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Friday, October 31, 2008

Ielts Test: Time Constraints Issues

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In the IELTS test, time is your enemy. Candidates who have taken the test and did not perform as well as they had hoped often complain that they were unable to give all the answers in the Listening Test because the tape was too fast, and that they ran out of time in the Reading Test.

To begin with, do not worry if you do not finish the tests. Remember, the test is designed to measure candidates over a range of scores from 0 to 9 (0 indicates the test was not attempted). Candidates whose English is near perfect can expect to score 9, but even native English-speaking people would be unlikely to complete every Listening Test answer perfectly or finish the Reading Test a long time before the examination ends. Remember, the test is meant to be challenging.

The IELTS test measures many aspects of your English ability including the speed at which you listen, read, write, speak, and think in English. Your personal speed is not something which changes a great deal from day to day, but does change considerably over a longer period of time, as a direct result of practice in working with the English language.

Your personal speed and ability in the 5 areas previously mentioned is pretty well fixed at any given time. The official IELTS Band Scores you receive are extremely accurate, since each test is trialled extensively to achieve standardised results for candidates at all English levels. Nonetheless, there are certainly many things you can do, before and on the day of the test, to help maximise the use of your time and give yourself the best chance of success.

Consider the following situation: although a racing car cannot go faster than its maximum speed, the race can still be won, and its maximum speed maintained for longer, if an expert driver is at the wheel. An expert racing car driver will:

• … spend a great deal of time practising at the wheel before race day
• … visit the track so that he or she knows where to go and what to expect
• … get enough sleep before the day of the big race
• … eat a good breakfast on race day morning;
• … check his or her watch constantly to monitor the car’s progress
• … keep moving along the track and not get stuck on a bad corner
• … breathe long and deeply to relax and keep the oxygen going to the brain
• … drink water (but not too much!) when the car is at the pit-stop.

The Listening, Reading, and Writing Tests are given in that order, and are usually held on a single morning. The combined length of those three tests is 2 hours and 30 minutes. (The Speaking Test is conducted at an appointed time in the afternoon.) Only one short break is given between the Reading and Writing Tests, so you need to be at your best for a long period of time, which is why you must sleep and eat well before the test. The hints and guidelines in this book should help you achieve your “maximum speed”. The more effort you put in, the faster your personal speed will be on the day. (See also IELTS Test - Basic Hints 1 and 2.)

INCREASE YOUR SENTENCE READING SPEED
The faster and more accurately you read, the more questions you will be able to answer. In all the tests, the instructions, the example, and the questions themselves need to be read quickly, and must be well understood in order for you to have more time to find the answers. It pays to increase your overall reading speed. (See also Reading Hint 41.)

To increase your reading speed, you must learn to read in groups of words that form logical units of thought within sentences. Look at the following sentence:

Britain has been a popular choice for thousands of international students over many years

Notice how you can think of the sentence as being made up of 3 main parts:

1. Britain has been a popular choice (What and where?)

2. … for thousands of international students (Who for?)

3. … over many years. (When?)

Note also, that in this case (and many others) all the phrases answer wh/how questions. It may be helpful at first to think of wh/how questions when trying to read in phrases.

If you read each word in a sentence one at a time, you will read very slowly and most likely misunderstand the meaning of much of what you read. So read your sentences in phrases by considering all the words of a phrase as a single unit.

Notice how much quicker it is to read the sentence, and how the meaning of what you say is more clear. Practise reading in phrases everyday. Look ahead on the page as you read, and always aim to find logical places in the sentences where phrases begin and end. Note also that there is often more than one solution as to where the logical breaks between phrases occur within sentences.

Read faster by reading words in groups that form logical units of thought

DEVELOP A MEMORY FOR ENGLISH
In the Reading Test, it pays to remember as much as you can of what you have just read, but at least the words can be read again. However, in the Listening Test you cannot go back, and the tape is only played once. If the answer comes before the keyword/phrase, your memory of what you have just heard is even more important. Nevertheless, the answer usually follows the keywords/phrases that you hear, and is close in time to the main keyword/phrase you are listening for.

To improve your “English memory”, try the following exercise. Using the pause button on the tape recorder, repeat the sentences spoken in the passages on the audio cassette tape that comes with this book, gradually increasing the length of what you repeat. Do not worry about repeating the exact words. Simply aim to remember more of what you have heard.

SOURCE OF Ielts Test: Time Constraints Issues




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Thursday, October 30, 2008

IELTS TIPS: Tips For Improving Your Reading Speed

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The purpose of this section is to teach you how to increase you reading speed. Shortly we will be adding a section for reading BETTER as opposed to FASTER.

We all have a capacity for reading much faster than we typically do. Our reading speed changes as we go through life. When we are in high school, we go through about two hundred words a minute. We get to college and, because we have to read faster due to more time constraints and a much greater amount to read, we read faster. Most people in college average about 400 words per minute. Then we get out of college, and now we don’t have to read so fast. There are no longer time constraints, and we can read slow and easy. We find ourselves dropping back down to about 200 words per minute.

