Mark Klimek NCLEX Prep UPDATED
Exam Questions and CORRECT Answers
What are the rule of B's in interpreting blood gases - CORRECT ANSWER - If the pH and
HCO3 are both in the same direction, then it is metabolic, and if the pH and HCO3 are in
opposite directions, it is respiratory
Acidosis and alkalosis is decided by pH
How does the body respond to pH imbalances? - CORRECT ANSWER - If the pH is
alkalotic, the body is irritable (K+ goes down)
Keep suction at bedside due to possible seizures!
If the pH is acidotic, the body shuts
down (K+ goes up)
Keep ambubag at bedside due to possible respiratory arrest!
Kussmauls respiration is a compensation for which ABG imbalance? - CORRECT
ANSWER - Metabolic acidosis
Overventilating and underventilating can cause which pH impalances? - CORRECT
ANSWER - Overventilating can cause respiratory alkalosis
Underventilating can cause respiratory acidosis
Which scenarios would result in which types of metabolic imbalances? - CORRECT
ANSWER - Metabolic alkalosis would result from prolonged vomiting or suctioning such
as hyperemesis gravidarum or suctioning for days
Metabolic acidosis would result from dehydration, renal failure
,What triggers a high pressure alarm? - CORRECT ANSWER - It is triggered by resistance
to airflow (machine pushing too hard to get air into lungs) such as kinks in the tubing, water
condensing in the tube, or mucus secretions in the airway
What triggers low pressure alarms? - CORRECT ANSWER - It is triggered by a decreased
resistance to airflow (air is going into lungs too easily) such as disconnections to main tubing and
oxygen sensor tubing (reconnect)
When do you suction? - CORRECT ANSWER - Suction only as needed, and only if you
have tried turning, coughing, or deep breathing and they don't work
What are the main psychological problems with alcoholism? - CORRECT ANSWER -
Denial and dependency/codependency
How do you treat alcoholism denial? - CORRECT ANSWER - Confront the denial by
pointing out differences in what they say vs what they do (not aggression)
How do you treat dependency/codependency for alcoholism? - CORRECT ANSWER -
Teach the codependent to set limits and enforce them, and work on self-esteem of the
codependent
Manipulation vs dependency/codependency - CORRECT ANSWER - Manipulation can be
dangerous and lead to harm (includes illegal) whereas dependency/codependency does not cause
harm
How do you treat manipulation - CORRECT ANSWER - Same as treating dependency and
codependency, by setting limits and enforcing them
What is Wernicke-Korsakoff syndrome? - CORRECT ANSWER - wernicke-
encephalopathy induced by vitamin B1 or thiamine deficiency
,korsakoff - memory loss, confabulation, personality changes resulting from alcohol abuse
Stages of Wernicke-Korsakoff and treatment - CORRECT ANSWER - Preventable: Take
vitamin B1 as it metabolizes alcohol
Arrestable: Stop it from getting worse with vitamin B1
Irreversible: Will kill brain cells
Stopping alcohol use isn't necessary
What is aversion therapy and which two medications are used for it? - CORRECT
ANSWER - Gives you a gut hatred for alcohol by interacting with it to make you feel
really sick
Antabuse and Revia
How long does it take for antabuse or revia to take effect? - CORRECT ANSWER - Two
weeks to take effect, will not work before the two weeks, it also take two weeks to get out of
your system
Patient education for antabuse or revia - CORRECT ANSWER - Avoid ALL FORMS OF
ALCOHOL including mouthwash, aftershave, perfumes, insect repellant, OTC that ends in elixir
such as cough meds, hand sanitizer, uncooked icings (vanilla extract)
They can have red wine vinaigrette
Which drugs would be considered uppers? - CORRECT ANSWER - Caffeine, cocaine,
PCP/LSD, methamphetamines, adderall
, Characteristics of uppers - CORRECT ANSWER - Euphoria
Tachycardia
Restlessness
Dilated pupils
Irritability
Diarrhea
+3/+4 reflexes
SEIZURES
Which drugs are considered downers? - CORRECT ANSWER - Opioids, sedatives,
marijuana, alcohol
Characteristics of downers - CORRECT ANSWER - Lethargy
Bradycardia
Hyporeflexia
Constipation
Respiratory arrest
Overdose characteristics for uppers and downers - CORRECT ANSWER - Uppers =
everything goes up
Downers = everything goes down
important things to note: upper overdose looks like a downer withdrawal and a downer overdose
looks like an upper withdrawal
Timeline considerations for drug intoxication and newborns - CORRECT ANSWER - If it
is under 24 hours, assume it is drug intoxication, if it is after 24 hours, assume it is withdrawal
Exam Questions and CORRECT Answers
What are the rule of B's in interpreting blood gases - CORRECT ANSWER - If the pH and
HCO3 are both in the same direction, then it is metabolic, and if the pH and HCO3 are in
opposite directions, it is respiratory
Acidosis and alkalosis is decided by pH
How does the body respond to pH imbalances? - CORRECT ANSWER - If the pH is
alkalotic, the body is irritable (K+ goes down)
Keep suction at bedside due to possible seizures!
