MED SURGE NCLEX-RN EXAMINATION

MED SURGE NCLEX-RN EXAMINATION 1. What is Addison's disease and what are the s/s? ANSWER: Hyposecretion of adrenal hormones (mineralocorticoids, glucocorticoids - cortisol, and androgens - aldosterone) Occurs in all age ...

MED SURGE NCLEX-RN EXAMINATION 1. What is Addison's disease and what are the s/s? ANSWER: Hyposecretion of adrenal hormones (mineralocorticoids, glucocorticoids - cortisol, and androgens - aldosterone) Occurs in all age groups and affects both sexes. Can be life-threatening. Treatment involves taking hormones to replace the insufficient amounts. Signs & Symptoms: - Fatigue - Weakness - Dehydration - Low BP - Hyperpigmentation - Low resistance to stress - Alopecia - Weight loss - Pathological fractures - Depression - Lethargy - Emotional lability - Patho: • Low na & dehydration • Low blood volume / shock • High k /metabolic acidosis/ arrythmias • Low blood sugar • Insulin shock 2. What are the precipitating factors of an Addisonian crisis? ANSWER: - Physical or emotional stress - Sudden withdrawal of hormones 3. What are the signs & symptoms of an Addisonian crisis? ANSWER: - N/v - Abdominal pain - Fever - Extreme weakness - Severe hypoglycemia - Hyperkalemia - Dehydration - Bp falls leading to shock/coma/death. 4. How do you treat an Addisonian crisis? ANSWER: Administer hydrocortisone Carefully monitor IV infusion of 0.9% NaCl or DSW/ NaCl Administer IV glucose, glucagon Administer insulin with dextrose in normal saline administer potassium-binding and excreting resin (e.g., sodium polystyrene sulfonate) Monitor vital signs 5. What is Reynaud's disease? ANSWER: Excessively reduced blood flow in response to cold or emotional stress, causing discoloration of the fingers, toes, and occasionally other areas. This condition may also cause nails to become brittle with longitudinal ridges. Treatment involves encouraging circulation and avoiding vasoconstriction. 6. What is impetigo, s/s? ANSWER: Highly contagious bacterial skin infection most common among pre-school children. Signs & Symptoms: Skin lesions/rash with honey-colored scabs. It is primarily caused by Staphylococcus. if intreated may cause glomerulonephritis. treat with antibiotics. 7. What are the s/s of toxic shock syndrome? ANSWER: Temp 8. What is the diet for a patient with Meniere's disease? why? ANSWER: Low-sodium diet to prevent fluid retention (specifically the endo-lymphatic fluid found in the labyrinth of the inner ear. 9. What is Meniere's disease? ANSWER: A disorder of the inner ear that causes spontaneous episodes of vertigo (a sensation of a spinning motion), fluctuating hearing loss, ringing in the ear (tinnitus), and sometimes a feeling of fullness or pressure in your ear. In many cases, Meniere's disease affects only one ear. Chronic. Episodes usually last 20min-2H, but may last 24 h. severe N/V may occur. Vertigo is uncommon and could be a sign of stroke, brain tumor, multiple sclerosis or cardiovascular. disease. 10. Diet for cystic fibrosis. ANSWER: High protein, high calorie b/c of impaired intestinal absorption. salty foods recommended due to excess sodium loss during sweating. 11. What foods help manage smells from a colostomy? other methods? ANSWER: - Cranberry juice - Buttermilk - Parsley - Yogurt help prevent odors. - Crackers, toast and yogurts help prevent gas. may also use a commercial deodorant. - Avoid skipping meals, chewing gum, drinking beer, and smoking. 12. RX for ectopic pregnancy. ANSWER: Abortion - if allowed to grow may kill mother because of hemorrhage. Methotrexate or surgery. 13. Correct positioning after lumbar puncture ANSWER: Flat supine; to prevent headache by preventing leakage of CSF at site. 14. Diet for dumping syndrome. ANSWER: - Increase fat and protein. - Decrease carbs because they are the first to be digested (want to slow digestion) - Decrease fiber. - Avoid drinking fluids with meals (none 1h before or 2h after), 5-6 small meals per day - Lie down after eating. 