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Nursing Board Exam Test Drill 1

Nursing Board Exam Test Drill 1

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Published by Kira
visit this sites for more references
http://www.enurse-careplan.com/

thank you very much and your feedback is very much appreciated.
visit this sites for more references
http://www.enurse-careplan.com/

thank you very much and your feedback is very much appreciated.

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Published by: Kira on Oct 05, 2008
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HERBAL MEDS
St. John's wort - antidepressant, photosensitive (C/I
in SULFA drugs)

Garlic - antihypertensive (avoid aspirin) Ginseng - Anti stress (C/I in coumadin) Green tea - antioxidant (check if risk for

calculi-oxalates)
Echinacea - immune stimulant (6-8 weeks only)(C/I in

SANDIMMUNE-Immunosuppressant)
Licorice - cough and cold
Ginger root - antinausea (C/I in Coumadin)
Ginkgo - improves circulation (C/I in anticoagulant,

headache side effect - check PT)
Ma huang - bronchodilator, stimulant (Ephedra)
Digitalis Toxicity includes..
N - nausea
A - anorexia

V - vomiting
D - diarrhea
A - abdominal pain

Drugs which can cause URINE DISCOLORATION
Adriamycyn------ Reddish
Rifabutin--------- Red orange
Rifampicin------- Red orange
Bactrim---------- Red orange
Robaxin--------- Brown, Black or Greenish
Azulfidine------ Orange yellow
Flagyl------------ Brownish
Dilantin---------- Pink tinged
Anti Psychotic-- Pinkish to Red brown
Early signs of hypoxia:
R-restlessness
A-anxiety
T-Tachycardia
Late signs of hypoxia:
B-bradycardia
E-extreme restlessness
D-dyspnea

In pedia-

F-feeding difficulty
I-inspiratory stridor
N-nares flare
E-expiratory grunting
S-sternal retractions
Respiratory Patterns
Kussmaul- fruity acetone breath odor
Cheyne-stokes- near death breathing pattern

Seasonal Affective Disorder (SAD) may affect over 10 million
Americans.
The typical symptoms of SAD include depression, lack of energy,
increased need for sleep, a craving for sweets and weight gain.
Symptoms begin in the fall, peak in the winter and usually resolve in
the spring. Some individuals experience great bursts of energy and
creativity in the spring or early summer.
Susceptible individuals who work in buildings without windows may
experience SAD-type symptoms at any time of year. Some people with
SAD have mild or occasionally severe periods of mania during the
spring or summer. If the symptoms are mild, no treatment may be
necessary. If they are problematic, then a mood stabilizer such as
Lithium might be considered. There is a smaller group of individuals

who suffer from summer depression.
SAD is recognized in the DSM-IV (The American Psychiatric
Association's diagnostic manual) as a subtype of major depressive
episode.
Some individuals who work long hours inside office buildings with few
windows may experience symptoms all year round. Some very
sensitive individuals may note changes in mood during long stretches
of cloudy weather.

A sign of improvement from dehydration would be a decreased urine
specific gravity and a decreased/decreasing hematocrit. So the SG of
1.015 and a Hct of 46% would be the answer. It is the best answer of
the two you had in you question.
The normal urine SG is 1.003-1.035 (Usually between 1.010-1.025
with normal hydration and volume) (different texts give a slightly
different range).
SG 1.025-1.030+ (concentrated urine)
SG 1.001-1.010 (dilute urine)
SG 1.001-1.018 in infants under 2 years of age
Specific gravity is a measurement of the kidney's ability to concentrate
urine. The range of urine's SG depends on the state of hydration and
varies with urine volume and the load of solids to be excreted under
standardized conditions; when fluid intake is restricted or increased, SG
measures the concentrating and diluting functions of the kidney. Loss
of these functions is an indication of renal dysfunction.
SG values usually vary inversely with amounts of urine excreated
(decrease in urine volume = increase in specific gravity). However in
some conditions this is not the case.

