Kaplan Nclex Trainer...just some of it..

Women need 1200-1500 kcal/day (men need 1500-1899 kcal/day); women need 15mg/day of iron (men need 10mg/day); with pregnancy 30mg required

Hemolytic reaction when tranfusing blood includes chills, headache, backache, dyspnea, cyanosis, chest pains, tachycardia, and hypotension.

Glycosylated Hemoglobin assay (BhA1c) test indates how well blood suger has been controlled during the past 6-8 weeks.

Primary goal of a reminiscing group for geriatric clients is to review and hsare their live experiences with the group members.

Symptoms associated with hypercalcemia are constipation, decreased reflexes, decreased muscle strength.

Miller-Abbott tube provides intestinal decompression; intestinal tube is often used for treatment of paralytic ileus

Promethazine hydrocloride (Phenergan) - nurse should check patency of the patient's vein; extravasation will cause necrosis.

Buerger's disease - digital sensitivity to cold; vasculitis of blood vessels in upper and lower extremities.

Continuous bladder irrigation (CBI) is necessary because it enables urine to keep flowing; prevents formation of clots that can lead to obstruction and spasm in the postoperative TURP client.
Pain related to a gastric ulcer occurs about one-half to one hour after a meal and rarely at night; is not helped by ingestion of food

To auscultate patient's right middle lobe (RML), RML is found in the right anterior chest between the fourth and sixth intercostal spaces.
Characteristics of Mania --- agitation, grandiose delusions, euphoria, difficulty concentrating

Characteristics of Sxhizonphrenia -- Paranoia, hallucinations, disturbed thought processes, hypervigilance.

Meniere's disease - Stand in front of the patient so that the client does not have to turn her head to see the nurse; by decreasing movement of the client's head, vertigo attacks may be decreased.

Use standard precautions is method of transmission is saliva, feces and blood; use contact isolation if fecal incontinence.

Play theraphy is suggested for children undergoing a stressful event because they have diffulty putting feelings into words; play is how they express themselves.

Normal PT 11-15 sec, normal Hgb male : 13.5-17.5 g/dl, female: 12-16 g/dl

Normal BUN 10-20 mg/dl, normal creatine 0.6-1.2 mg/dl

Normal Ca+ 4.5-5.3 mEq/L

Normal AST (SGOT) 8-20 U/L, normal ALT (SGPT) 8-20 U/L

Fluid challenge test is used to rule out dehydration as the cause of oliguria. Expected response after a fluid challenge on normally functioning kidneys is an increase in urine output; will occur if low urine output is due to dehydration; if it is due to acute renal failure, there will continue to be oliguria.

Normal specific gravitity is 1.010-1.030

Chlorpromazine (Thorazine) medication is contraindicated for the treatment of alcohol withdrawal symptoms; medication will lower client's seizure threshold and BP, causing potentially serious medical consequences.

Low intestinal obstruction, nurse would anticipate that the client's abdomen will be distended, nausea, vomiting; no stool, as motility distal to (below) the obstruction would cease

Why are we not using beef or pork insulin and only human insulin? Human insulin does nto cause the formation of antibodies because the protein structure is identical to your own.
Approx. 65% of AIDS clients demonstrate a progressive dementia staged according to severity of debilitation; late stage ois typified by cognitive confusion and disorientation.

Two major side effects of haloperidol (Haldol) is hematologic problems primarily blood syscrasia and extrapyramidal symptom (EPS)

Taken from Kaplan Nclex Trainer Explanation Test 2





. DIC

Hemophilia is a sex-linked disorder. A mother who is a carrier has a 50% chance of passing the faulty X chromosome to her daughter, while an affected father will always pass on the affected gene to his daughters. A son cannot inherit the defective gene from his father.

There are two main types of hemophilia. If you have hemophilia A, you have little to no clotting factor VIII (8). About 9 out of 10 people with hemophilia have type A. If you have hemophilia B, you’re missing or have low levels of clotting factor IX (9).

