NCSBN Questions

1.) Celiac Disease? S&S: steatorrhea, foul smelling stool.

Give gluten free diet: no bread, no vanilla, can have corn and rice

2) Viagra? Take 1 hr before sex, not for pts. taking organic nitrates.

SE: H/A, flushing and dyspepsia, if erection more than 4 hours call M.D

3) Chronic Cirrhosis Leanac? Color jaundice, commonly caused by alcoholism.

4) Cystic Fibrosis? Sweat test > 60 is positive, normal is 40.

5) Pheochromocytoma? Check BP

6) Addison Disease? Decreased secretion of adrenocorticotropic hormone (ACTH)

S&S: hypoglycemic, hyperpigmentation, > K+, weight loss, decreased NA+

7) Side effect of Coarctation of Aorta? Upper extremity, > circulation

Lower extremity, < circulation

SE: Leg cramps, thready or absent pulse, cold extremity

8) Pt states feel funny? Check H&H, because when H&H low; SE: dizzy, tachy, and low bp, fatigue, weakness.

9) Agoraphobia? Fear of open spaces, defense mechanism: repression and displacement.

10) Multiple Myeloma? Tumors of the bone, check for Calcium.

11) Nursing Intervention for Chemotherapy? Neutropenic and bleeding precautions, increase fluids for increase Ca+, encourage ambulation to prevent renal problems.

12) Hypospadius, how can you know patient is ready for toilet? Surgery is done before the age of between 16-18 months of age. Child should not be circumcised, cause foreskin may be used for surgical reconstruction.

13) Hypopasdius? Urethral orifice is located below the glans penis along the ventral surface.

14) Epispadius? Urethral orifice is located on the dorsal surface of the penis.

15) Patient is intubated, how to collect a sputum? Via suction, nasotracheal suction.

16) Patient states he cannot sleep? What do you do or use before, assess pt. sleeping patterns.

17) Uteroplacental Insufficiency? Stop oxytocin if on it, and give oxygen.

18) Early Deceleration- Head compression

Late Deceleration- Utero-placental insufficiency: Give oxygen

Variable Deceleration- Umbilical Cord compression: reposition

19) Liver Biopsy? Place pt. on right side; leaks, check for bleeding. Bleeding and bile peritonitis are the major complication after a liver biopsy.

20) S&S of rheumatic fever? To qualify for rheumatic fever, you have to have 2 major side effects and 2 minors.

Signs of Rheumatic fever: carditis, abnormal heart sounds

-Subcutaneous nodules; small nontender swelling over the joints

-Chorea; sudden involuntary movement

-Polyarthritis; inflammation of more than one joint, elbow, knees, ankle, wrists.

-Erythema margination; truncal erythatous non pruritic rash

Nursing Intervention:

Bed rest, administer antibiotics prophylactic to prevent infection.

21) CVA risks? Uncontrolled HTN, > cholesterol, hyperlipidemia, African American, Men, oral contraceptive, obesity, diabetes.

22) C5 Quadriplegia? Full sensation to head, neck, chest and upper arms, independent breathing, but poor lung capacity.

23) C1-C3? No voluntary movement or sensation, ventilator dependent.

24) Parathyroid? Regulates Ca+ and phosphate

25) Hypoparathyroidism? < Ca+, phosphate >, see (+) Chvostek’s and Trousseau’s sign. Signs of muscle cramps, signs of overt tetany, such as bronchospasms, dysphagia, cardiac dysrhythmias.

Diet: >Ca+, <Phosphate.

Intervention: Initiate seizure precaution, Place tracheostomy set, oxygen, and suctioning at bedside.

26) Hyperparathyroidism? > Ca+, < phosphate, fatigue and muscle weakness. Call M.D if precipitous drop in Calcium occurs.

27) Patient controlled analgesia, how do you know it’s not working?

28) Cushing Triad? It is a grave sign, change in mental, < LOC status and v.s.

- It is late sign of > ICP, hypertension, bradycardia, bradypnea as

condition deteriorates, pt. becomes decorticate and decerebrate posturing.

29) Personality Disorder, what to do with patient? Talk to the patient.

30) Diverticulosis? Low fat, > fiber, food with no skin or seeds.

31) Aneurysm surgery (AAA)? Check for bowel sounds.

32) Clostridium deficile? Contact precaution, have diarrhea, watery diarrhea, or diarrhea containing blood or mucus.

33) Umbilical Cord Prolapse? Knee chest position, give oxygen

34) S&S of shock? ↓ BP, ↑pulse, tachycardia, ↑ respirations, diaphoresis,

And cold clammy skin.

35) Multiple Myeloma? < production of immunoglobulin and antibodies and increased > levels of uric acid and calcium which can lead to renal failure.

36) Hepatic encephalopathy? Asterexis; flapping tremor of the hand

37) BUN 8 – 25

Creatinine 0.6 – 1.3

Platelet 150,000 – 400,000

Hemoglobin 12 – 14 Female

Hemoglobin 14 – 16 male

Hematocrit 35 – 47 Female

Hematocrit 42-52 Male

WBC 5,000 – 10,000

Magnesium 1.3 – 2.1

38) Prostate Cancer? Nocturia, Urinary hesitancy, urinary retention, lower back pain, and hematuria, < force of the urinary stream.

39) TPN? Check for bowel sounds, because of the high concentration of glucose solution of TPN.