Think of reading like you do a muscle, the more you read, the better you get at it, the faster you’re going to read. And we have a great capacity for reading faster. We aren’t even scraping the surface of how fast we can read. You see, we have 1,000,000,000,000 brain cells. In fact, the inner connections, the synapses, in our mind are virtually infinite. It has been estimated by a Russian scientist that the number of synapses we have would be one followed by 10 million kilometers of zeros. Our physical capacity for reading is beyond our comprehension. Our visual unit has the capability to take in a full page of text in 1/20 of a second. If we could turn the pages fast enough, our brain could process it faster than our eyes can see it. If we could turn those pages fast enough, our eyes have the capacity to read a standard book in six to twenty-five seconds depending on the length of the book. We could take in the entire Encyclopedia Britannica in one hour. So reading 700 - 1,000 words a minute is easily within our reach.

The key to improving our speed is to SIGHT READ, and that’s what we are going to show you how to do. We are going to start being pure sight readers. Obstacles get in our way, however. What do we mean by obstacles? Well, these are things that impede us from reading faster.

REGRESSIONS are the most wasteful. Regressions are going back over words. You can call it back-skipping if you want. You go back over words you previously read. People do it for two reasons. Initially we read it to clarify the meaning of what we’re reading. We want to be sure of the words we read as we go along. In our early years in school, when we were first taught - incorrectly - to “read slowly and carefully,” it became easy to go back over words.

Well, this not only slows you down, it causes you comprehension problems. For instance, lets say you have a sentence, “The man jumped over the log.” Well, if you back-skip, you read that passage like this: “The man jumped,” “the man . . . jumped. . . over the log,” “jumped over the log.” So, what your brain is processing, “The man jumped,” “the man jumped,” “jumped over the log.” Our brain is used to processing our flaws, so the brain thinks, “OK, I know what this clown is saying, “The man jumped over the log.” But this takes time to sort out. And it’s confusing. Think how much easier it would be if you simply took the sentence in in one sight, “The man jumped over the log.” There’s no confusion there. Then you move on to the next phrase. Regressing or back-skipping is the most harmful thing we do to slow our reading speed.

Our second obstacle is that we have BAD HABITS that we pick up. Bad habits manifest themselves in a number of ways. For one, you’ve got people who have MOTOR habits as they read. These are the people who are tapping a pencil when they read, tapping a foot when they read, moving a book, flicking their hand, etc. If they’re sitting next to you, they drive you nuts. But they are the people who have to be moving while they read.

Some may even move their lips. If they do that, they’re kind of edging over into another bad habit where we find AUDITORY readers. This is the bad habit that we have that is the hardest to drop. Auditory reading is difficult to beat because we are used to reading and hearing the words in our minds. Some people even go so far as to mumble the words. You can see their lips moving sometimes, or you can even hear a guttural growl as they go through the words.

The other obstacle are the FIXATIONS. Fixations are the actual stops or pauses between eye-spans when the eye is moving to its next fixation point. We can’t see while the eye moves so you do need the fixation points to see. The problem is, most people fixate word by word by word. They stop their eyes on each separate word. The fixations slow you down because you are stopping on each word.

The problem that comes up here is this that, like the other obstacles, it impedes concentration and comprehension as well. The paradox with reading slowly is that it really hurts your concentration.

Research has shown a close relation between speed and understanding. In checking progress charts of thousands of individuals taking reading training, its been found that in the vast majority of cases, that an increase in speed reading rate has also been paralleled by an increase in comprehension. The plodding word by word analyzation actually reduces comprehension.

In this day and age, our brains are used to constant stimulation. Television, radio, even people talking to you, provide constant stimulation. So when we are reading along slowly and carefully, it’s kind of like watching a movie and we encounter a slow motion scene. The slow motion scene is kind of interesting at first because the movie has been moving along at a rapid clip and now we have a change of pace. We’ve got the slow motion scene of the guy getting shot or the couple running across to each other across a field, and the mind initially says, “Oh, this is cool. This is something different.” After a while we get a little impatient and we’re ready for the guy who got shot to hit the ground, or the couple who are running across the field to finally get to each other. We start thinking about other things..weve lost our focus on the movie.

The brain does the same thing when we read. The brain is getting all the stimulation it normally gets, then we hit this patch where you’re reading slowly. And boom, the brain says, “I don’t like this. I think I’m going to start thinking about something else.” And the reader starts thinking about the date they had Saturday night or the date they hope to have Saturday night. And therefore, you’ve got another impediment to comprehending the reading correctly.

OK, what do we do? Well, there are several things we are going to do to increase reading speed. First of all. we are going to increase the EYE SPAN. Eye span is the number of words that you take in as you look at the words. In other words, if my eye span is just one word, I am going to move from word to word to word. If my eye span is two words, I am going to move along twice as fast. If my eye span is three words, three times as fast. If I am moving along in phrases, I’m flying along pretty good.

