Mark Klimek NCLEX Pharm Questions and Answers Already Passed

Mark Klimek NCLEX Pharm Questions and Answers Already Passed Never hold the hormone for what patient? ✔✔patient who is NPO with mydexema Addison's disease easy way to remember ✔✔Add a Sone (sone = steroid) Best defau ...

Mark Klimek NCLEX Pharm Questions and Answers Already Passed Never hold the hormone for what patient? ✔✔patient who is NPO with mydexema Addison's disease easy way to remember ✔✔Add a Sone (sone = steroid) Best default order for click and drag order questions? ✔✔Hold ..... med Assess ..... what med does Prepare ...... the correction Call ..... or notify Rarely if ever answer ... ✔✔call Doctor, NCLEX wants you to think critically INR lab values ✔✔2-3, critical value if off, potential for patient to bleed. Use default order for order ?'s (hold all coumadin, assess for bleeding, prepare Vit K (antidote for Coumadin), Call or notify Potassium lab values ✔✔3.5-5.3 If low it is a critical lab to worry about assess the heart and then prepare to give K if high, hold all K, assess heart (EKG), give D5W and reg insulin, call if really high, hold, assess, prepare, call STAT Get someone else involved! Dangerous!! If question says there is pitocin running and there are complications ✔✔stop pit first then LIONpit Pain meds in labor ✔✔know your peaks for IV, IM, PO, Subling. If baby is likely to be born when the pain med is peaking don't give! Why? Respiratory depression in baby OB medications tocolytics ✔✔stop contractions, Brethine causes maternal tachycardia, Nifedipine (dipine - CCB) causes Hypotension and headache OB medications oxytocics ✔✔makes labor more intense, Pitocin, Methergine, Cervidil OB medications Fetal/Neonatal Lung meds ✔✔Betamethasone, speeds the development of the baby's lungs, given to Mom before baby is born, given IM, will increase the blood sugar of Mom Survanta (surfactant) ✔✔given to baby after baby is born given trastracheal through the airway develops lungs Med hints for IM injections ✔✔Look for 1's in both parts (the 1 looks like an I), guage and length, 21 g, 1 inch means IM Med hints for SQ injections ✔✔look for 5's in both parts (the 5 looks like an S), guage and length, 25 g, 5/8 inch means SQ Drawing up Insulin rules ✔✔R then N, Draw up R then N, NRRN the whole process Pressurizing Insulin rule ✔✔put air into N then R , NRRN the whole process If 70/30 insulin it is ✔✔70% N and 30% R, may have to make your own on boards, no 70/30 on the floor Heparin is given IV or SQ NOT PO, info re: Heparin ✔✔works immediately, labs Ptt or any clotting or bleeding time, antidote: protamine sulfate, course: 21 days, pregnancy: YES (Class C pregnancy drug, use caution) Coumadin is given PO, info re: Coumadin ✔✔takes days to work, labs ONLY PT-INR, antidote: Vit K (think Koumadin), course: forever, prengancy: NO (never use) If a diuretic ends in the letter X it is a potassium ✔✔wasting drug plus Diurel Baclofen/ Flexoril ✔✔muscle relaxant, think on your back loafin'! makes a patient drowsy, weak muscles, don't drink, don't drive, don't care of kids under 12 Piaget's stage Sensorimotor age 0-2, totally When can a child give themselves their own insulin shot? ✔✔7 What 2 parts are always irrelevant in a prioritization question? ✔✔age and gender (NCLEX is testing discrimination against agism), age only important for peds All psych drugs cause ✔✔low BP and weight change (usually gain) Phenothiazines ✔✔all end in 'zine Ex: Thorazine, Compazine, they are major tranquilizers so think safety 'Zines for the ✔✔Zanny In large doses Phenothiazines are ✔✔anti-psychotics In small doses Phenothiazines are ✔✔anti-emetics Side effects of Phenothiazines ✔✔Anticholinergic (dry mouth), Blurred vision, Constipation, Drowsiness, Extrapyramidal syndrome (parkinsons), Fotosensitivity, aGranulocytosis (low WBC's) #1 problem or concern for patient taking Phenothiazines ✔✔SAFETY Deconoate drug is ✔✔a long acting IM form given to non compliant patients Tricyclic Antidepressants are ✔✔mood elevators to treat depression Examples of Tricyclic anti depressants ✔✔Elavil, tofranil, aventyl desyrel Side effects of Tricyclic medications ✔✔Anticholinergic(dry mouth), Blurred Vision, Constipation, Drowsiness, Euphoria HInt: Elavil starts with E so this group goes through E How long does a tricyclic need to be taken before results are seen? ✔✔2-4 weeks Benzodiazepines are for ✔✔anti anxiety, they are minor tranquilizers, have 'zep in the name, EX: Diazepam (Valium), plus Xanax, Often given pre op, muscle relaxant, alcohol withdrawal, seizures, facilitates mechanical ventilation Benzodiazepines works ✔✔quickly, must not take for 6 weeks, keep on Valium until Elavil kicks in Side effects for Benzodiazepines ✔✔Anticholinergic (dry mouth), Blurred Vision, Constipation, Drowsiness Number one nursing concern for patient taking Benzo's is ✔✔also safety MAOI's ✔✔antidepressants, happy pills Depression is caused by a deficiency of ✔✔norepinephrine, dopamine and serotonin in the brain Names of MAOI's ✔✔MAR, NAR, PAR: Marplan, Nardil, Parnate Side effects of MAOI's ✔✔Anticholinergic (dry mouth), Blurred vision, Constipation, Drowsiness How long can a person be on MAOI's and how long before they work? ✔✔rest of life, 2-4 weeks MAOI's interact with LOTS ✔✔Avoid all foods containing Tyramine, causes fatal hypertension Tyramine foods ✔✔Fruits and Veggies are okay except remember salad BAR, avoid Banannas, Avacados, Raisins, Grains are okay except for active yeast, no organ meats, no preserved meats, no dairy, no alcohol, tinctures, caffiene, chocolate, licorice, soy sauce Lithium ✔✔for bipolar disorder (manic depression) it decreases mania Side effects of Lithium ✔✔peeing, pooping, parasthesia Lithium Toxicity ✔✔2 or greater, tremors, metallic taste, severe diarrhea, number one intervention, give fluids, if sweating give electrolytes too Lithium monitor what levels ✔✔sodium, low sodium levels prolong lithium's half-life, causing lithium toxicity, high sodium levels decrease the effectiveness of lithium Prozac ✔✔it an SSRI, similar to Elavil so same info as Tricyclic's Prozac causes ✔✔insomnia, so give before noon, so if BID, give at 6A and 12N NOT at bedtime When changing the dose of Prozac for an adolescent or young adult, watch for ✔✔suicide 'zine, 'zep, 'zap ✔✔all tranquilizers a good guess about psych med weening ✔✔decrease the dose of the old drug Haldol ✔✔just like the Thorazine's, also has a deconoate form Dose of Haldol for elderly patient should be ✔✔half of usual adult dose Clozaril (Clozapine) ✔✔'zap's, for schizophrenia 'zap's, for schizophrenia ✔✔aGranulocytosis How often should WBC be drawn when pt is taking 'zap's for schizo? ✔✔1 time per week for 1 month, 1 month every month for 6 months then every 6 months Zoloft (sertraline) ✔✔also a SSRI like prozac, antidepressant, doesn't cause insomnia so it can be taken at bedtime. Zoloft interacts with other medications like ✔✔St John's wart (causes serotonin syndrome) - sweating, apprehension (impending sense of doom), dizziness (vertigo), headache, also with Coumadin so watch for bleeding Zoloft with Coumadin? ✔✔Question the order if the coumadin dose wasn't lowered Never mix ___________ in children's food ✔✔medications If you know what a particular drug does, choose a side effect in the same ______ ___________ where the drug is working. ✔✔body system Ex: heart drug - tachycardia If a medication is taken PO and you dont know what the drug does pick a ______ side effect ✔✔GI If two answers say the same thing ... ✔✔neither one is right EX: tachycardia and racing heart If two answers are opposite, one of them is ✔✔probably right (consider one of them) Names of uppers ✔✔caffiene, cocaine, PCP/LSD, Amphetamines/meth, adderol/ritalin Do give aminoglycocides via PO in ✔✔hepatic encephalopathy & pre-op bowel surgery Peak level for sublingual ✔✔5-10 minutes after disolved Peak level for IV ✔✔15-30 min after finished Peak level for IM ✔✔30-60 min after drug is in Peak level for SQ ✔✔diabetes peak levels apply here Ventricular gets what med ✔✔Lidocane (think of the V turning sideways to an L) & Amiodorone AsystolE gets what med ✔✔A for Atropine and E for Epinephrine ... Epi is first though Atrial Arrhythmias (same as supraventricular) medications ✔✔ABCD Adenocard (push fast) Beta Blockers ('lol) CCB's Digoxin Water Seal bubbling intermittently or a suction control chamber bubbling continously is ✔✔GOOD Water Seal bubbling continuously or a suction control chamber bubbling intermittently is ✔✔BAD A Seal should not be ✔✔bubbling What to do first if a water seal breaks? ✔✔clamp What is best to do if a water seal breaks? ✔✔submerge Diabetes is a ________ ____________ problem. ✔✔glucose metabolism Diabetes Insipidus is a dificiency of ✔✔ADH Treating Type 1 diabetes ✔✔Insulin, Diet Exercise Treating Type 2 diabetes ✔✔Diet, Activity, Oral Hypoglycemia Regular Insulin onset peak duration ✔✔onset 1 peak 2 duration 4 NPH insulin onset peak duration ✔✔onset 6 peak 8-10 duration 12 Regular insulin rules ✔✔Rapid, Run IV, Regular NPH insulin rules ✔✔Not so fast, Not IV, NPH Insulin does what to blood sugar? ✔✔it lowers it When will a patient go hypoglycemic? ✔✔when insulin is at its peak If you exercise you need ______ insulin? ✔✔less For a diabetic if they have sick days ✔✔hydrate, take insulin What priority are hypoglycemic patients? ✔✔#1 or #2, they are always a high priority DKA ✔✔Hyperglycemia in Type 1 patients HHNS ✔✔Hyperglycemia in Type 2 which is really just dehydration Treatment for HHNS ✔✔High flow rehydration, IV 150 or more Therapeutic level for Aminophyline (airway spasms), Dilantin (anticonvulsant), Bilirubin ✔✔10-20, 20 or more is toxic Therapeutic level for Lanoxin or Dig ✔✔1-2 (2 or more it toxic) Earliest sign of any electrolyte disorder is ✔✔parathesia or numbness and tingling Universal sign of any electrolyte imbalance is ✔✔paresis or muscle weakness Fast but temporary solution to decrease K is to ✔✔give D5W w/regular insulin Never give more than ____ of K/liter of IV fluid ✔✔40 mEq, question the order of more is ordered