Preview Extract
ATI RN Predictor Study 2016 Real Exam Study Guide
Review Questions (396 Terms) with Verified Answers
A+ Score Solution Update 2023
1. Addison's Disease
Answer: Is an endocrine disorder that occurs when the adrenal glands do not produce enough of
the hormone cortisol and in some cases, the hormone aldosterone.
The disease is characterized by weight loss, muscle weakness, fatigue, low BP and
hyperpigmentation (darkening) of the skin in both exposed and non-exposed parts of the body.
2. Common symptoms of Addison's Disease
Answer: Weight loss
• Hyperpigmentation
• Weakness/fatigue
• Low BP
• Loss of Body hair
3. Cushing's Disease
Answer: S/S: Hirsutism (excessive hair), moon face, purple striatum (typically in the skin of the
abdomen, thighs or breast), thin extremities, buffalo hump
4. Testing for TB
Answer: A Mantoux skin test is the most accurate and valuable screening tool available for TB.
A positive result means only that the client has been exposed to TB; it does not meant that the
client has active TB.
A sputum culture for acid fast bacillus (AFB) is used to confirm the diagnosis of pulmonary TB
after a screening test and chest x-ray come back positive.
5. Teaching instructions for the use of a cane:
Answer: (1) The cane is moved forward about 12 inches
(2) Then, the weak leg is moved even with the cane.
(3) Finally, the strong leg is brought forward and ahead of the cane and weak leg.
• Canes are held on the strong side
• The grip of the cane should be level with the trochanter of the femur
6. Veracity
Answer: Is truthfulness. This is the value that requires the nurse to tell the truth to every client
and to make sure that the client fully understands the message.
7. Autonomy
Answer: Is the right to independence and personal freedom, which leads to the primacy of selfdetermination
8. Fidelity
Answer: Is the duty to keep promises. It refers to the obligation to be faithful to agreements,
commitments and responsibilities that are made.
9. Nonmaleficence
Answer: Is the obligation and duty to do no harm.
10. Meningococcal vaccine
Answer: Recommended that this vaccine be given to children who are 11 through 12 years of
age and then given a booster dose at age 16.
11. When should the single dose of Herpes zoster vaccine be given?
Answer: To adults 60 years or older whether or not they report a previous episode of herpes
zoster.
12. Rotavirus should be given at what age?
Answer: During the child's first year of life.
13. Alendronate (Fosamax)
Answer: This medication is used to prevent and treat postmenopausal osteoporosis and Paget's
Disease.
• Alendronate must be taken first thing in the morning on an empty stomach.
• The pt must be instructed to wait at least 30 minutes after taking Alendronate before eating,
drinking, or taking other medications.
14. What to expect with a pt having a chest tube?
Answer: Continuous gentle bubbling in the suction control chamber
• Crepitus (with a pneumothorax, this will persist for several hours depending)
• Oscillations or also called tidaling in the water seal chamber upon respiration are also expected.
15. Symptoms of hypocalcemia
Answer: Numbness and tingling in the hands, soles of the feet and around the lips.
A nurse would assess the client for a positive reaction by eliciting the Chvostek's sign.
16. What is a potential complication of a thyroidectomy?
Answer: Hypocalcemia, which can include numbness and tingling in the hands, soles of the feet
and around the lips.
17. What assessment tool would a nurse use to determine hypocalcemia?
Answer: Chvostek's sign
18. What is Chvostek's sign? And how is it done?
Answer: Tap on the pt's face at a point just anterior to the ear and just below the zygomatic bone.
A positive response would be twitching of the ipsilateral (same side only) facial muscles,
suggestive of neuromuscular excitability caused by hypocalcemia.
19. Brudzinski's sign
Answer: Is an indication of meningeal irritation, which may be positive with pt's with
meningitis.
To perform this, the client needs to be supine. The nurse places one hand behind the pt's head and
places the other hand on the clients chest. The nurse then raises the clients head (with the hand
behind the head) while the hand on the chest restrains the clients and prevents the client from
rising. Flexion of the clients lower extremities constitutes a positive sign.
20. Kernig's sign
Answer: Is an indication of meningeal irritation. The maneuver is usually performed with the
client supine with hips and knees in flexion. Extension of the knees is attempted and the inability
to extend the clients knee beyond 135 degrees w/out causing pain constitutes a positive test.
21. Babinski sign
Answer: This is used to test for brain damage or upper motor neuron damage. It is considered
positive if the toes flare up upon stroking the plantar aspect of the foot.
22. Cataract surgery discharge instructions
Answer: Do not lift anything heavier than 10lbs for at least one week
• Sleep on your back or unaffected side to lessen the pressure.
• Need to report any pain, decrease in vision or increase in discharge in the eye.
• It is normal to feel itching and mild discomfort after surgery, but the pt should be instructed not
to rub or place pressure on the eye.
23. Exposure or possible exposure to anthrax
Answer: Administer an antibiotic prophylaxis to all pt's newly exposed
Those exposed to anthrax do not require decontamination and are not considered contagious
24. Botulism treatment
Answer: Give an antitoxin
25. Why would lidocaine (Xylocaine) be given to someone following cardiac arrest?
Answer: Lidocaine is an antiarrhythmic med that is commonly used to restore a regular
heartbeat in a client who has arrhythmia. This effect is produced by delaying abnormal nerve
pulses to the heart and reducing irritability of the heart tissue.
26. Factors that can trigger an exacerbation of SLE?
Answer: Infection (especially a strep or viral infection. This can be a major stressor and can
trigger an exacerbation)
• Pregnancy (due to hormonal changes. The pt should be advised of the risks and must be
monitored closely for effects on the renal and cardiovascular system if she decides to get
pregnant)
• Sunlight (Exposure to sunlight and artificial UV light is the leading cause of SLE exacerbation
manifestations, especially the characteristic skin manifestations of lesions and butterfly rash)
27. Hemoptysis
Answer: Coughing up blood or bloody sputum
28. Normal BUN value
Answer: 7-20 mg/dL
29. Normal Hemoglobin levels
Answer: Male: 13-18 g/100mL
Female: 12-16 g/100mL
30. Normal Hematocrit levels
Answer: Male: 45%-52%
Female: 37-48%
31. Normal lactic acid levels
Answer: 0.5-1.5 mEq/L
32. Normal creatinine levels
Answer: 0.8-1.4 mg/dL
33. Defense mechanism: Conversion
Answer: Operating unconsciously, expresses emotional conflict via physical symptoms.
Example: The pt converts repressed ideas or impulses into a variety of somatic (physical)
symptoms that may include paralysis, pain or loss of sensory function.
34. Defense Mechanism: Projection
Answer: In which the pt refused to acknowledge unacceptable personal characteristics and
transfer feelings, thoughts or traits onto another person.
Example: Projecting emotions about self onto something or someone else.
35. Defense Mechanism Undoing
Answer: Is also known as reaction formation. It is a defense mechanism in which the pt,
operating unconsciously, acts out of behavior or attitude in opposition to what he really believes.
36. Defense Mechanism Idealization
Answer: Is when the positive attributes of another person are exaggerated in an effort to reduce
related emotional conflicts.
Example: Someone that got into a horrible car accident and had to go through rehab to walk
again, now wants to be a physical therapist for a career.
37. What diagnostic test would help the nurse monitor and evaluate the effectiveness of the
aspirin medication for an Rhematoid arthritis patient?
Answer: Erythrocyte sedimentation rate (ESR)
RA is a chronic inflammatory disease. ESR is useful in detecting and monitoring tissue
inflammation in clients with RA.
38. Antinuclear antibody (ANA)
Answer: ANAs are frequently present in pts who have systemic lupus erythematosus and other
autoimmune disorders such as RA and scleroderma.
39. Rheumatoid factor (RF) diagnostic test
Answer: This is helpful in diagnosing RA, but the levels do not always correlate with the
severity of the disease activity.