That’s where you increase the rate of eye span. You also want to learn to work in THOUGHT UNITS. Thought units help you move faster. This is where you group the words according to context. For instance, lets say you have, “He said something.” It’s easy to put that in a phrase, then you move to the next phrase. If I had this sentence, “It’s safe to say that almost anyone can double his speed of reading while maintaining equal or higher comprehension.” If I want to read that in phrases, “It’s safe to say that almost anyone…….can double his speed……..of reading while maintaining…….equal or even higher comprehension.” You move much faster that way.

So, we are going to increase the number of words we see and we are going to group them according to context. One of the key things that we are also going to work on is RETURN EYE SWEEP. When you get to the end of the sentence or the end of the line on the written page, if your eye meanders back to the other side, you have a chance to pick up words. If you’re picking up words and you’re sight reading, that can be confusing. So you want to dramatically, quickly, forcefully, go from the end of one line to the beginning of the next one. Using a fingertip or pen as a pointer is a great way to quickly and directly to the next line.

The other thing that helps us increase our speed is CONFIGUATION. As you read faster and faster, you’ve got to learn to rely on your increased recognition of how words are configured, how they look, as you do it. In other words, “material” looks different than “response”. “Recognition” looks different than “perceptual”. The words have visual configurations. As you learn to read faster and faster you learn to pick up on the configurations and, as you do better and better, your skills at this improve with practice.

So, we are going to have no REGRESSIONS, no VOCALIZATIONS, and increased EYE SPAN. That’s the way to true sight reading. How do we do this?

First, we avoid the problem areas. We avoid the limited eye-span by expanding the number of words that we take in. We get rid of regressions and we get rid of the return eye sweep problem by using a pointer. You can use a pen, a pencil, even your finger. That gives you a point of focus for your eyes. It helps you focus on the page, and you move faster because you can dictate how fast you are moving across the page. Your eye will follow your finger, or pen, or pencil.

Absolutely stay away from the vocalizations. You have got to be a sight reader. You have got to read fast enough so that you don’t have time to hear the words. This way you are comprehending simply with your eyes.

You also need to keep in mind that you don’t always read at the same speed. If you’ve got a car that will go 120 miles per hour, you’re not going to drive that care 120 miles per hour in a shopping center. You’d get killed and get a heck of a ticket. But you may, on a highway when you are passing a car, get it up to a high speed. When you are in that shopping center, you are going to be driving about 30 miles per hour.

It’s the same thing with reading. This is specifically addressed in our Better Reading section. But you must learn that you speed read in certain areas and there are other areas that may be particularly dense, that may have something that’s particularly confusing to you, when you will need to slow down and read in shorter phrases, smaller groupings of words so that you can comprehend it clearly. It may be a particularly dense passage where each word has great deal of meaning. It may be even an unusual or specific word.

Let’s look at what we’ve got to do to practice it. The big step here is to simply read faster. It sounds like such a simple statement, it almost sounds stupid. But it’s what you have to do. You have to focus on “I’m going to read faster,” first.

Comprehension comes later. Practice reading without a great concern for comprehension. In clinical terms, we call this the comprehension lag. It takes the mind as many as ten to fifteen days to adapt to the new reading rate.

You are going to go through periods, practice periods, you can’t use on school books, but it’s a practice period where you are simply adapting to reading that much faster. Comprehension lags for a while but when it catches up it makes a stunning difference.

A good place to practice this is magazines or newspapers. They have narrow columns that almost make a perfect thought unit. You can almost go straight down the column, taking that finger and puttting it in the middle of the column and moving it straight down the page. You will be stunned how soon you will be able to improve and comprehend what you are reading that way. You find that it’s quick. It’s easy reading.

Originally published at http://www.studyhall.com/sread.htm





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Wednesday, October 29, 2008

How To Perform Testicular Self-Examination?

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Definition
A testicular self-examination (TSE) is the procedure by which a man checks the appearance and consistency of his testes.

Purpose
Most testicular cancers are first noticed by the man himself. Men should do a TSE every month to find out if the testes contain any suspicious lumps or other irregularities, which could be signs of cancer or infection.

Precautions
None.

Description
A TSE should take place during a warm shower or bath, when the skin is warm, wet, and soapy. The man needs to step out of the tub so that he is in front of a mirror. The heat from the tub or shower will relax the scrotum (sac containing the testes) and the skin will be softer and thinner, making it easier to feel a lump. It is important that the exam be done very gently.

The man should stand facing his mirror and look for swelling on the scrotum. Using both hands, the scrotum should be gently lifted so that the area underneath can be checked.

The next step is examination by hand. The index and middle fingers should be placed under each testicle, with the thumbs on top. The testes should be examined one at a time. The man should roll each testicle between his fingers and thumbs. He should feel for lumps of any size (even as small as a pea) particularly on the front or side of each testicle. He should also look for soreness or irregularities. Next, the epididymis and vas deferens, located on the top and back of the testes, should be felt. This area feels like a cord, and should not be tender.