40) Cast Care? Handle cast with palm of hand, do isometric exercises to prevent disuse syndrome.

41) Pt. with status asthmaticus, pt. showing worse? There is no wheezing, sign of impending respiratory failure, PACO2 >, PH <, reflecting respiratory acidosis.

42) Paracentesis? Remove fluids from peritoneal cavity

Pre op: Consent, void, sitting position

Post op: measure abdominal girth and weight before and after procedure

Watch for s&s of schock, watch for scrotal edema

43) Laryngectomy? Avoid swimming, showering using aerosol spray and exposure to persons with infections.

44) Patient wandering what to do? Redirect patient

45) Cholecystitis? Observe patient for infection, leakage of bile and obstruction of bile.

46) Priority, 2 month old baby with fever 100.3, or 4 month old with fever of 100.4, which would nurse assess first? Assess 1st 2 month old baby.

47) Rheumatoid Arthitis? Morning stiffness (joints).

48) Retinal Detachment? Pre op: Same side as detachment

Post op: Avoid coughing, vomiting, bending from waist.

49) Retinal Detachment? Pt. reports sensation of curtain drawn before eye, flashes of light or blurred sooty vision, pt. does not complain of pain.

Nursing Intervention: Cover both eyes with patches to prevent further detachment.

50) Scoliosis? Unequal leg length, > 5 degree deviation or scoliometer; body image disturbance.

51) Leukemia? Fever or infection, neutropenic precautions (decrease in WBC’s), reverse isolation, assess for anemia or bleeding.

52) After CABG (open heart surgery) what do you assess? Neurologic status, cardiac status, respiratory status, peripheral status, pain status, fluids and electrolytes.

53) Duodenal Ulcer, type 0? Pain relieved by eating 2 – 4 hrs. after eating

54) Gastric Ulcer? Pain 1 – 2 hrs after eating, weight loss, vomiting.

55) Cholecystectomy? Monitor for infection, leakage and peritonitis, assess for t- tube drainage.

56) Gonorrhea transmission? Sexually transmitted

57) Pancreatitis, what do you assess? Pain left upper quadrant radiating to the back.

58) Sigmoidoscopy, what to assess? Rectal bleeding for sign of bowel perforation, position knee-chest.

59) Endoscopy? Pre-op: NPO 6-12 hrs.

Post-op: check for gag reflex

60) Stage 11 year old? School age, collect cards, games

61) Hip replacement? ALL that apply; abduction pillow, do not cross legs, pillow to hold internal rotation.

62) Magnesium sulfate? Respiratory depression, antidote: calcium gluconate.

63) Digoxin for child 4 years old; HR 90 – 150

HR < 90 hold med

64) Mononucleosis? Epstein Barr virus, contact with pharyngeal secretion 4- 6 weeks incubation.

65) Sickle Cell? Give morphine, no Demerol

66) Meningitis? Droplet Precautions

67) S&S of Lyme Disease: flu like symptons, rash noted, what do you ask patient? If you went out door forest, park

68) Legionnaire’s Disease? From dirty water, Airbone Precautions

S&S: joint pain, loss of energy, headache, coughing of blood, chest pain and fever.

Tx:Levofloxazin, erythromycin

69) Diabetes Insipidus? Polydipsia, Polyuria, excessive thirst.; ts: vasopressin

70) Patient has no period for 1 year? You know she had menopause.

71) Pinworms, Dx: tape test

72) Colostomy irrigation? Bag hangs 18-20 inches above stoma when patient sitting above shoulder.

73) 3 point gait crutch? Advance both crutches forward with the affected leg and shift weight to the crutches. Advance unaffected leg and shift weight. Advantages: allows the affected leg to be partially or completely free of weight bearing. Requirements: full weight bearing on one leg and upper body strength.

74) 2 point gait crutch? Advance left crutch with right foot, advance right crutch with left foot. Advantages: more normal walking patterns. Requirements: partial weight bearing on both legs, balance.

75) Autonomic Dysreflexia? Constipation x 3 days

76) Osteoarthitis? All that applied

77) Twin birth (labor)? Risk for bleeding

78) ECT? Reorient to time and place SE: temporary memory loss

79) Meningitis? All that applied

80) Multiple Sclerosis? All that applied; chronic long term condition that affects the CNS, which includes brain, and spinal cord. Is an autoimmune disease, body’s immune system attacks itself targeting the cells, tissues and organs.

81) Chest tube with constant bubbling? Air leak.

82) HHNKS Hyperosmolar hyperglycemia nonketotic syndrome? Patient urinates a lot, monitor K+ level, blood sugar gets extremely elevated may lead to seizures, and coma.

83) Epiglotitis? Drooling

84) Croup? Inspiratory stridor

85) Anthrax? Standard Precaution

86) Plague? Standard Precautions

87) Baby of 15 months, what do you report to M.D? Walking sideways.

88) B.S??? All that applied

89) Hepatitis A? Document

90) Incident report? Must be kept confidential, they are kept in a locked file.

91) Genital Herpes? Caused by herpes simplex, flu like symptons, tx:acyclovir?

92) Mental Retardation? Palmar crease, protruding tongue, hypotomia, dry skin, poor eye contact during feeding.???

93) Open reduction? Proper alignment, weight hang freely and do not touch floor

94) Parathyroidectomy? Low calcium, tingling in the fingers

95) Pyloric stenosis? Projectile vomiting, non-bilious vomiting, olive-like mass tx: stomach decompressed with NG tube.

