Random Questions Flashcards
(203 cards)
1
Q
Air/Pulmonary Embolism name 3 signs and symptoms, and turn patient to the ____ side and ____ the head of the bed
A
chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom. (left, lower)
2
Q
Women in labor with un-reassuring FHR (late decals, decreased variability, fetal bradycardia). What to do? 3 things
A
Turn on left side
stop Pitocin
increase IV fluids
3
Q
Tube feeding w/ decreased LOC. Place patient on ___ side (promotes emptying of stomach) with the HOB ____ (to prevent aspiration
A
right, elevated
4
Q
During an epidural position how to place the patient ?
A
side-lying
5
Q
After a lumbar puncture ( and an oil-based myelogram) pt lies _____ to prevent ____ and leaking of ______
A
supine, HA & CSF
6
Q
Pt w/ heat stroke? _____ with legs ____
A
flat, elevated
7
Q
During continuous bladder irrigation ? catheter is taped to ____ so leg should be kept ____, no other positioning restrictions
A
thigh, straight
8
Q
After myringotomy- position patient on side of _____ ear after surgery to allow?
A
affected , to allow drainage of secretions
9
Q
After cataract surgery-> patient will sleep on ______ side with a ____ _____ . How long ?
A
unaffected side, night shield 1-4 weeks
10
Q
After thryoidectomy-> low or _______, support head, neck, shoulders
A
semi-fowlers
11
Q
Infant with spin bifida? Position them ____ so that sac does not rupture
A
prone
12
Q
Bucks tractions ? Positioning ? for counter-traction
A
elevate foot of bed
13
Q
After total hip replacement -> don’t sleep on which side? don’t flex hip more than ___ degrees. Maintain hip ___ by separating ___ with pillows
A
affected
45
abduction
thighs
14
Q
Positioning gor prolapsed cord?
A
knees to chest
Trendelenburg
15
Q
Infant with cleft lip - position on ___ or in ___ ___ to prevent trauma to suture line, while feeding hold baby in ____ ____
A
back, infant seat , upright position
16
Q
To prevent dumping syndrome( post-op ulcer/stomach surgeries) eat in ___ position , lie down after meals (how long?) also restrict ? low ___ and ____ diet, with small frequent meals
A
reclining , 20-30 mins, fluids, CHO & fiber
17
Q
Above the knee amputation-> first 24 hours? how to position daily to provide for hip extension ?
A
elevate on pillow, prone
18
Q
Below the knee amputation -> first 24 hours? how to position daily to provide for hip extension ?
A
elevate foot of bed, prone
19
Q
Detached retina-> area of detachment should be in what position ?
A
dependent
20
Q
Administration of enema? (positioning)
A
left-side lying with knees flexed (SIMs)
21
Q
After supratentorial surgery (incision behind hairline) -> positioning?
A
elevate HOB 30-45 degrees
22
Q
After infratentorial surgery (incision at nape of the neck)-> position pt ____ and ____ on either side
A
flat & lateral
23
Q
During internal radiation -> on _____ while implant is in place
A
bedrest
24
Q
Autonomic Dysrefelxia/ Hypereflexia : s/s HR? BP? pounding headache , profuse sweating , nasal congestion, goose flesh, how to position ?
A
bradycardia, hypertension, elevate HOB first before any other implementation
25
Shock-> ____ with extremities elevated _____ degrees, knees ____, head _____ ____ (modified trendelenburg)
bedrest , 20 , straight, slightly elevated
26
Head Injury : HOB ? to decrease intracranial pressure
30 degrees
27
Peritoneal Dialysis when outflow is inadequate-> turn patient ??? Before checking for kinks in tubing
side to side
28
Lumbar puncture- AFTER the procedure , the client should be placed in what position for how long?
supine, 4-12 hours as prescribed
29
_____ for pancreatitis not ____ ____
demoral, morphine sulfate
30
1) Worsens with exercise and improves with rest
2) A + reaction to Tensilon- will improve symptoms
3) Causes by excessive medication- STOP MEDS- giving Tensilon will make it worse
myasthenia gravis
myasthenia crisis
cholinergic crisis
31
Given for head injury patients (osmotic diuretic) crystalizes at room temp so always use ___ needle
mannitol , filter
32
Prior to a liver biopsy its important to be aware of what lab result?
prothrombin time
33
From the ass- diarrhea - ?
| From the mouth - vomiting - ?
metabolic acidosis
| metabolic alkalosis
34
Myxedema/ hypothyroidism : slowed ___ and ____ function, sensitivity to ? ___ skin & hair
mental and physical, cold, dry hair and skin
35
Another name for hyperthyroidism ? mental & physical functioning is? sensitive to ? hair type?
