2023 NCLEX Uworld Pharmacology Real Exam Part 2 With Answers-864 Solved Questions

NCLEX UWorld 2023 Real Exam Questions (1,819 Terms) All Correctly
Answered, A+ Score Solution
Part 2
Nursing care for NG tube feeding
Answer: • elevate HOB during and after
• check gastric residual every 4 hours with continuous feeding or before each intermittent
feeding/medication giving -flush tube before and after bolus feedings
• aspirate but return contents to stomach
• check for excessive residual volume
• start feeding after getting residual volume 15-20 ml in the pleural space between parietal and
visceral preventing the lung from expanding fully

results in: dec lung volume, atelectasis, and ineffective gas exchange
Wheezing indicates what in a respiratory issue?
Answer: an obstructive process like asthma, COPD
When is hyperresonance percussed?
Answer: over hyperinflated lung (eg asthma, emphysema) or in air in pleural space (eg
pneumothorax)
What is fremitus?
Answer: palpable vibration on the chest wall when talking
What is Midazolam (Versed)?
Answer: a benzo used for conscious sedation. commonly given with an opioid
What is the antidote used for benzodiazepines?
Answer: Flumazenil (Romazicon).
Fundal height- just need to memorize this
Answer: • 12 weeks:
• just above pubic symphysis
• 16 weeks: halfway between public symbiosis and umbilicus
• 20-22 weeks: reaches umbilicus
• 36 weeks: xiphoid process
Which heart meds cannot be given during pregnancy?
Answer: ARBs and ACE inhibitors
Positive orthostatic vital signs are present when
Answer: systolic BP drops by at least 20 OR diastolic dops by at least 10 pulses usually rises
about 20
If you are having a patient do orthostatic vitals and they become symptomatic like dizzy, stop
the measurement and have them lie in bed

Answer: If a patient becomes symptomatic, such as feeling dizzy or lightheaded during
orthostatic vital sign measurements, you should stop the procedure immediately. Have the
patient lie down to prevent falls and ensure their safety. It's important to monitor their vital
signs and symptoms closely and provide any necessary interventions. If symptoms persist,
further evaluation may be required.
If a patient does have orthostatic hypotension and vitals are changing when sitting and
standing, then they could be dehydrated. give fluids
Answer: Yes, that's a good approach. If a patient shows signs of orthostatic hypotension—
such as a significant drop in blood pressure or symptoms like dizziness when moving from
sitting to standing—they may indeed be dehydrated or have inadequate blood volume. In
such cases, administering fluids can help stabilize their blood pressure and alleviate
symptoms. It's important to monitor their response to the fluids and reassess their vital signs
regularly. If dehydration is suspected, ensuring adequate hydration is key to their recovery.
Ovarian cancer symptoms:
Answer: Subtle abdominal pain, pelvic pain or pressure, abdominal bloating, urinary
urgency/frequency, and gastrointestinal disturbances.
Expect heavy bleeding with IUD
Answer: Heavy bleeding can be expected with some IUDs, especially initially, but
significant concerns should prompt evaluation.
RN can still delegate a task that is less than an LPN's scope, for example, checking a pulse
oximeter
Answer: Yes, an RN can delegate tasks that are within the scope of practice of other team
members, including tasks that are typically less complex than those performed by an LPN,
such as checking a pulse oximeter. However, the RN remains responsible for the overall
patient care and must ensure that the person to whom they delegate is competent to perform
the task.
LPNs can measure peak expiratory flow
Answer: Yes, LPNs (Licensed Practical Nurses) can measure peak expiratory flow as part of
their scope of practice, as long as they have received the appropriate training and are working

under the supervision of an RN or physician. This measurement can help assess a patient's
lung function, particularly in conditions like asthma.
Black stools (melena) indicate what?
Answer: upper GI bleeding
Avoid what after open radical prostatectomy
Answer: anything that could cause strain on the rectal area
Location of the phlebostatic axis (for measuring continuous arterial bp readings)
Answer: level of atria at 4th ICS, 1/2 anterior/posterior diameter
If a child has an asthma exacerbation and there is no wheezing/breath sounds heard, this is an
emergency priority because it could indicate what?
Answer: lack of airflow so airway obstruction. this is called "silent chest"
Acute asthma exacerbation
Answer: rapid labored respirations using accessory muscles
Croup
Answer: • Viral inflammation and edema of the epiglottis and larynx
• Symptoms: runny nose, tachypnoea, inspiratory stridor, and a seal-like barking cough.
Bronchiolitis is associated with RSV
Answer: isolation low grade fever, tachypnoea, wheezing, poor feeding
Gallstone surgery- may have referred pain
Answer: Yes, after gallbladder surgery (cholecystectomy), patients may experience referred
pain, commonly in the right shoulder or between the shoulder blades. This is often due to
irritation of the phrenic nerve or diaphragmatic irritation from the surgical procedure. It's
important to monitor pain levels and educate patients about this potential side effect.
Placenta previa is when placenta is at bottom touching the cervix

Answer: Yes, that's correct! Placenta previa occurs when the placenta is positioned low in the
uterus, partially or completely covering the cervix. This condition can lead to complications
during pregnancy and delivery, including bleeding. It often requires careful monitoring and
management to ensure the safety of both the mother and the baby.
Ultra sound done around 36 weeks to see location of placenta
Answer: Yes, an ultrasound is typically performed around 36 weeks of pregnancy to assess
the location of the placenta, especially if there are concerns about placenta previa or if it was
noted in earlier ultrasounds. This helps determine if the placenta has moved away from the
cervix, allowing for a safer delivery plan.
Don’t stick anything into vagina with suspected placenta previa
Answer: With suspected placenta previa, it's crucial to avoid inserting anything into the
vagina, including during examinations or intercourse, to prevent bleeding and complications.
Careful monitoring and follow-up with healthcare providers are essential in these cases.
Nursing interventions for a child with ADHD in hospital
Answer: calm, structured, organized, consistent environment written chart or list of daily
activities
If a child is suddenly in distress and can’t speak what should you suspect
Answer: foreign body aspiration
If schizophrenia is hearing voices, always asses what they are saying
Answer: When a patient with schizophrenia reports hearing voices, it's important to assess
the content of those voices. Understanding what the voices are saying can provide insight into
the patient's mental state, help identify any potential risks, and guide treatment planning.
Always approach the assessment with empathy and non-judgment.
Schizophrenia: Assessment
Answer: • delusions
• tangentiality (deviating from original topic of conversation)
• waxy flexibility (tendency to remain in immobile posture)

Necrotizing enterocolitis
Answer: mostly preterm infants from underdeveloped interesting/gut immunity so bacteria is
introduced into bowel and get worse fast because compromised immunity inflammation and
ischemic necrosis of the intestine progression causes bowel congestion and gangrenous with
gas forming inside bowel wall
Nursing interventions for necrotizing enterocolitis
Answer: • measure abdominal girth daily
• NPO
• NG suction to decompress stomach/intestines
• parenteral hydration
• IV antibiotics
• place supine to avoid pressure on the abdomen
• avoid rectal temps in case perforation
Marfan syndrome need to avoid what
Answer: contact sports
Why?
Answer: heart problems
Raising the HOB causes BP to do what?
Answer: decrease
Hypovolemic shock patient should never be places in high fowlers
Answer: A patient in hypovolemic shock should never be placed in high Fowler's position
Norepinephrine (Levophed)
Answer: A vasopressor used to increase stroke volume, cardiac output (CO), and mean
arterial pressure (MAP).
What is normal MAP
Answer: 60 or more

Different stages/phases of kidney disease
Answer: Kidney disease has five stages based on GFR: Stage 1 (≥90 mL/min, normal), Stage
2 (60-89 mL/min, mild decrease), Stage 3 (30-59 mL/min, moderate decrease), Stage 4 (1529 mL/min, severe decrease), and Stage 5 (15 mm is
generally used for healthy individuals without risk factors.
After found positive, more tests are needed to see if its latent TB where its noncontagious, or
active TB where its contagious thru the air
Answer: After a positive TB test, further evaluations, such as a chest X-ray and sputum tests,
are needed to determine if it's latent TB (non-contagious) or active TB (contagious).
Latent vs active TB
Answer: asymptomatic/can’t spread vs symptomatic and can spread
A positive reaction to a TST indicated infection only. further testing is needed to see if its
active therefore contagious
Answer: A positive reaction to a tuberculin skin test (TST) indicates infection, but further
testing is required to determine if it is active TB, which is contagious.
Dopamine

Answer: increases heart rate and increases blood pressure
The lower the IV catheter gauge number, the larger the bore
Answer: Yes, the lower the IV catheter gauge number, the larger the bore of the catheter.
14 guage (large bore)
Answer: for giving fluids/drugs in prehospital emergency setting or for hypovolemic shock
18 guage
Answer: some what stable adults needing large amounts of fluid or blood
20-22 guage
Answer: sufficient for giving general IV fluids an meds to adults
24 guage
Answer: children and elderly with frail veins
Sepsis should be treated immediately by getting blood cultures then antibiotic because it lead
to septic shock then multi organ dysfunction
Answer: Sepsis should be treated immediately by obtaining blood cultures followed by the
administration of antibiotics, as prompt intervention is crucial to prevent septic shock and
multi-organ dysfunction.
Expected side effects of lithium
Answer: drowsiness, weight gain, dry mouth, GI upset
Lithium and sodium are closely related in the body so keep their levels normal
Answer: Lithium and sodium are closely related in the body, so maintaining normal sodium
levels is crucial to avoid lithium toxicity and ensure effective treatment.
Lithium toxicity occurs with dehydration and hyponatremia so why should you do if taking?
Answer: drink lots of fluid (2 L?) per day and get adequate salt. and don’t take NSAIDS or
thiazide

When prioritizing care, especially in a disaster, remember life over limb.
Answer: In prioritizing care during a disaster, remember the principle of “life over limb,”
focusing on saving lives first before addressing less critical injuries.
Cheyne-Stokes breathing:
Answer: Not a good sign and concerning in a traumatic brain injury (TBI). It consists of
tachypnea followed by a gradual decrease in breathing that eventually results in apnea. This
breathing cycle repeats and is often seen in patients who are dying.
Classic presentation of a fractured hip
Answer: shortened, abducted externally rotated leg
Disaster triage
Answer: greatest good for the greatest number ppl with alterations in airway breathing and
circulation who are likely to survive with timely interventions are given first priority
Left-to-Right congenital heart defects
Answer: Acyanotic defects
1. Patent ductus arteriosus (PDA)
2. Atrial septal defect (ASD)
3. Ventricular septal defect (VSD)
Left-to-right cardiac shunts results
Answer: pulmonary congestion (increased pulmonary blood flow
Compensatory mechanisms (eg tachycardia, diaphoresis) result from sympathetic stimulation
Clinical Manifestations of left-to-right cardiac shunts
Answer: 1. Tachypnea
2. Tachycardia, even at rest
3. Diaphoresis during feeding or exertion
4. Heart murmur or extra heart sounds
5. Signs of congestive heart failure
6. Increased metabolic rate with poor weight gain