Pincher grasp present at nine months of age

Posterior fontanels closed by two to three months

Phobias involves projection and displacement.

An infant with fetal alcohol syndrome will have a small head circumference, low birth weight and underveloped cheekbones.
Hydromorphone hydrochloride (Dilaudid) is a narcotic analgesic used for moderate to severe pain, monitor vital signs frequently.

Chlorpromazine hydrocloride (Thorazine) extrapyramidal side effects includes akathisia (motor restlessness), dystonias (protrusio of tongue, abnormal posturing), pseudoparkinsonism (tremors, rigidity), dyskinesia (still neck, difficulty swallowing)

1 grain (gr) = 60mg

Right upper quadrant pain to diagnose cholecyctitis

Tremors, elevated temperature and pain symptoms are indicative of an alcohol-related problem

Long term use of ceftriaxone sodium (Rocephin) can cause overgrouth of organisms; monitoring of tongue and oral cavity is recommended.
Client with hypothyroidism are very sensitive to narcotics, barbiturates and anesthetics


When performing a Rinne tests, the stem of a vibrating tuning fork is held against the mastoid bone until the child indicates that she can no longer hear the sound. Then the tuning fork is moved in front of the auditory canal.

Clomiphene citrate (Clomid) induce ovulation by changing hormonal effects n the ovary. It alters estrogen and stimulating follicular growth to produce a mature ovum.

Naproxen sodium (Naprosyn) is an NSAID used as analgesic; side effects include headache, dizziness, GI distress, pruitus and rash. Assess the patient for fluid retention and dizziness.

Cortisol is responsible for converting proteins and fat into glucose; is also an antiflamatory agent.

Verapamil (Isoptin) is indicated for the treatment of supraventricular tachycardias, so the client's heart rate should be checked prior to administration

Breastfeeding mothers are advice to increase their caloric intake because milk productions requires an increase of 500 calories per day.

Digoxin increases the force of myocardial contraction.

Pacemaker increase the cardiac output; acts to regulate cardiac rhythm.

Quinidine prevent premature ventricular contractions (PVCs); antiarrhythmics

Lasiz prevent systemic overload; diuretics

With lead poisioning, milk provides a large amount of vitamin D; vitamin D optimizes depoosition of lead in the long bones; purpoase of the treatment is to remove lead from the blood and soft tissues.

An intravenous pyelogram (IVP) is an x-ray examination of the kidneys, ureters and urinary bladder that uses contrast material.

SIDS is a support group of parents who have had an infant die from sudden infant death syndrome

SHARE is a support group for parents who have lost a newborn or have experienced a miscaarriage

RESOLVE is a support group for infertile clients

CANDLELIGHTERS is a support group for families who have lost a child to cancer

Accurate intake and output is the best indicator for fluid status.

Taken from Kaplan NCLEX Training Explanation 1

 • Bruising, purpura
• Presence of occult blood
• Low fibrinogen level, hct, platelet
• Increased PT, PTT
• Complication: RENAL FAILURE

42. PERIPHERAL ARTERIAL DISEASE
• Dry scaly skin on lower extremities
• Rest Pain, at night
• Intermittent claudication/
• Thickened toenails
• Cold & gray-blue color of skin
• Decreased or absent peripheral pulses
• Instruct pt. to walk to point of claudication, stop & rest & walk a little farther

43. THROMBOPHLEBITIS
• Avoid pressure behind legs
• Avoid prolonged sitting
• Avoid constrictive clothing
• Avoid crossing the legs
• Avoid massaging the legs

44. SYPHILIS
Painless chancre fades after 6 weeks
Low grade fever
Copper-colored rash on palms and soles of feet
Spread by contact of mucous membranes
Treat with Penicillin G IM
If patient has penicillin allergy, will use erythromycin for 10-15 days.
After treatment, patient must be retested to make sure disease is gone

