NCLEX

the nurse is caring for a patient with a diagnosis of heart failure who suddenly complains about shortness of breath and dyspnea. the nurse should take which immediate action - CORRECT ANSWER elevate the head of the patients bed early sign of hypovolemic shock - CORRECT ANSWER increased pulse rate What should you consider when selecting an answer or determining the order of priority - CORRECT ANSWER using ABCs A-airway B-breathing C-circulation (exception: CPR. then remember CAB- compre...

Is a process of learning a different culture to adapt to a new or changing environment. - ANSWER Acculturation. It is a subjective perspective of the person's heritage and a sense of belonging to a group - ANSWER Ethnic identity Include meditation, relaxation techniques, imagery, music therapy, massage, touch, laughter, humor, & spiritual measures (prayer). - ANSWER Low-risk therapies: Because of their health & dietary practices, Native Americans, Latino Americans, Hispanic Americans, & ...

Pitocin: Indication? Adverse Effects/Monitoring? - ANSWER Given to strengthen contractions and labor. Can cause uterine hyperstimulation. Contractions should be NO LONGER than 90 seconds and no closer than 2 minutes apart. If they are any more than that; slow pitocin How to Mix insulins (step 1-5) - ANSWER 1. Draw up the total amount of (AIR) 2. Air into N 3. Air into R 4. Draw up R 5. Draw up N IM injection - Needle size + length? Sub-Q Size + length? - ANSWER IM: 21g 1 inch needle *...

A patient with a diagnosis of major depression who has attempted suicide says to the nurse, "I should have died! I've always been a failure. Nothing ever goes right for me." Which response demonstrates therapeutic communication? A "You have everything to live for." B "Why do you see yourself as a failure?" C "Feeling like this is all part of being depressed." D. "You've been feeling like a failure for a while?" - ANSWER D Responding to the feelings expressed by a patient is an...

Amiodarone - ANSWER Antidysrhythmic Use: A-fib, v-fib, v-tach SE: lung damage, HF, liver & thyroid toxicity Aripiprazole - ANSWER Atypical antipsychotic Uses: schizophreia, BPD, major depression;autism. SE: headache, agitation, EPS (low risk) Aspart - ANSWER Rapid acting insulin. Use: type 1 & 2 diabetes SE: hypoglycemia. Atorvastatin - ANSWER Statin Uses: lower cholesterol & LDL; raise HDL SE: rhabomyolysis; hepatotoxicity Clopidogrel - ANSWER Anti-platelet Uses: prevent MI & CVA ...

2. Placenta Previa 3. Molar Pregnancy 4. Ectopic Pregnancy - ANSWER 1. Abruptio placentae a client w/ severe abruptio placentae will often have SEVERE abdominal pain. The uterus will have increased tone w/ little to no return to resting tone btw/ contractions. The fetus will start to show signs of distress, with decels in the HR or even fetal death w/ large placental separation. Placenta previa usually involves PAINLESS vaginal bleeding w/out UCs. A molar preg. generally would be detecte...

The name selected by the original manufacturer based on the chemical structure of the drug is the: A) chemical name B) drug name C) generic name D) trade name - ANSWER C) generic nam The interaction of one drug increased by the presence of a second drug is known as: A) potentiation B) addictive effect C) antagonism D) synergism - ANSWER A) potentiation When two drugs given together have an effect equal to the sum of their respective effects, the interaction is known as: A) potentia...

The nurse checks the postoperative client for signs of infection. Which observations are indicative of a potential infection? Select all that apply. 1.Slight redness along the incision 2.The presence of purulent drainage 3.A temperature of 98.8° F (37.1° C) 4.The client states that he feels cold. 5.The client states that the incision itches. 6.Tender firmness palpable around the incision - ANS 2.The presence of purulent drainage 6.Tender firmness palpable around the incision Rationale...

Alteplase (t-PA) - ANSWER *class*: thrombolytics *Indication*: MI, acute ischemic stroke, occluded central lines *Action*: converts plasminogen to plasmin which degrades the fibrin found *Nursing Considerations*: - contraindicated in active bleeding -monitor for anaphylaxis - use caution with uncontrolled hypertension Atorvastatin (Lipitor) - ANSWER *class*: lipid-lowering agent *Indication*: management of high cholesterol (hypercholesterolemia), primary prevention of cardiovascular dis...

(PROVIDES FULL EXPLANATIONS) The health care provider prescribes ibuprofen (children's Motrin) 5 mg per kg for a child who weighs 13 pounds. How many milligrams (mg) should the nurse administer to the child? Fill in the blank. Record your answer using one decimal place. - ANSWERS 143 A client with sickle cell anemia is being treated for sickle cell crisis. The health care provider prescribes morphine sulfate 2 mg. The concentration of the vial is 10 mg/mL of solution. How many milliliters...