15. What is the cerebrum and what are the 4 lobes? ANSWER: The cerebrum controls emotions, hearing, vision, personality all voluntary actions and more. The 4 lobes are: - Frontal - Temporal - Occipital - Parietal 16. What is the location and function of the temporal lobe? ANSWER: Responsible for processing auditory information from the ears (hearing) 17. What is the location and function of the frontal lobe? ANSWER: Carries out higher mental processes such as thinking, decision making, and planning, where our personality is formed 18. What is the location and function of the occipital lobe? ANSWER: Responsible for processing visual information from the eyes 19. What is the location and function of the parietal lobe? ANSWER: 20. What are the functions of the left hemisphere of the brain? ANSWER: 21. What are the functions of the right hemisphere of the brain? ANSWER: 22. Symptoms of right hemisphere damage ANSWER: - 23. Symptoms of left hemisphere damage ANSWER: - 24. Normal urine output ANSWER: 25. What is the effect of increased carbon dioxide on intracranial pressure? what are the potential implications for patients? (Nursing Care) ANSWER: 26. Name the 12 cranial nerves, their functions, and how to assess their functionality ANSWER: 27. What is Autonomic dysreflexia and what are the symptoms? What are a few nursing actions? ANSWER: 28. Priority nursing actions for a woman in labor showing late decelerations on the fhr monitor. ANSWER: 29. What is the timeline for alcohol withdrawal? ANSWER: 30. Priority assessments preceding femoral angiogram ANSWER: 31. What is the priority assessment for a damaged parathyroid gland? ANSWER: 32. Early s/s for hypocalcemia ANSWER: 33. Level and s/s hypoglycemia ANSWER: 34. Tracheostomy care: catheter size, 02 level, wall suction range ANSWER: 35. Chron's diet ANSWER: - 36. What is a lumbar laminectomy and why is it done? ANSWER: 37. How do you perform a log roll? ANSWER: 38. What is lupus? ANSWER: 39. What conditions is a moist warm compress used for? Nursing considerations? ANSWER: 40. When to use cold therapy? ANSWER: 41. How is Lyme disease treated? ANSWER: 42. Signs & Symptoms of Lyme disease? ANSWER: - 43. What is the incubation period for rubella? ANSWER: 44. Can pregnant women receive the rubella vaccine? ANSWER: 45. What syndrome can lithium use cause? ANSWER: 46. What are the Signs & Symptoms of diabetes insipidus? ANSWER: - 47. What are the dietary needs of a patient taking lithium? ANSWER: - 48. What is SIADH? what are the s/s? what are the causes? ANSWER: 49. If a pregnant woman has a drop in blood pressure from medication or other reasons, what is the best position to put her in and why? ANSWER: 50. What is the first thing to do for a patient whose trach. tube has become dislodged and they cannot breathe? ANSWER: 51. Is there communication between the upper airway and the stoma of a patient who has undergone a tracheostomy or a laryngectomy? ANSWER: 52. After a vasectomy, can a man get a woman pregnant? ANSWER: 53. How should a client be positioned for the first 24 hours after a below the knee amputation? ANSWER: 54. How should a client be positioned after the first 24 hours after a below the knee amputation? ANSWER: 55. In terms of delegation, what are the rules of thumb for the types of patients to give to: Nursing assistive personnel LVN/LPN? ANSWER: - 56. What causes metabolic acidosis? ANSWER: 57. What causes respiratory acidosis? ANSWER: 58. What are the available vaccines that are considered to be live? ANSWER: - 59. What amount of time must pass after a traumatic head injury for a patient to be eligible for thrombolytic therapy? ANSWER: 60. Is it preferable for an Alzheimer’s patient to be in a private room or a semi private room? ANSWER: 61. What time of the day is the best for giving methylphenidate? ANSWER: 62. What is a normal platelet range? ANSWER: 63. What is the major difference between in-hospital catheterization and in -home catheterization? ANSWER: 64. Signs & Symptoms of preeclampsia