Normal results
It is normal for one testicle to be larger than the other is, and for them to hang at different levels; but the size should stay the same from one month to the next. The testes should be free from lumps, pain, irregularities and swelling.

Abnormal results
A TSE is considered abnormal if any swelling, tenderness, lumps, or irregularities are found. Hard, unmoving lumps are abnormal, even if they are painless. A lump could be a sign of an infection or a cancerous tumor. A change in testicle size from one month to the next is also abnormal. A feeling of heaviness in the scrotum is another abnormal sign. If any abnormality is found, a man is encouraged to check with his doctor as soon as possible because testicular cancer is highly curable if found early.

Key Terms

Epididymis
A tube in the back of the testes that transports sperm.

Scrotum
The pouch containing the testes.

Testes
Egg-shaped male gonads located in the scrotum. Testes is the plural form of testis, which is a testicle.

Vas deferens
A tube that is a continuation of the epididymis. This tube transports sperm from the testis to the prostatic urethra.


SOURCE for How To Perform Testicular Self-Examination?



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Tuesday, October 28, 2008

Tactile Fremitus : Lung Examination

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Patient to say "99" "1, 2, 3" or "E"


Each time you lay your hands or listen

All around the chest and compare

Dorsal surface of your fingers or ulnar surface of your hand (tactile fremitus)

Listen with diaphragm (vocal resonance)

If increased have patient whisper

Note the intensity

Quality of pitch

Compare




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Sunday, October 26, 2008

Nursing Review Glossary - Z

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Z-track
An I.M. injection technique in which the client's skin is pulled in such a way that the needle track is sealed off after the injection. The technique is done to minimize subcutaneous irritation and discoloration.



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Nursing Review Glossary - X

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X-linked recessive disorders
Genetic disorders in which the abnormal gene exists on the X chromosome; only males exhibit clinical signs of the disorder because they have no offsetting X chromosome.



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Saturday, October 25, 2008

Nursing Review Glossary - W

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wet-to-dry dressings
Type of wound covering (dressing) in which gauze moistened with normal saline is applied wet to the wound and removed once the gauze becomes dry and adheres to the wound bed; used for debridement.

Wilms' tumor
A rapidly growing malignant kidney tumor that occurs most commonly in children younger than age 5, although it sometimes develops before birth. Rare cases occur later in life. Also called adenomyosarcoma.



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Nursing Review Glossary - V

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variability
Differing rhythmicity or changes in condition; often used to describe fetal heart rate reflected on the fetal heart rate tracing as a slight irregularity or jitteriness.

vaso-occlusive crisis
The most common type of sickle cell crisis resulting from blood vessel obstruction by rigid, tangled sickle cells leading to tissue anoxia and possibly necrosis. Also called a painful crisis or infarctive crisis.

vastus lateralis
The largest of the four muscles that make up the quadriceps femoris; located on the outside of the thigh, extending from the hip joint to the common quadriceps tendon and inserted in the patella; extends the leg.

venography
A radiographic test using a contrast medium to identify thrombi or obstruction in the veins of the lower extremities or the kidneys.

ventricular septal defect (VSD)
An abnormal opening in the septum separating the ventricles, usually resulting from failure of the fetal interventricular foramen to close; results in blood flow from the left ventricle to the right ventricle and recirculation of blood through the pulmonary artery and lungs.

ventricular tachycardia
A life-threatening arrhythmia that occurs when the ventricles produce several premature ventricular contractions in succession; usually due to a problem with the heart's conduction system and increased myocardial contractility.

vertigo
A sensation of movement in which the client feels himself revolving in space (subjective vertigo) or his surroundings revolving about him (objective vertigo); may result from diseases of the inner ear or from disturbances of the vestibular pathways in the central nervous system.

vesicle
1. Any small anatomic sac that contains liquid. 2. A small blister that contains clear fluid.



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Friday, October 24, 2008

Nursing Review Glossary - U

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ulcerative colitis
A chronic, recurrent ulceration of the colon of unknown cause in which there is abdominal cramping, rectal bleeding, and diarrhea containing blood, pus, and mucus.

urinary incontinence
Inability to prevent urine discharge.

urinary tract infection (UTI)
A bacterial infection, most commonly caused by Escherichia coli or a species of Klebsiella, Proteus, Pseudomonas, or Enterobacter, affecting one or more parts of the urinary tract.

urticaria
A vascular reaction caused by dilation and increased permeability of the capillaries. Symptoms include the development of transient wheals with pale centers and well-defined erythematous margins.