40. Cheyne-Stokes Respirations
Answer: Is characterized by a rhythmic increase (to the point of hyperventilation) and decrease
(to the point of apnea) in the rate and depth of respirations.
• It is commonly seen in pts who are unconscious, comatose or moribund (approaching death).
41. Cryoprecipitate
Answer: Clients with hemophilia (deficiency of clotting factor), are given cryoprecipitate to
replace the deficient factor as a prophylactic measure before any invasive procedure, surgery or
when actively bleeding.
Cryoprecipitate provides therapeutic amounts of Facto 8, Factor 13, von Willebrand factor and
fibrinogen. These concentrates are made with recombinant DNA technology and are the
treatment of choice with hemophilic A and von Willebrands disease.
42. Cisplatin (Platinol)
Answer: Treatment for cancer.
If a client has reported fatigue it is important to check the pts most recent CBC. The client I
likely to be anemic as a result of myelosuppression (bone marrow suppression) from the chem.
The pt may require tx for the anemia (transfusion, medications) and further chemo may be need
to be delayed until the blood counts are higher.
43. Jerking movements of the extremities
Answer: Such as ataxia, may be seen with many neurologic conditions affecting the clients
ability to produce a smooth movement.
44. Ataxia
Answer: Jerky movements of the extremities
45. Spasm of the extremities
Answer: Involuntary spasms may be found with such conditions as cerebral palsy, trauma,
cerebral infection and certain degenerative disorders.
46. Peripheral neuropathy
Answer: Is a neurological disorder resulting from damage to the peripheral nerves. It may be
caused by diseases of the nerves, systemic illness or a side-effect from chemo. If sensory nerve is
damaged, the client is likely to experience pain, numbness, tingling, burning or a loss of feeling
in the extremities.
47. RAST testing
Answer: Involves measuring the quantity of IgE present in the serum after exposure to specific
antigens that are selected based on the pts symptom hx. An elevated IgE indicates a positive
response to RAST testing and is seen in pts who have a hx of allergic manifestations,
anaphylaxis and asthma.
48. Immunoglobulin G (IgG)
Answer: An elevation of this indicates the production of antibodies to all types of infections
49. Immunoglobulin A (IgA)
Answer: An elevation in this is associated with several autoimmune diseases and chronic
infections
50. Immunoglobulin M (IgM)
Answer: IgM produces antibodies against the ABO blood groups and gram-negative.
51. If clear drainage is coming out of a patient and you suspect that it could be CSF, first action
is to?
Answer: Test it for glucose, then notify doctor
52. What is a complication that you should frequently assess if a patient is suspected of having
diabetes insipidus?
Answer: Hypotension
A pt who has diabetes insipidus will continue to excrete urine even though there is no intake.
Hypovolemia, with resulting hypotension is possible.
53. Active TB treatment duration?
Answer: Active TB is usually treated with the simultaneous administration of a combo of meds
to which the organisms are susceptible. Such therapy is continued until the disease is controlled.
A 6-9 month regimen consisting of two meds is frequently used.
54. Chlorpromazine (Thorazine)
Answer: Chlorpromazine is used to treat psychotic disorders such as schizophrenia or manicdepression, and severe behavioral problems in children ages 1 through 12.
Chlorpromazine is also used to treat nausea and vomiting, anxiety before surgery, chronic
hiccups, acute intermittent porphyria, and symptoms of tetanus.
This medication can cause photophobic skin reactions and damage to the retina of the eye if
exposed to direct sunlight. PTs taking this should be reminded to wear protective clothing, apply
sunscreen and wear sunglasses when they are outside.
55. Ileal conduit
Answer: It is used to divert urine outside of the body when the urinary bladder has been
removed. The conduit cannot store urine the way the bladder did; therefore, urine will be flowing
continuously and an appliance must be worn as a collection device. The bag should be emptied
approx. every 2 hours to prevent leakage, skin irritation and infection.
56. Manifestations of tardive dyskinesia
Answer: Tongue thrusting and lip smacking
• Facial grimacing and eye blinking
• Repetitive involuntary movements
57. Ulcerative Colitis
Answer: Is a chronic, episodic, inflammatory disease of the large intestines and rectum
characterized by bloody diarrhea.
Maintaining fluids and electrolyte balance is one of the most important nursing goals.
58. To assess for cyanosis in a pt with dark skin where is the most appropriate areas to assess for
this?
Answer: Examine body areas with the least melanin, such as the underarm, soles of the feet,
conjunctiva and mucous membranes.
59. Panic level of anxiety
Answer: Pt is highly disorganized and may appear either paralyzed (unable to act) or
hyperactive and agitated because the client is not able to focus on anything except the anxiety
itself.
Inability to concentrate and feelings of impending doom, as well as possible delusional
statements such as "my dad can read my thoughts".
60. Sever anxiety
Answer: Pt's perceptual field is scattered and the pt is unable to focus on anything except
relieving the anxiety.
61. Moderate anxiety
Answer: The pt's perceptual field narrows, but with assistance the pt is able to cope
62. Mild
Answer: Mild anxiety is associated with the stress of daily living, the client has a heightened
sense of alertness and is able to concentrate closely on the task at hand.
63. Post operative tx of arthroscopy
Answer: This is used to visualize, diagnose and treat problems inside a joint. Applying ice to the
affected area in the immediate postop period reduces pain and swelling. Pt may be allowed to
walk as tolerated, but joint used should be minimizes for the first few days to reduces pain and
swelling.
64. Patient with Gout
Answer: Gout is a painful and potentially disabling form of arthritis that is caused by an excess
of uric acid in the body.
• Pt should remain well hydrated (this will minimize uric acid stones)
• Should avoid foods high in purines
• Should limit alcohol consumption (too much alcohol can inhibit excretion of uric acid, leading
to its build up and causes an onset of gout.
• Pt's should not take aspirin and/or salicylates (this can interfere with uric acid excretion and
may precipitate an acute onset
65. Hyperthyroid s/s:
Answer: Frequent mood changes
• Nervousness
• Hand tremors
• Rapid, pounding irregular heartbeat
• heat intolerance
• Diarrhea
• Weight loss
66. Colostrum
Answer: Colostrum is secreted from the mother's breasts during postpartum days 1 to 3. It
contains the IgA immunoglobulin that provides passive immunity to the newborn.
67. Breastfeeding schedule
Answer: Newborns should be breastfed every 2 to 3 hr. Parents should awaken the newborn to
feed at least every 3 hr during the day and at least every 4 hr during the night until the newborn
is feeding well and gaining weight adequately. Breastfeeding should occur 8 to 12 times within a
24-hr window. Then, a feed-on-demand schedule may be followed.
Tell the mother how to tell if her newborn is receiving adequate feeding (gaining weight, voiding
6 to 8 diapers a day, and contentedness between feedings).
68. Two components of Advanced Directives
Answer: Living will
Durable Power of Attorney for Health Care
69. Living Will
Answer: A living will is a legal document that expresses the client's wishes regarding medical
treatment in the event the client becomes incapacitated and is facing end-of-life issues. Types of
treatments that are often addressed in a living will are those that have the capacity to prolong
life. Examples of treatments that are addressed are cardiopulmonary resuscitation, mechanical
ventilation, and feeding by artificial means. Living wills are legal in all states.
70. Durable Power of Attorney for Health Care
Answer: A durable power of attorney for health care is a legal document that designates a health
care proxy, who is an individual authorized to make health care decisions for a client who is
unable.
