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Wednesday, July 30, 2008

Free Nclex Review Questions 1 (Nclex Practice)

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Aldosterone plays a major role in fluid and electrolyte balance. The nurse maintains an accurate intake and output record to monitor this function.

Clients with multiple myeloma experience severe bone pain due to destructive bone lesions that are visible on x-ray. Radiation is very useful in relieving bone pain and reducing the size of plasma cell tumors.

Maintaining confidentiality and the client’s dignity is a component of the client’s rights.

Excessive drooling is an indicator of a client’s inability to handle secretions and an indicator of the risk for aspiration. Since clients with Guillain-BarrĂ© syndrome have dysphagia, sitting in high-Fowler’s and swallowing with the head slightly flexed forward help decrease the risk of aspiration.

Quinidine is an antidysrhythmic that is used to maintain normal sinus rhythm following conversion of atrial fibrillation or atrial flutter. Verapamil (Calan) is generally used to control heart rate. Nifedipine (Procardia) is a vasodilator and bretylium (Bretylol) is generally used for control of ventricular dysrhythmias.

Hypoparathyroidism is a disorder in which parathyroid hormone is lacking and thereby causing low serum calcium levels. Hypocalcemia can cause tetany, which if untreated, can lead to seizures. The nurse would institute seizure precautions in order to maintain a safe environment.

Most clients in body casts are non-ambulatory and are likely to develop constipation. The use of fruits, fruit juices, and high-fiber foods will promote normal bowel elimination habits

After lumbar fusion the client is on bed rest and placed in the flat position, but may be logrolled every 2 hours. When turning, the nurse should be aware of the fact that the client’s proper body alignment must be maintained

Simmondsia chinensis (Jojoba) is a shrub found in Mexico and the southwestern region of the United States. It has been used to treat skin disorders such as chapped dry skin, scaling, eczema, psoriasis, and seborrhea.

Serenoa repens (Saw Palmetto) is a palm found in the United States. It is primarily used to treat benign prostatic hypertrophy. It is also used as a mild diuretic; to treat chronic and subacute cystitis; and to increase breast size, sperm count, and sexual potency.

Continuous Arteriovenous hemofiltration (CAVH), also called ultrafiltration, is a continuous treatment for acute renal failure that causes minimal or no changes in the client’s blood pressure. It is therefore an ideal form of dialysis for the client who is hemodynamically unstable.

With a complete placenta previa, cesarean delivery is indicated because the placenta covers the entire internal cervical os. A Foley catheter is indicated to keep the bladder empty and less vulnerable to trauma during the surgery. Enemas are contraindicated due to their stimulatory effect on contractions, which can contribute to maternal-fetal hemorrhage as the cervix dilates and pulls away from the back of the placenta. An abdominal, not perineal, shave prep is done in preparation for abdominal surgery.

Prednisone is given to clients with myasthenia gravis to reduce symptoms of the disease. Prednisone is given without regard to food unless GI upset occurs.

Mestinon is intended to improve both muscle strength and endurance. A history of hyperthyroidism complicates therapy, because the risk of cardiac dysrhythmia exists.

Alkaline phosphatase is an enzyme found in osteoblasts that reflects osteoblastic activity. Alkaline phosphatase is expected to be significantly increased with osteogenic sarcoma. Therefore it is not necessary to call the physician immediately. An elevated level is also seen in Paget’s disease, rickets, hyperparathyroidism, myeloma, and sarcoidosis. Concern should be taken to decrease the risk of fractures and reduce pressure and skin breakdown.

Prednisone is a glucocorticoid. It can be taken without regard to meals or can be taken with food if gastrointestinal upset occurs. It is best to take a single daily dose in the morning before 9:00 a.m. to mimic the natural burst of glucocorticoid secretion that occurs in the morning.

Intake and output are monitored and fluids are encouraged because trimethoprim and sulfamethoxazole is nephrotoxic.

Nursing care to meet the nutritional needs of clients with AIDS centers around nursing interventions to provide protection from infection. The main considerations to be remembered include avoiding all milk or milk products, and completely cooking all meals, especially raw vegetables and fruits prior to eating. Remember that these clients are immunocompromised. Foods that have the potential to harbor bacteria need to be avoided.

From 5 to 10 days after the first day of menses is the best time for BSE in a premenopausal client. After menopause, BSE needs to continue once a month and should be done on the same day of the month for ease in remembering to do so. BSE may begin on either breast but is usually performed on the left breast first. As with nursing assessments, inspection is the first step in BSE. Breasts of unequal size are common; changes in size or contour are findings that should be reported to the practitioner.

Adrenal insufficiency can result in hypoglycemia. Aldosterone insufficiency can result in hypovolemia

Levothyroxine sodium (Synthroid) is a synthetically prepared thyroid hormone that increases body metabolism and thus increases energy level. It promotes weight loss and increases body temperature. It does not affect acid production.

Before initiating a tube feeding, the nurse needs to determine that the tube is correctly placed. If the tube is not correctly placed and the client is fed, serious complications such as aspiration can result.

An advantage of the Venturi mask is that it can deliver precise amounts of oxygen to the client. A partial rebreather mask is used to permit conservation of oxygen while allowing rebreathing of approximately one third of the client’s exhaled air. The nonrebreather mask provides for the highest concentration of oxygen available using a mask. The simple oxygen mask is used for clients who need humidified oxygen by mask for short-term use (less than 12 hours) at rates of 6 to 10 liters per minute.

Reversal of hypoglycemia requires a 10- to 15-gram simple carbohydrate load that will work quickly to increase the blood glucose levels.

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