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Nursing Review Glossary - T

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tachycardia
A condition characterized by a regular but accelerated action of the heart, usually l00 to 150 beats per minute.

tactile fremitus
Vibration in the chest wall that can be felt when a hand is applied to the thorax while the patient is speaking. It's most commonly due to consolidation of a lung or a part of a lung but may also be caused by congestion, inflammation, or infection.

tardive dyskinesia
A neurological syndrome marked by slow, rhythmical, automatic movements that occur as an adverse effect of extended phenothiazine use.

tension pneumothorax
A condition in which air enters the pleural space through a tear in lung tissue but can't exit through the same vent, thereby trapping air in the pleural space with each inspiration and producing positive pleural pressure. This in turn causes the ipsilateral lung to collapse.

tenting
An indication of decreased skin turgor, as exhibited by a fold of skin remaining or holding in the pinched position after being released.

teratogenic
Causing harm to the developing fetus.

tetany
Hyperexcitability of nerves and muscles as a result of a lessened concentration of extracellular ionized calcium; symptoms include convulsions, muscle twitching and cramps, and sharp flexion of the wrist and ankle joints.

tetralogy of Fallot
A combination of congenital cardiac defects consisting of pulmonic stenosis, interventricular septal defect, dextroposition of the aorta so that it overrides the interventricular septum and receives venous as well as arterial blood, and right ventricular hypertrophy.

thrombocytopenia
A reduction in the number of blood platelets; usually caused by destruction of erythroid tissue in bone marrow. The condition may be a result of neoplastic disease or an immune response to a drug.

thrombophlebitis
Inflammation of a vein, often involving clot formation. Common causes include chemical irritation, blood hypercoagulability, immobilization, infection, postoperative venous stasis, prolonged sitting or standing, trauma to the vessel wall, or a long period of I.V. catheterization.

tonic-clonic seizure
Paroxysmal, uncontrolled discharge of central nervous system neurons extending to the entire brain and characterized by stiffening (tonic phase) and then rapid synchronous muscle jerking and hyperventilation (clonic phase). Also called a major or grand mal seizure.

tonsillectomy
The surgical removal of the palatine tonsils.

total parenteral nutrition (TPN)
The administration of total caloric needs in a nutritionally adequate solution of glucose, protein hydrolysates, minerals, and vitamins through a catheter inserted into the superior vena cava.

tracheoesophageal fistula
Abnormal opening between the esophagus and trachea that may lead to aspiration.

tracheostomy
The surgical creation of an opening through the neck into the trachea; used to relieve upper airway obstruction and aid breathing.

traction
1. The action of pulling a part of the body along the long axis. 2. In orthopedics: the act of exerting force through a system of weights and pulleys to align, immobilize, or relieve pressure in a limb, bone, or group of muscles.

transdermal
Method or route of topical drug administration; provides continuous drug delivery through the skin to achieve a constant, steady blood concentration level.

transsphenoidal adenohypophysectomy
Surgery involving the pituitary gland, most commonly performed to remove a pituitary tumor. The physician enters from the inner aspect of the upper lip through the sphenoid sinus.

transsphenoidal hypophysectomy
Microsurgery in which an incision is made at the junction of the gums and upper lip. A surgical microscope is advanced and a special surgical instrument is used to excise all or part of the pituitary gland.

Trendelenburg's position
Position in which the client's head is lower than the trunk; typically, the body and legs are elevated on an incline.

Trousseau's sign
An assessment technique for evaluating neuromuscular irritability (tetany) associated with hypocalcemia. When Trousseau's sign is positive, the client develops a carpopedal spasm (adducted thumb, flexed wrist and metacarpophalangeal joints, and extended interphalangeal joints) after a blood pressure cuff is applied to the client's upper arm and inflated to a pressure above systolic pressure for approximately 1 to 4 minutes.

tuberculosis
An acute or chronic infection from exposure to Mycobacterium tuberculosis or another strain of mycobacteria characterized by pulmonary infiltrates and formation of granulomas with caseation, fibrosis, and cavitation.

type 1 diabetes
An endocrine disorder involving disturbances in carbohydrate, protein, and fat metabolism, usually occurring before age 30 and requiring the use of exogenous insulin and dietary management. Also called insulin-dependent diabetes mellitus.

type 2 diabetes
An endocrine disorder involving disturbances in carbohydrate, protein, and fat metabolism; characterized by insulin resistance with varying degrees of insulin secretory defects. May be treated with diet, exercise, and oral antidiabetic agents. Exogenous insulin is sometimes necessary.

type 2 herpes simplex
A type of herpes simplex virus transmitted primarily through contact with genital secretions and affecting the genital structures.



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Thursday, October 23, 2008

Nursing Review Glossary - S

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scabies
A contagious skin disease caused by the itch mite, Sarcoptes scabiei.

schizotypal personality disorder
A disorder characterized by acute discomfort with and reduced capacity for close relationships and by cognitive or perceptual distortions and eccentricities of behavior, beginning in early adulthood.

scoliosis
An appreciable lateral curvature of the spine resulting from numerous causes, including congenital malformations of the spine, muscle paralysis, poliomyelitis, sciatica, and unequal leg length.

sensorineural hearing loss
Hearing loss caused by a defect or lesion of the inner ear or the acoustic nerve resulting in a distortion of sound that makes discrimination difficult.

sensory perceptions
Awareness of one's surroundings through the use of vision, hearing, taste, touch, and smell.

serosanguineous
Of a discharge containing both serum and blood.