Graves Disease , accelerated, heat, fine/soft
36
Thyroid Storm -> INCREASED (3 things)
BP, pulse, temp
37
Post-thyroidectomy: positioning to prevent neck flexion/hyperextension, what at bedside?
semi-fowlers
38
Hypo-parathyroidism - CATS and diet?
convulsions, arrythmia, tetany, spasms, stridor, high CA and low phosphorus diet
39
Hyper-parathyrodism- Think sedations, a lot of calcium , name 3 symptoms and their diet
fatigue, muscle weakness, renal calculi, back and joint pain , low CA and high phosphorus diet
40
Hypovolemia -> pulse? BP? temp? resp? Urine Specific Gravity
increased temp, rapid/weak pulse, increase resp. , hypotension, anxiety , urine specific gravity >1.030;
41
Hypervolemia -> pulse? BP? temp? Urine Specific Gravity
bounding pulse, SOB, dyspnea, rales/crackles, peripheral edema, HTN, USG
42
Diabetes Insipidus is an _____ in _____? Name some symptoms? what drug to admin?
decrease ADH, polyuria, excessive thirst, dehydration , admin Pitressin
43
SIADH is a ____ in _____? s/s and meds
increase in ADH, change in LOC, decreased DTR , tachycardia, n/v, HA, admin declomycin & diuretics
44
Hypokalemia - name two s/s what foods to eat other than bananas?
muscle wekaness, dysrythmia ( apricot, rasins, oranges, beans, potatoes, carrots, celery)
45
Hyperkalemia- MURDER
muscle weakness, urine (oliguria, anuria), respiratory depression, decreased cardiac contractility, ecg changes, reflexles
46
Hyponatremia- name some s/s
| How to treat?
nausea, muscle cramps, increased ICP, muscular twitching , convulsion - osmotic diuretic and fluids
47
Hypernatremia - name some s/s and treatment
increased temp, weakness, disorientation/delusion, hypotension, tachycardia, HYPOTONIC
48
Hypocalcemia- CATS
convulsions, arythmia, tetany, spasms, stridor
49
Hypercalcemia- s/s
muscle weakness, lack of coordination, abdominal pain, confusion, absent deep tendon reflexes , shallow respirations, EMERGENCY
50
HypoMg- think non sedation
tremors, tetany, seizures, dysrythmia, depression, confusion, dysphagia, dig toxicity
51
HyperMg- think sedation
depresses the CNS, hypotension, fascial flushing, muscle weakness, absent deep tendon reflexes, shallow respirations, EMERGENCY
52
Addison's: hypo___, hyper___, ___ pigmentation , decreased resistance to ___, fractures, hair?, weight? GI distress
hypoNA, hyperK, dark, stress, alopecia,
53
Cushings: hypo____, hyper_____, prone to ? muscle ____ and ______ , edema , BP?, (2 other specific symptoms)
hypoK, hyperNA, infection, weakness/wasting, HTN, hirsutism, moonface/buffalo bump
54
Addisonian crisis: blood sugar? bp? other symptoms
nausea/vomiting, confusion, abdominal pain, extreme weakness, hypoglycemia , dehydration, decreased BP
55
Hypersecretion of epi/norepi , persistent HTN, increased HR, hyperglycemia, diaphoresis, tremor, pounding HA, avoid stress, frequent bathing and rest breaks, avoid cold and stimulating foods, surgery to remove this tumor
pheochromocytoma
56
a rare, but life-threatening, idiosyncratic reaction to neuroleptic medications that is characterized by fever, muscular rigidity, altered mental status, and autonomic dysfunction. Often occurs shortly after the initiation of neuroleptic treatment, or after dose increases.
Neuroepileptic syndrome - you get hot, stiff, sweaty, BP, pulse, and respirations increases, you start to drool
57
Danger : Never get pregnant with a german
german measles dangerous when you're pregnant
58
What comes first when drawing up regular insulin and NPH together ?
regular
59
Tetralogy of fallot : DROPS
child drops to floor or squats: 1) defect, septal 2) right ventricular hypertrophy 3) overriding aorta 4) pulmonary stenosis
60
Parnate, Marplan, Nardil
MAOIs used for depression thing Arrrrr like a pirate
61
Autonomic dysreflexia: potentially life threatening emergency. 1) what do you do first ? 2) loosen constrictive clothing 3) assess for bladder distention and bowel impaction 4) administer what meds ?
elevate head of bed 90 degrees , admin antihypertensives (may cause stroke, MI, seizure
62
MAOI's go !! ( PANAMA) - what they taste like ?
parnate, marplan, nardil -> metallic
63
Digoxin 1) Check 3 things . 2) Hold meds
check pulse, check dig levels, check K+ , hold if BP is less than 60
64
Amphojel
Tx of GERD and kidney stones. watch out for constipation
65
Vistaril- use? watch for? given when ?
Tx of anxiety and itching, watch for dry mouth , given prep commonly
66
Versed- use? watch for?
conscious sedation , hypotension and resp. depression
67
PTU and Tapazole- use?
prevention of thyroid stom
68
Sinemet- use? s/s?
Tx of parkinson, sweat, saliva, urine may turn red/brown , and causes drowsiness
69
Artane - use? effect?
Tx of parkinson.. sedative effect
70
Cogentin- use? effect?
x of parkinson and extrapyramidal effects of other drugs T
71
Tigan - use? effect?
Tx of post-op n/v and for nausea associated with gastroenteritis
72
Timolol (Timpotic)- use?
Tx of glaucoma
73
Bactrim
antibiotic, don't take if allergic to sulfa drugs, diarrhea is a common side effect , drink plenty of fluids
74
Gout meds - tuPAC
Probenecis (benemid) , Colchicine , Alluopurinol (Zyloprim)
75
Apresoline (hydralazine)
txt for HTN and CHF , report flu-like sx, rise slowly from sitting to lying position , take with meals
76
Bentyl
txt if irritable bowel disease, asses for anticholinergic effects
77
Calan( verapamil)
CCB, txt of HTN, angina, assess for constipation
78
Carafate
tx of duodenal ulcers, coats the ulcer , so take before meals
79
Theophylline
tx of asthma and COPD, therapeutic drug level 10-20
80
Mucomyst is the antidote for? admin ?
tylenol, orally
81
Diamox
tx of glaucoma, high altitude sickness, don't tale if allergic to sulfa drugs
82
Indocin
NSAID, tx of arthritis ( osteo, rheumatoid, gouty) , bursistis, tendonitis
83
Synthroid
tx of hypothyroidism, may take several weeks to take effect, notify the doctor of chest pain, take in the morning on empty stomach, can cause hyperthyroidism
84
Librium
tx of alcohol w/d, don't tale alcohol with this , very bad nausea and vomiting can occur
85
Oncovin ( vincristine )
tx of leukemia, given IV only
86
Kwell
tx of scabies and lice, apply lotion and leave on 8-12 hours (lice) , use the shampoo and leave on for 4 mins with hair uncovered then rinse with warm water and comb with a fine tooth comb
87
Premarin
tx of menopause estrogen replacement
88
Dilantin
tx of seizures, therapeutic level 10-20
89
Navane
tx of schizophrenia, asses for EPS
90
Ritalin
ADHD, asses for heart related side effects (report immediately) child may need a drug holiday, could stunt growth
91
Dopamine ( Intropine )
tx for hypotension, shock, low cardiac output, poor perfusion to vital organs, monitor EKG for arrhythmias, monitor BP.
92
Fetal HR Patterns
VEAL CHOP
V-variable dcels c-cord compression
E-early decals h- head compression (cause)
A- accels O-okay !
L- late decels P- placental insufficiency , can't fill
93
For cord compression, place the mother ______ position
Trendelenburg, because this removes the pressure of the presenting part off the cord. (If her head is down, the baby is no longer being pulled by gravity).
94
Prolapsed cord...
cover it with sterile gauze to prevent drying of the cord and to minimize infection
95
For late decals... place mother ?
on her left side to allow more blood flow to the placenta
96
For any bad FHR, give ?
O2 by masks
97
When doing an epidural anesthesia what is a priority ?