96) Paget Disease? Progressive enlargement and deformity of bone. Dx: x-ray, > serum alkaline phosphatase and urinary hyroxy excretion. Have gait problem, unsteady gait.

Nursing Intervention: weight control, calcitonin.

97) Hemophilia? Mother give the disease to the son. Women carry, male transmit disease to son.

98) Bell’s Palsy? Eye drops, mouth care. Is a one sided facial paralysis from compression of facial nerve. Facial droop from paralysis of face muscles, painful sensations in eye, face, or behind ears, and speech or chewing difficulties may occur.

99) Pericarditis? Inflammation of the pericardium, pain radiate to back and abdomen most with coughing. Pericardial friction rub? Scratchy, grading sound heard at end of exhalation.

100) Osteoporosis? All that apply

101) Scoliosis? Body image disturbance

102) Lead Poisoning? Milk

103) Restraint renewal? M.D order q 24 hrs, check restraint q 2 hrs.

104) Total hip replacement? Leg roll

105) Pudental block? Local anesthetic instill into vagina, just before delivery

106) Prior to administration of anesthesia? Cervical dilation 4 – 6 cm.

107) Colostomy irrigation? Hang bag 18 – 20 inches above stoma. On bed rest position client on the side, hang the irrigation bag so that the bottom of the bag is at the level of the client’s shoulder or slightly higher. Perform irrigation preferably 1 hr after a meal.

108) Hydiatiform? Not to become pregnant for 1 year.

109) Pulse oximeter? Nail polish

110) Blakemore tube? Scissor at bedside

111) Rheumatoid Arthritis? All that apply

New Paper

1) Patient has just arrived, and does not speak well, what should nurse do? Tell him that you do not understand him and need to clarify.

2) Patient with dysphagia? Give thick liquids

3) Cranial nerve 7? Facial nerve, face (motor)

4) Patient with HTN and glaucoma what most concern to R.N? Constipation last week and frequently.

5) Baby is going to surgery, what R.N has to report to M.D? Passage of brown stool

6) Crohn’s Disese? Characterized by nonbloody diarrhea, not more than 4 -5 stools/daily.

7) Early sign of bowel obstruction? Hyperactive bowel sounds above obstruction, and hypoactive below obstruction.

8) Cushing’s Diet? > protein, K+ : Signs: moon face, buffalo hump, hypokalemia, peripheral edema, > weight, apetite, hyperglycemia, > WBC.

9) Toracotomy? “I will have a chest tube.”

10) Patient with Urinary retention? R.N should measure I & O hourly

11) Lumbar puncture?? Fluids??

12) Total gastrectomy (feeding)? Before 10 days feeding is thru NG tube. After 10 days small frequent feeding ( normal).

13) Which patient to diagnose first? Pt. with surgery 2 days ago using a device.

14) Which see first? Pt. with hematuria with > temp.

15) Renal Failure? < Na=???

16) Lithium diet? Avoid can foods high in Na+

17) Attention Deficit Disorder? Give meds daily

18) Oxytocin? 6

19) Confidentiality? Don’t reveal dx of pt.

20) Priority? Pneumonia, history of hepatitis

21) Teach risk for patient with PAD? Exercise

22) Pt. with osteoporosis, diagnose? History of fracture

23) Hemophilia? Kid with tricycle and helmet

24) Which can’t you place together? MRSA and Hepatitis C

25) Which can’t place together? Diabetic with ulcer, placed with pt with bacterial pneumonia.

26) GI, early symptom of obstruction? Auscultate 4 quadrants X 5 mins.

27) Cholecystectomy? Red brownish drainage not expected, greenish drainage expected.

28) Pacreatitis, most concern? Breath sounds diminished

29) No k+ if HF.

30) Order passes of cane? Hold cane unaffected side with elbow flexed 30 degrees.

-Advance cane and affected leg

- Lean on cane when moving good leg.

31) IV site with swelling and redness? Decrease IV rate.

32) Cranial nerve 9? Glossopharyngeal; swallowing

33) Cranial nerve 11? Accesory; Assess shoulder

34) Diabetic with somogi effect? 2 – 3 a.m hypoglycemia

-5 – 8 a.m hyperglycemia; give food before bed, ↓dose of NPH.

35) Cane: Flex elbow 30 degrees and hold handle, tip of cane should be 15 cm lateral to the 5th toe.

-Hold cane in the unaffected side

-Advance cane with affected leg together

-Lean on cane when moving good leg

36) Which on is not negligence? Pt. with syncope tell him to raise his feet.

37) Which is negligence? Do self catheterization with out gloves.

38) Pt. with multiple sclerosis with self cath. How do you know if pt. doing it right? Uses a mirror to do it. Multiple Sclerosis is a chronic long term condition that affects the CNS, which includes brain and spinal cord. MS is an autoimmune disease. Body’s immune system attacks itself targeting the cells, tissues, and organs.

39) Pt. undergoing toratomy, what do you teach patient regarding after surgery? Pt will have a chest tube.

40) Pt. undergoing bronchoscopy, what to do before surgery?

Pre-op: NPO from midnight, v.s, ptt, pt, remove dentures and eye glasses

Post-op: assess gag reflex, NPO until gag reflex present.

41) Which toy to give child? 11 month old give hand puppet

42) Pt. with rubella 1 month before given birth what will R.N do?

Private room for mom and baby.