shock
An abnormal physiologic state characterized by reduced cardiac output, circulatory insufficiency, tachycardia, hypotension, restlessness, pallor, and diminished urinary output. Shock may be caused by a variety of conditions, including trauma, infection, hemorrhage, poisoning, myocardial infarction, and dehydration.

sickle cell anemia
A chronic and incurable hereditary disorder occurring in people homozygous for hemoglobin S (Hb S). The presence of Hb S results in distortion and fragility of erythrocytes.

sickle cell crisis
Episode of widespread cellular sickling in which the client's red blood cells containing hemoglobin S are exposed to conditions in which oxygen supply to the cells is decreased. This leads to cellular contraction and piling within the cell, altering the shape of the red blood cells (sickling). These sickled cells become rigid and clump together to form clusters, ultimately obstructing capillary blood flow and causing tissue ischemia.

simple fracture
An uncomplicated, closed bone fracture in which the skin isn't broken.

skin turgor
Skin characteristic determined by pinching a small area of skin on the medial arm or anterior chest and noting how quickly it returns to its position when released.

somatoform pain
Development of the symptom of pain as a result of psychological stress.

spinal shock
Loss of autonomic reflex, motor, and sensory activity below the level of a lesion. Signs of spinal shock include flaccid paralysis, loss of deep tendon and perianal reflexes, and loss of motor and sensory function.

standard precautions
Infection control guidelines established by the Centers for Disease Control and Prevention requiring all health care personnel to use gloves, gowns, and goggles to prevent contact with a client's blood or body fluids and to adhere to strict safety measures when handling needles, scalpels, and other sharp instruments.

status asthmaticus
A severe and prolonged asthma attack in which bronchospasm fails to respond to oral medication, sometimes resulting in hypoxia, cyanosis, and unconsciousness.

Stokes-Adams attack
Episode of confusion and light-headedness accompanying syncope with or without seizures due to inadequate cerebral perfusion secondary to heart block.

stoma
1. A minute pore, orifice, or surface opening. 2. An artificial, surgically created opening of an internal organ on the body surface, such as for a colostomy or tracheostomy. 3. A new opening surgically created between two structures, such as for a gastroenterostomy or pancreaticogastrostomy.

stomatitis
An inflammation of the mouth that may result from bacterial, viral, or fungal infection; exposure to chemicals or drugs; vitamin deficiency; or a systemic inflammatory disease.

stridor
A high-pitched respiratory sound, usually heard during inspiration, caused by an obstruction of the trachea or larynx.

stroke
A condition of sudden onset in which a cerebral blood vessel is occluded by an embolus or cerebrovascular hemorrhage. The resulting ischemia of brain tissue that is normally perfused by the affected vessel may lead to permanent neurologic damage.

subdural hematoma
A condition involving the collection of blood between the dura mater and the brain.

sublingual
Under the tongue.

sudden infant death syndrome (SIDS)
The sudden, unexpected, and inexplicable death of an infant who appears to be healthy. It occurs during sleep, typically in infants between the ages of 3 weeks and 5 months. Also called crib death.

supratentorial
Located above the tentorium of the brain.

suspension
A liquid that contains solid particles that aren't dissolved; stirring or shaking the liquid maintains the dispersal.

sympathomimetics
Group of drugs that mimic the effects of impulses conveyed by adrenergic postganglionic fibers of the sympathetic nervous system.

synchronized cardioversion
Delivery of an electrical shock to the client in conjunction with the R wave on his ECG, just as the heart muscle contracts. Delivery is timed to avoid the T wave because an electrical discharge at this time may cause ventricular fibrillation.

synergistic effect
Administration of two drugs producing the same qualitative effect together to produce a greater response than either drug alone.

systemic lupus erythematosus (SLE)
A chronic inflammatory multisystemic disorder of connective tissue, characterized principally by involvement of the skin, joints, kidneys, and serosal membranes.



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Wednesday, October 22, 2008

Practice for the NCLEX-RN: Practice Exam 3 and Rationales

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A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use?

Body temperature of 99°F or less

Toes moved in active range of motion

Sensation reported when soles of feet are touched

Capillary refill of < 3 seconds

A 30-year-old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for this client?

Side-lying with knees flexed

Knee-chest

High Fowler's with knees flexed

Semi-Fowler's with legs extended on the bed

A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this client?

Taking hourly blood pressures with mechanical cuff

Encouraging fluid intake of at least 200mL per hour

Position in high Fowler's with knee gatch raised

Administering Tylenol as ordered

Which of the following foods would the nurse encourage the client in sickle cell crisis to eat?

Peaches

Cottage cheese

Popsicle

Lima beans

A newly admitted client has sickle cell crisis. The nurse is planning care based on assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 92. Which of the following interventions would be implemented first? Assume that there are orders for each intervention.

Adjust the room temperature

Give a bolus of IV fluids

Start O2

Administer meperidine (Demerol) 75mg IV push

The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?

Roast beef, gelatin salad, green beans, and peach pie

Chicken salad sandwich, coleslaw, French fries, ice cream

Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie

Pork chop, creamed potatoes, corn, and coconut cake

Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and hypoxemia. Which of the following activities would the nurse recommend?