Atrial septal defect (ASD):
Answer: An abnormal opening between the left and right atria that causes a murmur from
blood flowing between them.
Right-to-Left congenital heart defects
Answer: Cyanotic defects - decreased pulmonary circulation
1. Tetralogy of Fallot
2. Transposition of the Great Vessels
Clinical Manifestations of Right-to-Left congenital heart defects
Answer: 1. Clubbing of fingertips - associated with chronic hypoxia
2. Cyanosis - evident shortly after birth and during periods of physical exertion
Muffled heart tones are heard in?
Answer: cardiac tamponade
Coarctation of the aorta
Answer: strong upper pulses and weak lower pulses
Some children may be in pain but is not showing it when playing
Answer: Some children may experience pain but may not show it while playing, as they
might be distracted or not express their discomfort openly.
Tetralogy of Fallot is the one with the 4 issues, its cyanotic. “tet spell” where kids will squat
down to breathe better. clubbing of fingers and irritability expected.
Answer: Tetralogy of Fallot is a cyanotic congenital heart defect characterized by four issues,
including "tet spells" where children may squat to relieve breathing difficulties; clubbing of
fingers and irritability are also common symptoms.
Ventricular septal defect is the same as atrial septal defect, but the hole is between the
ventricles instead and can lead to congestive heart failure (CHF); so watch for signs of CHF
like dyspnea and tachypnea.

Answer: Ventricular septal defect (VSD) involves a hole between the ventricles, unlike atrial
septal defect (ASD), and can lead to congestive heart failure (CHF). Therefore, it's important
to monitor for signs of CHF, such as dyspnea and tachypnea.
Patent ductus arteriosus
Answer: Patent ductus arteriosus (PDA) is a condition where the ductus arteriosus fails to
close after birth, leading to abnormal blood flow between the aorta and pulmonary artery. It
can result in increased workload on the heart and may cause symptoms like respiratory
distress and poor weight gain. Treatment options include medication, such as indomethacin,
or surgical intervention if necessary.
If a sickle cell patient is has an enlarged spleen this is an emergency. splenomegaly that can
lead to hypovolemic shock
Answer: In sickle cell patients, splenomegaly is a medical emergency as it can lead to splenic
sequestration crisis, resulting in hypovolemic shock.
Hypo magnesia causes a prolonged QT interval which leads to torsade’s de pointes
Answer: Hypomagnesemia can cause a prolonged QT interval, increasing the risk of
torsade’s de pointes, a potentially life-threatening arrhythmia.
What does atrial flutter look like
Answer: saw tooth
What is trismus
Answer: lockjaw
Normal vancomycin level
Answer: 10-20
Vancomycin can cause nephrotoxicity. check vancomycin trough levels, bun, and creatinine
Answer: Vancomycin can cause nephrotoxicity, so check trough levels, BUN, and creatinine.
Radon can cause lung cancer
Answer: Radon exposure is a known risk factor for lung cancer.

What 2 races have a high incidence of getting a cough from ace inhibitors?
Answer: blacks and Asians
Children should not take aspirin as it can cause Reye syndrome especially in children with a
recent viral illness. it causes acute encephalopathy and hepatic dysfunction. children can
instead take acetaminophen and ibuprofen
Answer: Children should not take aspirin due to the risk of Reye syndrome, particularly
following a recent viral illness, which can lead to acute encephalopathy and hepatic
dysfunction; instead, acetaminophen and ibuprofen are safer alternatives for pain and fever
relief.
Rationalization
Answer: I do poorly on the test because the questions were hard
Projection
Answer: placing one own thoughts, feelings, or impulses onto someone else
Displacement
Answer: transferring thought feelings toward one person to another- person mad at boss
comes home and yells at wife
Regression
Answer: returning to a previous level of development
Reaction formation
Answer: behaving in a manner or expressing a feeling opposite of one true feelings
If patient and in are 2 times the control value then this is the therapeutic effect
Answer: If both patient and control values are doubled, this indicates a therapeutic effect.
What does coffee ground emesis indicate?
Answer: upper GI bleed

Rotate staff members with bpd patient
Answer: Rotate staff members assigned to patients with borderline personality disorder
(BPD) to prevent staff burnout and manage dynamics effectively.
When a patient is on methylphenidate, what do you measure
Answer: blood pressure and weight/height cut can cause lack of appetite leading to weight
loss and can also cause hypertension an tachycardia
Steps for putting in an NG tube
Answer: • measure, mark, and lube
• tell client to extend neck back
• insert tube just passed nasopharynx
• tell client to flex neck forward and swallow
• advance tube to the marked point
• verify placement of tube and anchor to nose
Measure NG tube
Answer: nose tip, to earlobe, down to the xiphoid process
What should pH be when you aspirate for ng tube?
Answer: 5.5 or below
Warfarin should not be given in pregnancy cut it crosses the placenta and can cause fetal
bleed
Answer: Warfarin should not be given during pregnancy because it crosses the placenta and
can cause fetal bleeding and other complications.
Vastus lateralis for children less than 7 month immunizations
Answer: The vastus lateralis muscle is the preferred site for immunizations in children less
than 7 months old due to its adequate muscle mass and accessibility.
Nausea and pruritic are common effects of opioids
Answer: Yes, nausea and pruritus are common side effects of opioids.

Penicillin’s and cephalosporins can have a cross sensitivity response
Answer: Yes, penicillin’s and cephalosporins can have cross-sensitivity, meaning that
individuals allergic to penicillin’s may also react to cephalosporins.
Codeine used for acute pain or as a cough suppressant. don’t give to a COPD patient because
it causes accumulation of secretions. in general, sedatives like narcotics and benzos shouldn’t
be given to COPD because they can depress the respiratory center in someone with already
respiratory problems
Answer: Codeine is used for acute pain and as a cough suppressant, but it should be avoided
in COPD patients due to the risk of secretions accumulation. Generally, sedatives like
narcotics and benzodiazepines should be used cautiously in COPD patients, as they can
depress the respiratory center and exacerbate respiratory problems.
Amlodipine, nifedipine
Answer: calcium chennai blockers
Ipratropium
Answer: short acting inhaled anticholinergic to promote bronchodilation
Clear and simple sentences when speaking with an Alzheimer’s patient
Answer: Use clear and simple sentences when speaking with an Alzheimer's patient to
enhance understanding and reduce confusion.
Lumbar puncture purpose is to get a sample of CSF like for meningitis. need informed
consent. always remember to have the patient empty the bladder
Answer: The purpose of a lumbar puncture is to obtain a sample of cerebrospinal fluid
(CSF), often to test for meningitis; informed consent is required, and patients should always
be encouraged to empty their bladder beforehand.
How to administer oral liquid med to a child?
Answer: give small amounts into the back of the cheek

Isotonic solutions (0.9 NaCl and LR) are given to expand intravascular fluid volume and have
the same osmolality as plasma. these solutions relace fluid volume association with vomiting
and diarrhoea, Hurns, and traumatic injury
Answer: Isotonic solutions, such as 0.9% NaCl and lactated Ringer's, are given to expand
intravascular fluid volume and have the same osmolality as plasma, making them suitable for
replacing fluid lost due to vomiting, diarrhoea, burns, and traumatic injuries.
Early indicator of hypocalcaemia is numbness and tingling of the lips
Answer: An early indicator of hypocalcaemia is numbness and tingling around the lips and
fingertips.
Acute pancreatitis stool
Answer: fatty and foul smelling
2 major clinical features of major depressive disorder
Answer: 1. depressed mood
2. loss of interest or pleasure.
3. one of these two symptoms must be resent daily for 2 weeks for the diagnosis to be made
How much weight you should gain during pregnancy is determined by pregnancy BMI. if
you are obese, you should gain less weight during pregnancy and etc
Answer: Weight gain during pregnancy is determined by pre-pregnancy BMI; for example,
obese individuals should aim to gain less weight, while those with a lower BMI may be
advised to gain more.
For all pregnant clients, weight gain in the first trimester should be what?
Answer: about 1.1-4 lbs
BMI pregnant client should gain how much per week in the 2nd and 3rd trimesters
Answer: 1 lb per week
A client with a normal pre-pregnancy weight should gain a total of about 25-35 during the
whole pregnancy

Answer: A client with a normal pre-pregnancy weight should gain a total of about 25-35
pounds throughout the entire pregnancy.
Radiation and chemo affect what type of cells first?
Answer: rapidly dividing cells like oral mucosa, GI, and bone marrow causing oral
ulcerations, nausea and vomiting, and low blood counts of RBC, WBC, etc
Fever and raised pustules = smallpox
Answer: Fever and raised pustules are characteristic symptoms of smallpox.
Diverticular disease → diverticulitis
Answer: • sac like protrusions off the large intestine. asymptomatic usually and patient not
aware until they become infected or inflamed called diverticulitis.
• what patient can do? prevent constipation which may cause diverticula to become inflamed
• high fiber diet, daily intake 8 glasses water, and exercise
• decrease red meats and high foods
Low residue diet may be used for acute diverticulitis but high fiber for future episodes
Answer: A low-residue diet may be used for acute diverticulitis, while a high-fiber diet is
recommended for preventing future episodes.
Peritoneal dialysis
Answer: • for someone with insufficient renal function
• a catheter goes into peritoneal cavity and dialysate is infused
• then clamped off for 30 mins.
• then its unclamped for the dialysate to drain via gravity
Bladder scanner residual urine volume to report
Answer: Amounts >100 mL - may have urinary retention
Cystoscope
Answer: inserted through urethra to directly visualize bladder wall and urethra. May cause
slight burning sensation with voiding for a day or two