ANSWER: - 65. Risk factors for preeclampsia ANSWER: 66. When does fetal quickening occur? ANSWER: 67. Treatment for preeclampsia ANSWER: 68. Do you need a clean catch or a sterile catch for a culture and sensitivity urine collection? ANSWER: 69. What is one priority assessment after a cholecystectomy? ANSWER: 70. What are the appropriate actions for a mother in labor having late decelerations? ANSWER: - 71. How do you score an APGAR? ANSWER: 72. What level of precaution is warranted for disseminated herpes zoster? ANSWER: 73. What is the difference between herpes zoster and disseminated herpes zoster? ANSWER: 74. What is the timeframe for an expected low-grade fever reaction to an immunization? ANSWER: 75. What is the expected onset and duration of swelling associated with vaccine injection? ANSWER: 76. What is Cushing’s syndrome? ANSWER: 77. How does medication induced Cushing’s syndrome occur? ANSWER: 78. While hospitalized, how long should a post-surgical client wear anti-embolism stockings? ANSWER: 79. What is multiple sclerosis? ANSWER: 80. What are the recommendations regarding pregnancy for women with lupus? ANSWER: 81. What is the recommended sleeping / bed arrangement for a person with Parkinson's? ANSWER: 82. What must patients with cystic fibrosis supplement in their diet? ANSWER: 83. What is the recommended diet for patients with kidney disease? ANSWER: - 84. What is the target weight gain of a patient hospitalized for anorexia? What is this patient at risk for until they reach this weight? ANSWER: 85. How much weight gain is safe for a person recovering for anorexic wasting? ANSWER: 86. What is the best way for a patient with peripheral arterial insufficiency to increase blood flow to the limbs? ANSWER: 87. What is dissociative personality disorder? ANSWER: 88. What is bell’s palsy? what causes it? ANSWER: 89. What is the treatment for bell’s palsy? 90. In an emergency situation, it is better for one person to take the role of leader, or for leadership to be assumed by everyone? ANSWER: 91. What is the purpose of the z-track method? ANSWER: 92. What is myxedema? Signs & Symptoms? ANSWER: 93. What is myasthenia gravis? Signs & Symptoms? ANSWER: 94. Are shingles contagious? ANSWER: 95. When administering oral medication to an infant, what is the best method? ANSWER: 96. What is talipes equinovarus? ANSWER: 97. What is the normal duration and frequency of labor contractions? ANSWER: 98. How can you tell if contractions are Braxton hicks or true labor? ANSWER: 99. What is the immunization schedule for Hep B? ANSWER: 100. What is the best way to evaluate for fluid status? ANSWER: 101. What diet changes must be made for a patient that has an ileostomy? ANSWER: - 102. How often should you change an ileostomy bag? ANSWER: 103. What types of ostomies can you irrigate? what does this accomplish? ANSWER: 104. What is the proper technique to use a cane? ANSWER: 105. Where should the nurse stand when instructing a client how to use a cane? ANSWER: 106. If an infusion of iv fluids or parenteral meds is behind, what do you do? do you infuse faster? ANSWER: 107. In a patient with type 1 diabetes, what is the appropriate action regarding administration on the morning of a major surgery? ANSWER: 108. Can you turn a patient in Bucks traction? ANSWER: 109. In bucks traction, what method us used to counteract the pull of the weights? ANSWER: 110. What is a Sengstaken–Blakemore tube ? ANSWER: 111. What is the purpose of the T tube? ANSWER: 112. How does a baby inherit Rh /- status? ANSWER: 113. When will there be an Rh sensitization? ANSWER: 114. What type of heart problems are a complication of rheumatic fever? ANSWER: 115. What is the proper way to treat a pneumothorax in the field? ANSWER: 116. In a child with spina bifida (myelomeningocele), does corrective surgery restore function lost by damaged nerves? ANSWER: 117. Why would a client report itching to the nurse if they are beginning use with a pca? ANSWER: 118. What is impetigo and what is its hallmark symptom? ANSWER: 119. Why is it important for a post-partum mother to empty the bladder if the fundus is soft? ANSWER: 120. What is the proper method to change a wet to dry dressing on an infected wound? ANSWER: 121. What is the lecithin–sphingomyelin ratio (aka L-S or L/S ratio) ? What is the desired range? 