A family vacation in the Rocky Mountains

Chaperoning the local boys club on a snow-skiing trip

Traveling by airplane for business trips

A bus trip to the Museum of Natural History

The nurse is conducting an




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The IELTS Routine - Ace The IELTS (Essential tips for IELTS General Training Module)

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The IELTS test consists of four parts in the following order:

Listening, Reading, Writing and Speaking.

Listening takes about 30 minutes - 20 minutes to listen to a tape and to answer
questions on what you hear, and 10 minutes to transfer your answers to Answer Sheet.

Reading takes 1 hour and your task is to read passages of text and answer questions
according to what you have read. There are also other types of assignments which I
will cover later on.

Writing takes also 1 hour and is divided into 2 sub-parts: 20 minutes to write a letter
and 40 minutes to write an essay.

Speaking takes up to 15 minutes and consists of 3 parts: Personal Interview, Little
Speech and a Discussion.

All the parts continue one after another, and only before Speaking you get a little
break.

Listening at a glance
Listening consists of 4 sections. There are about 38-40 questions in total. You need to
answer all the questions as you listen to the tape. Tape is not paused at any time and
you hear it only once. The questions get more difficult as you progress through the
test.

Reading at a glance
Reading consists of 4 text passages and about 40 questions in total. Your job is to read
the passages and either answer questions, label diagrams, complete sentences or fill
gaps. For every type of task there are instructions and example. Passages are taken
from books, newspapers, magazines and the topics are very diverse, from scuba
diving to space exploration. Passages progress in difficulty, with first being the easiest
and fourth the hardest

Writing at a glance
Writing has 2 sub-tasks. First one is to write a letter according to scenario you
receive, using about 150 words. The second task is to write an Essay on given topic,
present and justify opinion or give solution to a problem, using not less than 250
words.

Speaking at a glance
This is the fun part of the test, for many reasons. You get to rest before it, you are a
little tired from previous 3 parts and therefore more relaxed. The examiners are
trained to smile no matter what, so you feel as if you were speaking to your best
friend.

First sub-part of Speaking test is an interview, which means that the examiner asks
you questions about yourself, your work, studies, parents, brothers/sisters, pets, etc.
This is an easy task to prepare for.

In the second sub-part of Speaking test you receive a card with 3-4 questions. After
one minute, that you have to think about something to say, you should give a little
speech for one to two minutes, which answers those questions. In the end the
examiner might ask you a couple of additional questions.

SOURCE: Ace The IELTS
Essential tips for IELTS General Training Module (How to get your IELTS Score To Open Doors For You) by Simone Braverman


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Nursing Review Glossary - R

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radical mastectomy
Surgical removal of an entire breast, pectoral muscles, axillary lymph nodes, and all fat, fascia, and adjacent tissues; usually used in the treatment of breast cancer.

reaction formation
Substitution of behavior, thoughts, or feelings that are completely opposed to one's own unacceptable behavior, thoughts, or feelings.

rectal route
Use of the rectum to administer medication

reflection
A technique in which the listener interprets the feelings of the client and repeats them back to the client; encourages the client to clarify his feelings.

repolarization
Part of the cardiac conduction cycle in which the cell returns to its resting state, a more negatively charged state. Calcium ions move into the cell and potassium ions move out, followed by the extrusion of sodium and calcium ions from the cell and the restoration of potassium ions into the cell by the sodium potassium pump.

respiratory acidosis
Caused by reduced alveolar ventilation; is marked by increased partial pressure of arterial carbon dioxide, excess carbonic acid, and increased plasma hydrogen-ion concentration. Hypoventilation inhibits the excretion of carbon dioxide, which consequently produces excessive carbonic acid and thus lowers blood pH.

respiratory alkalosis
Caused by both respiratory and nonrespiratory factors, this condition is marked by decreased partial pressure of arterial carbon dioxide, decreased hydrogen-ion concentration, and increased blood pH. Extreme anxiety can precipitate hyperventilation associated with respiratory alkalosis.

resuscitation
A method used to support a client's breathing and circulation until the body can do so on its own or the client is mechanically supported. It involves maintaining an open airway, providing artificial ventilation through rescue breathing, and promoting artificial circulation through external cardiac compression.

Reye's syndrome
Acute encephalopathy and fatty infiltration of the internal organs following acute viral infections, such as influenza B, chickenpox (varicella), the enteroviruses, and the Epstein-Barr virus; has also been associated in children with administration of aspirin and other salicylates.

Rh incompatibility
In hematology: two blood groups that are antigenically different and, therefore, aren't compatible because one group lacks the Rh factor.

rheumatic fever
An inflammatory disease sometimes occurring if group A beta-hemolytic streptococcal infection is inadequately treated.

rheumatoid arthritis
A chronic, systemic collagen disease marked by inflammation, stiffness, and pain in the joints and related structures that result in crippling deformities.

ritodrine therapy
A prescribed treatment that uses the beta-receptor agonist ritodrine to halt preterm labor.