Renal arteriogram
Answer: Radiologic test performed to visualize renal blood vessels to detect abnormalities
(renal artery stenosis or aneurysm). Contrast medium is injected into femoral artery; client
should increase fluid intake after procedure to flush dye; increased output is expected finding
What could be causing insufficient outflow in PD and what to do?
Answer: constipation. assess bowel pattern and give stool softener, assess for abdominal
distention and constipation, check tubing for kinks, reposition client to side lying or walk
with them keep drainage bag below abdomen
Patient with chronic venous insufficiency should not clip their own toenails
Answer: Patients with chronic venous insufficiency should avoid clipping their own toenails
to prevent injury and complications, such as infections or ulcers.
As far as ostomies, any Gray or paleness to the area of the stoma is usually priority because
this means lack of blood flow
Answer: In the case of ostomies, any Gray or pale appearance of the stoma is a priority
concern, as it indicates a lack of blood flow and may require immediate medical attention.
Clozapine
Answer: • treatment of schizophrenia
• Agranulocytosis
• Must Check CBC And ANC
Rule of nines
Answer: • 9 per arm
• 18 per leg
• 36 for torso
• 1 perineum
• 9 for head and neck
Parkland formula
Answer: • once TBSA is calculated so you have say 46%

• 4mL/kg of body weight × TBSA
What is exophthalmos?
Answer: complication of hyperthyroidism from graves’ disease. keep eyes moist and
protected
Protective factors for SIDS
Answer: • sleep supine
• breastfeeding
• pacifier during sleep
• up to date vaccines
• appropriate clothing like sleep sack
• firm sleep surface
• remove loose items from bed like pillows toys blankets
• don’t let them sleep in parent room
At what age can infants roll
Answer: Begin at 4-5 months.
Patients with a fib are usually given a anticoagulant due to increased risk for blood clots
Answer: Patients with atrial fibrillation are usually given anticoagulants due to an increased
risk of blood clots.
What is Sjogren's syndrome?
Answer: chronic autoimmune disorder that damages moisture-producing glands dry eyes,
mouth, skin, and vagina
Sjogren's Syndrome symptoms
Answer: • dry eyes (xerophthalmia)
• can lead to corneal ulcerations
• dry mouth (xerostomia)
• can lead to dental caries, oral thrush
• dry skin & rashes
• chronic dry cough

• vaginal dryness & painful intercourse
Sjogren's syndrome Treatment & Patient Education
Answer: • eye drops
• wearing goggles
• sugar free gum and/or artificial saliva
• regular dental appointments for dental caries
• lubricants (eg KY Jelly)
• sip water frequently
• use lukewarm water and mild soap when showering
• humidifiers to maintain adequate humidity (mainly at night)
What to avoid with Sjogren's syndrome
Answer: Avoid
• decongestants can cause further dryness
• oral irritants (eg coffee, alcohol, nicotine)
• acidic drinks
• low-humidity environments (eg centrally heated houses, airplanes)
All chest pain is considered cardiac until proven otherwise. Patients need to go to the ER
right away for chest pain to get an ECG
Answer: All chest pain is considered cardiac until proven otherwise, so patients should go to
the ER immediately for an ECG.
In priority questions, chest pain is priority regardless of age
Answer: In priority questions, chest pain is always a priority, regardless of age.
Delerium in older adults
Answer: behaviour changes and confusion that require assessment by the nurse. they have
acute onset and are usually reversible often caused by meds, infection, and hypoxia
If an older client is experiencing acute delirium, the priority nursing action is to assess what
is causing it and then to intervene

Answer: The priority nursing action for a client with acute delirium is to assess the
underlying cause through history, physical exam, and lab tests. Once identified, appropriate
interventions can be implemented to address the cause.
Rheumatoid arthritis
Answer: • systemic inflammation of the synovial joints
• swollen and painful joints
• usually starts in smaller joints and affects clients ability to button
• clothing and etc making adults hard
• what to do?
• moist heat for stiffness
• rom exercises
• ice on painful joints as needed
• allow from periods of rest in the afternoon
Stridor is not good at all as it indicated potential airway obstruction
Answer: Stridor is concerning as it indicates potential airway obstruction and requires
immediate medical attention.
Autistic kids
Answer: minimal stimulation and calming environment
Statin drugs = report muscle aches
Answer: Patients taking statins should report any muscle aches, as this can indicate a risk of
serious side effects.
Always suction pharynx first in a newborn
Answer: Always suction the pharynx first in a newborn to clear secretions and prevent
aspiration.
Caput succedaneum
Answer: • Expected finding; remember 'C' and 'S' for 'crosses suture.'
• Edema/hematoma above the periosteum that crosses suture lines.
• Resolves within the first week of life.

Cephalohematoma
Answer: bleed that does NOT cross suture lines
What is spina bifida
Answer: spinal cord contents protrude through vertebrae an there is a tuft of hair
When calculating GTPAL, twins count as 1 in the preterm and term categories
Answer: When calculating GTPAL, twins count as one in both the preterm and term
categories.
Addisons disease-wat is it?
Answer: adrenal glands not producing enough steroids
Symptoms of Addison’s disease?
Answer: • Hyperpigmentation
• weight loss
• muscle weakness
• low blood pressure
• hypoglycemia
What is acanthosis nigricans?
Answer: skin condition patches of darkened thick skin
What is hirsutism?
Answer: happens in women where they developed male pattens of hair on the face, abdomen,
chest and back crushing’s can cause this
Don’t take licorice root with that medications?
Answer: heart meds
How to calculate the parkland formula
Answer: The Parkland formula calculates fluid resuscitation for burn patients:

4 mL of lactated Ringer's solution per kg of body weight per percentage of total body surface
area burned, with half given in the first 8 hours and the remainder over the next 16 hours.
IV hydralazine for hypertensive emergency
Answer: vasodilator. goal is to slowly drop bp but not to fast
Droplet precautions
Answer: • meningitis
• haemophilus influenza type b
• diphtheria
• mumps
• rubella
• pertussis
• strep group A
• viral influenza
What do you need?
Answer: surgical mask and private room as needed for procedures that can splash, gloves,
gown, goggles/shield
Pertussis (whooping cough) symptoms
Answer: • cough lasting ≥ 2 weeks with ≥1 of the following:
• violent, spasmodic cough/paroxysms of cough
• inspiratory whooping sound
• coughing up thick mucus plug sometimes followed by vomiting (post tussive emesis)
Pertussis management & treatment
Answer: • oral antibiotics
• droplet precautions
• supportive measures (humidified oxygenation and oral fluids)
Which way to pull pinna in an adult?
Answer: up and back

Which way to pull pinna for a child?
Answer: For a child, pull the pinna down and back when administering ear drops.
Down and back what temp means hypothermia?
Answer: below 95
In a hypothermic patient, make sure to put them on cardiac monitor and anticipate
defibrillation because they can easily go into v fib
Answer: the myocardium becomes cold and prone to dysrhythmia’s
Infants don’t have complete closure of the oesophageal sphincter therefore they are prone to
gastroesophageal reflux. this is why they spit up after feeds. how can this be reduced?
Answer: burp during and after feeds to get air out, hold baby upright for 20-30 after feeding,
and smaller more frequent meals
If children eat honey less than 1 years old this can cause botulism
Answer: Yes, giving honey to children under 1 year old can cause botulism due to their
immature digestive systems.
What happens to the body in botulism?
Answer: • constipation, respiratory failure and neurologic decline.
• infants usually have constipation , generalized weakness, and diminished deep tendon
reflexes
• IV human derived botulism immune globin is given asap to reduce severity
Blunt force trauma can have delayed symptoms from a slow subdermal bleed. after 24-48 hrs
may show signs of increased ICP like change in LOC (which is usually the first sign),
projectile vomiting, ataxia (loss in body movement), unilateral pupil dilation, and seizures
Answer: Blunt force trauma can lead to delayed symptoms from a slow subdural bleed, with
signs of increased ICP appearing 24-48 hours later, including changes in LOC, projectile
vomiting, ataxia, unilateral pupil dilation, and seizures.
There are different types of POAs, like medical and financial

Answer: Yes, there are different types of Powers of Attorney (POAs), including medical
POAs for healthcare decisions and financial POAs for managing financial matters.
Isotretinoin
Answer: • med for severe acne- a huge teratogenic!!
• derived from vitamin A. don’t take extra vit A as this could cause toxicity
• required to enter risk management plan and also use 2 forms of birth control
• can’t give blood while on because some could still be in blood
Children 3-6 put inappropriate causes to things that happen for example
Answer: they were bad so their knee was scraped
What contains live vaccines?
Answer: influenza nasal spray, MMR, and varicella
Read the endocrine chattering the book
Answer: Please read the endocrine chapter in the book for comprehensive information on
hormone regulation and related disorders.
Hypertensive crisis
Answer: A hypertensive crisis is a severe increase in blood pressure, typically above 180/120
mmHg, that can lead to organ damage and requires immediate medical intervention.
Malignant hyperthermia
Answer: Malignant hyperthermia is a rare, life-threatening reaction to certain aesthetic
agents, causing a rapid increase in body temperature and severe muscle contractions.
Serotonin syndrome
Answer: Serotonin syndrome is a potentially life-threatening condition caused by excessive
serotonin in the brain, often due to medication interactions, leading to symptoms like
confusion, agitation, rapid heart rate, and muscle rigidity.
Thyroid storm

Answer: Thyroid storm is a severe and life-threatening exacerbation of hyperthyroidism,
characterized by high fever, rapid heart rate, and altered mental status, requiring immediate
medical treatment.
Normal urine specific gravity value?
Answer: The normal urine specific gravity value ranges from 1.005 to 1.030.
Review how to do ABG values
Answer: To analyse ABG values, assess pH, PaCO2, PaO2, and HCO3- to determine acid-base
status and identify respiratory or metabolic causes.
Win disaster triage, what do red yellow green and black mean?
Answer: • red- life threatening, significant impairment to the ABCs, will likely survive if
treated within an hour
• yellow- can wait 1-2 hours- like bone piercing thru skin, etc
• green- walking wounded- can wait hours
• black- exacted to die
Flail chest what happens?
Answer: paradoxical breathing from multiple rib fractures- inspiration chest moves inward
and expiration chest moves outwards. fix rubs can puncture lung or vessels- can likely lead to
Hemo or pneumothorax
Just like chemotherapy, methotrexate causes bone marrow suppression which places patients
at risk for what?
Answer: infection
Wear gloves when in contact with blood, bodily fluids, secretions, excretions, nonintact skin
and mucous membranes and wash in between pts and after removing gloves
Answer: Wear gloves when in contact with blood, bodily fluids, secretions, excretions,
nonintact skin, and mucous membranes, and wash hands between patients and after removing
gloves.
Routine contamination when hands are not visibility soiled its safe to use alcohol sanitizer

