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Thursday, June 12, 2008

NLE / CGFNS / Nclex Review Materials 3

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

• 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

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

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

• Increased RBC
• Leukocytosis / Thrombocytosis
• Angina
• Intermittent claudication
• Dyspnea /HPN
• Lethargy / Syncope / Paresthesia

Risk Factors:
• Aging
• Black race
• Chronic stress
• Family Hx
• Obesity
• Smoking
• Men

• 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)

1. 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

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
Solution: 20/5 x 1 = 4 tablets


AIRBORNE : Hepa Filter Mask / N95

Particulate MASK
Measles / Rubella
Chicken Pox/

Open wounds /drainage

DROPLET : Surgical Mask
Scarlett Fever
Strep. Pharyngitis

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

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

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

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.

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
- 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.

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