43) Pt. with HIV place with Hepatitis B

44) Which one will you see first? Muffled heart sounds with pneumothorax, signs of cardiac tamponade.

45) Pt with pneumonia recently transferred to ICU, upon assessment, 02 sat is diminished, nursing intervention? Call M.D.

46) Teaching for Addison patient? Risk for Deficient Fluid volume, encourage intake of Na+, protein and complex carbs. S&S: Postural HTN, muscle weakness, wight loss, depression, irritability.

47) Which pt. you see first? Pt. with singed nose hairs.

48) SC injury??? Put foley in dependent position??.

49) Pt. with diarrhea what can’t you give? Apple sauce and wheat bread??

50) Priority? Pt with MI was having PVC 4 – 5 per min. Note pt. with 3 PVC’s in 10min (normal).

51) Diabetic pt. what a goal to give NPH? Maintain Ha1c less than 7 %.

52) Pt. with anorexia? Lanugo

53) Pt. taking cortocosteroids what is wrong comment? Now I don’t have to take care of my cold.

54) After chemo, with WBC on 5000, what will you do? Reverse Isolation.

55) Nurse from medsurge to ob? Give triplet

56) Priority? Streptococcal infection with facial edema

57) Pt. taking iron what needs further assessment? Pt. take iron with breakfast.

58) Glaucoma? No peripheral vision.

59) Pt. with Raynauld’s disease? Ask about past history.

60) Which pt. inform to come to the clinic?? Pt. says that he has not urinated fro the last 4 days with prostate problems.??

61) Risk factor for testicular cancer? Undescended testicles (cryptochordism).

62) Meds for diabetic Type 2? Take 30 mins. before food.

63) Pt. with spinal cord injury lumbar what will you tell pt. before catherization? Take deep breaths to relax???

64) Mastectomy? Do exercises starting with the hands, then arm and then shoulder.

65) Heimlich maneuver???

66) Old lady with diabetes, incontinent of urine and stool, stage 2 pressure ulcer, lives with children who are adults. What does R.N do? Start papers so she can go to a nursing home care.???

67) Deceleration? HR decreases after a contraction.

68) Which you do not place together? Pt with pressure ulcer with pt with bacterial pneumonia???

69) Wrong about Lithium? Pt. says she can eat foods high and salt (can foods).

70) Laryngectomy? Avoid crowded places.

71) Alcohol and marijuana do not have same effect.

72) Priority? – Pt. with esophageal varices with lots of coughing

      - Pt. with ulcerative colitis with 5 bloody diarrheas in 1 hr.

73) Something wrong with precaution? R.N enters the room for pt with T.B with a surgical mask.

74) An R.N from psych to E.R cause a catastrophe, which pt. to give R.N? A child who thought that what happened was his fault.

75) A woman suffers from domestic violence, came to hospital saying she left her home. What is the best form for R.N to make her talk? Give me more information of how everything occurred.

76) Patient going for surgery which order does R.N question? Insulin is given before surgery because stress during surgery increases glucose.

77) Pt. going to partial abd. Recreation, what does pt. say that he understood teaching? I will have a stoma and I will need a colostomy bag.

78) Infection precaution, right statement? Nursing assistant attended Aids pt. using gloves.

79) A primipara tells R.N that she had Chlamydia 2 weeks before baby was born, asks how do you know that baby has this? Baby with watery eyes a lot.

80) Priority? Pt with DVT complains of pain in the calf in the affected leg.

81) Pt. with pacemaker that is setup at 70 bpm, what does R.N find wrong in pt. Regular hr of 60 bpm.

82) Pt. underwent venography, what r.n advises pt. after procedure? Increase fluid intake

83) Pt. with Pancreatitis, which most concerns R.N??? Guilen turner sign expected, complications: pleural effusion, ARDS, hypocalcemia, renal failure.

84) Pt. with Parkinson’s, how to take new med? Take it with an empty stomach

85) Pt. with heart problems, which most concerns R.N? Pt with JV distend inflamed at 1 inch above clavicle.

86) Teaching new parents essential when preparing the milk in polvo for infant? Mix well with water with the polvo so it will be good diluted.

87) Cushing’s symptom? Hypocalcemia, decreased potassium level, increased blood glucose level, increased sodium level.

88) Pt. with Myasthenia Gravis in pt. with crisis, most concerns R.N? Cuffing reflex of swallowing loss. Neuromuscular disorder characterized by variable weakness of voluntary muscles, which often improves with rest and worsens with activity. Caused by abnormal immune response. S&S: swallowing difficulties, weakness or paralysis.

89) Scenerio, pt with history of osteoporosis, pt. ask to nurse how she can decrease risk? Make diet to < lb???

90) R.N teaching to parents, which indicates parent’s understood teaching? Parents state that they will place the gun and bullets in a locked cabinet.

91) Infant with 3 months, with intussusception, which concerns most to R.N? Decreased bowel sounds (obstruction).

92) Pt. with blood transfusion, v.s normal, after 1 hr everything begins to change, <Bp, >pulse, fever, what nurse do first? Stop transfusion.

93) Pt. undergoing neck radiation? Pat and dry in the neck.

94) Diet for pt. with ESRD? >carb, <sodium, <protein.

95) A primipara, r.n checking fetal hr, what is most concern to R.N? variable deceleration between contractions.

96) Pt. in ventilator? Low alarm when pt is in semi-fowler position.

97) Diet for Diverticulitis? >fiber found in internet lowers pressure inside colon, > carb.