Hydrate patient first
98
What are major risks in pregnancies?
hypotension, bradypnea, bradycardia
99
NCLEX tip about prego question
Never check the monitor or machine first. Always assess first; for example listen to the fetal heart tones with the stethoscope in NCLEX land. Sometimes its hard to tell who to check on first, the mother or the baby, its usually easy to tell the right answer if the mother or baby involves a machine. If you're not sure who to check first, and one of the choices involves a mating, that is the wrong answer
100
If the baby is in the posterior position....
the sounds are heard at the sides
101
If the baby is in the anterior position....
the sounds are heard closer to the midline, between the umbilicus and where you would listen to a posterior presentation.
102
If the baby is breeched the sounds are heard...
high up in the funds near the umbilicus
103
If the baby is vertex..
the sounds are a little bit above the symphysis pubis
104
Also for ventilator alarms ( HOLD)
High alarm- Obstruction due to increase secretions, kink, pt. coughs, gag, or bites. Low press alarms - Disconnection or leak in ventilator or in pt. airway cuff, pt. stops spontaneous breathing
105
Hot and Dry Sugar High
| Cold and Clammy need some candy
hyperglycemia, hypoglycemia
106
ICP and shock have opposite vitals.. go !
ICP- hypertension, decreased pulse, decreased resp.
| Shock - hypotension, increased pulse, increased resp
107
What is Cor Pulmonale ?
right sided heart failure caused by left ventricular failure
(so pick edema, jvd, if it is a choice)
108
Heroin withdrawal with neonate will have...
irritable poor sucking
109
Jews- NO and NO
milk and meat together
110
Pulse area for cpr on infant?
brachial
111
When to test child for lead poising?
12 months
112
3 sources of K+
bananas, potatoes, citrus fruits
113
before starting IV antibiotics?
cultures are obtained
114
Pt with leukemia may have ?
epitaxis b/c of low platelets
115
Best way to warm newborn
skin to skin contact covered with blanket on mom
116
When patient comes in and she is in active labor... nurse first action is to ??
listen to fetal HR and tone
117
Phobic d/o use...
systematic desensitization
118
NCLEX TIP
When getting down to two answers choose the assessment answer (assess, collect, auscultate, monitor, palpate) over the intervention except in an emergency or distress situation. If one answer has an absolute, discard it. Give priority to answers that deal directly to the patient's body, not the machines/equipments.
119
NCLEX TIP
Key words are very important. Avoid answers with absolutes like: always, never, must
120
With lower amputations patient is placed..
prone
121
Small frequent feeding are...
better than large ones
122
What can not be delegated to UAP?
assessment, teaching, meds, evaluation, unstable patient
123
LVN/LPN cannot..
handle blood
124
Amynoglycosides (like Vancomycin) cause ( 2 things )
nephrotoxicity, ototoxicity
125
IV push should go over..
2 mins
126
NCLEX TIP
If the patient is not a child an answer with family option can be ruled out easily
127
In an emergency who is treated first?
patient with greater chance to live are treated first
128
ARDS (define) DIC (define) are always....
fluids in the alveoli, disseminated intravascular coagulation , secondary to another disease
129
Cardinal sign for ARDS?
hypoxemia ( low O2 in the tissues )
130
In pH regulation what are the two organs of concern?
lungs and kidneys
131
Edema is located?
in the interstitial space not the cardiovascular space
132
Best indicator of dehydration?
weight
133
Where ever there is glucose what follows?
water
134
What can reduce Reye's syndrome in children ?
aspirin
135
When aspirin is given once a day, it acts like...
an antiplatelet
136
What to use for acute and chronic pain ?
acute(sprained ankle)- cold chronic(rheumatoid arthritis)-hot
137
Guided imagery is great for ?
chronic pain
138
When patient is in distress..
medication admin is rarely a good choice
139
With pneumonia 1) and 2) are present... with the elderly ___ is present
fever, chills
| confusion
140
Always check for allergies when admin antibiotics especially _____, make sure culture and sensitivity has been done before admin. of first dose of antibiotic
PNC
141
Cor pulmonale - s/s _____ ______ . ____ heart failure caused by ____ disease, occurs with 1) and 2)
fluid overload
rt. heart failure
pulmonary
bronchitis and emphysema
142
COPD is _____ (2 types of COPD)
| Pneumonia is ______
chronic emphysema, bronchitis
| acute
143
In COPD patients the baroreceptors that detect ____ levels are ____. Therefore ____ levels must be ___ because high O2 concentrations blows the patient's stimulus for breathing
CO2 , destroyed
| O2, low
144
Exacerbation =
acute, distress
145
EPI is always given with
TB syringe
146
Prednisone toxicity: ________ _________
cushings syndrome : buffalo hump, moon face, high glucose, hypertension.