EYE ABBREVIATIONS

OU- both eyes
OR- right eye
OS- left eye

CUSHINGS (Hypersecretion of Adrenal Cortex Hormones)

C = Check VS, particularly BP
U = Urinary output & weight monitoring
S = Stress Management
H = High CHON diet
I = Infection precaution
N = Na+ restriction
G = Glucose & Electrolytes Monitoring
S = Spousal support

ADDISON'S (Hyposecretion of Adrenal Cortex Hormones)
Always Remember the 6 A's of Addison's disease
1.) Avoid Stress
2.) Avoid Strenuous
3.) Avoid Individuals with Infection
4.) Avoid OTC meds
5.) A lifelong Glucocorticoids Therapy
6.) Always wear medic alert bracelet

Hirschsprung\u2019s diagnosed with rectal biopsy looking for absence of
ganglionic cells. Cardinal sign in infants is failure to pass meconium,
and later the classic ribbon-like and foul smelling stools.

Intussusception common in kids with CF. Obstruction may cause fecal
emesis, currant jelly-like stools (blood and mucus). A barium enema
may be used to hydrostatically reduce the telescoping. Resolution is
obvious, with onset of bowel movements.

With omphalocele and gastroschisis (herniation of abdominal contents)
dress with loose saline dressing covered with plastic wrap, and keep
eye on temp. Kid can lose heat quickly.

After a hydrocele repair provide ice bags and scrotal support.
No phenylalanine with a kid positive for PKU (no meat, no dairy, no
aspartame).
Second voided urine most accurate when testing for ketones and
glucose.
Never give potassium if the patient is oliguric or anuric.

Nephrotic syndrome is characterized by massive proteinuria (looks
dark and frothy) caused by glomerular damage. Corticosteroids are the
mainstay. Generalized edema common.

A positive Western blot in a child <18 months (presence of HIV
antibodies) indicates only that the mother is infected. Two or more
positive p24 antigen tests will confirm HIV in kids <18 months. The
p24 can be used at any age.

For HIV kids avoid OPV and Varicella vaccinations (live), but give
Pneumococcal and influenza. MMR is avoided only if the kid is
severely immunocompromised. Parents should wear gloves for care,
not kiss kids on the mouth, and not share eating utensils.

Hypotension and vasoconstricting meds may alter the accuracy of o2
sats.

An antacid should be given to a mechanically ventilated patient w/ an ng tube if the ph of the aspirate is <5.0. Aspirate should be checked at least every 12 hrs.

Ambient air (room air) contains 21% oxygen.
The first sign of ARDS is increased respirations. Later comes dyspnea,

retractions, air hunger, cyanosis.
Normal PCWP is 8-13. Readings of 18-20 are considered high.
First sign of PE (pulmonary embolism) is sudden chest pain, followed

by dyspnea and tachypnea.

High potassium is expected with carbon dioxide narcosis (hydrogen
floods the cell forcing potassium out). Carbon dioxide narcosis causes
increased intracranial pressure.

Pulmonary sarcoidosis leads to right sided heart failure.
An NG tube can be irrigated with cola, and should be taught to family
when a client is going home with an NG tube.
PRIORITY QUESTIONS (WHO TO SEE FIRST)

Sample Test Item:
1. Which of the following clients should the nurse deal with FIRST?
o 1 A client who needs his daily vitamin
o 2 A client who needs to be suctioned
o 3 A client who needs diaper to be changed
o 4 A client who is being prepared for discharge
Correct Answer: 2. A client who needs to be suctioned

PRIORITY (Use ABC)

Obstruction in the airway \u2013 secretions
Need to be suctioned
2. Delegation, RN, LVN, UAP, CNA
Which of the following clients should the LPN be assigned to?
o 1 A newly diagnosed patient with MYASTHENIC CRISIS
o 2 An immediate post-op client in PACU
o 3 A client awaiting medication for vitamins
o 4 A new admission for KIDNEY Transplant Patient
Correct Answer: 3-stable, A client awaiting medication for vitamins
Myasthenic Crisis \u2013 Unstable, Acute Respiratory Failure
Immediate Post \u2013 op \u2013 Unstable, Risk for Complications,
Kidney Transplant \u2013 Unstable, needs assessment for rejection
DELEGATION: Remember the 5R's, Right Task, Right Person, Right
Circumstance, Right Communication & Right Feedback)
RN Least stable, unstable, central catheters (hickman, broviac),
admission, discharge, health teachings, patient for transfer, blood
transfusion (2RNs)
LPN Technical Doer, Stable, medications, wound dressing
CNA Routine Care, Urine Dip Stix, Reporting to RN, Routine VS
UAP turning q2H, conducting group activities, ambulation
For future USRNs
This is for you... from the purkinje fibers of my heart....
Room Assignment(Who to Share Room with)
Check:

A ge
B eside the nurse's station? At the end of the hallway? Single
Room/Private Room?