98) A pt. with substance abuse is in stage of Denial. How would R.N help pt. because he says he does need to go to A.A? You couldn’t stay sober before coming here.

99) R.N in nursery in newborn unit, doing assessment on 2 day old infant, what worries most to R.N? Baby is quiet with irregular rapid eye movements.

100) Lab values seen in Iron Deficiency Anemia? < rbc, platelets, hemoglobin, > iron.

101) Priority most critical? Pt. with AAA abdominal aorta aneurysm operated 16 hrs ago and restless with hypoxia.

102) Pt. with HF restless with bounding pulse, what R.N does before call M.D? elevate HOB 30 degrees.

103) Which case does R.N informs M.D to admit him to social worker? 26 year old pt. with below the knee amputation living alone.

104) Right statement of pt. placing eye drops in eye? Press the corner (inner canthus) of the eye.

105) Pt. with peritoneal dyalisis, R.N, teaching was effective? Dialysate at room temp.

106) Chronic Renal Failure? >WBC, rbc, proteins, glucose.

107) Vericose vein ligation? All that apply

108) R.N was doing an conference, statement made by parent indicates good teaching? Enroll the child in the swimming class in the community pool.

109) What happened to pt 89 yr old with olfactory problems? Pt said that his foods weren’t tasting good.

110) All that apply with aging process

111) Pt with rectal fistula, which advice r.n gives? Clean well the perineal area when out of bathroom.

112) Patient with status asthmaticus which worries R.N? Absent of wheezing breathing sign.

New Paper

1) Mammography? Breast is compressed two times fro top to bottom and from side to side.

2) Which needs further assessment? One that came out of depression and was ready to take a walk.

3) Teaching of nephrostomy tube??? Report if there is drainage out of the tube??

4) Priority? Pt. with renal failure with 2ml/hr

5) More risk for testicular cancer? The mother while pregnant took diethylotillbestrol (DES)??.

6) Which is correct concerning Hepatitis? Hep. B Has to be vaccinated with Hep. B in order to be safe from Hep. D.

7) thallium Scan test teaching? Choices: Have to go 2 times to the radiopaque??, or NPO for 6 hours. Info: Is a method of examining the heart, you go to a treadmill, radiopaque injected to you, NPO 4 hours before test. There are two parts of the test, exercise and rest portion with pictures.

8) Pt. with anorexia nervosa, what should R.N do? Analyze the triggers that prohibit her to eat.

9) Pt. with hip fracture has a fever, > BP, diaphoresis, what to do? Obtain an ABG, order for an ABG.

10) Priority? 1) Give insulin to pt with bg of 237 or 2) K 2.3, give 20 meg IV.***

11) Thalassemia teaching? Plan activities with frequent rest periods. Info: Thalassemias are hereditary disorders characterized by defective production of hemoglobin. This leads to low production, and excessive destruction, of red blood cells. S&S: Fatigue , Shortness of breath ,Jaundice.

12) What to expect in hemolytic anemia? Hemolytic anemia is a condition of an inadequate number of circulating red blood cells (anemia) caused by premature destruction of red blood cells. S&S: Increased urine and fecal urobilinogen, Elevated absolute reticulocyte count , Low red blood cell count (RBC) and hemoglobin ,Elevated serum LDH, hemoglobin in urine: Also fatigue, SOB and enlarged spleen. Answer they chose?? WBC < ???

13) Teaching before bronchoscopy? Mouth care??;Info: Do not eat or drink anything 6 to 12 hours before the test. Your doctor may also want you to avoid any aspirin or ibuprofen medications before the procedure.

14) Which should be delegated to CNA? Pt. with Parkinson’s ambulate.

15) Which med to give first? Albuterol to pt. with Asthma and cough

16) Pt. with hepatic cirrhosis what to expect? Hum sound in the abdomen using the bell of the stethoscope.

17) ESRF with hepatitis? Place at end of hallway with private room??

18) Patient with hypoglycemia, how to avoid of this from happening? Find the causes of hypoglycemia.

19) Which is not wrong? Suction of the tracheostomy with cuff and R.N was disinflating the cuff before suction.

20) Diet for pt. with dysphagia; CVA? Tuna with mayonnaise

21) Pt. with laryngectomy has difficulty swallowing, what R.N does? Suction the pt. the prevent aspiration.

22) Order for culture and sensitivity test? 1) Place clean gloves and remove old dressing 2) Take out swab from tube 3) Pass swab by injury site 4) Place swab inside the tube 5) Press the tube to release the culture medium.

23) Pt. talking with nurse looking to roof? Ask are you hearing voices.

24) Rubella, what is correct? Pt. using a surgical mask.

25) Pt. with rubeola? Pt.using a repiratory mask.

26) T.B close door

27) All that apply- Insulin for a pt. with Diabetes type 2?Includes:

-I have to perform the Hba1c every 2-3 months

-If I have hypoglycemia, I have to drink orange juice

28) All that apply NPH? Includes: -I have to take A1aC every 2 -3 months

- If I feel signs and symptons of hypoglycemia, I will drink orange juice

-after 8 hrs I will feel s&s of hypoglycemia??.

29) Who will be at more risk for fluid and electrolyte imbalance???

-70 yr old pt. with an urinary drainage coming from the veriga o barriga

-5 yr old child with an ileal conduit.

30) Which test to have annual to test for colon cancer? Fecal occult blood after age 50.