Answer: For routine contamination when hands are not visibly soiled, it is safe to use
alcohol-based hand sanitizer.
Anaphylactic shock
Answer: • Hives, itching, skin rash, rapid swelling of the mouth and throat- give epi quick in
the thigh- Benadryl can be given for hives or rash.
• Epinephrine is the only thing that can treat anaphylaxis. if you have any kind of history of
severe allergic reaction then you should always carry an epi pen.
New graduate RNs can be assigned stable clients who do not require specialized skill or
knowledge and can discharge them if they are stable or ones that require new teaching
Answer: New graduate RNs can be assigned stable clients who do not require specialized
skills or knowledge, and they can also discharge stable patients or those needing new
teaching.
A newly admitted client with GBS is not stable. it is unclear when the analysis will stop aka it
could reach the respiratory system
Answer: A newly admitted client with Guillain-Barré syndrome (GBS) is not stable, as the
progression can be unpredictable and may eventually affect the respiratory system.
What does magnesium toxicity cause?
Answer: central nervous system depression
What is the earliest sign of magnesium toxicity?
Answer: absent or decreased deep tendon reflexes (normal 2+) and should be assessed during
magnesium infusion
If mg toxicity is not recognized early by the DTRs, what can it lead to ?
Answer: respiratory depression and cardiac arrest
If mg toxicity occurs, what should be done?
Answer: stop infusion and give its antidote
What is the antidote for magnesium toxicity?

Answer: calcium gluconate
Hydralazine is a vasodilator usually given to what?
Answer: lower blood pressure
Magnesium toxicity also causes low urine output like
Answer: indicate uteroplacental insufficiency and no
How are late decals corrected?
Answer: oxygen, reposition on right or left side, stop oxytocin if on it, IV fluid bolus
Chemical burn to the eye is an emergency- priority is what?

Answer: copious eye irrigation (water at home and NS or LR at hospital)- eye must remain
open
First degree (superficial) burns
Answer: • dry with blanchable redness
• usually only epidermis is damaged
Second-degree (partial thickness) burns
Answer: moist or weeping wounds with blisters and shiny, fluid-filled vesicles and moderate
to severe pain
Third-degree (full-thickness) burns
Answer: • dry & inelastic with waxy white, leathery, or charred black color
• Destroy the dermis and may involve subcutaneous tissue
Fourth-degree (full-thickness) burns
Answer: same as third degree (dry & inelastic with waxy white, leathery, or charred black
color) plus involvement of fascia, muscle, and/or bone tissue Pain is NOT major feature due
to nerve damage
Lupus- autoimmune-mild to severe chronic inflammation of different parts of the body like
face, mucosal ulcers, pericarditis, pleuritis, nephritis, arthritis, development
Answer: Lupus is an autoimmune disease characterized by mild to severe chronic
inflammation affecting various body parts, including the face, mucosal ulcers, pericarditis,
pleuritis, nephritis, arthritis, and an increased risk of DVT.
Lupus nephritis characteristics
Answer: increased creatinine and BUN, abnormal urinalysis (protein, RBCs)- can lead to
irreversible kidney damage. recognize early.
elevated kidney tests tells us which organ is being attacked by inflammation
What is expected with a lupus pt?
Answer: elevated ESR, positive antinuclear body test, anaemia, mild leukopenia, and
thrombocytopenia

What does an antinuclear body tell us?
Answer: the presence of DNAs which the body produces against its own DNA and material
so this should be positive in autoimmune disorders
D-dimer
Answer: blood clot test
Super ventricular tachycardia SVT
Answer: • regular, narrow QRS complex tachycardia with HR 150-220/min
• stimulants like cocaine, caffeine, nicotine can cause SVT.
• client may experience palpitations, dyspnea, and angina
• IV adenosine is treatment of choice, vagal stimulation the lines up are very narrow
Vagal maneuvers examples
Answer: Valsalva, coughing, carotid massage
Sinus tachycardia has a normal looking rhythm with a p wave and QRS complex, it is just
really fast
Answer: Sinus tachycardia has a normal rhythm with recognizable P waves and QRS
complexes, but the heart rate is elevated, typically above 100 beats per minute.
PTSD characteristics in people
Answer: • flashbacks of the traumatic event
• persistent angry, fearful mood
• difficulty concentrating
• feeling detached from others
Someone suffering from PTSD
Answer: has flash backs/nightmares of the event and their body responds with rapid HR,
sweating, etc. they avoid reminders of the trauma like places or activities, they feel detached
and numb and are hypervigilant, can’t sleep are mad, can’t concentrate
3 main categories a person with PTSD has

Answer: 1. reexperiencing the traumatic event
2. avoiding reminders of the trauma
3. hyperarousal
What is Ketorolac?
Answer: NSAID analgesic used for short term pain relief-usage should not exceed 5 days
due to kidney injury, GI ulcers, and bleeding
When giving a needle IM, the needle length should be what?
Answer: 1-1 1/2 inch
When giving morphine or hydromorphone IV push, dilute slowly so it doesn’t cause opioid
indeed adverse reactions like nausea, itching, flushing
Answer: When administering morphine or hydromorphone IV push, dilute slowly to
minimize the risk of opioid-induced adverse reactions, such as nausea, itching, and flushing.
Hydromorphone IV push can be given diluted with 5 ml NS or undiluted should be given
slowly over 2-3 mins
Answer: Hydromorphone IV push can be given diluted with 5 mL of normal saline or
undiluted, but should be administered slowly over 2-3 minutes.
Undiluted morphine IV push should be given slowly over 4-5 mins
Answer: Undiluted morphine IV push should be administered slowly over 4-5 minutes.
When giving an IM injection use which method?
Answer: Z Track
After an ABK amputation, the residual limb really should not be elevated but maybe only in
the 1st 24 hrs. definitely not after 24 hours
Answer: After an above-knee amputation, the residual limb should generally not be elevated
after the first 24 hours to prevent complications and promote proper healing.
Manage edema on the residual limb by using the figure eight compression bandage

Answer: Manage edema on the residual limb by applying a figure-eight compression
bandage to provide support and reduce swelling.
To prevent hip fractures after leg amputation
Answer: place patient prone with hip extension for 30 mins 3-4 times/day
Following hip replacement, place an abducted pillow between a pts legs to maintain hip in
straight and neutral position
Answer: Aldo don’t bend at the hip for more than 90 degree or cross the legs or ankles
Buck traction
Answer: immobilizes hip/femur fractures supine position with foot of bed raised
A cast is place, elevated limb above heart for the first 48 hrs
Answer: After a cast is placed, keep the elevated limb above the heart for the first 48 hours to
help reduce swelling.
Compartment syndrome
Answer: "7 P's"
1. paraesthesia
2. pain
3. pressure
4. pallor
5. pulselessness
6. poikilothermic (cool skin temp)
7. paralysis
never elevated if this develops
"Sartans"
Answer: angiotensin receptor blockers like valsartan
Ace inhibitors and angiotensin receptor blockers can cause hyperkalaemia
Answer: ACE inhibitors and angiotensin receptor blockers (ARBs) can cause hyperkalaemia
by reducing potassium excretion in the kidneys.

Polycythaemia
Answer: too many RBCs, WBCs, and platelets leading to increased haematocrit and blood
volume, thicker blood, and abnormal clotting. HCT of 66 is an abnormal finding
After a splenectomy, pts are subject to what?
Answer: lifelong infections. minor infections can quickly become life threatening. report any
signs asap.
Immediately report any signs of infection after having a splenectomy because the spleen is
part of the immune system and filters the blood
Answer: Immediately report any signs of infection after a splenectomy, as the spleen plays a
crucial role in the immune system and blood filtration.
Mastitis
Answer: • postpartum breast infection from clogged milk ducts (poor latch). not draining
properly
• Symptoms: fever, breast pain, breast inflammation and redness
• Treatment:
1. Antistaphylococcal antibiotics (dicloxacillin or cephalexin) and analgesics (ibuprofen)
2. Frequent continued breastfeeding (every 2-3 hours)
3. increase oral fluid intake
4. wear soft cup bras to encourage milk flow
Characteristics of fetal alcohol syndrome
Answer: microcephaly, short eyelids (palpebral fissure), flat midface (Cheekbones), smooth
philtrum (between nose and upper lip), thin upper lip
fetal alcohol syndrome causes what?
Answer: intellectual disability and developmental delay
Advanced age and pregnant association with what?
Answer: down syndrome

Cigarettes and pregnant can cause what things
Answer: perinatal loss, sides, low birth weight, premature
Birth defect associated with Depakote during pregnancy
Answer: spina bifida
When starting an IV, start distally so you can move your way up the arm if infiltration occurs
or the vein blows
Answer: When starting an IV, begin distally to allow for progression up the arm if infiltration
occurs or the vein blows.
Pulmonary embolism (PE) signs & symptoms
Answer: 1. anxiety/restlessness
2. pleuritic chest pain/tightness
3. shortness of breath
4. tachycardia 5. hypoxemia
6. haemoptysis
Pulmonary embolism - Nursing Priorities
Answer: 1. rapid symptom identification
2. assessment of oxygenation
3. notification of HCP
What to do if an air embolus is expected?
Answer: clamp the tubing, turn the patient on the left side and put them in Trendelenburg to
trap air in the right atrium
Circulatory (or fluid) overload sings
Answer: increased bp, distended jugular veins, rapid breathing, dyspnea, moist cough and
crackles
What does the nurse do if fluid over load occurs?
Answer: decrease the rate to a min or at KVO rate, elevate HOB, assess lung sounds and
edema

Who is at risk for circulatory overload?
Answer: respiratory cardiac, renal or liver disease, order clients, and very young.
A patient with renal or heart failure are usually not given NS because this promotes fluid
retention
Answer: Patients with renal or heart failure are usually not given normal saline because it
promotes fluid retention.
Lactated ringers contains what electrolyte?
Answer: potassium
Which patients should LR not be given to?
Answer: AKI or chronic kidney disease
A patient with diabetes does not get dextrose solutions why?
Answer: it can increase blood glucose levels
Infiltration signs
Answer: edema, coolness, numbness, pain
If infiltration or phlebitis occur, what should the nurse do with either immediately?
Answer: remove the IV device
What is the difference between atropine and dopamine
Answer: Atropine is an anticholinergic used to increase heart rate and reduce secretions,
while dopamine is a sympathomimetic agent that increases cardiac output and blood pressure.
Where should there be intermittent bubbling on a chest tube?
Answer: water-seal chamber
What is docusate?
Answer: stool softener