The person who serves in the role of health care proxy to make decisions for the client should be
very familiar with the client's wishes. Living wills may be difficult to interpret, especially in the
face of unexpected circumstances. A durable power of attorney for health care, as an adjunct to a
living will, may be a more effective way of ensuring that the client's decisions about health care
are honored
71. Verapamil (Calan)
Answer: Calcium channel blocker
Used to Tx angina, hypertension & arrhythmias
72. Left Hemisphere
Answer: Dominant for language
73. Left-sided CVA
Answer: Could have some aphasia and would need speech therapy
Will also demonstrate hemiplegia of the right side
74. Right-sided Lesion (CVA)
Answer: Most likely to have impulsive like behaviors
75. Late signs of ICP
Answer: Alterations in VS (Including increased systolic pressure)
• Widening pulse pressures
• Bradycardia
76. Early signs of ICP
Answer: Lethargy
• Headache
• Neck pain
• Generalized muscle aches
77. Pediculosis Capitis
Answer: Head lice
Nits shed into the environment and are able to hatch up to 7-10 days
78. Scabies
Answer: Appear as grayish brown, threadlike burrows on the skin
79. Cocaine intoxication
Answer: Dilated pupils
80. EKG strip of hypokalemia
Answer: A prominent U wave
• Prolonged P-R interval
• ST segment is depressed
• T wave is flattened
81. EKG strip of hyperkalemia
Answer: Wide PQR
82. Hemianopsia
Answer: Blindness in one half of the field, a functional defect that can affect the right or left
side.
83. Hypothyrdoism expected lab results
Answer: Elevated TSH levels
Decreased T4, T3 & free thyroxine
84. Specific & Sensitive indicator for renal function
Answer: Creatnine
85. Emphysema expected findings
Answer: Dyspnea
• Tachycardia
• Barrel chested
• Clubbing of the fingers
• Shallow respirations
86. Rescue breathing
Answer: When someone is not breathing but has a pulse
Deliver a breath every 5 seconds for a adult
87. Addison's Disease Treatment:
Answer: High protein, high carb diet
• Weigh daily
• Injectable IV fast acting steroid may be ordered or indicated for a pt experiencing an
Addisonian crisis until the pt is no longer at risk for dehydration, hypotension and shock.
88. SSRIs
Answer: Citalopram (Celexa) an example of an SSRI
• Used to treat depression
• Can take 3-4 weeks before pt starts to experience signs of improvement and in some cases up to
8 weeks.
89. Agoraphobia
Answer: Fear of being in places in which help may not be available
90. Pernicious anemia
Answer: Caused by a lack of intrinsic factor, a substance needed to absorb Vit B12 from the GI
tract.
• Often has a red beefy looking tongue
• Vit B12 is needed for the formation of RBCs.
91. Iron deficiency Anemia
Answer: Is a condition in which RBCs contain decreased level of hemoglobin
92. Aplastic Anemia
Answer: Caused by a failure of the bone marrow to produce sufficient number of RBC's.
93. Hemolytic Anemia
Answer: Hemolytic anemia involves erythrocyte destruction and maybe medication induced or
caused by sickle cell disease, transfusion reaction or kidney disease.
Hematuria (blood in the urine) or hemoglobin present in the urine may indicate hemolytic
anemia
94. Diphenhydramine's such as Benadryl can also be given to treat what?
Answer: They also have an anticholinergic effect that can help control tremors in the early
stages of Parkinson's.
95. Agranulocytosis
Answer: Is a rare adverse reaction to Clozapine (Clozaril) in which WBC's drop causing pt to
become susceptible to acute infections.
96. Haloperidol (Haldol) can cause what?
Answer: This med can cause neuroleptic malignant syndrome which is a rare and potentially
fatal adverse effect that requires emergency medical intervention.
Other manifestations associated with NMS are sudden onset of rigidity, tremor, stupor,
incontinence, elevated serum enzymes, hyperkalemia, renal failure, elevated temp, BP & HR.
97. Haloperidol (Haldol) adverse effect?
Answer: Neuroleptic malignant syndrome
98. Clozapine (Clozaril) can cause?
Answer: Agranulocytosis
99. Utilitarianism
Answer: Refers to the actions that are right when they contribute to the greatest good.
100. Malpractice
Answer: Negligence
101. Assault
Answer: An intention tort
Example: Is a threat to touch a person without consent
102. Battery
Answer: An intentional tort
Example: Touching someone without consent
103. Isometrics
Answer: Is a form of exercise involving static (no movement) contractions of a muscle w/out
any movement of the joint. Isometrics may help to prevent muscle atrophy in pts who are on
complete bedrest.
Example: Instruct the pt to hold a muscle tight for approx. 5 seconds then relax
104. Clozapine can cause?
Answer: Agranulocytosis, therefore WBC count of expected gestation age
113. Pre-Eclampsia
Answer: Hyperactive deep-tendon reflexes
Hypertension
114. Methycenedioxymethamphetamine (MDMA)
Answer: Also referred to as Molly or Ecstasy
• Should expect diaphoresis
• Also might experience increased tactile sensitivity, lowered inhibition, chills, muscle cramping,
teeth clenching & mild hallucinations.
115. Mechanical restraints
Answer: Pt needs to be assessed q1530 minutes and document findings, check for a new
prescription q4h for clients >18 years, q2h for children 9-17 & q1h for children younger than 9
years.
116. Pulse paradoxus
Answer: A finding in which systolic BP is 10 mmHg or greater on expiration than inspiration. Pt
also may present with JVD, bradycardia & hypotension.
A symptom of cardiac tapenade
117. Estradiol
Answer: Estradiol is used to treat symptoms of menopause such as hot flashes, and vaginal
dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal
women, and replacement of estrogen in women with ovarian failure or other conditions that
cause a lack of natural estrogen in the body. Estradiol is sometimes used as part of cancer
treatment in women and men.
Adverse effect of a headache needs to be reported as medication can cause thromboembolism.
Monitor for swelling & tenderness of the calf, monitor for hypertension and report as well.
118. Hemolytic transfusion reaction
Answer: Back pain is an adverse reaction, hypotension, tachycardia
119. Hypokalemia
Answer: Muscle weakness
• Decreased in deep tendon reflexes
• Decrease in bowel sounds
A SIC WALT
120. Hypocalcemia
Answer: Would expect numbness and tingling of the extremities and around the mouth.
Need to watch for tetany
121. Tetany symptom is linked to what?
Answer: Hypocalcemia
122. Tetany
Answer: A condition marked by intermittent muscular spasms, caused by malfunction of the
parathyroid glands and a consequent deficiency of calcium
123. Stages of Kawasakis Disease
Answer: Acute
• Subacute
• Convalescent
124. Acute phase of Kawasakis
Answer: Beginning stage
• Starts with high fever uncontrolled by antipyretics
• Tachycardia
• Irritability
• Strawberry tongue
• Conjunctival redness
125. Sub-acute phase of Kawasakis
Answer: Pain in childs weight bearing joints
Peeling of soles of feet and hands
126. Post-op of Tonsillectomy
Answer: Should position pt so that the head is lower than the chest.
• Avoid having pt cough & clear throat, avoid using straw in the first 2448 hours.
• Administer analgesics q4hours for the first 24-48 hours.
• No red liquids (including red-popsicles)
• No diary products
127. Abruptio placentae
Answer: Persistent uterine contractions
• Painful
• Placenta separates from the uterus
• Bleeding inside the uterus
• Life-threatening to the fetus
128. Herbal supplement Saw Palmetto
Answer: This can result in a false low prostrate specific antigen level
129. Herbal supplement Valerian
Answer: Can lower BP
130. Ginsing
Answer: Used to stimulate mental activity and increase appetite
This can interact with caffeine and cause irritability
131. Flaxseed
Answer: This can be used for migraine prophylaxis can lead to GI symptoms such as bloating,
abd pain and flatulence
132. Rooting reflex
Answer: Stroke the infants check and the infant should turn to the side, stroked.
133. Lithium expected side/adverse effects (non-urgent)
Answer:
Headache
• Polyuria
• Hyperglycemia
134. Signs of lithium toxicity (Urgent)
Answer: Confusion
• Coarse hand tremors
• ECG change
• Sedation
135. Macular Degeneration
Answer: Decrease in central vision
136. Double vision
Answer: Can be a symptom of cataracts
137. Floating dark spots
Answer: Retinal detachment
138. Glaucoma
Answer: ICP
139. Misoprostol
Answer: This med reduces gastric acid secretions so that ulcers can heal.