45. POLYCYTHEMIA VERA
• Increased RBC
• Leukocytosis / Thrombocytosis
• Angina
• Intermittent claudication
• Dyspnea /HPN
• Lethargy / Syncope / Paresthesia

46. PRIMARY HPN
Risk Factors:
• Aging
• Black race
• Chronic stress
• Family Hx
• Obesity
• Smoking
• Men

47. CHOLECYSTITIS
Sx:
• N & V
• Belching
• Indigestion
• Flatulence
• Epigastric pain that radiates to the scapula 2 hrs. after eating fatty food
• Pain localized in RLQ
• Guarding, rigidity & rebound tenderness
• Cannot take a deep breath when fingers are pressed below hepatic margin (Murphy’s Sign)

II. COMPUTATION1. Dopamine
2. Dobutamine drip: Order is 2.5mcg/kg/min, patient weights 176 lbs.
Stock is 500mg in 500ml of NSS,
Compute for ml/hr?

Formula: Stock (mg) x 1000 mcg/mg
Quantity (ml)
Flow rate: Dose (mcg/kg/min) x wt (kg) x
60 min/hr
Concentration
(mcg/ml)

Answer: 12ml/hr

3. Md with IV order for patient 3,000ml in 24 hrs., get the rate at ml per hour.
Solution: 3000/24 = 125 ml/hr

4. Tablets : Dose of 20 mg per dose in stock dose of 5 mg per tablet, how many
tablets?
Solution: 20/5 x 1 = 4 tablets


III. TOPICS
1. SAFETY INFECTION CONTROL

AIRBORNE : Hepa Filter Mask / N95

Particulate MASK
PTB
Measles / Rubella
Chicken Pox/
Varicella
SARS
Anthrax

CONTACT : GGG
(gown,gloves,goggles)
Conjunctivitis
Open wounds /drainage
Lesions
MRSA / VRSA /
CDAD
RSV/ VRE

DROPLET : Surgical Mask
Scarlett Fever
Diphtheria
Meningitis
Strep. Pharyngitis
Pneumonia

ENTERIC: Gown , Gloves
Diarrhea
Hep. A
Salmonella
Acute Gastroenteritis
Peptic H. Pylori
Shigella / Rotavirus Giardiasis /
Cryptosporidium Muris

FROTECTIVE:
Blood dyscrasias
Aplastic anemia
Leukemia
Major burns (50%)
Organ transplant
Aids
Multiple Myeloma
Prolong Steroid Therapy


Concepts:1. Infection control:
a. clean with clean for example patients with CVA, DM, Cardio disease

2. Same precaution techniques:
a. Universal precaution: Hep B,D, AIDS

2. PRIORITIZATION
Remember the rule of stable vs. unstable. Although you consider the client unstable but if it expected in him, this is stable. Example. Asthma with wheezing- you consider this unstable.
ABC, unstable , first think EXPECTED in asthma so this will be considered stable.

3. DELEGATION
RN - Newly admitted, needs assessment, pre op teaching and post op, nsg. Judgment & discharge planning ,IV meds, BT.

LPN-Can give meds except IV, sterile techniques like wound dressing, catheterization, insertion of NG tube, remove sutures. Stable expected outcome.

NA/ UAP/CN/ Senior nursing student - All “-ing” ex bathing, reading v/s in long term pt. Testing occult blood, BS, monitoring, soap sud enema, testing occult blood,
-Isolation precautions, basic hygiene ADL, Input & Output, Finger stick with gestational diabetes, urinalysis, TSB, turning unconscious patient, change perineal pad, assist in ambulation,
discharge tomorrow,
-Stable v/s, pulse oximetry, reading,
terminally ill because of comfort only
needed.
- Routinary Procedure