Interventions to prevent abdominal wound dehiscence
Answer: stool softeners, antiemetics, use abdominal binder, monitor blood sugar to maintain
tight glucose control to dec infection risk and promote wound healing, splint the abdomen
with pillow when coughing of moving
Remember protein is important for wound healing
Answer: Remember that protein is essential for wound healing as it supports tissue repair and
regeneration.
Infants have a higher body water percentage than adults so they can become dehydrated
quickly with vomiting and diarrhoea
Answer: severe dehydration occurs more rapidly in infants and young children
Signs of severe dehydration in infants
Answer: lethargy, sunken fontanel, poor feeding, tachycardic, increased RR
So what to do with dehydrated infant?
Answer: rehydrate is priority- bolus NS for an infant
What is homonymous hemianopsia?
Answer: • loss of one half of the field of vision on the same side in both eyes
• so like a patient can only see one side of their plate
• teach them to scan with their good eye by turning their head
• they are at risk for neglecting that side with the deficit or not eating food placed on the side
they can’t see
• they are also at risk for safety related injured because they simply can’t see as well
Umbilical cord care after birth
Answer: • keep it clean and dry an open to air (so don’t put diaper over it)
• do not put alcohol on it, just soap and water to clean
• report signs of infection redness swelling and pus (but remember the normal yellow crust
that should form)
• the cord is cut after birth and a little remains there. the cord will shrivel and turn black in a
few days and will fall off by itself in a 1-2 weeks- teach them not to mess with it or pull it off

Newborns should void and pass meconium within 24 hrs
Answer: Newborns should void and pass meconium within the first 24 hours after birth.
Desquamation is skin peeling and is a normal finding in an infant, especially those born late
Answer: Desquamation is skin peeling and is a normal finding in infants, especially those
born late or post-term.
Normal newborn head circumference
Answer: 32-37 cm
Jaundice in a newborn in the first 24 hours is considered pathological (ABNORMAL!)
Answer: Jaundice in a newborn within the first 24 hours is considered pathological and
abnormal, requiring further evaluation.
Jaundice that develops after 24 hrs is physiologic (normal) because their liver is still maturing
but it should disappear an about a week. both should still be reported
Answer: Jaundice that develops after 24 hours is typically physiological and normal due to
the liver maturing, but it should resolve within about a week; both types of jaundice should
still be reported.
If someone is having hypoglycaemic reaction and glucose is below 70, what is the first thing
to do?
Answer: give them simple carbs like orange juice or low fat milk
Signs of hypoglycaemic reaction
Answer: low glucose, shaking, sweating, pale
If a patient cant ingest a simple oral carb, they are given dextrose or glucagon
Answer: but these can cause rebound hypoglycemia by stimulating more insulin release from
the body in response to increased glucose levels
Remember the SIRS continuum

Answer: starts with inflammatory response (fever, tachycardia, tachypnea, and then when an
infectious source is identified, this is considered sepsis. when they remain hypotensive
despite 2L of fluids, this is septic shock. shock and 2 or more systems damaged, this is
MODS
Atopic dermatitis aka what?
Answer: eczema
About eczema
Answer: • chronic skin disorder with pruritic, erythema, and dry skin
• goal: do not scratch
• leads to more infections
• alleviate the itching and keep skin hydrated
• moisturize, keep nails short, don’t wear wool or rough fabrics, gloves or cotton stockings
over the hands
What are the 2 core symptoms of ASD? autism?
Answer: abnormalities in social interaction and communication and patterns of behavior
interests and activities
If a 2 year old id exhibiting these symptoms or other abnormal behaviors/communication
then assess their vocab. because at 2 kids should have a vocab of about 300 words
Answer: If a 2-year-old exhibits abnormal behaviors or communication issues, assess their
vocabulary, as they should have a vocabulary of about 300 words by this age.
Infants should be breastfed until 6 month, then at 6 month they can introduced to pureed
foods. at 1 year or later they can have cow milk
Answer: Infants should be breastfed until 6 months, after which pureed foods can be
introduced, and cow's milk can be offered at 1 year or later.
Introduction of solid food usually happens how many month?
Answer: 4-6
What to remember when introducing new foods to a baby?

Answer: allow 5-7 days between introduction of new food to see allergies
Retinoblastoma
Answer: • Tumor of eye usually diagnoses in children under 2
• the pupil will reflect a white color and the child will not have the normal
• red eye reflex
• radiation therapy or removal of the eye
Strabismus
Answer: • cross eyes
• misalignment of the eyes
• eyes looking in different directions
Ptosis means injury to what nerve
Answer: oculomotor nerve (cranial nerve III)
Common side effects of immunizations
Answer: • mild fever
• redness and soreness at the injection site
• apply a warm compress to the site
Peripheral arterial pulses
Answer: 0 absent
1. + weak
2. + normal
3. + increased, full, bounding
Peripheral arterial pulses are the palpable beats felt in arteries located away from the heart,
such as the radial, femoral, popliteal, posterior tibial, and dorsalis pedis arteries. They
indicate blood flow and can help assess circulation and cardiovascular health.
What is the normal force of the pulse on the scale
Answer: 2+
Negativism

Answer: client resists instructions or attempts to be moved
What is waxy flexibility?
Answer: the patients limbs stay in the same position in which they are placed by another
person
Catatonic
Answer: • client remains in a fixed stupor and refuses to move about or do adults, remaining
mute, bizarre postures
• they are unable to meet their basic needs for adequate fluid and food intake and are at risk
for dehydration and malnutrition
How much after TB injection should arm be checked?
Answer: 48-72 hours
What does a positive tuberculin skin test show?
Answer: induration (basically a white patch) surrounded by redness
What does it mean when induration is shown?
Answer: that the person has been exposed to TB, has developed antibodies, and is infected
with TB bacteria. however, this doesn’t tell if the infection is active or latent so further testing
is required.
What things confirm an active TB infection?
Answer: presence of symptoms, positive sputum culture, and chest x-ray
QuantiFERON-TB (QFT) blood test is what?
Answer: an alternative to the Mantoux test. it too only indicates that the individual has been
infected with TB. the test is more expensive but it only requires a single visit rather than
having the person coming back in 4872 hours to have their TBT test read.
What is an arteriovenous malformation (AVM)?
Answer: • congenital deformity of tangled BVs occurring in brain. usually found in the brain
and can cause headaches, seizures, and neurological deficits.

• Blood Pressure Control Is Crucial
• at high risk for having an intracranial bleed due to the weak vessels
• any neurological changes like sudden severe HA, nausea, vomiting should be assessed
immediately as these are symptoms of a haemorrhage
• do not perform heavy exercising as this increases BP
Care of Alzheimer’s in the home
Answer: • keyed deadbolts
• med bracelet
• remove clutter and throw rugs
• grab bars in showers/bathrooms
• household hazards removed
St john’s wort used to treat what?
Answer: depression but interacts with many prescription meds
Melatonin
Answer: sleep and wake cycles helps body adjust to time zones and treat jet lag take when
you get to destination take a low dose and for a short time
Refeeding syndrome
Answer: What happens after a starved and severely malnourished person finally gets fed via
any of the routes. Electrolytes disturbances happen and declines in phosphorus, potassium,
and magnesium happen
What are the key signs of refeeding syndrome?
Answer: PPM rapid decline in phosphorus, potassium, magnesium also fluid overload
Phosphorus value
Answer: 2.4-4.4
Magnesium value
Answer: 1.5-2.5

How does the nurse prevent refeeding syndrome?
Answer: • get baseline electrolytes
• initiating nutrition support cautiously with hypocaloric feedings
Closely monitor electrolytes increase caloric intake gradually calcium value notecard
Answer: 8.6-10.2
Hypocalcaemia is a potential complication of thyroidectomy. the parathyroid glands that
regulate calcium are sometimes removed during thyroidectomy because they are so small.
watch patient for signs of hypocalcaemia like trousseau and Chvostek signs give calcium
gluconate
Answer: Hypocalcaemia is a potential complication of thyroidectomy, as the small
parathyroid glands may be inadvertently removed. Monitor the patient for signs of
hypocalcaemia, such as Trousseau's and Chvostek's signs, and administer calcium gluconate
if needed.
When is atropine given?
Answer: symptomatic bradycardia
What is the specific action of atropine?
Answer: inhibits the action of the vagus nerve (the vagus nerve slows the heart rate. this is
why you do vagal nerve stimulation in hypertensive crisis.
Dopamine does what?
Answer: treats hypotension due to bradycardia
What is failure to capture on a heart rhythm?
Answer: pacemaker spikes that are not followed by QRS complexes. the pacemaker may be
malfunctioning related to the machine like battery or something big patient will be
bradycardic and hypotensive. the nurse should put on transcutaneous pacemaker pads to
regulate the heart beat until the problem with the pacemaker is fixed. TP is uncomfortable for
the patient so give analgesia.
Signs of complications after a prostatectomy

Answer: bleeding, passing blood clots, a decrease in urinary stream, urinary retention,
symptoms of a UTI and should able reported
You should not be symptomatic of anything after a prostatectomy
Answer: You should not experience any significant symptoms after a prostatectomy.
A peak flow meter
Answer: uses traffic control signals to recognize degree of asthma symptoms. an asthma
action plan is individualized and developed between patient and HCP.
What do the traffic signal colors mean in a peak flow meter?
Answer: • green- asthma is under control. there are no worsening of cough, wheezing, or
trouble breathing.
• Yellow- means caution. symptoms are getting worse. even after return to the green zone
after use of medication, further med or chance in treatment is needed. still take meds if you
return to green zone after taking rescue meds.
• Red- needs emergency treatment if the level does not immediately return to yellow after
taking reuse meds.
For a blood transfusion, UAP can obtain bp before the transfusion begins and any time after
the first 15 mins of infusion. UAP can also pick up blood from the blood bank
Answer: For a blood transfusion, a UAP can obtain blood pressure before the transfusion
begins and any time after the first 15 minutes of infusion, and they can also pick up blood
from the blood bank.
If a CVC is occluded while trying to flush with 10 ml NS, the first thing to do is reposition
the pts arm and then check for tubing kinks
Answer: If a central venous catheter (CVC) is occluded while trying to flush with 10 mL of
normal saline, the first step is to reposition the patient's arm and then check for any kinks in
the tubing.
Normal O2 sat for test purposes is 95-100 and if under 95 this is hypoxemia
Answer: Normal oxygen saturation (O2 sat) for test purposes is 95-100%. A reading below
95% indicates hypoxemia.