If the pH is acidotic, the body shuts
down (K+ goes up)
Keep ambubag at bedside due to possible respiratory arrest!
Kussmauls respiration is a compensation for which ABG imbalance? - CORRECT
ANSWER - Metabolic acidosis
Overventilating and underventilating can cause which pH impalances? - CORRECT
ANSWER - Overventilating can cause respiratory alkalosis
Underventilating can cause respiratory acidosis
Which scenarios would result in which types of metabolic imbalances? - CORRECT
ANSWER - Metabolic alkalosis would result from prolonged vomiting or suctioning such
as hyperemesis gravidarum or suctioning for days
Metabolic acidosis would result from dehydration, renal failure
,What triggers a high pressure alarm? - CORRECT ANSWER - It is triggered by resistance
to airflow (machine pushing too hard to get air into lungs) such as kinks in the tubing, water
condensing in the tube, or mucus secretions in the airway
What triggers low pressure alarms? - CORRECT ANSWER - It is triggered by a decreased
resistance to airflow (air is going into lungs too easily) such as disconnections to main tubing and
oxygen sensor tubing (reconnect)
When do you suction? - CORRECT ANSWER - Suction only as needed, and only if you
have tried turning, coughing, or deep breathing and they don't work
What are the main psychological problems with alcoholism? - CORRECT ANSWER -
Denial and dependency/codependency
How do you treat alcoholism denial? - CORRECT ANSWER - Confront the denial by
pointing out differences in what they say vs what they do (not aggression)
How do you treat dependency/codependency for alcoholism? - CORRECT ANSWER -
Teach the codependent to set limits and enforce them, and work on self-esteem of the
codependent
Manipulation vs dependency/codependency - CORRECT ANSWER - Manipulation can be
dangerous and lead to harm (includes illegal) whereas dependency/codependency does not cause
harm
How do you treat manipulation - CORRECT ANSWER - Same as treating dependency and
codependency, by setting limits and enforcing them
What is Wernicke-Korsakoff syndrome? - CORRECT ANSWER - wernicke-
encephalopathy induced by vitamin B1 or thiamine deficiency
,korsakoff - memory loss, confabulation, personality changes resulting from alcohol abuse
Stages of Wernicke-Korsakoff and treatment - CORRECT ANSWER - Preventable: Take
vitamin B1 as it metabolizes alcohol
Arrestable: Stop it from getting worse with vitamin B1
Irreversible: Will kill brain cells
Stopping alcohol use isn't necessary
What is aversion therapy and which two medications are used for it? - CORRECT
ANSWER - Gives you a gut hatred for alcohol by interacting with it to make you feel
really sick
Antabuse and Revia
How long does it take for antabuse or revia to take effect? - CORRECT ANSWER - Two
weeks to take effect, will not work before the two weeks, it also take two weeks to get out of
your system
Patient education for antabuse or revia - CORRECT ANSWER - Avoid ALL FORMS OF
ALCOHOL including mouthwash, aftershave, perfumes, insect repellant, OTC that ends in elixir
such as cough meds, hand sanitizer, uncooked icings (vanilla extract)
They can have red wine vinaigrette
Which drugs would be considered uppers? - CORRECT ANSWER - Caffeine, cocaine,
PCP/LSD, methamphetamines, adderall
, Characteristics of uppers - CORRECT ANSWER - Euphoria
Tachycardia
Restlessness
Dilated pupils
Irritability
Diarrhea
+3/+4 reflexes
SEIZURES
Which drugs are considered downers? - CORRECT ANSWER - Opioids, sedatives,
marijuana, alcohol
Characteristics of downers - CORRECT ANSWER - Lethargy
Bradycardia
Hyporeflexia
Constipation
Respiratory arrest
Overdose characteristics for uppers and downers - CORRECT ANSWER - Uppers =
everything goes up
Downers = everything goes down
important things to note: upper overdose looks like a downer withdrawal and a downer overdose
looks like an upper withdrawal
Timeline considerations for drug intoxication and newborns - CORRECT ANSWER - If it
is under 24 hours, assume it is drug intoxication, if it is after 24 hours, assume it is withdrawal