4. Patient Hx C/I for MRI :• Mitral Valve Replacement

5. Glaucoma :
• Halos around light

6. U waves :• Hypokalemia

7. Patient with arterial insufficiency
• Elevate the affected leg

8. Patient with Dumping Syndrome:• Avoid cheese

9. Adverse Effect of Anti-metabolite 5FU• Stomatitis

10. Obtaining sputum specimen from pt. with tracheostomy:
• Instruct pt. to cough prior to obtaining sputum

11. Post-hypophysectomy pt. Report if:
• Specific Gravity of 1.005

12. Diet for Hypothyroidism• Low sodium, High K

13. Patient with CHF cor pulmonale S & S• Jugular vein distention & peripheral edema

14. Circumcision of a new infant:
• Diaper fasted loosely

15. Acute Pancreatitis
• Increase lipase/amylase

16. Short-term goal for anti-social patient• Follow unit rules

17. Use of walker• Partial weight bearing
• Stand in front, walk unto walker

18. Borderline patient• Splitting

19. Neonates in nursery developed diarrhea• Meconium stool study w/in 24 hrs.

20. Nsg. Action in pt. post cardiac catherization
• Check pulse in lower extremities

21. Diet for Diverticulitis
• Avoid high-fiber foods when inflammation occurs, only low residue
• Introduce soft high-fiber foods when inflammation has resolved

22. Low iron.WBC & albumin, what type?
• Nutritional deficit (malnutrition)

23. What will you ask on pt for cardiac stress test (Thallium stress test)?
• Is he on beta-blocker? (if with radionuclide already, Persantine, then invasive & shld.
avoid caffeine, calcium channel blockers, b-blockers, theophylline)

24. Highest risk of accident
• 9 month infant eating grapes & apricot

25. Pancrease in Cystic Fibrosis• Give with meals, dilute in applesauce

26. Client post-CVA, diet teaching
• Low salt, low fat

27. Client passing stones with calcium, diet teaching:
• Should be acid-ash diet & avoid oxalate rich & Ca rich food such as tea, almonds, rhubarbs beans, spinach, cocoa, vegetables, fruits
• Give cranberries, prunes, plums, tomatoes, cereals, corn, legumes I

28. Paget’s Disease• Bowing of bones

29. Side Effect of Ansef (Cefazolin)• Antibiotic (RTI,URTI)
• Diarrhea, Nausea
• Oral candidiasis
• Pancythopenia

30. Peptic ulcer disease
• Avoid stressful situation to prevent exacerbation

31. Schilling’s Test
• For pernicious anemia

32. Prior To MUGA SCAN:• Informed consent
• Allergy not a concern

33. Action of Aquamephyton
• Prevention of hypoprothrobinemia

34. Action of Lipitor
• Anti-lipimec

35. Positioning of Hip Spica Cast in children• Maintain flexion, abduction & external rotation

36. Fear of 3 y/o child• Injury (abandonment, castration)

37. To prevent ureteral stones
• Increase fluids

38. MDI
• Hold breath

39. Frostbite
• Soak in warm water

40. Normal respiratory changes in elderly
• Decreased cough reflex

41. Patient w/ DM & HPN, question if• Given beta-blocker (causes bronchospasm )

42. Maximum injection on 10 month old infant• 1 ml

43. Pt. with endometriosis takes Danocrine, action of the drug?
• Suppress menstruation/ ovulation

44. Post NSD with epidural anesthesia with bladder distension• Offer bedpan

45. Apmhotericin B, side effect?
• Headache
• Hypokalemia
• Hypotension

46. PT. with angina unrelieved by 3 nitroglycerin• Administer O2

47. Patient on Halo Vest
• Tape the wrench to the vest (Torque screw)

48. Pre-menopausal syndrome experiencing hot flashes
• Black Cohosh for menoposh

49. Abdominal Assessment
• Inspection
• Auscultation
• Percussion
• Palpation

50. Sclerotherapy• Application of pressure dressing for 12-48 hrs.