31) All that apply in Ovarian cancer? Pain in sex, abdominal pain, flatulence Info: weight gain or loss and also unexplained back pain that worsens over time.

32) Signs of Pernicious anemia? Include weakness, mild diarrhea, and a smooth red tongue. Pt. may also have nervous system symptons , paresthesias, difficulty in balance, and occasional confusion. Have vit. B12 deficiency. Will also see right shift of WBC’s which indicate increased number of neutrophils seen in pernicious anemia and following tissue breakdown. Decreased RBC seen with vit. B6 and B12 deficiencies as well as with hemolytic anemia, and pernicious anemia. RBC decreased in corticosteroid therapy, dehydration, diarrhea. Also see > hematocrit in pernicious anemia, and dehydration.

33) What can you do to prevent osteoporosis? Decreased smoking

34) Pt. with osteoporosis, what to give her? Vit. D

35) How do you know a pt. has Diabetes Insipidus? Urinates 8 L in 24 hrs.

36) Risk for ovarian cancer? Ovarian Cyst

37) Endometriosis, all that apply? Infertility, Dysmenorrhea, most common in bear children.

38) Diet for Diverticula Disease? I will eat sandwich made with whole bread, can also eat broccoli and cabbage, and lettuce.

39) Pt. with hemodyalisis which was taking meds, what would be the best answer? Let me help you to schedule the med during the day.

40) All that apply with precautions? A pt. with Heptitis B in a private room (Did not pick this answer.??

41) Which precaution is incorrect? R.N was entering room of pt. with Legionnaire’s Disease with gown and gloves.??

42) Which is incorrect? Pt with an implant states once she gets home she will read a book to her grandchildren.

43) Herbs which is correct??? Save Palmeto with BPH.

44) Priority?? –Pt. with tonsillectomy 12 hrs ago with bright red mucus with 19 years old or – 20 yr.old pt. with hip fracture 3 days ago

45) A paranoid schizophrenic tells R.N not to write in their chart because the people of security will know about me, what to say? That may be frightening for you.??

46) Cholecystectomy Laparoscopy? –Several incisions, Pain in the shoulder which alleviates with position change, Deep breath and ???

47) Superior Vena Cava Syndrome? Flushed edematous face, venous distention.

48) Diet for Dysphagic pt? Pure de papa

49) Exam of testicles? Rolling the testicles with fingers

50) Pt. with cystic fibrosis, which option indicates that condition is worsening?? Pt. has infection and sputum thick and yellow.

51) Pt. with polycythemia, see? Smooth, red tongue.

52) Parkinson’s? Pill rolling motion.

53) How to document an error, always pick statement that is objective.

54) Post ? Disorder, 4 children that had seen a homicide taken place? Correct choice, the one that 1 thought that something bad was going to happen.

55) Niacin Vit. B 12? Regular dose is 250 mg P.O Daily (H.S)

56) Intubated pt, R.N auscultates and does not find lung sounds in all lung, what to do? Prepare to reintubate.

57) Hyponatremia? Fatigue

58) If chest tube becomes disconnected, nurse should place end of tube in a container of sterile water or saline as quickly as possible to maintain an underwater seal.

59) If chest tube is pulled out accidentally, nurse immediately would apply an occlusive dressing and contact the physician.

60) Bronchiovesicular breath sounds located over major bronchi.

61) Vesicular breath sounds located over peripheral lung fields.

62) Bronchial (tracheal) breath sounds located over trachea and larynx.

63) Huntington’s Disease? Huntington's disease is an inherited condition characterized by abnormal body movements, dementia, and psychiatric problems. Huntington's disease is a progressive disorder involving wasting (degeneration) of nerve cells in the brain. S&S: antisocial behaviors, psychosis, paranoia, unsteady gait ,progressive development of abnormal (choreiform) movements. Psychiatric illness, depression and suicide are common in Huntington's Disease. Give Haldol

64) NPH duration? 12 – 24 hrs.

65) Regular insulin? Onset 10 – 30 mins, , peak 15-30 mins, duration 30 – 60 mins. At 10 a.m expect reaction.

66) NPH? Onset 3-4 hrs, peak 6 – 12 hrs, duration 24 hrs. Expect reaction at late afternoon, like at 4 p.m

67) Rubeola (Measles)? Airborne/Contact precautions. Info: white spots with bluish tinge inside the cheek, koplik spots in the mouth. Downward rash (head to toe)

68) Smallpox? Airborne/Droplet/Contact. Info: circular rash (extremities then body)

69) Rubella(German Measles)? Droplet/Contact. Info: petichiae spots on pallet of mouth

70) Mumps? Droplet/Contact. Info: parotid gland enlargement

71) T.B.? All that apply, - pressure, close door/windows, respirator mask

72) Nurse from ped floor to medsure? Give pt. with Alzheimer’s

73) Ovarian cancer risk? Ovarian cyst

74) Another question of ovarian cancer? All that apply

75) Risk for dehydration? 70 year old with cystocopy.

76) Vein ligation? All that apply

77) After stop transfusion because of reaction, what do you do? Take vital signs.

78) Negligence? Pt walking outside in the hall with rheumatic fever? and diarrhea???

PRECAUTIONS

Airborne Precautions

-Chickenpox    Airborne, Droplet, Contact

-Rubeola(Measles)   Airbone, Contact

-Disseminated Herpes Zoster  Airborne, Contact

-T.B     Airborne

-Smallpox    Airborne, Droplet, Contact

Droplet Precautions

-Diphtheria    Droplet, Contact

-Pertusis    Droplet, Contact

-Rubella(German Measles)  Droplet, Contact

-Scarlet fever    Droplet

-Mumps    Droplet, Contact

-Meningitis    Droplet

-Pneumonic    Droplet

-Influenza    Droplet

Contact

-Mononucleosis   Standard

-Tonsilitis    Contact?

-Hepatitis    Standard

-HIV     Standard

Standard Precautions

-Botulism    Standard

-Bubonic Plague   Standard

-H. influenze pneumonia  Standard

-Legionnaires    Standard

-Pneumococcal Meningitis  Standard

-Lyme Disease   Standard

-Anthrax    Standard       -Plague    Standard

Note: Droplet: use surgical mask

Airbone: use particle respirator

MEDS

1) Side effects of Prozac (SSRI) antidepressant? Agitation, Tremors, sexual dysfunction, weight changes. Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity).

2) Toxicity of A.S.A?

3) Evista? Bone reabsorption inhibitor treats or prevents osteoporosis in post- menopausal women. SE: an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); sharp pain in the legs; swelling of the legs; sudden chest pain; coughing up blood; changes in vision. Insomnia, migraine, depression, hot flash, and peripheral edema.    

4) Buspar? Short-term relief of anxiety, drowsiness, H/A, nausea. Takes 3-4 weeks to take effect. No addiction potential. Non-bendodiazepine. SE: an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; hives); chest pain or an irregular heartbeat; headache, dizziness, lightheadedness, slurred speech, confusion, or blurred vision.         

5) Coumadin? All that applied. Info: Avoid eating cranberries, drinking cranberry juice, or taking cranberry herbal products. Avoid drinking alcohol, which can increase some of the side effects of this medication. Avoid smoking cigarettes or chewing tobacco. Tobacco can alter the effects of warfarin and cause problems with your therapy. SE: pain in your stomach, back, or sides; severe dizziness, headache, or weakness; diarrhea. 

6) Calcitonin? Assist in ambulation??        

7) Propanarol (Inderal)? Propranolol is in a group of drugs called beta-blockers. Beta-blockers affect the heart and circulation (blood flow through arteries and veins). Propranolol is used to treat tremors, angina (chest pain), hypertension (high blood pressure), heart rhythm disorders, and other heart or circulatory conditions. SE: feeling light-headed, fainting; feeling short of breath, even with mild exertion; swelling of your

ankles or feet; nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); Take this med with food 

8) Labetolol? <HR, and BP. Take this med with food.      

9) Sicke Cell? Give morphine, not Demerol.        

10) Captopril teaching? Antihypertensive. Take med one hour before meal. 2 hrs after meal because food in the GI tract reduces absorption.      

11) Pt. with Diabetic Insipidus, give pt? Vasopressin. Monitor for specific gravity.   

12) Nitroglycerin? Dilate coronary arteries. SE: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); an irregular heartbeat; blurred vision or dry mouth; or fainting. Tachycardia, hypotension.         

13) When are you suppose to give Prozac? In A.M to prevent insomnia.      

14) Librium SE: Yellowing of skin or eyes. Poor concentration, impaired judgement, drowsiness, fatigue, confusion.             

15) Provera SE: Weight gain, irregular bleeding, H/A, SOB or pain in chest.     

16) Aminoglycoside SE: Ototoxicity

New Paper

1. Haldol adverse effects? Call your doctor immediately if you experience uncontrollable movements of the mouth, tongue, cheeks, jaw, arms, or legs. Use caution when driving, operating machinery, or performing other hazardous activities. Haloperidol may cause dizziness or drowsiness.            

2. 2) Digoxin? Digoxin helps the heart to beat more strongly and regularly. Hold if HR in infant < 90, of child <70 and adult <60. SE: a severe headache, fainting, or extreme drowsiness or dizziness, irregular heartbeats; slow heartbeats (fewer than 60 beats per minute). Arrrythmias, yellow vision, bradycardia. 

3) Propanolol? Don’t give to pt. with asthma.      

4) Amitriptylline? Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania. SE: fast or irregular heartbeat, heart attack, high bp. PRODUCES blood dyscracias.      

5) Fluconazole? Is a antifungal. Hepatotoxic, so monitor BUN, ALT, AST. 

6) Flagyl ( Metronidazole)? Metronidazole is an antibiotic. It fights bacteria in your body. SE: darkening of your urine, nausea, vomiting, or loss of appetite; an unpleasant metallic taste in your mouth; constipation or mild diarrhea. Avoid Alcohol.          

7) Cimitedine? SE: Arrthymias, confusion, agranulocytosis, aplastic anemia, gynecomastia.           

8) Ampicillin? Take each dose with a full glass of water. Take ampicillin on an empty stomach 1 hour before or 2 hours after meals. Photosensitivity, Nephrotoxic and hepatoxic. Pt has to report weight gain of 1lb per day.   

9) Levaquin? Levofloxacin fights bacteria in the body. SE: Seizures, diarrhea, affect CNS. –Photosensitivity, - Pt states that this med will make my ulcerative colitis worse.

10) Cipro, pick all that apply? Photosensitivity, take whole cycle, 1 hr or 2 hrs after food.