With a chest tube, intermittent bubbling in the water seal chamber consistent with respirations
is normal
Answer: With a chest tube, intermittent bubbling in the water seal chamber that coincides
with respirations is considered normal.
What is the most accurate indicator of fluid loss or gain?
Answer: weight measurements
Lithium therapeutic range
Answer: 0.6-1.2
When are lithium levels considered toxic?
Answer: >1.5
When does lithium toxicity usually occur?
Answer: • dehydration
• decreased renal function (elderly)
• diet low in sodium
• drug-drug interactions- NSAIDS and thiazide diuretics
Lithium is cleared renally so a minor change in kidney function could cause lithium toxicity
Answer: Lithium is primarily cleared renally, so even minor changes in kidney function can
lead to lithium toxicity.
Do not take NSAIDS while on lithium, instead use acetaminophen for pain relief
Answer: Do not take NSAIDs while on lithium; instead, use acetaminophen for pain relief to
avoid potential toxicity.
Teaching when on lithium
Answer: drink 1-2 L of fluid daily blood levels checked periodically get adequate sodium
Don’t take NSAIDS on lithium or with heart failure because NSAIDS do what?
Answer: decrease renal blood flow

Itching and nausea are adverse effects of giving opioid. Benadryl and Zofran can provide
antihistamine and antiemetic relief.
Answer: Itching and nausea are adverse effects of opioids; Benadryl can provide
antihistamine relief, while Zofran can help with nausea as an antiemetic.
Changing peripheral IV tubing should occur no sooner than every 72 hours.
Answer: Changing peripheral IV tubing should occur no sooner than every 72 hours.
Heparin and warfarin are given simultaneously until the INR reaches 23, and then the heparin
can be discontinued and warfarin continued
Answer: Heparin and warfarin are given simultaneously until the INR reaches 2-3, at which
point heparin can be discontinued and warfarin continued.
If signs of phlebitis are present immediate removal of the catheter is done because phlebitis
can lead to clot formation (thrombophlebitis) or serious bloodstream infection
Answer: pain swelling warmth at site, redness
Chronic alcohol abusers suffer from poor nutrition from improper diet and altered nutrient
absorption. which vitamin are they specifically at risk for deficiency in?
Answer: thiamine
What can inadequate thiamine lead to?
Answer: Wernicke encephalopathy- altered mental status, oculomotor dysfunction, and
ataxia. can lead to seizures
Gross tremors and seizures from acute alcohol withdrawal are treated with what?
Answer: benzos like lorazepam and diazepam
When is using an indwelling catheter appropriate?
Answer: • urinary obstructing or retention
• the need of strict I/O’s in critically ill pts
• peri op like urologic procedures, prolonged surgeries, or when LG fluids or diuretics re
given during surgery

• prolong immobilization when bed rest is necessary
• to improve end of life comfort
• to promote healing of an open perineal or sacral wound in incontinent pts
Catheters should not be used just because a patient is elderly, incontinent, or confused
Answer: Catheters should not be used solely because a patient is elderly, incontinent, or
confused; alternative management strategies should be considered first.
Stress incontinence teaching
Answer: • void every 2 hours while awake and 4 hrs at night
• Kegels to strengthen pelvic floor muscles
With chlamydia and gonorrhoea, always make sure the partner is tested too
Answer: With chlamydia and gonorrhoea, it's essential to ensure that the partner is also tested
and treated if necessary.
Sodium nitroprusside
Answer: • vasodilator used in hypertensive emergencies
• can produce a sudden and drastic drop in bp causing symptomatic hypotension
• monitor BP closely every 5-10 mins
Hypotensive signs
Answer: • light-headedness
• cold clammy skin
Diabetic ketoacidosis (DKA)
Answer: • common for type 1 diabetes
• cardinal signs are fruity breath and rapid deep respirations (Kussmaul respirations)
• hyperglycemia, ketosis, acidosis
• caused by an intense deficit of insulin
• treat: IV normal saline first , then IV regular insulin, fingerstick glucose
Signs of dehydration

Answer: poor skin trigger, dry mucous membranes, tachycardia, orthostatic hypotension,
weakness, lethargy
Soap and water for c diff and scabies
Answer: Use soap and water for handwashing and cleaning surfaces with C. diff, and for
scabies, wash skin and use prescribed treatments; also launder affected items in hot water.
Empty a JP drain every 4-12 hrs or when its 1/2 to 2/3 full, same thing as an ostomy
Answer: compress the empty bulb room side to side
Disaster hits and home care nurse needs to prioritize care, definitely one that needs pre-filled
insulin syringes because they could become hyperglycaemic without insulin and lead to life
threatening diabetic ketoacidosis
Answer: In a disaster situation, a home care nurse should prioritize care for patients needing
pre-filled insulin syringes to prevent hyperglycemia and the risk of diabetic ketoacidosis, as
timely insulin administration is critical for their safety.
Meniere disease key to remember
Answer: safety falls -salt restricted diet to prevent further fluid build up
What helps minimize vertigo?
Answer: To minimize vertigo, consider vestibular rehabilitation, stay hydrated, avoid
triggers, and consult a healthcare professional for appropriate medications.
Quiet dark environment clients with hypertension should take decongestants why?
Answer: decongestants can contain a vasoconstrictor and exacerbate hypertension
Mitral valve regurgitation does what?
Answer: causes a backflow of blood from the L ventricle their the mitral valve and into the L
atrium. the backflow can lead to dilation of L atrium and pulmonary edema.
-make sure to report any signs of heart failure
Signs of heart failure
Answer: dyspnoea, orthopnoea, weight gain, cough, fatigue

Nurse finds a client slumped over in respiratory distress with low sats and visible food in
throat, steps of what to do
Answer: • position to high fowlers
• oral suction
• oxygenate
• lung sounds
• notify HCP (usually always last)
Vitamin K is the antidote for what?
Answer: warfarin
What is sodium polystyrene sulfonate?
Answer: reduces potassium levels
Oral warfarin is started about 5 days before a continuous heparin infusion is discontinued.
and why?
Answer: this is the time it takes warfarin to reach therapeutic level
Vitamin K reverses the anticoagulant effect of warfarin
Answer: Yes, vitamin K can effectively reverse the anticoagulant effects of warfarin by
promoting the synthesis of clotting factors.
aPTT therapeutic range
Answer: 46-70
INR therapeutic range
Answer: 2-3
Epoetin is what?
Answer: stimulates production of erythropoietin (to make RBCs) that treats anaemia in
chronic kidney disease because the kidneys have a big role in blood cell production
Chronic kidney disease patients are at risk for hyperkalaemia

Answer: Yes, patients with chronic kidney disease are at risk for hyperkalaemia due to
impaired potassium excretion.
When I see chronic kidney disease, think not producing RBCs so need epoetin, think
potassium reducer cyst of hyperkalaemia
Answer: In chronic kidney disease, remember that erythropoietin (EPO) may be needed to
stimulate red blood cell production, and potassium levels need to be monitored and managed
to prevent hyperkalaemia.
Symptoms of an aortic dissection
Answer: abrupt, worst ever tearing ripping moving from upper to lower back epigastric and
abdominal pain- life threatening. surgery and lowering the BP which is a contributing factor
Calf pain that relives with rest is what
Answer: peripheral arterial disease
Pressure ulcer develop how?
Answer: external pressure compressing capillaries and underlying soft tissue- occurs mainly
over bony prominences
Braden scale assess for what
Answer: pressure ulcer
Pulmonary embolus symptoms
Answer: Symptoms of a pulmonary embolus include sudden shortness of breath, chest pain,
coughing (possibly with blood), rapid heart rate, and feeling faint.
Dyspnea, sob, tachycardia, pleuritic chest pain, severe anxiety, impending doom criteria for
diagnosis of IBS
Answer: • recurrent abdominal pain/discomfort 3 or more days a month for 3 months and at
least 2 of these
• improvement with bowel movement, change in frequency of stool, or change in form of
stool

Goals for IBS
Answer: reduce diarrhoea or constipation, abdomen pain, and stress. manage with diet, meds,
exercise, and stress reduction
Patient teaching for IBS
Answer: • no gas producing foods (bananas cabbage onions), caffeine, alcohol, honey, high
fructose corn syrup, and other GI disturbances like spices, hot food/drink, dairy, fatty foods
• gradually increase fiber intake
• generally tolerated well re protein, bread, and bland food
What is important after an abdominal aortic aneurysm repair?
Answer: hemodynamic stability because of graft leakage
Clients with a cast are at risk for compartment syndrome so they should always have
neurovascular checks
Answer: Yes, clients with a cast are at risk for compartment syndrome and should have
regular neurovascular checks to monitor for signs of impaired circulation and nerve function.
What do you do if there is itching under a cast?
Answer: cool air from an air dryer
4 lobes of the brain and what they control
Answer: The four lobes of the brain are the frontal (reasoning and movement), parietal
(sensory processing), temporal (hearing and memory), and occipital (visual processing).
Parietal lobe
Answer: Sensation. somatic and sensory input- injury causes deficits with sensation
Frontal lobe
Answer: Personality/Behavior
Temporal lobe
Answer: Auditory input cannot understand visual or written language

Occipital lobe
Answer: vision
What are some common side effects of anticholinergics?
Answer: constipation, urinary retention, flushing, dry mouth, and heat intolerance
Decreased sweat production can lead to what?
Answer: Decreased sweat production can lead to overheating and heat-related illnesses, such
as heat exhaustion or heat stroke.
Hyperthermia because you aren’t sweating which naturally cools your body off albuterol
Answer: short acting and immediate bronchodilation
Side effects of albuterol and other beta 2 agonists
Answer: tremor, tachy, palpitations, restless, hypokalaemia
Constricted pupils seen with opioids
Answer: Yes, constricted pupils (miosis) are commonly seen with opioid use.
COPD teaching
Answer: get pneumococcal and flu vaccine and report any signs of infection
Theophylline toxicity presents as what symptoms?
Answer: central nervous stuff- HA, insomnia, seizures, GI disturbances, and cardiac toxicity
Screening for latex question
Answer: do your lips swell when blowing up balloons or do your hands get itchy when you
put on rubber gloves
Which foods may cause a latex-food syndrome in pts with a latex allergy?
Answer: bananas, avocados, tomatoes, kiwi, potatoes, peaches, grapes, apricots
Shellfish allergy may carry a concurrent risk for allergic reaction to contrast dye