C hain of infection/circumstance
D iagnosis
E nviroment (dim light, darkened, red nightlapm)
Sample Test Item:
The best roommate for patient with LEUKEMIA is
O 1 A 9-year-old with ruptured appendix
O 2 A 12-year-old with chicken pox
O 3 A 2-year-old with fever of unknown origin
O 4 A 5-year-old with nephrotic syndrome
Correct Answer: 4. A 5-year-old with nephrotic syndrome.
1,2 & 3, manifest symptoms of infection. A client with leukemia is
immunosuppressed and Patients with infection shouldn't be placed in
this room. Since patient with nephrotic syndrome receives diuretics and
steroids, this child will also need immunocompromised host precaution.

INFECTION CONTROL:

Sample Test Item:
3. Which of the following methods should the RN utilize in patient with
SALMONELLA?
O 1 Airborne Precautions
O 2 Droplet Precautions
O 3 Neutropenic Precautions
O 4 Enteric Precautions
The correct answer: 4.
Salmonella mode of transmission is fecal oral (enteric)
Handwashing
Gloves must be used in handling bedpan and diapers
Gown - if soiling is likely to happen.
Source of infection:
Contaminated food and water.
Remember - Transmission Based precautions:

A ir

B orne, small particles are dispersed in the air like MTB, varicella
C ontact, drug-resistant microorganisms
D roplet, large particles are dispersed into air, resp.infections except
resp syncytial
E nteric, fecal-oral like hepaA & salmonella

AGE APPROPRIATE GROWTH AND DEVELOPMENT

(HOPPING WITH ONE LEG)
Sample test Item:
4. Which of the following is NOT a characteristic of a preschooler?
O 1 predominantly "parallel play" period
O 2 balances on 1 foot with eyes closed
O 3 skips on alternate feet
O 4 jumps rope
The correct answer is: 1. Parallel play is more common in
TODDLERS.
Preschooler (3-6 years)
Gross motor development
HOPS ON ONE (1) FOOT BY 4 YEARS
SKIPS & HOPS ON ALTERNATE FEET BY 5 YEARS

PLAY : ASSOCIATIVE, IMAGINATIVE, MAGICAL THINKING,

SUPERHEROES (Remember the movie: Jingle All The way!)
FEAR: Intrusive procedures, venipunctures, IM injections, body
mutilation

Toxoplasmosis, where else you can contract this (thinking of cat litter
but it aint there)
Sample test Item:
5. To which of the following pregnant clients will be risk for
TOXOPLASMOSIS?
Select all that apply:
O 1 A pregnant client who eat raw meat.
O 2 A pregnant client handling cat litter of infected cats.
O 3 A pregnant client gardening and cultivating soil exposed to cat
feces.
O 4 A pregnant client with low rubella titer
O 5 A pregnant client who have undergone external radiation.
O 6 A pregnant client with draining, painful vesicles in the external
genitalia.
The correct answers: 1, 2 & 3.
TOXOPLASMOSIS
How do people get toxoplasmosis?
A Toxoplasma infection occurs by:

Accidentally swallowing cat feces from a Toxoplasma-infected cat that
is shedding the organism in its feces.
This might happen if you were to accidentally touch your hands to your
mouth after gardening,
cleaning a cat's litter box, or
touching anything that has come into contact with cat feces.
Eating contaminated raw or partly cooked meat, especially pork, lamb,
or venison;
by touching your hands to your mouth after handling undercooked
meat.
Contaminating food with knives, utensils, cutting boards and other
foods that have had contact with raw meat.
Drinking water contaminated with Toxoplasma.
Receiving an infected organ transplant or blood transfusion, though this
is rare.
(From the internet-Division of Parasitic Disease)
Which of these statements by the nurse is incorrect if the nurse has the
goal to reinforce information about cancers to a group of young adults?
1. \u201cYou can reduce your risk of this serious type of stomach cancer by
eating lots of fruits and vegetables, limiting all meat, and avoiding
nitrate-containing foods.\u201d
2. \u201cProstate cancer is the most common cancer in American men with
results to threaten sexuality and life.\u201d
3. \u201cColorectal cancer is the second-leading cause of cancer-related
deaths in the United States.\u201d
4. \u201cLung cancer is the leading cause of cancer deaths in the United
States. Yet it's the most preventable of all cancers.