11) Flagyl ? Metronidazole is an antibiotic. It fights bacteria in your body. Take each dose with a full glass (8 ounces) of water. Avoid alcohol. Take with food. S&S: numbness or tingling, dizziness or loss of coordination, or severe diarrhea.

12) Teaching de Levodopa? For Parkinson’s. Take each dose with a full glass of water. Levodopa is usually taken several times a day with food. It may be several weeks or months before the benefits of levodopa are seen. Give before food, avoid > protein intake. Teach pt. to rise slowly. Do not take OTC vit. B6 meds. SE: uncontrolled movement of a part of the body. Persistent nausea, vomiting, or diarrhea, unusual changes in mood or behavior.      

13) Ace Inhibitors? All that apply. Can be given after MI. Give before meals, crush if unable to swallow, avoid sun because causes more hypotension. SE: cough, agranulocytosis, Tachy, MI, and hyperkalemia, and hypotension. 

14) Right statement pt. taking INH and Rifampin for T.B? both are hepatotoxic, Rifampin turns body fluids red. INH need vitamin B to prevent peripheral neuropathy and CNS complication. Paresthesias.      

15) Pt is allergic to Peptobismol, which med the R.N cannot give to pt? Any medicine parecida to peptobismol (Can’t gie ASA, NSAIDS, cause peptobismol has A.S.A.           

16) Wrong statement of a pt. taking meds antivertignous?? Pt. said now I am going to go home driving.( Because med causes drowsiness).   

17) Nardil? Phenelzine is a MAOI, called antidepressants. Works by increasing certain chemicals in your brain. Use caution when driving, operating machinery, or performing other hazardous activities. Phenelzine may cause dizziness, drowsiness, or blurred vision. Rise slowly to prevent dizziness and a possible fall. Avoid alcohol, chocolate. Take each dose with a full glass of water. Avoid cheese sour cream, yogurt, beef or chicken liver,

pepperoni, avocados, caffeine. SIDE effect: hypotension, If given with tyramine foods causes severe HTN.   

18) Pt with Parkinson’s (right statement of how to take med)? Take it with an empty stomach. Sinemet should be taken on an empty stomach just before meals to prevent gastric irritate.        

19) Captopril? Ace Inhibitor. Captopril is used to lower blood pressure, to relieve symptoms of congestive heart failure (shortness of breath, swelling of the legs), to improve survival after a heart attack, and to prevent kidney disease in some diabetic patients. Take each dose with a full glass of water. Take captopril on an empty stomach 1 hour before or 2 hours after meals unless your doctor directs otherwise. SE: dizziness, drowsiness, hypotension, vomiting, diarrhea.   

20) Pt. with respiratory problems which med you cannot give? Propanolol (Inderal). Propranolol is in a group of drugs called beta-blockers. Beta-blockers affect the heart and circulation (blood flow through arteries and veins. Also used to treat angina, hypertension, heart attack, migraine headaches.    

21) Antidote for Ativan? Zomazicon.       

22) Cialis? All that apply. Relaxes muscles and increases blood flow to particular areas of the body. Do not take if have CHF or angina, or blood cell disorder. Take each dose with cup of water, can be taken with or without food. Usually taken before sexual activity. Avoid drinking alcochol.      

23) Don’t take Garlic with Coumadin.       

24) Tapazole? All that apply. Prevents thyroid from producing too much thyroid. Notify your doctor immediately if you develop abdominal pain, nausea, loss of appetite, yellowing of the skin or eyes, light-colored stools, or dark-colored urine. These symptoms may be early signs of liver damage.     

25) Coumadin? Bad SE: melena        

26) Tofranil? Class of drugs called tricyclic antidepressants. Report fever. toxicity: fever, arrhythmia, seizures, hypotension, blood dyscracias.   

27) Zetia? Ezetimibe reduces the amount of cholesterol absorbed by the body. Take med with or without food. Eat low-fat, low-cholesterol diet. FURTHER teaching: take med 1 hr before eating.       

28) Tapazole? Report sore throat, coughing, hematuria.     

29) Pt. taking aspirin 600 mg, what to monitor? Monitor for ototoxicity. 

30)Luvox (fluvoxamine) Avoid driving if feel dizzy.     

31) Digoxin? < heart rate 62, <K+, <Bp and pulse, fatigue, diplopia.   

32) Digoxin >, K 3, BUN 10, what to do, all that apply? Give food rich in K+, Hold the Digoxin, Check for blurred vision, n/v.      

33) Ampicillin teaching? Give in empty stomach.     

34) Sumatripten Imitres, for migraine? Avoid OTC medications.    

35) Pick wrong statement on Cialis. If med doesn’t work, I’ll take another pill.???

36)Bethanechol? All that apply. Used to treat urinary retention (difficulty urinating). Take bethanechol on an empty stomach 1 hour before or 2 hours after meals to prevent nausea and vomiting. Bethanechol may cause dizziness or fainting, especially when you rise from a sitting or lying position. Rise slowly to avoid becoming dizzy, falling, or hurting yourself. Take med with full glass of water. STAY inside house when temp. is high outside.      

37) Betametazona inhalation teaching with pt. having allergic rhinitis? If have severe mucupurulent stop medication and call M.D.     

38) Omeprazole, 2 questions, Assess? Blood in stool or dark stools. Omeprazole decreases the amount of acid produced in the stomach.     

39) Diabetes with NPH? H/A, nausea       

40) Nystatin SE: N/V, diarrhea, stomach upset. BLURRED vision???