Answer: Shellfish allergy may increase the risk of allergic reactions to contrast dye due to
similar proteins.
What foods to think when you see latex allergy
Answer: bananas, avocados, tomatoes
What can happen as a result of emergent catheterization from acute urinary retention?
Answer: hypotension and bradycardia
How to treat acute urinary retention?
Answer: rapid complete bladder decompression
Cataracts have opaque color to the eye
Answer: Yes, cataracts cause an opaque or cloudy appearance in the lens of the eye, affecting
vision.
Acute angle closure glaucoma requires immediate medical intervention
Answer: Yes, acute angle-closure glaucoma requires immediate medical intervention to
prevent vision loss.
Glaucoma
Answer: increased intraocular pressure that can lead to severe eye pain, reduced central
vision, blurred vision, ocular redness
ACE inhibitors do what main thing?
Answer: dilate blood vessels
ACE inhibitors side effects
Answer: dry cough, orthostatic hypotension, hyperkalaemia, angioedema
Teaching for ace inhibitors
Answer: • kidney levels in the first week
• contraindicated in pregnancy
• watch foods high in potassium since can cause a mild hyperkalaemia

• get out of bed slowly
• possible allergic reaction like rash or angioedema
Beta blockers, calcium channel blockers, and digoxin can all cause bradycardia
Answer: withhold beta blockers if hr below 60
Beta blockers major side effects
Answer: bradycardia, bronchospasm, hypotension, depression, impotence
Thyroid replacement can give symptoms of hyperthyroidism like
Answer: diarrhoea weight loss, palpitations, tachycardia, sweating, heat intolerance
Symptomatic bradycardia will present like what?
Answer: pale, cool skin, hypotension, weakness, confusion, dyspnea, chest pain, syncope
Remember BETA blocker Bradycardia
Answer: Yes, beta-blockers can cause bradycardia as a side effect by reducing heart rate and
contractility.
Baseline data before open abdominal aneurysm surgery is essential, especially regarding the
character and quality of peripheral pulses.
Answer: Baseline data, particularly the character and quality of peripheral pulses, is essential
before open abdominal aneurysm surgery.
Nursing management for haemorrhoidectomy primarily involves providing pain relief and
preventing constipation.
Answer: NSAIDs rather than opioids, as opioids can worsen constipation; recommend warm
sitz baths, a high-fiber diet, plenty of fluids, and stool softeners.
Dysrhythmias are common after an MI
Answer: Dysrhythmias frequently occur after a myocardial infarction (MI).
An S3 heart sound is a sign of what?
Answer: heart failure

When are different oxygen systems used?
Answer: Different oxygen delivery systems are used based on the patient's needs, such as
nasal cannula for low-flow oxygen, simple masks for moderate needs, and non-rebreather
masks for high-flow oxygen in emergencies.
Nasal cannula
Answer: short term, allows to eat and drink- delivers oxygen up to 44%
Simple face mask
Answer: delivers higher concentration than cannula about 40-60. can be used if hypoxemia
doesn’t resolve
Non rebreather
Answer: used in emergencies, delivers high concentrations of oxygen up to 90-95
Venturi mask
Answer: delivers a guaranteed oxygen concentration to pts with unstable COPD
Major complication of rheumatoid arthritis is morning stiffness
Answer: take a warm shower or bath upon wakening
What does fasting do to the body?
Answer: • the body goes into starvation mode. metabolism slows down and cortisol (stress
hormone) increases. body breaks down muscle and converts amino acids to glucose.
• fluid loss
• depletion of essential nutrients
• fatigue, HA, dehydration, dizziness, muscle weakness
Patients with chlamydia should abstain from sex for one week after starting treatment, and
partners must also be treated.
Answer: Patients with chlamydia should abstain from sex for one week after starting
treatment, and all partners must be treated.

After a burn, do not place ice, ointments, creams, or butter; instead, run the burn under cool
water, remove clothing if it’s not stuck to the skin, and cover it with a clean, dry cloth.
Answer: After a burn, avoid ice, ointments, or butter; run the burn under cool water, remove
non-adhering clothing, and cover with a clean, dry cloth.
If a sibling has autism, there is a high chance another sibling will have it too, think of
Caroline’s family
Answer: If a sibling has autism, there is a high chance another sibling will also have it, as
demonstrated by Caroline's family.
Voluntary control over urethral and anal sphincters occurs about 18-24 month
Answer: Voluntary control over urethral and anal sphincters typically occurs around 18 to 24
months of age.
What a some indicators that a child is ready for toilet training?
Answer: • child can express the need to pee or poor
• can understand commands, communicate, and follows directions
• pull clothing up and down (necessarily get dressed and undressed by themselves)
• walk to and sit on toilet for about 5-8 mins without crying or getting up
• remain dry several hrs thru nap
Pericardial effusion can lead to cardiac tamponade
Answer: Pericardial effusion can lead to cardiac tamponade, where fluid accumulation
compresses the heart and impairs its function.
What is pericardial effusion?
Answer: build-up of fluid in the pericardium
Tamponade, a major complication of pericardial effusion, happens has the effusion increases
in volume and starts to compress the heart.
Answer: Tamponade, a major complication of pericardial effusion, occurs as the effusion
increases in volume and compresses the heart.
When I see pericardial effusion and/or cardiac tamponade, think what?

Answer: When I see pericardial effusion and/or cardiac tamponade, think of potential
hemodynamic instability and the need for urgent medical intervention.
What does tamponade require?
Answer: immediate pericardiocentesis
Signs/symptoms of cardiac tamponade
Answer: hypotension (heart isn’t contracting effectively), muffled or distant heart tones,
JVD, dyspnea, tachynea, tachycardia, weak thready pulses
Bounding pulses may be present in
Answer: fluid overload hypertension
Decreased breath sounds on left side could indicate what
Answer: pleural effusion, pneumothorax, atelectasis
Why is a post-operative C-section patient at high risk for pulmonary embolism?
Answer: • abdominal C-section
• engorged blood vessels from hypercoagulability of blood and venous stasis
• immobility due to surgery
• postpartum hypercoagulable state because the body makes a lot more blood to prepare for
blood loss during birth.
C-section patients have a longer recovery than vaginal birth and are in the hospital longer.
Watch out for VBAC (vaginal birth after C-section) because previous scarring may easily
tear.
Answer: C-section patients have a longer recovery and hospital stay than those with vaginal
births, and VBAC carries risks due to potential tearing of previous scarring.
Rice, corn, and potatoes are gluten free and are allowed in what type of diet?
Answer: celiac gluten free BROW diet barley, rye, oats, wheat
Chronic bronchitis interventions
Answer: • increase fluids to 2-3

• L which helps thin secretions
• humidifier
• Guaifenesin an expectorant
• abdominal breathing using huff method (sit in chair lean forward and expel it out) chest
physiotherapy
Rhonchi
Answer: Sonorous wheeze, continuous, low-pitched adventitious breath sounds similar to
moaning or snoring that occur when thick secretions or foreign bodies (eg tumors) obstruct
airflow in upper airways
When are rhonchi primarily heard?
Answer: primarily during expiration but also may be present during inspiration
Conditions when rhonchi are heard
Answer: 1. bronchitis
2. cystic fibrosis
3. some types of pneumonia
may clear with coughing or suctioning
Pneumonia assessment findings
Answer: 1. Crackles
2. Fever, chills, productive cough, dysnpea, and pleuritic chest pain
3. Increased vocal/tactile fremitus
4. Bronchial breath sounds in peripheral lung fields - can be an early sign
5. unequal chest expansion
6. dullness on percussion
Shortness of breath and high pitched expiratory wheezing are expected side effects of what
Answer: asthma
Normal muscle strength is
Answer: 5/5

Normal pupils are what in diameter?
Answer: 3-5 mm
In up to 18 month, the toes should fan upward and this is a normal response
Answer: Up to 18 months, the toes should fan upward, which is a normal reflex response.
Once a nurse provides care to someone, this establishes a legal caregiver
obligation/relationship between the nurse and the person; she could be held negligent if she
does not continue the care until someone else takes over or unless they are stable.
Answer: Providing care establishes a legal obligation for the nurse, who could be held
negligent if care is not continued until another caregiver takes over or the patient is stable.
What does a peak flow meter measure in a person with asthma?
Answer: airflow out of the lungs
Best indicator of moving air in an asthma patient is what?
Answer: peak flow
Asthma green
Answer: 80 to above of personal best
Yellow asthma 50-79
Answer: In asthma management, a yellow zone indicates a peak flow of 50-79% of the
personal best, suggesting caution and the need for medication adjustments.
Red asthma
Answer: below 500 medical alert
PTT should be 1.5-2.0 times the control value
Answer: should not be equal to the control value
Heparin has a short duration like 2-6 hrs so if it is not being infused, the aPTT level will go
back to the control value- so check for infiltration if their lab studies show aPTT at the
control value despite heparin administration

Answer: Heparin has a short duration of 2-6 hours, so if it's not infusing, check for
infiltration if aPTT levels return to control despite administration.
In some pts with COPD, too high a level of inspired oxygen can depress the respiratory drive
to breathe causing alveolar hypoventilation. removing supplemental oxygen like a cannula
may actually increase the reading
Answer: In some COPD patients, excessive oxygen can depress respiratory drive and cause
hypoventilation, while removing it may increase oxygen saturation readings.
An atrial pacemaker shows a spike when?
Answer: before the
P wave
Dental hygiene with phenytoin
Answer: Patients taking phenytoin should maintain good dental hygiene, as the medication
can cause gingival hyperplasia.
MAOIs interact with many medications, including antidepressants; MAOIs and SSRIs should
not be given within 2 weeks of each other.
Answer: MAOIs interact with many medications, and should not be taken with SSRIs within
2 weeks of each other.
Correct CPR
Answer: • place heel of hand in center of chest between nipples
• compress 2-2.4 in
• rate of 100-120
• 30 compressions to 2 breaths
In terms of fetal heart rate, the only normal accelerations are accelerations. what are the
abnormal ones?
Answer: variable, early, and late are all abnormal.
What are the 2 signs the nurse does to check for meningitis?
Answer: Brudzinski and Kernig