• Pt's taking this should avoid taking magnesium containing antacids as this will increase the risk
of diarrhea.
• Misoprostol tends to cause diarrhea.
• This can induce uterine contractions, so women of childbearing age must r/o pregnancy.
140. Oxygen toxicity
Answer: Bradypnea
Crackels
141. Hypoxemia
Answer: Restless
Tachycardia
142. Want lots of Vit A
Answer: 1 medium raw carrot
143. Early Decels
Answer: Indicate progression of labor and are benign.
Nurses should continue to observe FHR.
144. Prolapsed Cord
Answer: Knee-chest position
145. Late Decels
Answer: Emergency cesarean
146. Deficient Fluid Volume (DFV)
Answer: Not enough volume
• Ortho hypotension
• Increased BUN
147. Fluid Volume Excess (FVE)
Answer: Too much volume
• SOB
• Blurred vision
148. PACE
Answer: program that provides adult daycare services along with in home assessments and
supportive services
149. Chlorpromazine
Answer: Schizophrenia medication
• One of the greatest risks for a pt taking this is neuroleptic syndrome. It is a potentially life
threatening adverse effect of this medication, which can show symptoms of a high fever,
dysrhymias, decreased LOC and labile BP.
• Headaches, constipation & vomiting are common side effects of this medication.
150. Hemoptysis
Answer: Coughing up blood
If the amount is greater than 275 mL/24 hours this indicates a risk for hemorrhage and needs to
be reported.
151. Sickle cell anemia
Answer: A common manifestation of a vaso-occlusion in a sickle cell crisis can be hematuria
(blood in the urine) resulting from ischemia of the kidneys
152. Autonomic dysreflexia
Answer: Potentially life threatening emergency
• Spinal cord injury @ T6 or higher
• Facial flushing, nasal congestion, severe headache
Example: Elevate head of bed to 90 degrees, loosen constrictive clothing, assess for bladder
distention and bowel impaction, administer antihypertensive meds (as this may cause stroke, MI,
seizures)
153. Obtaining temp or giving ear drops to a child
Answer: Up & back
154. Methadone can be taken while pregnant?
Answer: True, it can be taken for opioid withdrawl
155. Blood Transfusion
Answer: Normal Saline ONLY!
• Only collect one unit of blood @ a time.
• Want a 20 gauge needle or larger.
• Initiate blood transfusion 30 minutes or less after obtaining blood.
156. Warfarin
Answer: Daily blood draws are needed for the 1st 5 days of starting this medication.
• Pt should not take calcium supplements
• Do not take acetaminophen for headaches (increases risk for bleeding)
157. Permanent Trach Care Steps
Answer: 1st: Remove inner cannula
2nd: Remove soiled dressing
3rd: Clean stoma
4th: Change collar
158. Newborn Care
Answer: Pick dry newborn 1st unless suction mouth is there as AIRWAY is most important, then
dry!
159. Safety Teachings for parents
Answer: No more than 120 degrees for water heater
• Crib slates should be no more than 2.25 in apart
• Car seat should face the rear until 2 years of age
• Newborn car seat should be at 45 degree angle.
160. Myasthenia gravis care (with attention to improving nutrition)
Answer: Monitor weight each week
• Take your anticholinesterase medications 45-60 minutes before meals to prevent aspiration
• Cut food into small bites & eat slowly
• Choose snacks that are high in calorie
161. Acupressure band
Answer: These bands can be worn on the wrists and can help alleviate nausea and vomiting.
An alternative therapy option for pregnancy n/v.
162. Rheumatoid Arthritis (RA)
Answer: Want to balance exercise/activity and rest
Pain, stiffness and swelling are worse in the morning
163. BRAT diet
Answer: B = Bananas
R = Rice
A = Applesauce
T = Toast
This may be suggested if the child is having a hard time keeping things down from vomiting or
GI upset. This is high in carbs but has little nutritional value
164. Infectious Gastroenteritis (Diarrhea) rehydration
Answer: Should initiate oral rehydration therapy that should contain sodium, potassium,
chloride, citrate or bicarb and glucose.
165. With PTSD, type of alternative therapy
Answer: Guided imagery
166. Upper chest petechiae after a long bone fracture
Answer: Purple/red small dots that are caused by minor bleeding from capillary blood vessels.
This indicates that the pt is at great risk for a fat emboli a life-threatening complication of
fractures.
167. Diabetes Insipidus
Answer: A deficiency in antidiuretic hormone
Increase in urine output (polyuria)
168. If a pt has a hx of a stroke and we want to decrease risk of ICP while caring for them, what
are some interventions to reduce the risk?
Answer: Keep the bed no more than 25 degrees
Place pt in a quiet room
169. Fluoxetine
Answer: This can cause serotonin syndrome within 2-72 hours of starting treatment.
• Pt could experience tremors, agitation, confusion, anxiety and hallucinations and need to be
reported.
• Educate pt to monitor and report any black tarry stools.
• Weight gain is an adverse effect and can cause a rash.
170. Yellow tag
Answer: Major injury & should be given attention within 30 minutes to 2 hours.
171. Red tag
Answer: Life-threatening and requires immediate attention
172. Pressure ulcer stage 2
Answer: Partial thickness (some skin loss or blistering)
173. Pressure ulcer stage 3
Answer: Subcutaneous tissue visible
174. Pressure ulcer stage 4
Answer: Muscle damage, tendon exposure
175. Antisocial personality Disorder
Answer: Will show lack of remorse
176. Narcissistic personality disorder
Answer: Is more likely to show sensitivity to rejection
177. Bipolar
Answer: Mood swings
178. Borderline personality disorder
Answer: Self-mutilation behaviors
179. True Labor signs & symptoms
Answer: The cervix transitions to the anterior position
• Contractions increase with ambulation
• Contractions in true labor should be felt in the lower abdomen and back
• Cervix shortens and thins
180. Amitriptyline
Answer: Medication for tx of depression
• Pts should watch out for reactions like dry mouth & constipation
• Pts should avoid overheating because of the lack of an ability to sweat while taking this med.
• Should take at night before bedtime.
181. Ulcerative Colitis medications
Answer: Pts with this should take glucocorticoids such as prednisone to decrease the
inflammation
182. Caution with a pt that has an ileostomy
Answer: Should avoid taking enteric-coated medications
183. RACE acronym for fire
Answer: R = Retreat pts and self
A = Activate alarm
C = Contain fire (turn off O2, close doors & windows)
E = Extengish
184. Implementing an emergency preparedness plan, what do you need to do FIRST?
Answer: FIRST you want to notify the incident commander to initiate the command hierarchy
and maintain order
185. Thrombocytopenia
Answer: Decrease amt of platelets
186. Neutropenia
Answer: Decreased amount of WBC's ( <4000)
Initiate precaution for infection (wear masks when going in patients room, limit visitors, no
flowers & no fresh veggies or fruit)
187. Ice is contraindicated with what disease?
Answer: Type 1 DM
188. Signs of Stevens-Johnson Syndrome
Answer: A vesicular crusty rash
• This should be reported
• Sulfamethazazole can cause this as well as many others
189. Indomethacin
Answer: Is a nonsteroidal anti-inflammatory that reduces pain and inflammation
Adverse effects of this med: Dizziness, vertigo, muscle weakness, n/v, anorexia that leads to
weight loss
190. OTC decongestants
Answer: Can constrict blood vessels causing an increase in BP & HR, so want to caution anyone
that has hypertension or on cardiac meds
191. Clonidine may be prescribed for some experiencing?
Answer: Alcohol withdrawal, this will help diaphoresis
192. Chlordiazepoxide
Answer: This med is used to prevent delirium tremens for someone experiencing alcohol
withdrawal
193. Acetazolamide
Answer: This is a med used for open angle glaucoma
Adverse effect of this med is tingling of fingers and hyperglycemia
194. Donepezil
Answer: Used for Alzheimer's
• Side Effects: Dyspepsia, diarrhea, dizziness
• Adverse effect: Dyspnea (NEED TO REPORT TO PROVIDER)
195. Furosemide
Answer: Puts pt at risk for hypokalemia, dizziness (can cause drop in BP which leads to the
dizziness) & urinary frequency
196. Decreased LOC signs
Answer: Depressed deep tendon reflexes
• Decreased BP
• Lethargy
197. Methotrexate
Answer: This med is an immune suppressant and can cause bone marrow suppression. Should
advised pt about monitoring for fever or sore throat.
