Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified, Exams of Nursing

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Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score As the pH goes, - CORRECT ANSWERS so goes my patient, EXCEPT for potassium (Mac) Kussmaul's is only seen in... - CORRECT ANSWERS Metabolic Acidosis In respiratory, if the patient is OVERventilating, - CORRECT ANSWERS Respiratory Alkalosis In respiratory, if the patient is UNDERventilating, - CORRECT ANSWERS Respiratory Acidosis The only cause for metabolic alkalosis is... - CORRECT ANSWERS prolonged vomiting or suctioning A HIGH pressure alarm is due to... - CORRECT ANSWERS obstructions (kinks in tubing, mucus secretions) A LOW pressure alarm is due to... - CORRECT ANSWERS disconnections (disconnected main tubing or O2 sensor tubing) BEFORE choosing to suction a patient, you should... - CORRECT ANSWERS Change their position (turn, cough, deep breathe) What are the stages of grief? - CORRECT ANSWERS DABDA (Denial, Anger, Bargaining, Depression, Acceptance) The number one problem in abusive situations is _______. How do you treat it? - CORRECT ANSWERS Denial Treat by CONFRONTING IT! The number two problem in abusers is... - CORRECT ANSWERS Dependency/Codependency If what a codependent person is being asked to do is harmful/dangerous, this is called _________. How do you treat it? - CORRECT ANSWERS Manipulation Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score Treat by setting limits + enforcing it. SAY NO! What is Wernicke-Korsakoff syndrome? - CORRECT ANSWERS Psychosis-induced by vitamin B1 (thiamine) deficiency Amnesia with confabulation (pt making up stories + believes it) It is IRREVERSIBLE How do you prevent Wernicke-Korsakoff syndrome? - CORRECT ANSWERS Take vitamin B1 What is Disulfiram (Antabuse)? How long does it take to be effective? - CORRECT ANSWERS Aversion therapy for alcoholism 2 weeks to be effective What does Naltrexone (Revia) do? - CORRECT ANSWERS Reduces alcohol cravings What should you teach patients to avoid when taking Disulfiram? - CORRECT ANSWERS Mouthwash, aftershaves, perfume/cologne, insect repellent, any OTC that ends in "elixir", alcohol-based hand sanitizer, uncooked icings (no bake), red wine vinaigrette What are the 5 uppers? - CORRECT ANSWERS Caffeine Cocaine PCP/LSD Methamphetamines Adderall *Everything else is a downer... What is an overdose? What are the sxs like? - CORRECT ANSWERS Too much of an upper/downer Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score What is the route for aminoglycosides? Which route to avoid except for what 2 cases? - CORRECT ANSWERS Route: IM or IV Do NOT give PO, because they are not absorbed, EXCEPT for 2 cases -- *hepatic encephalopathy and pre-op bowel surgery* to clean out the bowels Who can sterilize my bowel? - CORRECT ANSWERS Neo Kan! (Neomycin, Kanamycin) What is a trough? - CORRECT ANSWERS When the drug is at its lowest point What is a peak? - CORRECT ANSWERS When the drug is at its highest point "TAP" levels - CORRECT ANSWERS Trough, Administer, Peak When do you draw a trough level? - CORRECT ANSWERS 30 minutes before next dose (true for ALL med routes) When do you draw a peak for a sublingual med? - CORRECT ANSWERS 5-10 mins after drug is dissolved When do you draw a peak for a IV med? - CORRECT ANSWERS 15-30 mins after drug is finished When do you draw a peak for a IM med? - CORRECT ANSWERS 30-60 mins after you give it CCBs are like _________ for your heart, they _____________. - CORRECT ANSWERS Valium Calm it down! CCBs are *negative* ____ , ____ , and _____. - CORRECT ANSWERS inotropic, chronotropic, dromotropic Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score What would a *positive* inotropic, chronotropic, dromotropic do? - CORRECT ANSWERS Cardiac *stimulant* CCBs are A, AA, AAA... - CORRECT ANSWERS Antihypertensives Anti-Anginals Anti-Atrial Arrhythmias ***EXCEPTION: SVT, because "supra" means "above" the ventricles, which means it is an atrial rhythm. Side effects of CCBs are HNH... - CORRECT ANSWERS Headache + Hypotension CCBs end in ______, except for ______ & ______. - CORRECT ANSWERS -dipine Except for Verapamil and Cardizem Treat V.Tach/PVCs with... - CORRECT ANSWERS Lidocaine or Amiodarone Treat SVT with... - CORRECT ANSWERS ABCDs Adenosine (rapid push) Beta blockers Calcium channel blockers Digoxin/Digitalis/Lanoxin Treat V.Fib with... - CORRECT ANSWERS Defibrillation For V.Fib, you defib! Treat asystole with... - CORRECT ANSWERS Epinephrine and Atropine Epi before Atropine Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score An *a*pical chest tube removes... - CORRECT ANSWERS Air A *b*asilar chest tube removes... - CORRECT ANSWERS Blood What should you do if the water seal of a chest tube breaks? - CORRECT ANSWERS Clamp, cut, submerge, unclamp What should you do if the CT gets pulled out? - CORRECT ANSWERS First thing to do is take a gloved hand and cover the hole BEST thing to do is to cover it with vaseline gauze If asked about bubbling---*WHEN* and *WHERE* is it bubbling? Continuous bubbling in the water seal is... - CORRECT ANSWERS BAD. If something is sealed, you should NOT have continuous bubbling. Never clamp a chest tube for longer than _______ without a doctor's order. - CORRECT ANSWERS 15 secs All congenital heart defects are either "TRouBLe" or not. What are the characteristics? - CORRECT ANSWERS T -- All CHDs that start with "T" are trouble! R + L -- Shunts blood R -> L B -- Makes them turn blue (cyanotic) Examples: Tetralogy of Fallot Truncus arteriosus Transposition of Great Vessels Tricuspid atresia Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score (i.e. Client overhears nurses talking and laughing, they say "I hear demon voices") What are the 5 types of hallucinations? - CORRECT ANSWERS Auditory, visual, tactile, gustatory, olfactory How do you deal with psychosis patients? - CORRECT ANSWERS Ask yourself, "what kind of psychosis do they have?" 1. Functional psychotic (schizo-schizo-major-manics) 2. Psychosis of dementia 3. Psychotic delirium How do you address a functional psychotic? - CORRECT ANSWERS Teach reality using 4-step process: 1. Acknowledge feeling 2. Present reality 3. Set a limit 4. Enforce the limit *Do NOT punish them! How do you address psychosis of dementia? - CORRECT ANSWERS They CANNOT learn reality. 1. Acknowledge feeling 2. Redirect them / reality orientation (person, place, time) How do you address psychotic delirium? - CORRECT ANSWERS 1. Acknowledge feeling 2. Reassure that it is temporary, it will go away, and that they're safe. Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score How do you address a patient with a personality disorder? - CORRECT ANSWERS Use good therapeutic communication EXCEPT for abnormal (antisocial, borderline, narcissists -- treat these more like a functional psychotic and SET LIMITS). The lower the urine output, the _____________ the urine specific gravity. - CORRECT ANSWERS Higher The higher the urine output, the _____________ the urine specific gravity. - CORRECT ANSWERS Lower The opposite of diabetes insipidus is... - CORRECT ANSWERS SIADH Diabetes insipidus is... - CORRECT ANSWERS polyuria, polydipsia, leading to dehydration due to low ADH What are the 3 types of DM type 1? - CORRECT ANSWERS Insulin-dependent Juvenile onset Ketosis prone What are the 3 types of DM type 2? - CORRECT ANSWERS Non-insulin dependent Adult onset Non-ketosis prone What are the 3 P's of Diabetes? - CORRECT ANSWERS Polyuria, polydipsia, polyphagia How to treat a DM type 1 client? - CORRECT ANSWERS "If you don't treat type 1's, they could DIE" D = Diet I = Insulin *priority E = Exercise Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score How to treat a DM type 2 client? - CORRECT ANSWERS "If you don't treat type 2's, they could DOA" D = Diet *priority O = Oral hypoglycemic A = Activity The main treatments for DM type 2 clients is... - CORRECT ANSWERS Calorie restriction *priority They need 6 small feedings per day Insulin to lower blood glucose Regular insulin peaks at... - CORRECT ANSWERS 2 hours NPH insulin peaks at... - CORRECT ANSWERS 8-10 