122. Correct positioning for liver biopsy ANSWER: 123. What are the types of fluids that should be ingested by a patient with a flaccid bladder? ANSWER: - 124. Post appendectomy positioning? ANSWER: 125. What is an appropriate fluid volume/24h for a 50 lb. child? ANSWER: - 126. Is it appropriate for a person to have all of their iv maintenance fluids be D5W? why? ANSWER: 127. What is the normal range for central venous pressure? (cm H2O) ANSWER: 128. What temperature should people set the water heater at to prevent burns? (i.e. if they have sensory issues etc.?) ANSWER: 129. What does RACE stand for? ANSWER: 130. Under what circumstances and for how long can you put a person in restraints? what is the protocol for having a physician's order for the restraints? ANSWER: 131. What is Hemophilia A? What is treatment for this? ANSWER: 132. Can an LVN: - Draw labs? - Administer IV meds? ANSWER: 133. 18 infections that can compromise a pregnancy ANSWER: - 134. If a confused client becomes distressed and combative during a bath, what is the proper thing to do? ANSWER: 135. How are vancomycin-resistant enterococcus (VRE) infections treated? ANSWER: - 136. What is tyramine and what are tyramine containing foods? ANSWER: 137. What diet is important to follow for a patient taking MAOIs? ANSWER: 138. What is a clinical pathway? what are they used for? ANSWER: 139. Risk factors for cataracts ANSWER: - 140. What is tubal ligation ANSWER: 141. What is Asterixis? ANSWER: 142. What is ataxia? ataxic breathing? ANSWER: 143. What is apraxia? ANSWER: 144. Is shaving an acceptable method of hair removal prior to surgery? ANSWER: 145. Is it ok to remove a scab/dried blood from a skin graft during a dressing change? ANSWER: 146. What is Paresthesia? ANSWER: 147. What is Waxy flexibility? ANSWER: 148. What is Guillain-Barre syndrome? ANSWER: 149. Can an LPN administer meds? ANSWER: 150. Can ace inhibitors be taken during pregnancy? ANSWER: 151. What are Universal precautions? ANSWER: 152. Why are Kayexalate enemas given? ANSWER: 153. What percent of total dietary intake should be protein? if patient has impaired renal function? ANSWER: 154. What is a positive Chvostek's sign? ANSWER: 155. What is a positive Trousseau's sign? ANSWER: . 156. What hormone deficiency is responsible for Diabetes Insipidus? ANSWER: 157. Where is ADH found? ANSWER: 158. Signs of increased ICP ANSWER: 159. What is a pneumonectomy? ANSWER: 160. Where do chest tubes go post-pneumonectomy? ANSWER: 161. What type of IV tubing (incl. drip factor) do we use for children and infants? ANSWER: 162. How often must the IV site be checked for blood return / infiltration when irritating drugs/vesicants are being administered? ANSWER: 163. When is it acceptable to recap a needle? ANSWER: 164. What is the proper way to store insulin? ANSWER: 165. What are the EKG changes associated with hypokalemia? ANSWER: 166. Diet for nephrotic syndrome ANSWER: 167. What are the possible tissue changes involved in insulin administration? ANSWER: 168. How should the client's chief complaint be recorded in the chart? ANSWER: 169. What type of precautions should be instituted for TB? ANSWER: 170. What causes a curling's ulcer? ANSWER: 171. What is the expected weight gain during pregnancy/each trimester? ANSWER: 172. What does NCLEX consider to be a good weight loss diet? ANSWER: 173. Discharge instructions for minor head injury ANSWER: - 174. What is the proper way to clear a clot in a chest tube? why? ANSWER: 175. Is it ok to clamp a chest tube? ANSWER: 176. What is the abbreviation hs? ANSWER: 177. Signs & Symptoms and complications of lead poisoning ANSWER: - 178. What changes in weight are seen in