147
Cancer management
chemo, radiation, surgery, allow to die with dignity
148
Neutropenic patients : No ____, ____, _____
live vaccines, fresh fruits, no flowers
149
Chest tubes are placed...
in the pleural space
150
Angina..
low oxygen to heart tissues - no dead tissue
151
MI..
dead heart tissue
152
Mevacor
anticholesterol med - must be given with evening meal if it is QD per day
153
Nitroglycerin is admin up to ____ times a day, ever ___ mins. If chest pain does not stop go to the hospital. do not give when...
3 times a day
5 mins
less than 90/60
154
Preload affects...
| Afterload is the..
the amount of blood that goes through the R. ventricle
| the resistance the blood has to overcome when leaving the heart
155
CCB affect
afterload
156
For a CABG operation when the great saphenous vein is taken it is....
turned inside out due to the valves that are inside
157
Unstable angina is not..
relieved by nitroglycerin
158
Dead tissues can not have PVCs, but if left untreated pvc's can lead to ?
ventricular fibrillation
159
1 t = how many mL
5
160
1T = how many t and mL
3, 15
161
1 oz = how many mL
30
162
1 cup = ___ oz
8
163
1 quart = ___ pints
2
164
1 pint = ____ cups
1
165
1 gr = ____ mg
60
166
1 g = ____ mg
1000
167
1 kg= ____ lbs
2.2
168
1 lb = ___ oz
16
169
How to convert C to F
| How to covert F to C
```
F= C+40, multiply 9/5 and subtract 40
C= F+40 , multiply 5/9 and subtract 40
```
170
Angiotensin 2 in the lungs = ______ ______, Aldosterone attracts?
Potent vasodialator
| sodium
171
Reverse Agent= Heparin
protamine sulfate
172
Reverse Agent=Coumadin
Vitamin K
173
Reverse Agent= Ammonia
lactulose
174
Reverse Agent=Acetaminophen
n-Acetylcysteine
175
Reverse Agent=Iron
deferoxamine
176
Reverse Agent=Digoxin
Digibind
177
Reverse Agent=Alcohol Withdraw
Librium
178
An opioid analgesic used to detoxify / treat pain in narcotic addicts
methadone
179
What electrolyte potentiates dig toxicity ?
K+
180
Heparin prevents
PTT/PT
181
What is elevated when patient is on Coumadin ?
PTT/PT
182
Cardiac output decreases with ?
| Dopamine does?
dysryhtmias
| increases BP
183
Med of choice for vtach?
lidocane
184
Med od choice for SVT
adenosine or adenocard
185
Asytole ?
| Med of choice?
no heart beat, atropine
186
Med of choice for CHF
ace inhibitor
187
Med of choice for anaphylactic shock
epi
188
Med of choice for status epilepticus
valium
189
Med of choice for bipolar d/o
lithium
190
Amiodorone is effective in 1) and 2) complications
atrial and ventricular complications
191
What sound is normal in CHF but not an MI
S3
192
When to give Carafate?
Before meals to coat the stomach
193
Protonix is given....
prophylactically to prevent stress ulcers
194
After and endoscopy check?
gag reflex
195
How is TPN given ?
subclavian line
196
What does low residue diet mean ?
low fiber
197
What is diverticulitis ? and where is the pain ?
Inflammation of the diverticulum , LL quadrant
198
What is appendicitis and where is the pain with rebound tenderness?
inflammation of the appendix, RL quadrant
199
______ + ______ = ascities
portal hypertension + albuminemia
200
What produces insulin ?
beta cells of the pancreas
201
What is contraindicated in pancreatitis? And what should be given instead?
Morphine- causes spasm of the Sphincter of ODDI
| Give Demerol
202
Trousseau and Tchovoski signs are observed in ?
hypocalcemia
203
What is given with meals with pancreatitis
pancreatic enzymes