hours When do you check for hypoglycemia in a DM client? - CORRECT ANSWERS At the insulin's peak time What is the onset for rapid acting insulin? - CORRECT ANSWERS 15 minutes Lantus peaks at... - CORRECT ANSWERS No essential peak (low risk for hypoglycemia, can give at bedtime) Once an insulin vial has been punctured, it is good for... - CORRECT ANSWERS 30 days from that date In DM clients, think of exercise as... - CORRECT ANSWERS Another injection of insulin *Teach patients who are going to exercise to bring rapidly metabolizable carbohydrates. If a DM client is sick, their glucose level will... - CORRECT ANSWERS Increase *Teach them to take insulin even if they're not eating + take sips of water to prevent dehydration. Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score Treatment for dumping syndrome? - CORRECT ANSWERS "If you want the stomach to go slow, pick low." (except protein) Flat HOB and eat on their side Low fluids Low carbs ***HIGH protein -Kalemias do the ______ as the prefix, except for __________ and ___________. - CORRECT ANSWERS Same as the prefix, except for heart rate and urine output (which are opposite of the prefix) -Calcemias do the ___________ of the prefix. - CORRECT ANSWERS Opposite -Magnesemias do the ____________ of the prefix. - CORRECT ANSWERS Opposite What is *Ch*vostek's sign? - CORRECT ANSWERS Tap the *ch*eek and the face spasms Sign of hypocalcemia What is Trousseau's sign? - CORRECT ANSWERS Hand spasm when BP cuff is inflated Sign of hypocalcemia For sodiums: The one with the _____ is dehydration, the one with the _____ is overload. - CORRECT ANSWERS HypErnatremia = Dehydration HypOnatremia = Overload The earliest sign of any electrolyte imbalance is... - CORRECT ANSWERS paresthesia (numbness and tingling), especially circum-oral paresthesia Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score The universal sign of electrolyte imbalance is... - CORRECT ANSWERS paresis (muscle weakness) What are the two rules for treatment in potassium imbalance? - CORRECT ANSWERS 1. Never push K+ IV 2. Not more than 40 of K+ per liter of IV fluid How do you treat hyperkalemia? - CORRECT ANSWERS D50W with regular insulin (fast temporary solution) Kayexalate and a lot of fluids (slow, permanent solution) Kayexalate = "K exits late" "Thyroidism", think __________. - CORRECT ANSWERS Metabolism Hyperthyroidism is... - CORRECT ANSWERS Hyper metabolism Grave's disease ("run yourself into the grave") What are S/S of hyperthyroidism? - CORRECT ANSWERS Weight loss High HR/BP Heat intolerance, cold tolerance Bulging eyes (exophthalmos) Treatment for hyperthyroidism? - CORRECT ANSWERS 1. Radioactive iodine (Pt needs to be in a room by themselves for 24 hours, after tx be careful with their urine). 2. PTU (Propylthiouracil = "Puts Thyroid Under", cancer drug that causes immunosuppression) 3. Thyroidectomy (total or partial) Mark Klimek NCLEX Prep 2023/2024 135Questions & Answers All Answers BRAND NEW 100%Verified: Updated 2023/2024 A+ Score What is a patient with a total thyroidectomy at risk for? - CORRECT ANSWERS Hypocalcemia, tetany d/t hypocalcemia What is a patient with a subtotal (partial) thyroidectomy at risk for? - CORRECT ANSWERS Thyroid storm/crisis ***MEDICAL EMERGENCY*** 1. High temps 105 F or > 2. High BPs 3. Severe tachycardia (180s) 4. Psychotic delirium What is the treatment for thyroid storm? - CORRECT ANSWERS Ice pack, cooling blanket, 10L O2 mask NO MEDS After a thyroidectomy, what are the post-op risks in the first 12 hours, 12-48 hrs, and after 72 hrs? - CORRECT ANSWERS First 12 hours: Airway, Hemorrhage 12-48 hours: *T*otal = *T*etany due to hypocalcemia, Partial = Thyroid storm After 72 hours: Infection What are S/S of hypothyroidism? - CORRECT ANSWERS Obesity Flat/dull personality Cold intolerance, heat tolerance Low HR/BP Treatment for hypothyroidism? 2 things to know about these patients? - CORRECT ANSWERS Thyroid replacement (Levothyroxine/Synthroid) 1. Do NOT sedate these patients (can lead to myxedema coma) 2. NEVER hold thyroid medication without an order.