MARK KLIMEK NCLEX EXAM REVIEW
QUESTIONS WITH COMPLETE
ANSWERS
Primary dietary prescription for calcium nephrolithiasis (kidney stones) ? PG. 85 -
Answer-Low calcium diet
For client with nephrolithiasis the diet should be ___ ash - Answer-Acid
If kidney stone is calcium phosphate the diet must be low in ___ too - Answer-
Phosphorus
Primary diet tx for uric acid nephrolithiasis is __ ____ - Answer-Low purine
Client with uric acid nephrolithiasis should have a diet low in ____ - Answer-Methionine
What is methionine? - Answer-Precursor of the amino acid cystine
2 foods high in methionine? - Answer-Eggs, milk
Clients with cystine nephrolithiasis should have an ____ ash diet - Answer-Alkaline
Inc. fluids over 3000 cc /day is more effective in treating renal calculi than ANY dietary
modification, T/F? - Answer-True. Want to flush tract than worry about diet
What is the common name for Laryngotracheobronchitis - LTB - Answer-Croup
What is the typical temp elevation in croup? - Answer-Low grade, usually below 102, but
can go up to 104.
Are ATBs helpful for croup? For epiglottits? - Answer-For croup, no. Epiglottitis, yes
Is croup viral or bacterial? - Answer-Viral
With which condition is croup most often confused? - Answer-Epiglottitis
Can croup be managed at home? Can epiglottitis be managed at home? - Answer-Yes.
No, epiglottitis is a 911 emergency
Are sedatives used for kids with croup? - Answer-No, bc this would mask the signs of
respiratory distress
What causes epiglottitis? A virus or bacteria? - Answer-H. influenza BACTERIA
,What is the best tx for croup? - Answer-Cool moist air
What should never be done to a child with epiglottitis? - Answer-Never put anything in
the child's mouth, ie, a tongue blade can lead to obstruction
What are the typical signs and symptoms of croup? - Answer-Barking cough, inspiratory
stridor, labored resp. pattern
What 3 signs tell you that the child has epiglottitis instead of croup? - Answer-Muffled
voice, drooling, increased fever
When is croup bad enough to be evaluated by a doc? - Answer-When retractions, and
high pitched stridor are present
What lead level needs intervention? - Answer-50-60 micrograms/ dl
With which class of drugs will a child with lead poisoning be treated? - Answer-
Chelating agents
What do chelating drugs do? - Answer-They increase the excretion of heavy metals
The most freq. cause of lead poisoning is... - Answer-Ingestion of lead-based paint
chips
Name 3 common chelating agents for lead poisoning - Answer-EDTA, desferal, BAL in
oil
S&S of lead poisoning - Answer-Drowsiness, clumsiness, ataxia, seizures, coma, resp.
arrest
Sx of lead poisoning show up in the ____ system - Answer-Neuro
Leukemia is cancer of the ___ forming tissues - Answer-Blood
The type of cell that is most common and problematic in leukemia is ____ - Answer-
Immature WBC
In leukemia the RBC count is ... - Answer-Low, bc the bone marrow is going "wild"
producing all those immature WBC - no energy or nutrients to make platelets
In leukemia, the platelet count is ... - Answer-Low, bc the bone marrow is going "wild"
producing all those immature WBC - no energy or nutrients to make platelets
Bc the RBCs are low, the pt will exhibit ___ and ___ - Answer-Pallor and fatigue
,Bc of the immature WBCs, the pt is at risk for ___ - Answer-Infection
Bc of low platelets, the pt is at risk for ___, ___, and ___ - Answer-Bruising,
ecchymosis, bleeding, petechiae
What causes lymph gland enlargement in leukemia? - Answer-All those small immature
WBC clog the lymph system
Should you take a rectal temp on a child with leukemia? - Answer-No
Should you take an oral temp on a child with leukemia? - Answer-Yes, as long as they
are over 4 years old, in remission, and have no sores in their mouth
Should the child with active leukemia use straws, forks, cups? - Answer-NO straws, NO
forks, YES cups
RN's priority in tx a child with newly diagnosed leukemia is... - Answer-Dec. risk of
infection
When the leukemia child's platelets and WBC's are low, his activities should be ... -
Answer-Limited
When the platelet and WBCs are low the nurse should not insert a.. - Answer-
Suppository
Are IM injections and IV sticks permitted on a child with leukemia? - Answer-When labs
are low IMs avoided and IVs limited; only done when absolutely necessary (to give
chemo or measure blood counts)
Why are kids on chemo also on allopurinol - Answer-To prevent uric acid kidney stones
(remember when chemo kills cancer cells, purines and uric acid build up and could
cause kidney stones
Why do some kids with leukemia have joint pain? - Answer-The immature WBCs
infiltrate the joint and cause inflammation
Why is a child with leukemia at risk for neuro sx due to ICP - Answer-The immature
WBCs infiltrate the brain and cause inflammation
What is alopecia? - Answer-Hair loss
If the platelet count is low what drug should the child not take? - Answer-Aspirin
Is the alopecia from chemo permanent? - Answer-No. It will grow back. (Alopecia of
radiation therapy is permanent bc the follicle is destroyed)
, What does ANC mean? - Answer-Absolute Neutrophil Count
What is the ANC used for in leukemia? - Answer-If ANC <500, then pt will be on
protective isolation
Which is used more commonly to decide if the pt should be on isolation: WBC or ANC -
Answer-ANC is more reliable and valid
By the end of the 1st 6 months of life an infants birthweight should ____ - Answer-
Double
By the end of the first year of life an infants birthweight should ___ - Answer-Triple
Ideal food for infants is ___ - Answer-Breast milk
Breast milk contains substances that increase immunities T/F? - Answer-True
Bottle-fed infants dont bond well with their moms T/F? - Answer-False
The 1 nutrient that commercial formulas are typically low in is ___ - Answer-Fe
Breast milk does not contain iron T/F? - Answer-False. However, it does not contain
enough iron- so they should be fed iron fortified cereal starting at 6 months
At what age should the infant be fed cows/goats milk? - Answer-Not before 12 months
What is the major problem with feeding an infant skim milk? - Answer-They dont get
enough calories and dont grow. Dehydration from excessive solute load and inability to
concentrate urine
When should the infant be introduced to textured solid foods? - Answer-4-6 months
What is the first food that an infant should be introduced to? - Answer-Iron fortified rice
cereal
When forced to eat, the preschool child will... - Answer-Rebel
Parents of preschool children should be taught that as long as the child eats ___ good
nutritious meal per day, they should not make eating food an issue - Answer-One
Refusal to eat is common in preschoolers T/F? - Answer-True, but still offer a variety
Youngsters develop food preferences by.. - Answer-Observing significant ppl in their
environ
QUESTIONS WITH COMPLETE
ANSWERS
Primary dietary prescription for calcium nephrolithiasis (kidney stones) ? PG. 85 -
Answer-Low calcium diet
For client with nephrolithiasis the diet should be ___ ash - Answer-Acid
If kidney stone is calcium phosphate the diet must be low in ___ too - Answer-
Phosphorus
Primary diet tx for uric acid nephrolithiasis is __ ____ - Answer-Low purine
Client with uric acid nephrolithiasis should have a diet low in ____ - Answer-Methionine
What is methionine? - Answer-Precursor of the amino acid cystine
2 foods high in methionine? - Answer-Eggs, milk
Clients with cystine nephrolithiasis should have an ____ ash diet - Answer-Alkaline
Inc. fluids over 3000 cc /day is more effective in treating renal calculi than ANY dietary
modification, T/F? - Answer-True. Want to flush tract than worry about diet
What is the common name for Laryngotracheobronchitis - LTB - Answer-Croup
What is the typical temp elevation in croup? - Answer-Low grade, usually below 102, but
can go up to 104.
Are ATBs helpful for croup? For epiglottits? - Answer-For croup, no. Epiglottitis, yes
Is croup viral or bacterial? - Answer-Viral
With which condition is croup most often confused? - Answer-Epiglottitis
Can croup be managed at home? Can epiglottitis be managed at home? - Answer-Yes.
No, epiglottitis is a 911 emergency
Are sedatives used for kids with croup? - Answer-No, bc this would mask the signs of
respiratory distress
What causes epiglottitis? A virus or bacteria? - Answer-H. influenza BACTERIA
,What is the best tx for croup? - Answer-Cool moist air
What should never be done to a child with epiglottitis? - Answer-Never put anything in
the child's mouth, ie, a tongue blade can lead to obstruction
What are the typical signs and symptoms of croup? - Answer-Barking cough, inspiratory
stridor, labored resp. pattern
What 3 signs tell you that the child has epiglottitis instead of croup? - Answer-Muffled
voice, drooling, increased fever
When is croup bad enough to be evaluated by a doc? - Answer-When retractions, and
high pitched stridor are present
What lead level needs intervention? - Answer-50-60 micrograms/ dl
With which class of drugs will a child with lead poisoning be treated? - Answer-
Chelating agents
What do chelating drugs do? - Answer-They increase the excretion of heavy metals
The most freq. cause of lead poisoning is... - Answer-Ingestion of lead-based paint
chips
Name 3 common chelating agents for lead poisoning - Answer-EDTA, desferal, BAL in
oil
S&S of lead poisoning - Answer-Drowsiness, clumsiness, ataxia, seizures, coma, resp.
arrest
Sx of lead poisoning show up in the ____ system - Answer-Neuro
Leukemia is cancer of the ___ forming tissues - Answer-Blood
The type of cell that is most common and problematic in leukemia is ____ - Answer-
Immature WBC
In leukemia the RBC count is ... - Answer-Low, bc the bone marrow is going "wild"
producing all those immature WBC - no energy or nutrients to make platelets
In leukemia, the platelet count is ... - Answer-Low, bc the bone marrow is going "wild"
producing all those immature WBC - no energy or nutrients to make platelets
Bc the RBCs are low, the pt will exhibit ___ and ___ - Answer-Pallor and fatigue
,Bc of the immature WBCs, the pt is at risk for ___ - Answer-Infection
Bc of low platelets, the pt is at risk for ___, ___, and ___ - Answer-Bruising,
ecchymosis, bleeding, petechiae
What causes lymph gland enlargement in leukemia? - Answer-All those small immature
WBC clog the lymph system
Should you take a rectal temp on a child with leukemia? - Answer-No
Should you take an oral temp on a child with leukemia? - Answer-Yes, as long as they
are over 4 years old, in remission, and have no sores in their mouth
Should the child with active leukemia use straws, forks, cups? - Answer-NO straws, NO
forks, YES cups
RN's priority in tx a child with newly diagnosed leukemia is... - Answer-Dec. risk of
infection
When the leukemia child's platelets and WBC's are low, his activities should be ... -
Answer-Limited
When the platelet and WBCs are low the nurse should not insert a.. - Answer-
Suppository
Are IM injections and IV sticks permitted on a child with leukemia? - Answer-When labs
are low IMs avoided and IVs limited; only done when absolutely necessary (to give
chemo or measure blood counts)
Why are kids on chemo also on allopurinol - Answer-To prevent uric acid kidney stones
(remember when chemo kills cancer cells, purines and uric acid build up and could
cause kidney stones
Why do some kids with leukemia have joint pain? - Answer-The immature WBCs
infiltrate the joint and cause inflammation
Why is a child with leukemia at risk for neuro sx due to ICP - Answer-The immature
WBCs infiltrate the brain and cause inflammation
What is alopecia? - Answer-Hair loss
If the platelet count is low what drug should the child not take? - Answer-Aspirin
Is the alopecia from chemo permanent? - Answer-No. It will grow back. (Alopecia of
radiation therapy is permanent bc the follicle is destroyed)
, What does ANC mean? - Answer-Absolute Neutrophil Count
What is the ANC used for in leukemia? - Answer-If ANC <500, then pt will be on
protective isolation
Which is used more commonly to decide if the pt should be on isolation: WBC or ANC -
Answer-ANC is more reliable and valid
By the end of the 1st 6 months of life an infants birthweight should ____ - Answer-
Double
By the end of the first year of life an infants birthweight should ___ - Answer-Triple
Ideal food for infants is ___ - Answer-Breast milk
Breast milk contains substances that increase immunities T/F? - Answer-True
Bottle-fed infants dont bond well with their moms T/F? - Answer-False
The 1 nutrient that commercial formulas are typically low in is ___ - Answer-Fe
Breast milk does not contain iron T/F? - Answer-False. However, it does not contain
enough iron- so they should be fed iron fortified cereal starting at 6 months
At what age should the infant be fed cows/goats milk? - Answer-Not before 12 months
What is the major problem with feeding an infant skim milk? - Answer-They dont get
enough calories and dont grow. Dehydration from excessive solute load and inability to
concentrate urine
When should the infant be introduced to textured solid foods? - Answer-4-6 months
What is the first food that an infant should be introduced to? - Answer-Iron fortified rice
cereal
When forced to eat, the preschool child will... - Answer-Rebel
Parents of preschool children should be taught that as long as the child eats ___ good
nutritious meal per day, they should not make eating food an issue - Answer-One
Refusal to eat is common in preschoolers T/F? - Answer-True, but still offer a variety
Youngsters develop food preferences by.. - Answer-Observing significant ppl in their
environ