Need to memorize for Nclex

Tonometry: normal (10-21 mm Hg)
PR Interval: normal (0.12-0.20 seconds)
Serum Amylase: normal (25-151 units/dL)
Serum Ammonia: normal (35 to 65 mcg/dL)
Calcium: adult (8.6-10 mg/dL)

child (8 to 10.5 mg/dL)
term<1week (7 to 12 mg/dL)
Partial Thromboplastin Time (aPTT): normal (20-36 seconds)
therapeutic 1.5-2.5
Prothrombin Time: normal (Male: 9.6-11.8 seconds) and

(Female: 9.5-11.3 seconds)
Platelet Count: normal (150,000-400,000 cells/uL)
Albumin level: normal (3.4 to 5 g/dL)

Serum Osmolality: normal (285 to 295 mOsm/kg)
high value indicates dehydration
Safe Suction Range: normal [Infant] 50-95 mm Hg
[Child] 95-115 mm Hg
[Adult]100-120 mm Hg)
Serum Lithium: normal (1 to 1.5 mEq/L)
acute mania (0.6 to 1.4 mEq/L) maintenance treatment
Phenytoin (Dilantin): normal serum (10 to 20 mcg/mL)
Digoxin: therapeutic blood level (0.8 to 2.0 ng/ml)

Magnesium Sulfate: Therapeutic Range (4 to 8 mg/dl)
Pregnancy Temperature: normal (36.2-37.6 celcius or 98-99.6
Farenheit)

WBC\u2019s In Pregnancy: normal (11,000 to 15,000 cells/mm3, up to
18,000 cells/mm3). Immediate postpartum period, (maybe as high as
25,000 to 30,000 cells/mm3)

Stomach Capacity:
Newborn infant (10 to 20 mL)
1-week-old (30 to 60 mL)
2-3-week-old infant (75 to 100 mL)
1-month-old infant (90 to 150 mL)

Left Atrial Pressure: normal (1 to 10 mm Hg)
Fibrinogen Levels: normal (male: 180 to 340 mg/dL) and
(female: 190 to 420 mg/dL)

Insulin
(Regular, Humulin R)
Type: Fast acting
Onset: \u00bd -1 hr
Peak: 2-4 hr
Duration: 6-8 hr Insulin
(NPH, Humulin N)
Type: Intermediate acting
Onset: 2hr
Peak: 6-12hr
Duration 18-26hr Insulin
(Ultralente, Humulin U)
Type: Slow acting
Onset: 4hr
Peak: 8-20hr
Duration: 24-36hr Insulin
(Humulin 70/30)
Type: Combination
Onset: \u00bd hr
Peak: 2-12hr
Duration: 24hr

Central Venous Pressure: < 3 mm Hg = inadequate fluid and >11 mm
Hg = too much fluid

Potassium: 3.5-5.0 mEq/L
Sodium: 135-145 mEq/L
Calcium: 4.5-5.2 mEq/L or 8.6-10 mg/dL
Magnesium: 1.5-2.5 mEq/L
Chloride: 96-107 mEq/L
Phosphorus: 2.7 to 4.5 mg/dL

PR measurements: normal (0.12 to 0.20 second)
QRS measurements: normal (0.04 to 0.10 second)
Ammonia: 35 to 65 ug/dL

Amylase:25 to 151 IV/L
Lipase: 10 to 140 U/L

Cholesterol: 140 to 199 mg/dL
LDL: <130 mg/dL
HDL: 30 to 70 mg/dL
Triglycerides: <200 mg/dL

Bilriubin
\u2022 Direct: 0 to 0.3 mg/dL
\u2022 Indirect: 0.1 to 1.0 mg/dL
\u2022 Total: <1.5 mg/dL

Protein: 6.0 to 8.0 g/dL
Uric acid: Male 4.5 to 8 mg/dL

Female 2.5 to 6.3 mg/dL
Glycosylated Hemoglobin HbA1c: good control 7.5% or less
Serum creatinine: 0.6 to 1.3 mg/dL
BUN: 9-25 mg/dL
Normal CK is 26-174 U/L
Troponin I value: normal (<0.6 ng/mL)

Troponin T >0.1 to 0.2 ng/mL = MI Erythrocyte studies: 0-30 mm/hour Serum iron: Male 65-175 ug/dL

Female 50-170 ug/dL
RBC: Male 4.5 to 6.2 M/uL

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