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NCLEX prep
Question | Answer |
---|---|
artery vs vein problem? leg(s) cool, shiny, weak pedal pulses | artery problem; "A" = legs go down |
artery vs vein problem? leg(s) warm, red, swollen | vein problem; "V" = legs go up |
tag? expected and allowed to die; prepare for morgue | black tag |
tag? stable; minor injuries that require treatment; can delay treatment 2 to 4 hrs | green tag |
tag? major injuries that require treatment; can delay treatment 30-min to 2-hrs | yellow tag |
tag? immediate threat to life; do not delay treatment | red tag |
-mechanical brain reset? -chemical brain reset? | -Electroconvulsive therapy (ECT) -Phenytoin |
How many days after surgery are patients on anticoags? | 14 days |
child squatting after light activity indicates what? | heart defect (squatting = tripod position) |
-hot & dry... -cold & clammy... | -sugars too high -give them candy |
Client w/asthma. Effect should nurse recognize as an adverse response to bronchodilator therapy? -hyperkalemia -hypoglycemia -↑ myocardial oxygen use -limited routes of administration | -↑ myocardial oxygen use |
Pt receives transfusion of PRBCs and tells nurse "My IV site is painful and looks swollen." Nurse action? -monitor for signs of infection/infiltration -double check blood type w/another nurse -start new IV site and resume transfusion -d/c transfusion | start new IV site and resume transfusion |
Semi-comatose pt after CVA has NG tube and started on TPN today. Nurse action to prevent fluid volume deficit? -give 120mL bolus of water -monitor BG every 4-6 hr -determine total fluid intake every 8 hr -↑ oral fluid intake to 3L/day | monitor BG every 4-6 hr (TPN has high sugar...hot & dry = sugars too high) |
RN, LPN, UAP? establish goals for nursing care | RN |
RN, LPN, UAP? ambulate a client with a walker | RN, LPN, UAP |
RN, LPN, UAP? initiate a client referral | RN |
RN, LPN, UAP? obtain a urine sample from an indwelling catheter | RN, LPN |
RN, LPN, UAP? administer the MMR vaccine | RN, LPN |
RN, LPN, UAP? regulate IV insulin | RN |
RN, LPN, UAP? check bowel sounds | RN, LPN |
RN, LPN, UAP? apply lotion to intact skin | RN, LPN, UAP |
RN, LPN, UAP? change a sterile dressing | RN, LPN |