What is the Brudzinski sign?
Answer: neck flexion and exhibits pain and hip/knee flexion
What is the Kernig sign?
Answer: leg extension on 90deg flexed hip causes pain and resistance
Post extracorpeal shock wave lithotripsy for kidney stones instructions
Answer: Bruising on back or abdomen is norma increase fluid to flush out fragments
ambulate to remove fragments blood in urine is normal
What are the 3 signs of positive (diagnostic) pregnancy?
Answer: 1. fetal heartbeat w/ doppler
2. visualization of fetus with ultrasound
3. fetal movement felt by the hcp
MMR and Varicella are first given at what age?
Answer: 12-15 month
Teaching for pediculosis capitis
Answer: • treatment with pediculicide (usually permethrin 1% cream)
• soak child’s comb and hair accessories in boiling water for 10 minutes
• may need to treat child's sibling if they share things
• use a nit comb daily for 2 weeks after treatment
• vacuum furniture, carpet, etc
•wash linens/bedding in hot and dry on hot
• pets don’t need to be treated as human lice doesn’t get on animals
Pneumonia pt- increase fluids to facilitate secretion removal more fluids help thin secretions
and facilitate expectoration of mucus
Answer: In pneumonia patients, increasing fluid intake helps thin secretions and facilitates
the expectoration of mucus.
How to use incentive spirometer

Answer: To use an incentive spirometer, inhale slowly and deeply through the mouthpiece,
keeping the indicator in the target zone, and then exhale normally; repeat several times to
promote lung expansion.
High fowlers is how many degrees?
Answer: 60-90
Semi fowlers is how many degrees?
Answer: 30-45
Peripheral Arterial Disease (PAD)
Answer: chronic, atherosclerotic disease caused by buildup of plaque in arteries
Peripheral Arterial Disease (PAD) - Assessment Findings
Answer: • (due to decreased blood flow to lower extremities)
• Hair loss
• decreased peripheral pulses
• Intermittent claudication (ischemic muscle pain)
• cool, dry, shiny skin
• thick, brittle nails
• toe ulcers , gangrene
Peripheral Arterial Disease (PAD) - Home Management Instructions
Answer: • Lower extremities below heart when sitting and lying down
• Engage in moderate exercise (eg 30- to 45-min walk, twice daily)
• Perform daily skin care , including application of lotion - prevents skin breakdown from dry
skin
• Maintain mild warmth (eg lightweight blankets, socks) but never use heating pads
• stop smoking
• avoid tight clothes and stress
• Take prescribed medications (vasodilators, antiplatelets)
Common expected findings in peripheral arterial disease

Answer: decrease blood supply from plaque buildup (watch lipid levels), lack of hair,
decrease peripheral pulses, thick brittle nails, cool, dry, shiny skin, skin atrophy, toe ulcers,
gangrene
Are statins supposed to be taken in the morning or at night?
Answer: NIGHT
Chest pain at rest indicates myocardial ischemia
Answer: Chest pain at rest indicates myocardial ischemia and may require immediate
medical evaluation.
When is stridor heard?
Answer: laryngospasm or edema of upper airway
Acute on set dyspnea and cough with spink frothy sputum indicates what?
Answer: pulmonary edema
What causes pink frothy sputum?
Answer: ruptured bronchial veins from the mix of blood and airway fluids
Should get annual chlamydia and gonorrhoea testing
Answer: Annual testing for chlamydia and gonorrhoea is recommended for sexually active
individuals, especially those under 25 and at higher risk.
clozapine
Answer: atypical antipsychotic used to treat schizophrenia
What medication is Riluzole?
Answer: It is used to treat ALS and slows the progression of the disease.
UAP can do nonsterile suctioning during oral care
Answer: UAPs can perform nonsterile suctioning during oral care under appropriate
supervision and protocols.

Myocardial infarction symptoms
Answer: chest pain, dizziness, sweating, sob, nausea/vomiting, pain radiation to neck, jaw,
left shoulder, arms, epigastrium
ECT patient teaching
Answer: • NPO 6-8 hrs before
• anaesthesia and muscle relaxant given before; patient will be unconscious during
• no driving
• temporary memory loss and confusion in immediate recovery period --discontinue
anticonvulsants because the treatment induces a seizure
What is the brand name for valproic acid?
Answer: Depakote- anticonvulsant
What is the desired effect of lactulose?
Answer: • improve mental status
• lactulose reduces ammonia by trapping it in the gut then expelling it with a laxative
Hepatic encephalopathy is caused from high ammonia levels and elevated ammonia levels
cause what?
Answer: mental confusion
Situations that nurses must legally report
Answer: 1. Suspected abuse
2. Suspicious deaths - medical examiners has legal authority & obligation to perform an
autopsy independent of family wishes when deaths are suspected to be result of crime,
trauma, or suicide
3. Impaired or intoxicated health care professionals regardless of their position
Suspected child abuse - injury patterns in nonaccidental trauma
Answer: • subdural & epidural hematomas
• retinal haemorrhage on fundoscopic examination
• Frenulum tears & gingival lesions
• Linear-type immersion burns

• long bone fractures in humerus or femur
Hypercalcemia signs and symptoms
Answer: • muscular weakness
• constipation
• depressed reflexes
• anorexia
• nausea/vomiting
• polyuria; polydipsia (extreme thirst)
• dehydration
• flank pain
• calcium stones
• deep bone pain
• hypertension
Heatstroke
Answer: • Medical Emergency
• Symptoms:
1. Temperature ≥ 104F (40C)
2. Hot, dry skin
3. Hemodynamic instability (tachycardia, hypotension)
4. Altered mental status/neurologic symptoms (confusion, lethargy, coma)
• Treatment
1. Stabilization of ABCs
2. Rapid cooling interventions (eg cool water immersion, cool IV fluid infusion)
Note: antipyretics are ineffective
Positive Pressure Ventilation (PPV)
Answer: Used most commonly in acute respiratory failure
causes increased intrathoracic pressure - leads to reduced venous return, ventricular preload
and cardiac output , which results in hypotension - effect is greater in presence of
hypovolemia (eg haemorrhage, hypovolemic shock) and decreased venous tone (eg septic
shock, neurogenic shock)

Refractory hypoxemia
Answer: inability to improve oxygenation with increases in oxygen concentration
hallmark of acute respiratory distress syndrome (ARDS)
• progressive form of acute respiratory failure that has high mortality rate
3rd degree AV heart block
Answer: Results in disassociation of atrial & ventricular contraction due to blocked electrical
activity → decreased cardiac output (dizziness, syncope, mental status changes, HF,
hypotension, bradycardia)
3rd degree AV heart block ECG changes
Answer: presents as a regular rate & rhythm with disassociated P waves and QRS complexes
Treatment/Interventions - 3rd degree AV heart block
Answer: requires temporary or permanent pacing to stabilize patient
Atrial fibrillation priority
Answer: Ventricular rate control by giving diltiazem, metoprolol, or digoxin to decrease
ventricular response rate to <100/min
Subjective (presumptive) signs of pregnancy
Answer: 1. Amenorrhea
2. Nausea and vomiting
3. Excessive fatigue
4. urinary frequency
5. Breast tenderness
6. Quickening.
Objective (probable) signs of pregnancy
Answer: 1. Uterine/cervical changes
• Goodell sign
• Chadwick sign
• Hegar sign

• Uterine enlargement
2. Braxton hicks contractions
3. Ballottement
4. Fetal outline palpation
5. Uterine & funic souffle
6. Skin pigmentation changes
• Chloasma
• Linea nigra
• areola darkening
7. Striae gravidarum
8. Positive pregnancy tests
Positive (diagnostic) signs of pregnancy
Answer: 1. Fetal Heartbeat heard with doppler
2. Fetal Movement (felt by an examiner or visible)
3. Visualization of Fetus (ultrasound)
Billroth II surgery (Gastrojejunostomy)
Answer: removes part of the stomach and shortens upper GI tract
dumping syndrome is possible post-op
Dumping syndrome
Answer: • Rapid emptying of gastric contents into small intestines.
• Client experience:
• abdominal cramping
• nausea, vomiting
• diarrhoea
• dizziness
• generalized sweating
• tachycardia
Ways to reduce dumping syndrome symptoms
Answer: Avoid fluids with meals and lie down after eating

Testicular self-examination (TSE) instructions
Answer: 1. Perform monthly on same day
2. Perform while taking a warm shower
3. Use both hands to feel each testis separately
4. Palpate each testicle gently, using the thumb and first 2 fingers
5. Check that the testicle is normally egg-shaped and moveable with a smooth surface
Disorders associated with manipulative behaviors
Answer: 1. borderline & antisocial personality disorders
2. substance abuse problems
3. somatic symptom disorder
4. bipolar disorder (during manic phase)
Nursing interventions for manipulative behaviors
Answer: 1. setting limits that are realistic, nonpunitive, and enforceable
2. Using a nonthreatening, matter-of-fact tone when discussing limits and consequences of
unacceptable behaviors
3. enforcing all unit, hospital, or center rules
4. Ensuring consistency from all staff members in enforcing set limits
Postpartum psychosis - signs
Answer: appear within 2 weeks after birth
include:
• hallucinations
• delusions
• paranoia
• severe mood changes
• delirium
• feelings that someone will harm baby
Postpartum psychosis - risk factors
Answer: • history bipolar disorder
• previous discontinuation of mood-stabilizing medications (eg lithium)

Examples of cost-effective care
Answer: • considering inside of sterile glove wrapper as a small sterile field
• donning clean , rather than sterile, gloves to remove client's dressing
Circumcision care
Answer: • washing hands before providing care
• applying petroleum jelly to glans penis at diaper changes (unless plastic ring was used) for
3-7 days to prevent adhering to diaper
• site typically heals within 7-10 days
• expect yellow exudate on penis after the first day, a normal part of healing
• use warm water (without soap) to remove urine/feces during diaper changes or at least twice
daily
Abnormal findings post circumcision
Answer: • unusual swelling, increasing redness
• odour, abnormal discharge
• excessive bleeding
• absent/decreased urine output (notify HCP if no voiding within 6-8 hours)
Wilms tumor (nephroblastoma)
Answer: • kidney tumor usually occurs in children age <5
• usually discovered when caregivers note an unusual bulging/swelling on one side of
abdomen
Wilms tumor precautions
Answer: • abdomen should not be palpated - important to post sign "do not palpate
abdomen" at bedside preoperatively
• handle carefully during bathing