical and life-threatening PTT value? > 100 sec. Common IV Heparin complications? - GI bleeds - Epistaxis - Hematuria Lab value taken for heparin therapy? PTT Instructions to prevent recurrent episodes for Raynaud phenomenon? - Avoid excess caffeine - Refain using tobacco products - Wear gloves handling cold objects - Reduce cold exposure, wear warm layers in cold weather - Implement stress-management strategies (yoga, tai-chi) - Avoid vasoconstricting drugs (cocaine, amphetamines) Treatment for Raynaud's phenomenon? Vasodilators, calcium channel blockers Teachings for patient who had coronary artery bypass grafting? - Refrain lifting weights 5 lb. < - Notify HCP of swelling, redness, or drainage at incision site or chest pain/SOB that does not subside with rest - Take a shower daily without soaking chest or leg incision - No applying lotion to incision site (may introduce pathogens) - No smoking - Increase activity levels through exercise - NO driving for 4-6 weeks Lab taken for heart failure? BNP (B-type natriuretic peptide) Troponin I normal levels? <0.5ng/mL or <0.5 mcg/L Troponin T normal levels? <0.1 ng/mL or <0.1 mcg/L Labs that detect MI? Troponin and CK-MB levels Instructions for wearing a Holter monitor? - Keep a diary of activities and monitor any symptoms - Do not shower or bathe during the testing period - Engage in normal activities to simulate conditions that may produce symptoms DVT reoccurence prevention? - Drink plenty of fluids, no caffeine - Change position frequently - Elevate legs and dorsiflex feet often - Stop smoking - Avoid constrictive clothing - Begin an exercise program Best indicators of peripheral perfusion? - Capillary refill - Skin color and temperature Signs of cardiac tamponade? distant heart tones, jugular vein distention, and hypotension Contraindication for heart failure? NSAIDs peripheral arterial disease instructions? - Lower the extremities below level of heart - Engage in moderate exercise - Perform daily skin care, such as applying lotion - Avoid constrictive clothing - Stop smoking - Maintain mild warmth - Take medications such as vasodilators or antiplatelets Buerger disease teaching? Smoking cessation Contraindications in Buerger disease? Nicotine replacements What does conservative management of Buerger disease include? - avoiding cold exposure to affected limbs - preventing trauma to extremities - implementing a walking program - analgesics for ischemic pain - administering of antibiotics for any infected ulcers Treatment of Buerger disease? IV iloprost Acute blood loss priority intervention? Lower head of the bed, placing client in a supine position. Acute blood loss s/sx? - Frank blood - Dizziness - Pale skin - Diaphoresis Which individuals require prophylactic antibiotics prior to dental procedures? - Hx of infective endocarditis - Anyone with prosthetic material in their heart valve - Anyone with an unrepaired cyanotic congenital heart defect Mitral Valve Proplapse teaching? - Stay hydrated and avoid caffeine - Reduce stress and avoid alcohol use - Avoid stimulants such as ephedrine - Maintain an exercise program Mitral valve prolapse s/sx - Palpitations - Dizziness - Lightheadedness Treatment for Mitral valve prolapse? Beta blockers Atypical heart attack s/sx? Nausea, vomiting, belching, indigestion, diaphoresis, dizziness, and fatigue; gastrointestinal distress Deep vein thrombosis risk factors? Trauma, surgery, prolonged immobility/inactivity, oral contraceptives, pregnancy, varicose veins, obesity, smoking, cancer, myeloproliferative disorders (such as polycythemia) and advanced age. Lung sounds in a client with pink, frothy sputum, dyspnea, and air hunger? Diffuse bilateral crackles Priority medication administration for a client who has myocardial infarction? Potassium replacement due to client being at risk for life-threatening dysrhythmias. Hold digoxin dosage for what pulse in infants and young children? < 90-110 bpm Hold digoxin dosage for what pulse in older children? < 70 bpm S/sx of a failing pacemaker? Failure to capture, hypotension, bradycardia Priority intervention for failing pacemaker? Initiate transcutaneous pacing Allen's test does what? Determines patency of the ulnar artery Risks for postpartum hemorrhage - Use of magnesium sulfate - Prolonged use of oxytocin during labor - Inhaled anesthesia - High parity - Prolonged labor lasting > 24 hr - Uterine distention due to macrosomnic infant (> 8 lb. 13 oz [4000g], excessive amniotic fluid, or multiple gestation S/sx for endometrial infection? Fever, chills, malaise, foul-smelling lochia, excessive pain s/sx of serotonin syndrome? mental status changes (eg, anxiety, agitation, disorientation), autonomic dysregulation (eg, hyperthermia, diaphoresis, tachycardia/hypertension), and neuromuscular hyperactivity (eg, tremor, muscle rigidity, clonus, hyperreflexia). Acrocyanosis intervention? Place infant skin-to-skin with mother for warmth Bulimia nervosa pt, most important time to monitor behavior? 1-2 hours after meals. Theophylline toxicity s/sx? - central nervous system stimulation (eg, headache, insomnia, seizures) - gastrointestinal disturbances (eg, nausea, vomiting) - cardiac toxicity (eg, arrhythmia) Risk for developing Reye's syndrome? Aspirin use Clinical manifestations of Reye's syndrome? fever, lethargy, acute encephalopathy, vomiting, altered LOC altered hepatic function, elevated serum ammonia levels Subjective data consistent with Reye's syndrome? recent viral infection, especially varicella (chicken pox) or influenza Age when infants experience separation anxiety? 6 months, peaking 10-18 months and lasting til 3 years old