198. Tetracycline
Answer: Can cause GI upset, suggest to take with applesauce.
• Should advise pt to take med in the morning to prevent esophageal ulceration.
• Do not take with antacids, will alter absorption
199. Flumazenil
Answer: Used for Benzo reversal (antidote)
200. Albuterol
Answer: Used for acute asthma attacks
201. Long-term tx of asthma
Answer: Montelukast (Leukotine)
• Beclomethasone (corticoseteriod)
• Nedocromil (Mast-cell)
202. Phenytoin
Answer: Medication for seizures (anticonvulsant)
• Should not take with other calcium containing foods
• Commonly causes gingival hyperplasia
• Nystagmus us a serious reaction and should be reported
• Levels less than 10 mcg/mL are sub therapeutic and can result in seizure activity. Levels more
than 20 mcg/mL can produce toxic effects.
203. Enalapril
Answer: (ACE Inhibitor)
Should monitor for hyperkalemia (due to potassium retention by the kidneys)
204. Insulin glargine
Answer: This should NOT be mixed in a syringe with any other insulins
This med should be injected once a day and does not cause peaks, instead it maintains a steady
blood level for 24 hours, which reduces the risk of hypoglycemia
205. Salmeterol
Answer: Bronchodilator that is used to tx exercise induced bronchospasm, prevention of asthma
attacks, COPD and chronic bronchitis & emphysema
Helps improve breathing
206. Oxybutynin
Answer: Med is used for tx of urinary incontinence
Can expect these common side effects: Tachycardia, constipation, dry mouth, blurred vision,
photophobia
207. Common medication given for Graves Disease
Answer: Propylthiouracil
• This medication increases the ability to focus which is a symptom of graves disease (inability
to focus).
• An increase in ability to focus would indicate that this medication is working.
208. Propylthiouracil
Answer: This medication is used to tx of Graves Disease (hyperthyroidism), but should not be of
first choice with this disease. (In patients with Graves' disease with hyperthyroidism or toxic
multinodular goiter who are intolerant of methimazole and for whom surgery or radioactive
iodine therapy is not an appropriate treatment option)
• Should not be used if pt has liver failure, or pregnant
• Watch out for and report : Black tarry stools, chills, chest pain, fever, cough, sore throat or
SOB.
209. Medication used for Diabetes Insipidus
Answer: Vasopression
210. Rhogam is given when mom and baby are what?
Answer: Mom is negative and baby is positive
211. Medication to induce labor?
Answer: Oxytocin
Misoprostol suppositories
212. Used to stop labor
Answer: Tocolytic medication = Terbutaline
213. Med for osteoporosis
Answer: Alendondrate
214. Antiepileptic (seizure) medications
Answer: Phenobarbital
• Phenytoin
• Carbamazepine
• Valproic acid
• Iamotrigine
• Gabapentin
For status epilepticus (Diazepam, Lorazepam)
215. Rheumatoid arthritis meds
Answer: Prednisone (Glucocorticoid)
Adalimumab (DMARD)
216. Alzheimer meds
Answer: Memantine
Donazepril
217. Med to tx Mysathena gravis
Answer: Neostigmine (its a anticholinesterase)
218. Liver failure medication (to eliminate ammonia levels)
Answer: Lactulose (causes diarrhea)
219. Medication specifically for migraines
Answer: Sumatriptan
220. Antifungals
Answer: End in "zole"
Also nystatin (used for mouth)
221. Azithromycin
Answer: Antibiotic: Macrolide
No cross allergy with penicillins
222. Medication for UTI's that causes urine and contacts to turn orange?
Answer: Phenazopyridie
223. Medications prescribed for UTI's:
Answer: Sufamethoxazole-trimethoprim
• Ciprofloxacin
• Phenazopyridine
224. Medications to fight bone marrow suppression (typically due to cancer treatment)
Answer: Erthropoietin
Filgrastim
Growth factors
225. Atorvastatin
Answer: Watch for muscle pain (stop med & contact provider)
Watch liver enzymes
226. Digoxin
Answer: Cardiac glycoside
• Common side effect: Bradycardia
• Watch Potassium levels (if too low = toxicity)
• Check HR & hold if under 60 bpm
• Toxicity symptoms: Anorexia, N/V, blurred/yellow haze vision
• Normal Dig levels: 0.5-0.8
227. Digoxin Toxicity manifestations
Answer: Anorexia
• N/V
• Blurred vision
• Yellow haze
• Fatigue/weakness
• Normal Dig levels: 0.5-0.8
228. Reasons to hold BP meds
Answer: HR <60 bpm
Systolic BP <90
229. Ace Inhibitors
Answer: Watch for dry cough (discontinue and report)
• Hypotension
• Increased K+ levels (can cause hyperkalemia)
• Common meds: Captopril, Enalapril (Ends in "pril")
230. Beta- Blockers
Answer: End in "olol"
• Metoprolol, propranolol
• Watch for bradycardia & hypotension
• Metroprolol can decrease cardiac output and needs to be cautioned with CHF. No grapefruit.
• Propranolol can cause bronchoconstriction (so don't want to give to someone with asthmatics)
231. Oprelevekin
Answer: This med is used to tx adverse effect of chemo ( low platelet count)
This med is a thrombopoletic growth factor and therefore a platelet count within the expected
range would mean it is therapeutic
232. Carbamazepine
Answer: This medication can be used to treat bipolar as well as seizures
This med can affect oral contraceptives
233. Neostigmine
Answer: This medication is used to treat myasthenia gravis
An adverse effect of this med is nausea, bradycardia, and salvation at the mouth.
234. Valproic Acid
Answer: Valproic acid is used to treat various types of seizure disorders. It is also used to treat
manic episodes related to bipolar disorder (manic depression), and to prevent migraine
headaches.
This medication can cause liver failure so watch for jaundice
235. Side effects of inhaled corticosteroids
Answer: Dysphonia
Oral candidiasis
Pt will need spacer and need to rinse the mouth after inhalation, this will help reduce the risk
236. Verapamil
Answer: This is a calcium channel blocker used to decrease workload and lower BP. So
changing positions slowly will prevent orthostatic hypotension and dizziness.
• Should take with food
• Palpitations should be discussed with pcp but not stopped w/out addressing with doc first
237. Metronidazole
Answer: Metronidazole is used to treat bacterial infections of the vagina, stomach, skin, joints,
and respiratory tract. This medication will NOT treat a vaginal yeast infection.
• This should not be taken with alcohol
238. When a pt is taking epoetin alfa, what should you watch for?
Answer: Increase in BP (if the pt hematocrit levels rise too rapidly, hypertension and seizures
could result
239. Doxycycline
Answer: An antibiotic
This should NOT be given to someone who is pregnant, due to the adverse effects on developing
bones and teeth)
240. What is the greatest risk for someone receiving mannitol IV?
Answer: Developing HF, so the nurse should watch for peripheral edema and report any findings
of this STAT!
241. Adverse effects of glucocorticoids are?
Answer: Osteoporosis, which needs to be monitored regularly w/bone density scans
242. Sucralfate
Answer: It is a mucous protectant that forms a gellike substance coating the ulcer, creating a
barrier.
• It works mainly in the lining of the stomach by adhering to ulcer sites and protecting them from
acids, enzymes, and bile salts.
• Sucralfate is used to treat an active duodenal ulcer. Sucralfate can heal an active ulcer, but it
will not prevent future ulcers from occurring.
243. Fluoxetine
Answer: Is an SSRI and used to Tx depression
This medication suppresses platelet aggregation which increases risk for bleeding when used
with NSAIDs & anticoagulants. Want to advise pt to use Tylenol instead of ibuprofen for
headaches.
244. Ferrous sulfate
Answer: Iron
Want to take on an empty stomach
245. Metoclopramide
Answer: This is a medication given for nausea
It increases gastric motility and can cause sedation
246. Ergotamine
Answer: Medication that should be taken on onset of a migraine
It should be taken upon aura of headache and a max of 3 tablets should be taken in a 24 hour
period.
247. Allupurinol
Answer: Inhibits production of uric acid
• Used to treat gout and/or kidney stones of that nature
• Watch for kidney toxicity
• Contraindicated with Warfarin & oral hypoglycemic (increases effects of meds)
248. Aminoglycosides (Gentamycin and Tobramycin)
Answer: Want to watch for nephron & Otto toxicities
They also interfere with diuretics, skeletal muscle relaxants and anticoagulant meds.
249. Amoxicillin
Answer: Watch for renal insufficiency
Decreases contraceptives, warfarin
250. Better perfusion: EleVate
Answer: Veins
251. Better perfusion: DAngle
Answer: Anteries
252. Airborne Precaution
Answer: Think MTV
M = Measles
T = TB
V = Varicella-Chicken pox/herpes Zoster-Shingles
253. Droplet Precautions
Answer: Think SPIDERMAN
S = Sepsis, scarlet fever, streptococcal pharyngitis
P = Parvovirus B19, pneumonia, pertussis
I = Influenza
D = Diptheria
E = Epiglottitis
R = Rubella
M = Mumps, meningitis, mycoplasma or meningeal pneu.
AN = Adenovirus (private room, mask)
Droplet requires mask, gown, gloves, mask & goggles
254. Contact Precaution
Answer: Think MRS.WEE
M = Multidrug resistant organism
R = Respiratory infection
S = Skin infections
W = Wound infection
E = Enteric infection (C. diff)
E = Eye infection (conjunctivitis)
Gloves and gown
255. Air/Pulmonary Embolism
Answer: S/S: Chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending
doom, bloody sputum
Example: Heaprin, d-dimer lab, O2
256. Women in labor with un-reassuring FHR
Answer: This would include late decels, decreased variability, fetal bradycardia.
Turn pt on left side, give O2, stop Pitocin (if running) and increase fluids
257. Tube feedings with decreased LOC
Answer: Position pt on right side (this promotes emptying of the stomach) and head of bed
elevated (to prevent aspiration)
258. Myringotomy
Answer: Myringotomy is a surgical procedure in which a tiny incision is created in the eardrum
to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear.
Pt should be positioned on affected ear after surgery (this allows drainage of secretions)
259. After cataract surgery
Answer: Pt will sleep on UNAFFECTED side with a night shield for 1-4 weeks
260. Positioning of a pt after total hip replacement
Answer: Don't sleep on operated side
• Don't flex hip more than 45-60 degrees
• Don't elevate HOB more than 45 degrees
• Maintain hip abduction by separating thighs with pillows.
261. Prevention of dumping syndrome
Answer: Eat in reclining position
• Lie down after meals for 20-30 minutes
• Restrict fluids during meals
• Low carb and fiber diet
• Small frequent meals
262. With peritoneal dialysis outflow is inadequate
Answer: Turn pt from side to side BEFORE checking kinks in tubing (according to
Kaplan)
263. Before a liver biopsy it is important to check what lab?
Answer: Lab results for prothrombin time
264. Hypo-parathyroid
Answer: Think CATS
C = Convulsions
A = Arrhythmias
T = Tetany
S = Spasms, stridor
• Decreased calcium
• Want to have high Calcium, low phosphorus diet
265. Hyper-parathyroid
Answer: Fatigue
• Muscle weakness
• Renal calculi
• Back and joint pain
• High levels of calcium
• Want pt to have a diet high in phosphorus and low in Calcium
266. SIADH (Increased ADH)
Answer: Holding on to fluids and not releasing (little output)
• Change in LOC, decreased deep tendon reflexes, tachycardia, n/v/a, headache
• Administer Declomycin, diuretics
267. Hypermagnesmeia
Answer: Depresses the CNS
• Hypotension, facial flushing, muscle weakness, absent deep tendon reflexes, shallow
respirations
• Emergency
268. Neuroleptic malignant syndrome (NMS)
Answer: NMS is like S & M
• You get hot (hyperpyrexia)
• stiff (increased muscle tone)
• Sweaty (diaphoresis)
• BP, pulse and resp go up
• Start to drool
269. Rubella
Answer: Dangerous when you are pregnant
German measles (rubella) …. Never get pregnant with a German (rubella)
270. Tetralogy of fallot
Answer: Think of DROP
D = Defect, septal
R = Right ventricular hypertrophy
O = Overriding aorta
P = Pulmonary stenosis
271. Amphojel
Answer: Tx of GERD and kidney stones
Watch out for constipation
272. Vistaril
Answer: Tx of anxiety and also itching
Watch out for dry mouth, given preop commonly
273. PTU and Tapazole
Answer: Prevention of thyroid storm
274. Sinemet
Answer: Used for tx of parkinsons
• Sweat, saliva, urine may turn reddish brown occasionally
• Causes drowsiness
275. Artane
Answer: A med used for Prkinsons
Sedative effect
276. Cogentin
Answer: Tx of parkinsons and extrapyramidal effects of other drugs
277. Timolol (Timoptic)
Answer: Tx of glaucoma
278. Bactrim
Answer: Antibiotic
• Don't take if allergic to sulfas
• Diarrhea is a common side effect
• Drink plenty of fluids
279. Antidote for Tylenol
Answer: Mucomyst
280. Librium
Answer: Used for tx of alcohol w/d
Don't drink alcohol with this as very bad n/v can occur
281. Kwell
Answer: This is used for the tx of scabies and lice
• For scabies: apply lotion once and leave on for 8-12 hours
• For lice: Use the shampoo and leave on for 4 minutes with hair uncovered, then rinse with
warm water and comb with a fine tooth comb.
282. OB Patterns
Answer: Think VEAL CHOP
V = Variable decels; C = Cord Compression
E = Early decels;
A = Accels;
H = Head compression caused
O = Okay, not a problem
L = Late decels;
P = Placental insufficiency
283. For cord compression
Answer: Trendelenberg position (this removes pressure off the cord)
If the cord is prolapsed, knee to chest, cover it with sterile saline gauze to prevent drying of the
cord and to minimize infection.
284. To test lead poisoning in a child?
Answer: Around 12 months of age
285. High in potassium
Answer: Bananas
• Potatoes
• Citrus fruits
286. Aspirin can cause what in children?
Answer: Reye's Syndrome
287. Morphine is contraindicated in what?
Answer: Pancreatitis
It causes spasms of the sphincter of Oddi, therefore Demerol should be given
288. Hodgkin's disease
Answer: Cancer of the lymph and is very curable in early stages
289. Birth weight
Answer: Doubles by 6 months
Triples by 1 year
290. First sign of cystic fibrosis
Answer: May be meconium ileus at birth
Baby is inconsolable, do not eat, not passing meconium
291. Rheumatic fever
Answer: Can lead to cardiac valve lafunctions
292. Hemophilia
Answer: A blood disorder. Is x-linked. Mother passes disease onto son.
293. Eclampsia
Answer: Seizure
294. Fontanelle closure timeframe
Answer: Anterior (front) fontanelle closed by 18 months
Posterior (back) close within 6-8 weeks.
295. Caput succedaneum
Answer: Diffuse edema of the fetal scalp that crosses the suture lines. Swelling reabsorbs within
1-3 days
296. Bethamethasone (Celestone)
Answer: Surfactant. Med for lung expansion
297. Dystocia
Answer: Baby cannot make it down to canal
298. Magnesium sulfate
Answer: Used to halt preterm labor
• Is contraindicated if deep tendon reflexes are ineffective
• If the pt experiences a seizure during Mg admission, get the baby out STAT! It's an emergency!
299. Cranial Nerves
Answer: Oh, Oh, Oh, To, Touch, And, Feel, A,
Girls, Vagina, And, Hymen
Oh = Olfactory #1 (Smell)
Oh = Optic #2 (Vision)
Oh = Oculomotor #3 (Motor control of some eye muscles and eyelid)
To = Trochlear #4 (motor control of some eye muscles)
Touch = Trigeminal #5 (Chewing & facial sensation)
And = Abducens #6 (Motor control of some eye muscles)
Feel = Facial #7 ( Motor control of facial muscles, salivation, tastes and cutaneous sensations)
A = Auditory #8 (Hearing, equilibrium)
Girls = Glossopharyngeal #9 (Salivation, sensations of skin, taste) Vagina = Vagus #10 (Motor
control of the heart, sensation from the thorax)
And = Accessory #11 (Motor impulses to pharynx and shoulder) Hymen = Hypoglassal #12
(Motor control of the tongue, some skeletal muscles, some viscera, sensation from skin and
viscera)
300. Glasgow Scale
Answer: 15 max points
8 and below you are in a coma
301. When taking Dig and k-supplements avoid this?
Answer: Salt substitutes because many are potassium based
302. Addisons Disease
Answer: Think of ADD as needs to add hormones
303. Universal donor blood
Answer: Type O
304. Universal recipient
Answer: AB
305. Bronchodilator inhaler before glucocorticoid inhaler.
Answer: True, you want to open up the alveoli to maximize the medications.
306. Diaphragms must stay in place for how long after intercourse?
Answer: 6 hours
In addition these contraceptive devices are also fitted so must be refitted if you lose weight or
gain a significant amount of weight.
307. Murphys sign
Answer: Pain with palpation of gall bladder area. Seen with cholecystitis
308. Cullen's sign
Answer: Ecchymosis in umbilical area, seen with pancreatitis
309. Turner's sign
Answer: Flank grayish blue (turn around to see your flanks)
Indicates pancreatitis
310. Shillings Test
Answer: This is a test for pernicious anemia, to see how well one absorbs Vit B12
311. Guthrie Test
Answer: This tests for PKU. The baby should have eaten source of protein first
312. Diverticulitis
Answer: Pockets within the intestine. Low residue, no seeds, nuts or peas
313. Rhogam is given when?
Answer: Given at weeks, & 72 hours post-partum, IM.
Only needs to be given to Rh NEGATIVE mother
314. If someone has a latex allergy, you should also assess if the patient is allergic to what?
Answer: Bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes
and peaches
315. Tensilon
Answer: This is used in myasthenia gravis to confirm the diagnosis.
Myasthenia gravis is caused by a disorder in the transmission of impulses from nerve to muscle
cell
316. Transesophageal Fistula (TEF)
Answer: Esophagus doesn't fully develop and is a surgical emergency
The 3 C's of TEF in the newborn are: Choking, Coughing, Cyanosis
317. MMR vaccines is given
Answer: Sub cut
Also ask about anaphylactic reaction to eggs or neomycin before
MMR
318. Strabismus
Answer: Botox may be given for this.
Patch the GOOD eye so that the weaker eye can get stronger.
319. A 12 month old infant recently had a fever, runny nose, cough and white spots in the mouth
for 3 days. A rash developed that started on the face and spread to the whole body. What should
you suspect that the child has?
Answer: Rubeola (Measles)
320. Rubeola
Answer: Measles is a highly contagious infection caused by the measles virus. Initial signs and
symptoms typically include fever, often greater than 40 °C, cough, runny nose, and inflamed
eyes. Two or three days after the start of symptoms, small white spots may form inside the
mouth, known as Koplik's spots. A red, flat rash which usually starts on the face and then spreads
to the rest of the body typically begins three to five days after the start of symptoms. Symptoms
usually develop 10-12 days after exposure to an infected person and last 7-10 days.
321. Stranger anxiety
Answer: Is greatest in ages 7-9 months
322. Separation anxiety
Answer: Peaks in toddlerhood
323. Akathisia
Answer: Motor restlessness, person needs to keep going
• Tx with antiparkinsons meds
• Can be mistaken for agitation
324. Before a Pulmonary Function Test (PFT)
Answer: A pt's bronchodilator will be withheld
And not allowed to smoke 4 hours before the test
325. EEG test
Answer: This is to assess a pt for seizure activity
• Need to hold meds for 24-48 hours
• No caffine or cigarettes for 24 hrs prior.
• Pt is able to eat
• Pt must stay awake the night before the exam, pt may be asked to hyperventilate and watch a
bright flashing light.
• After EEG, assess pt for seizures, pt will be at increased risk
326. Rifampin
Answer: Is used to tx TB, dyes bodily fluids orange
327. INH
Answer: Is used to treat and prevent TB
328. Antipsychotics are incompatible with
Answer: Caffeine and apple juice
329. Extrapyramidal effects
Answer: Adverse effects of antipsychotic meds
• Dystonia
• Tarditive dyskinesia
• Tightening of the jaw
• Stiff neck
• Swollen tongue
• Later on swollen airway
330. Risperdal
Answer: Is an anti-psychotic med
• Doses over 6mg can cause tarditive dyskinesia
• This is the first line anti-psychotic for children
331. Hydroxyurea
Answer: This is used for sickle cell
Report GI symptoms immediately this could be a sign of toxicity
332. Zocor
Answer: Tx of hyperlipidemia
Should be taken on an empty stomach to enhance absorption, report any unexplained muscle
pain, especially fever
333. Decorticate
Answer: Is pointing toward the "cord"
334. Decerebrit
Answer: Hands are pointing out.
To "celebrate"
335. Hirschsprungs
Answer: Ribbon like stools
Enlarged colon
336. IM administration site for an infant-6 months
Answer: Vastus lateralis
337. IM administration site for a toddler above 18 months of age?
Answer: Ventrogluteal
338. IM site for children above 18 months
Answer: Deltoid and gluteus maximus are appropriate sites
339. Cane walking
Answer: Think COAL
C = Cane
O = Opposite
A = Affected
L = Leg
340. What is the max amount that can be taken out at one time with a thoracentesis?
Answer: 1000cc
341. Preparation for cardiac cath:
Answer: NPO 8-12 hours (incase surgery is needed)
• Empty bladder, pulses
• Tell pt that they may feel heart palpitations or desire to cough with dye injection.
342. Post cardiac cath:
Answer: Monitor vital signs, pulses distal to site
• Apply pressure to cath site for at least 15 minutes
• Keep leg straight, bedrest for 6-8 hrs.
343. Paracentesis
Answer: Semi fowlers or upright on edge of bed
• Empty bladder
• Post procedure: VS, report elevated temp, observe for signs of hypovolemia
344. Hemovac
Answer: Used after a mastectomy
• Empty when full or q8h, remove plug, empty contents, place on flat surface, cleanse opening
and plug with alcohol sponge.
• Compress evacuator completely to remove air, release plug, check system for operation.
345. Downs syndrome
Answer: Protruding tongue
346. SLE
Answer: Butterfly rash
347. Pyloric stenosis
Answer: Projectile vomiting
Olive like mass
348. Hepatic Encephalopathy
Answer: Flapping tremors of the hands
Caused by an increased amount of toxins in the blood stream (ammonia)
349. Lyme Disease
Answer: Bulls eye rash
350. Iron elixir
Answer: NEVER take with milk
Take with juice or water
351. Kawasakis Disease
Answer: Leads to cardiac problems
352. Lithium levels
Answer: 0.5-1.5
353. Nephrotic syndrome
Answer: Edema (begins in the face)
• Hypotension
• Fatigue/malaise
• Weight gain, edema in the face and limbs
• Foamy/frothy urine
• Protein in the urine
• Hyperlipidemia
354. Glomerulonephritis
Answer: R/t recent strep infection
• Headache
• Elevated BP
• Lethargic
• Preorbital edema
• Decreased GFR
• Protein & blood in urine (cola-colored urine)
• Painful (dysuria) & oliguria (little urine)
355. DPT/MMR/OPV
Answer: Vaccines needed for ages 4-5 years
356. Cystic Fibrosis
Answer: Is an inherited autosomal recessive trait that involves exocrine (non-hormonal) gland
dysfunction.
• Increased viscosity of secretions
• Increased electrolyte levels in sweat
• Lungs become filled with mucus that is thick like glue
• A sweat test is used to diagnose
It "gums up" the ducts: spleen, gall bladder and lungs
357. Treatment for Cystic Fibrosis
Answer: "CF cleanout" medications to clean ducts, suction them out.
• Helrom vest: Shakes them to knock secretions loose
• Enzymes, insulin if glucose is high, antibiotics (antibiotics may seem high, but this is typical
for a child with CF)
• CF pt's don't absorb nutrients well, so they will be given AQUADEX, fat soluble vitamins
A,D,E, & K.
• Diet consists of high fats, high calorie/low sugar diet
358. Common symptoms of a cystic fibrosis pt:
Answer: Large, bulky, frothy, foul-smelling stools
• Barrel chest
• Life expectancy is 30-40's
• Cough
• Respiratory distress
• Thick secretions
359. Zoloft (Sertraline)
Answer: SSRI
Side effects are agitation, sleep disturbances and dry mouth, constipation, ortho hypotension,
possible urinary retention, blurred vision
360. Clozapine (Clozaril)
Answer: Antipsychotic medication
• Want to watch for tachycardia and seizures
• May cause severe agranulocytosis (weekly blood draws)
361. Glucose Tolerance Test while pregnant
Answer: A result of 140 or higher needs further evaluation
362. When assessing extra ocular eye movement what cranial nerves are you assessing?
Answer: 3, 4 & 6
363. Tension pneumothorax
Answer: Trachea shifts to opposite side
364. With Lithium
Answer: Hydrate, drinking 2-3 L of water/day
• Maintain sodium intake of 2-3g/day
• Toxic level is 2-3 (n/v, diarrhea, tremors)
365. Burns:
Answer: 1st degree: Red and painful
2nd degree: Blisters
3rd degree: No pain because of blocked and burned nerves
366. After a shunt placement, what is the bed position?
Answer: Flat (so fluid doesn't reduce too rapidly)
If you see signs of increasing ICP, then raise the HOB to 15-30 degrees.
367. Bence Jones
Answer: Specific protein in the urine that confirms multiple myeloma
368. Anectine
Answer: Is used for short-term neuromuscular blocking agents for procedures like intubation
and ECT
369. Glucagon increases the effects of what?
Answer: Oral anticoagulants
370. Intussusception
Answer: Common in kids with CF
• Obstruction may cause fecal emesis
• Currant jelly-like stools (blood and mucus)
• A barium enema may be used to hydrostatically reduce the telescoping.
• Resolution is obvious with onset of bowel movements.
371. Positive for PKU
Answer: No phenylalanine (no meat, no diary, no aspartame)
372. Antacids should be given ?
Answer: When mechanically ventilated
With an NG tube if the pH of the aspirate is <5.0. Aspirate should be checked every 12 hrs.
373. Amniotic fluid is?
Answer: Alkaline, it will turn nitrazine paper blue. Urine and normal vaginal discharge are
acidic and turn it pink.
374. Nitrazine paper
Answer: Blue is positive for amniotic fluid
375. Using crutches while going up stairs
Answer: GCB (Good leg, crutches, Bad leg)
• Good leg goes up first
• Crutches next
• Bad leg
376. Using crutches going down stairs
Answer: CGB (Crutches, Good leg, bad leg)
• Crutches
• Good leg
• Bad leg
377. Steroids such as Prednisone can increase what?
Answer: Increase glucose, so monitor blood sugar levels
378. A big cue with lithium toxicity is what?
Answer: If a pt complains of metallic taste in mouth.
379. Croup
Answer: Barking cough
• Difficulty breathing, fast breathing, noisy breathing, SOB or wheezing
• Fatigue or fever
• Hoarseness or impaired voice
380. Antidote for Magnesium Toxicity
Answer: Calcium Gluconate
381. Magnesium Sulfate Toxicity S/S:
Answer: Hyporefexia (absence of deep tendon reflexes)
• Respiratory depression
• Decrease in LOC
• Hypotension
• Urine output is decreased
382. Compensation : Defense Mechanism
Answer: Covering up a real or perceived weakness by emphasizing a trait one considers more
desirable.
Example: A handicapped boy is unable to participate in football, so he compensates by
becoming a great scholar.
383. Denial: Defense Mechanism
Answer: Refusing to acknowledge the existence of a real situation or the feelings associated
with it.
Example: A women drinks alcohol every day and cannot stop, failing to acknowledge that she
has a problem.
384. Displacement: Defense Mechanism
Answer: The transfer of feelings from one target to another that is considered less threatening or
that is neutral.
Example: A client is angry at his doctor, does not express it, but becomes verbally abusive with
the nurse.
385. Rationalization: Defense Mechanism
Answer: Attempting to make excuses or formulate logical reasons to justifying unacceptable
feelings or behaviors.
Example: John tells the rehab nurse, "I drink because its the only way I can deal with my bad
marriage and awful job."
386. Reaction Formation: Defense Mechanism
Answer: Preventing unacceptable thoughts or behaviors from being expressed by exaggerating
opposite thoughts or types of behaviors.
Example: Jane hates nursing. She attended nursing school to please her parents. During career
day, she speaks to prospective students about the excellence of nursing as a career.
387. Regression: Defense Mechanism
Answer: Responding to stress by retreating to an earlier level of development and the comfort
measures associated with that level of functioning.
Example: When 2 year old Jay is hospitalized for tonsillitis he will drink only from a bottle,
although his mother states he has been drinking from a cup for over 6 months.
388. Identification: Defense Mechanism
Answer: An attempt to increase self-worth by acquiring certain attributes and characteristics of
an individual one admires.
389. Repression: Defense Mechanism
Answer: Involuntary blocking of unpleasant feelings and experiences from ones awareness.
Example: An accident victim can remember nothing about the accident
390. Intellectualization Defense Mechanism
Answer: An attempt to avoid expressing actual emotions associated with a stressful situation by
using the intellectual process of logic, reasoning and analysis.
391. Sublimation: Defense Mechanism
Answer: Rechanneling of drives or impulses that are personally or socially unacceptable into
activities that are constructive.
Example: Mom of son killed by drunk driver, president of MADD.
392. Introjection: Defense Mechanism
Answer: Integrating the beliefs and values of another individual into one’s own ego structure.
Example: Children integrate their parents value system into the process of conscience formation.
393. Suppression: Defense Mechanism
Answer: The voluntary blocking of unpleasant feelings and experiences from ones awareness.
Example: "I don't want to think about that now. I'll think about that tomorrow."
394. Isolation: Defense Mechanism
Answer: Separate a thought or memory from the feeling tone or emotion associated with it.
Example: Without showing any emotion, a young women describes being attacked and raped.
395. Undoing: Defense Mechanism
Answer: Symbolically negating or canceling out an experience that one finds intolerable.
Example: Joe is nervous about his new job and yells at his wife. On his way home he stops and
buys her flowers.
396. Projection: Defense Mechanism
Answer: Attributing feelings or impulses unacceptable to one’s self to another person.
Example: Sue feels a strong sexual attraction to her track coach and tells her friend, "Hes
coming on to me!"