people with undiagnosed type 1 diabetes? ANSWER: 179. What is the proper way to draw up 2 types of insulin into the same needle? ANSWER: 180. How often should an ostomy bag be changed? ANSWER: 181. Which is a better indicator of pain relief: client report or physical cues? ANSWER: 182. What foods must be avoided for patients with latex allergies? (cross reactive?) ANSWER: - 183. Instructions for 24-hour creatinine clearance test. ANSWER: 184. What do you do if you experience fever when taking an SSRI? ANSWER: 185. Normal bilirubin levels in newborns. level of bilirubin that calls for phototherapy? ANSWER: 186. What is scleral buckling? ANSWER: 187. What is the proper way to transition from heparin to warfarin? ANSWER: 188. What is one important thing that might prevent complete release of dialysate in peritoneal dialysis? ANSWER: 189. Diet for GERD ANSWER: - 190. What IV solution is given for rehydration? Why? ANSWER: 191. Proper precautions for rubella? ANSWER: 192. Proper precautions for rsv? ANSWER: 193. What might subcutaneous emphysema indicate? ANSWER: 194. Priority action in sickle cell crisis? ANSWER: 195. Migraine triggers ANSWER: - 196. Signs & Symptoms of oxygen toxicity ANSWER: - 197. Can a nurse insert a chest tube if it has fallen out? ANSWER: 198. How do you determine the expected fundal height of a pregnant woman? ANSWER: 199. Risk factors for GERD ANSWER: - 200. How long does a person who had a VTE remain on warfarin for? ANSWER: 201. When recording the intake for peritoneal dialysis, what is included? ANSWER: 202. How many oz. are in a cup of water? ANSWER: 203. What is superior vena cava syndrome? ANSWER: 204. What is the expected order of labor of the primigravida/primipara? (same thing if fetus has passed 20 weeks) ANSWER: 205. What is the expected location of the fundus immediately after birth, at 12 hours after birth, 2 days after birth, one week after birth? ANSWER: 206. How do you perform fundal massage? ANSWER: 207. What are beta blockers used for? What is the common suffix for BBs? What are the typical side effects / adverse effects for BBs? Name as many BBs as you can. ANSWER: 208. How do beta blockers work? ANSWER: 209. Nursing considerations for beta blockers ANSWER: 210. What are ace inhibitors for? ANSWER: 211. What is the common suffix for ace inhibitors? List as many as you can. ANSWER: - 212. Common adverse effects for ace inhibitors ANSWER: - 213. What are calcium channel blockers used for? ANSWER: 214. What drugs can be given if an overdose of vasopressive drugs such as and ace inhibitor is taken? ANSWER: - 215. Signs & Symptoms of thyroid storm ANSWER: - 216. How is potassium related to acid base balance? ANSWER: 217. At what point does a new mother need to begin using contraceptives? ANSWER: 218. What is an intravenous pylogrmam ? ANSWER: 219. What does calcium gluconate do? ANSWER: 220. What electrolytes must be assessed for thiazides? ANSWER: 221. What do loop diuretics do with K ANSWER: 222. What can be given to counteract hypercalcemia? ANSWER: - 223. What foods have phosphorous? ANSWER: 224. Priority for calcium / effectiveness for vitamin D activation? ANSWER: 225. Foods with magnesium ANSWER: - 226. What is the common sign of sodium imbalance - either hypo or hyper Na ? ANSWER: 227. What does giving insulin and glucose help fix hyperkalemia? ANSWER: 228. What are benzodiazepines used to treat? What are some examples and what are the common suffixes? ANSWER: 229. What is buerger's disease? ANSWER: 230. What is the Somogyi Effect? ANSWER: 231. How/ when should oral steroids be taken? ANSWER: 232. Signs & Symptoms of steroids ANSWER: - 233. Why must muscle weakness be reported in patients taking po steroids? ANSWER: 234. What is the role of aldosterone? ANSWER: - 235. What is normal PaO2? ANSWER: 236. What is neuroleptic malignant syndrome? s/s? Cause? ANSWER: 237. Normal newborn heart rate ANSWER: 238. Do steroids cause hypo or hyperkalemia? ANSWER: 239. Acceptable range of temp for enema -? ANSWER: