Download NCLEX Review questions (Mark K) Questions and Answers 2024 Latest Update. and more Exams Nursing in PDF only on Docsity!
NCLEX Review questions (Mark K)
Questions and Answers 2024 Latest
Update.
Your pt. has respiratory acidosis your pt. has: (Select all that apply) a) +1 reflexes b) Diarrhea c) A dynamic ileus d) Spasm e) Urinary retention f) Paroxysmal atrial tachycardia e) 2nd degree, obits, type 2 heart block g) Hypokalemia - Correct answer a) +1 reflexes c) A dynamic ileus e) Urinary retention g) 2nd degree, obits, type 2 heart block A pt. has pneumonia present in 4 lobes, they have a RR of 52, and a SpO2 of 78. What acid-base imbalance is the patient exhibiting? a) Respiratory alkalosis b) Metabolic alkalosis c) Respiratory acidosis d) Metabolic acidosis - Correct answer c) respiratory acidosis -the rate is less important than the gas exchange, if the SpO2 is 78 then gas exchange is not good and shows acidosis -they are under ventilating, under = acidosis -not about rate about SaO2 or SpO If your pt. is on a PCA pump, what acid-base imbalance will cause you to take them off of it?
a) Respiratory alkalosis b) Metabolic alkalosis c) Respiratory acidosis d) Metabolic acidosis - Correct answer c) respiratory acidosis -PCA pumps depress respirations = under ventilation If you’re male pt. comes in with hyper-emesis what acid-base imbalance would he have? a) Respiratory alkalosis b) Metabolic alkalosis c) Respiratory acidosis d) Metabolic acidosis - Correct answer b) metabolic alkalosis -vomiting or suctioning = met alkalosis -losing acid If a male pt. comes in with prolonged hyper-emesis that has led to dehydration what acid-base imbalance would they have? a) Respiratory alkalosis b) Metabolic alkalosis c) Respiratory acidosis d) Metabolic acidosis - Correct answer d) metabolic acidosis -even though the pt. is vomiting, they are now dehydrated which is the main take away from the question, dehydration = acidosis If an infant comes in with diarrhea, what acid-base imbalance is anticipated? a) Respiratory alkalosis b) Metabolic alkalosis c) Respiratory acidosis d) Metabolic acidosis - Correct answer d) metabolic acidosis -diarrhea is not vomiting or suctioning so it is not alkalosis
You have a type 2 DM, what is the best dietary route to take? a) Restrict their calories b) Divide their food into 6 feeding/day - Correct answer a) restrict their calories **both are needed but since this is a "best" question this is the best option A young boy with type one diabetes comes into the E.R. with a blood glucose of 800, what is the best question to ask his parents to determine the cause of the DKA? a) Has your child be involved in high activity today? b) Did your child have an extra dose of insulin today? c) Has your child had an URI in the last two weeks? d) Did your child skip a meal today? - Correct answer c) Has your child had an URI in the last two weeks? ** (A) is correct but not the BEST answer, the most common cause of DKA is upper respiratory infection --the stress of the illness causes the body to break down fats, leading to ketones --need to confirm with ketones in the blood, ketonuria can be present without DKA so this is not diagnostic In what position should you put an opisthotonus baby? a) Side b) Prone C) supine d) Head elevated (sitting) - Correct answer a) side **opisthotonus is a hyperextension of the neck and back and can occur when an elevated bilirubin passes the BBB of a baby --important to report immediately as it’s a sign of impending kernicterus Your Pt. has hyperkalemia, select all that apply: a) Dynamic ileus b) Obtund ant c) +1 reflex
d) Clonus e) U wave f) Depressed ST g) Polyuria h) Bradycardia - Correct answer d) clonus h) Bradycardia **-kalmias do the same as the prefix except for the HR and urine output ---U wave starts on the baseline and goes down, it’s a sign of cardiac depression (if you don't know what it is on a select all apply then don't pick it) Your pt. has diarrhea, what caused it? a) Hyperkalemia b) Hypokalemia c) Hypocalcaemia d) Hypomagnesaemia - Correct answer a) hyperkalemia **if a tie and it’s not muscle or nerves then it’s always K+ A student nurse runs to you and says they ran 1L of IV into the pt. in 10 min b/c they forgot to clamp it, what electrolyte imbalance to you expect to see? - Correct answer - hypernatremia **would be put on fluid restriction, has fluid overload Your pt. has hypothyroidism, what pre-op order would you question? a) Penicillin b) Insulin c) Ambien - Correct answer c) Ambien **pt. should not be given sedation medications, can lead to myxedema coma --their whole body is slowed b/c decreased coma
**if actions need to be taken for a lab value you always:
hold, assess, prepare, and call Normal value for INR: 2- You are caring for a pt. whose lab value for K+ came back as a 6.1. Arrange the order of actions you would take from first to last. a) Assess heart rhythm/rate b) Prepare Kayxolate and D5W w/ insulin c) Stop K+ drip d) Call physician - Correct answer c) stop K+ drip a) Assess heart rhythm/rate b) Prepare Kayxolate and D5W w/ insulin d) Call physician **this is a critically high lab value, if it is critical you cannot leave the bedside of the pt., you must get other people involved to move stat to correct the imbalance b/c death is impending A woman comes into the doctors off advising she had a positive reading on a pregnancy test. Her last menstrual period was June 10th-June 15th. Calculate her due date. a) March 22nd b) February 10th c) March 17th c) May 17th - Correct answer c) March 17th -add 7 days to the first day of the last menstrual cycle, then subtract 3 months A women is in her 28th week, she has gained 22lbs, what is your impression a) She has average WG
b) she's underweight c) she's overweight d) Need an assessment to gather more information - Correct answer c) she's overweight
she should have gained 19 lbs. -to calculate weight gain, you take the number of week’s gestation and subtract 9 that will give you the number of lbs. supposed to be gained **a women gains 3 lbs. in the first tri and 1 lb. /wk. in the second and third *****if the weight is 1-2 lbs. off then that's okay, say w/in range You have a prima gravid at 5cm who wants her IV push pain medication, will you give it to her or not? A) no b) Yes c) Consult a physician - Correct answer Yes, b/c the mom is at 5cm and since it is her first baby she will tend to deliver at a slower rate -IV meds peak 15-30 min after they're given **do not give pain meds if they will peak when baby is bone You have a multigravida who is at 8 cm requesting her IM pain medication, would you give it to her? A) no b) Yes c) Consult a physician - Correct answer No, b/c the mom is at 8cm and she has delivered other babies her delivery could be faster -IM peaks at 30-60 minutes **do not give pain meds if they will peak when baby is bone Which patient would be see between a pt. with angina pectoris with unstable BP and the pt. with an MI with stable vital signs? - Correct answer -you would see the angina pectoris b/c of the unstable BP, the pt. being unstable is the unstable phrase and that breaks the tie on who you should see first Which patient would you see first, a pt. w/ COPD, pt. w/ CHF, or pt. w/ appendicitis?
If a high-pressure ventilator alarm is going off, what order of events would you follow? a) Reposition pt., turn, cough, deep breath b) Provide suctioning c) Empty any water out of the tubing D) Check for kinks/unkink tubing - Correct answer d) check for kinks/unkink tubing c) Empty any water out of the tubing a) Reposition pt., turn, cough, deep breath b) Provide suctioning **suction only if all else fails, always check for kinks in tubing first, then see if there's any condensation in the tubing if so empty, then turn pt. and then them to cough/deep breath, then and only then do you suction What does a low pressure alarm on a ventilator mean? - Correct answer -triggered by decreased resistance
causes: -disconnections (tubing is disconnected or sensory tubing is disconnected) The doctor says wean off vent in the a.m. tomorrow, the 6am ABG's show respiratory acidosis, what would you do? a) Follow the order b) Call respiratory therapy c) Hold the order, call the doctor d) Begin to decrease the settings - Correct answer c) hold the order, call the doctor -the pt. is under-ventilating b/c has respiratory acidosis so we don't want to take the pt. off the vent -if pt. had respiratory alkalosis then pt. could be on the ventilator "B" is a bad answer b/c you should never defer responsibility You have a pt. with chest-tubes in for a hem thorax, what would you report to the provider? a) chest-tube is not bubbling b) chest-tube drained 800mL in first 10hrs
c) chest-tube is not draining d) chest-tube is intermittently bubbling - Correct answer c) chest-tube is not training -supposed to be draining blood If it was a pneumothorax it could be a or b -supposed to bubble with pneumothorax b/c air should drain and not supposed to be draining Stages of Grief (Keebler-Ross) - Correct answer DABDA -Denial -Anger -Bargaining -Depression -Acceptance What is co-dependency? - Correct answer -when self-esteem is gain or loss from doing things for others -needs to be addressed in alcohol dependence -teach person to set limits and enforce them, must say "no" and then feel good about themselves saying it **manipulation is getting another person to do something for them that is not good for that person A 49yr old alcoholic gets her 17yr old daughter to the store to buy alcohol for her, is this okay? a.) yes, it’s for her mom who is sick b.) no, its dependence c) Yes, only if an adult is present d) No, it’s manipulation - Correct answer d) no, it’s manipulation -b/c a 17 yr. old buying alcohol is illegal which is harmful to her = manipulation
-cocaine -PCP/LSD -methamphetamine -methylphenidate (Adderall/retinal) -s/x: euphoria, techy, restlessness, irritability, borbaregmi, reflexes at 3-4, spastic, so, suction needs to be ready What is the relationship between overdosing and withdrawing on uppers and downers?
- Correct answer -if you overdose on an upper = everything goes up -w/drawl on an upper = everything goes down -if you overdose on a downer = everything goes down -if you w/drawl on an upper = everything goes up **watch for so w/ upper overdose or w/drawl of downer **rasp depression w/ upper w/drawl or downer overdose The ER nurse gets a call from an EMT reporting a patient with an overdose on cocaine, what would you expect to see? Select all that apply a) Respiration rate < b) Reflexes (+4) c) Borburigmi d) Irritability E) Difficult to arouse F) increased temp - Correct answer b) reflexes (+4) c) Borburigmi d) Irritability f) Increased temp
-too much upper, makes things go up If a baby is >24hrs old and has a mother who is addicted to drugs, what can we assume about the baby? - Correct answer -we would assume intoxication NOT w/drawls from birth to 24hrs -after 24hrs, baby will have w/drawl You're caring for a newborn that is 24hrs old. The mom is addicted and actively taking Quaaludes, what responses do you expect to see from the newborn? Select all that apply A) Difficult to console b) Low core body temp c) Exaggerated startle reflex d) Respiratory depression e) So risk f) Shrill high-pitched cry - Correct answer a) difficult to console c) Exaggerated startle reflex e) So risk f) Shrill high-pitched cry When does alcohol withdrawal and delirium tremens occur? - Correct answer - withdrawal= 24hrs stopping drinking -DT's = 72 hrs. not all people get this
life-threatening Described the care of someone going through alcohol withdrawal? - Correct answer - stable pt., not harmful to others -regular diet -semi-private ram -up ad lib -no restraints -give anti-HTN meds
-can give PO for hepatic encephalopathy and bowel surgery prep
dissolves in gut and sterilizes it kill bacteria (including bacteria that create ammonia) -drugs for bowel prep are: neomycin and kanamycin "Who can sterilize my bowel? Neo Ken!" What order do we draw peak and trough levels? - Correct answer TAP levels -T: draw trough -A: admin drug -P: draw peak **look at route not drug to know when to draw When do you draw trough and peak levels for sublingual, IV, IM, Sub, and PO meds? - Correct answer Trough: -draw all 30 min buff next dose Peak: -sublingual: 5-10min after drug has dissolved -IV: 15-30 min after drug has finished -IM: 30-60 min after given -sub "see DM meds" -PO: too variable Calcium Channel Blockers - Correct answer -like Valium for your heart, calm it -Use: A, AA, AAA (antihypertensive, antianginals, anti-atrial-arrhythmias)
-SE: H&H (headache and hypotension) -ex: anything that ends in -divine
"-dipping your toe in the channel"
plus verapamil and Cardizem/diltiazem (can be given cont. IV drip) -need to measure BP buff giving (causes hypotension) -need to titrate drip if BP low When you give a Calcium channel Blocker, what vital sign do you need to measure before you give it? a) Temperature b) Respirations c) Blood pressure d) SpO2 - Correct answer c) blood pressure -CA+ blockers are like Valium to the heart, it slows it down and creates vasodilation
dissolves in gut and sterilizes it kill bacteria (including bacteria that create ammonia) -drugs for bowel prep are: >>neomycin and kanamycin "Who can sterilize my bowel? Neo Ken!" What order do we draw peak and trough levels? - Correct answer TAP levels -T: draw trough -A: admin drug -P: draw peak **look at route not drug to know when to draw When do you draw trough and peak levels for sublingual, IV, IM, Sub, and PO meds? - Correct answer Trough: -draw all 30 min buff next dose Peak: -sublingual: 5-10min after drug has dissolved -IV: 15-30 min after drug has finished -IM: 30-60 min after given -sub "see DM meds" -PO: too variable Calcium Channel Blockers - Correct answer -like Valium for your heart, calm it -Use: A, AA, AAA (antihypertensive, antianginals, anti-atrial-arrhythmias) -SE: H&H (headache and hypotension) -ex: anything that ends in -divine "-dipping your toe in the channel" >>plus verapamil and Cardizem/diltiazem (can be given cont. IV drip) -need to measure BP buff giving (causes hypotension) -need to titrate drip if BP low When you give a Calcium channel Blocker, what vital sign do you need to measure before you give it? a) Temperature b) Respirations c) Blood pressure d) SpO2 - Correct answer c) blood pressure -CA+ blockers are like Valium to the heart, it slows it down and creates vasodilation leading to hypotension What are the 2 lethal arrhythmias? - Correct answer A-systole and V-Fib -lethal b/c little to no CO What is the treatment for ventricular dysrhythmias? - Correct answer -lidocaine and amiodarone What is the treatment for super ventricular arrhythmias aka atrial arrhythmias? - Correct answer -A, B, C, and D’s -undercard, adenosine -beta blockers -CA+ channel blockers -digoxin Adenosine - Correct answer -Antiarrhythmic -Use: atrial arrhythmias -need to use IV push in 8 seconds
-life expectancy is decreased -stress, grief, financial issues -apnea monitor, long hospital stays -exercise intolerance -etc. **all congenital heart defect kids, trouble or not have: a murmur and need an EKG What are the Trouble congenital heart defects? - Correct answer all of them start w/ a "T" -tetralogy of fallout -trunks arteriosus -transposition of vessels -tricuspid atresia **shunts R to L and cyanotic What are the 4 defects of Tetralogy of Fallout? - Correct answer -ventricular defect (R to L shunt) -pulmonic stenosis -overriding aorta -right hypertrophy What diseases do you need contact precautions for? - Correct answer -codify -help A -staph infections -RSV -HSV/herpes -cholera
What diseases do you need droplet precautions for? - Correct answer -meningitis -flu -influenza -mumps -pertussis -diphtheria *mask, gloves, disposable/dedicated equipment What diseases do you need airborne precautions for? - Correct answer -measles -TB -Rubella -varicella (chicken pox) In what order to you take your PPE off? - Correct answer Take off in alphabetical order -gloves, goggles, gown, mask Put in on in opposite order except mask is 2nd -gown, mask, goggles, gloves How to measure crutches? - Correct answer 2-3 cm/finger widths below anterior AXILLARY FOLD to a point lateral and slightly in front of the foot When the handgrip of a crutch is properly in place the elbow flexion should be? - Correct answer 30 Describe a 2 point gait? - Correct answer 1. One crutch and opposite foot together
- Other crutch and other for together.