Romberg’s sign
A swaying (or falling) when a person stands with feet together and eyes closed. It’s an indication that the person has lost a sense of position. Also called rombergism.

rooting reflex
A response in neonates to the cheek being touched or stroked. The infant turns the head toward the stimulated side and begins to suck. The reflex usually disappears by 3 to 4 months of age.

Russell traction
An orthopedic device that combines suspension and traction to align and immobilize the legs; used to treat diseases of the hip and knee and fractured femurs as well as hip and knee contractures.



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Tuesday, October 21, 2008

Nursing Review Glossary - Q

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quickening
The first notable fetal movement in utero, usually occurring at 16 to 20 weeks' gestation.



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Nursing Review Glossary - P

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Paget's disease
A common bone disease that usually affects middle-aged and elderly people. It’s marked by inflammation of the bones, softening and thickening of the bones, excessive bone destruction, and unorganized bone repair; the result is bowing of the long bones. The cause is unknown.

palilalia
Repetition of words or phrases with increasing rapidity.

pancreatitis
Acute or chronic inflammation of the pancreas.

paralysis
An abnormal condition characterized by the loss or impairment of motor function or the impairment of sensory function.

paralytic ileus
A decrease in or absence of bowel motility that may occur following abdominal surgery or may be caused by numerous other conditions, most commonly by peritonitis.

paranoid schizophrenia
Disorder involving disordered thinking with delusional thought content characterized by preoccupation with delusions or auditory hallucinations, lack of organized speech, disorganized or catatonic behavior, or flat or inappropriate affect.

paraplegia
An abnormal condition characterized by the loss of sensation and motor function in the lower limbs, which may result in either complete or incomplete paralysis.

parenteral
Not in or through the digestive system, but rather by injection through some other route, such as subcutaneously, I.V., I.M., or intradermally.

paresthesia
Abnormal or heightened touch sensations, such as burning, numbness, prickling, and tingling, that commonly occur without external stimulus.

perceptions
Awareness of objects and the ability to differentiate between them.

percutaneous transluminal coronary angioplasty (PTCA)
A technique to open stenosed atherosclerotic arteries. A balloon catheter is inserted through the skin and into the vessel to the site of narrowing; the balloon is inflated, thus flattening the plaque against the arterial walls.

pericarditis
Inflammation of the pericardium; may be caused by trauma, neoplasm, infection, uremia, myocardial infarction, or collagen disease.

perineum
1. The pelvic floor and its associated structures; located between the symphysis pubis and the coccyx and on the sides by the ischial tuberosities. 2. The body area between the thighs; bounded by the anus and scrotum in males and by the anus and vulva in females.

peristaltic waves
Alternating involuntary contraction and relaxation of the smooth muscle fibers of a structure in a wavelike fashion to propel the contents forward; commonly associated with the GI tract.

peritoneal dialysis
A procedure performed to remove toxins, drugs, or other wastes normally excreted by the kidney; transfers these substances across the peritoneum by intermittently introducing and removing a dialysate from the peritoneal cavity.

peritonitis
An inflammation of the peritoneum; can be produced by bacteria or irritating substances introduced into the abdominal cavity by a penetrating wound or perforation of an organ.

pernicious anemia
A megaloblastic anemia characterized by decreased gastric production of hydrochloric acid from the parietal cells of the stomach essential for vitamin B12 absorption; results in vitamin B12 deficiency.

phagocytosis
The process by which cells engulf and digest solid substances, such as microorganisms and cell debris.

phenylketonuria (PKU)
An inborn metabolic disorder caused by absence or deficiency of phenylalanine hydroxylase, the enzyme responsible for the conversion of phenylalanine to tyrosine; results in accumulation of phenylalanine and its metabolites, causing mental retardation and other neurologic problems, light pigmentation, eczema, and a distinctive mousy odor.

pheochromocytoma
A chromaffin-cell tumor of the adrenal medulla that secretes an excessive amount of the catecholamines epinephrine and norepinephrine, which results in severe hypertension, increased metabolism, and hyperglycemia.

phototherapy
The treatment of disease by the use of light, especially ultraviolet light or other concentrated rays; used to treat acne, psoriasis, and hyperbilirubinemia.

pituitary dwarfism
A condition characterized by a deficiency in secretion of the growth hormone from the anterior pituitary gland.

placenta accreta
Abnormal adherence of the placenta to the uterine wall.

placenta previa
Implantation of the placenta so that it adjoins or covers the internal os of the uterine cervix. The most common symptom is painless hemorrhage in the last trimester.

pneumonia
An acute infection of the lung parenchyma that commonly impairs gas exchange.

pneumothorax
A collection of air in the pleural space; may result from an open chest wound that permits the entrance of air or from the rupture of a vesicle on the surface of the lung. Common types of pneumothorax are open, closed, and tension.

polydipsia
Chronic, excessive thirst.

polymyositis
The simultaneous inflammation of a number of voluntary muscles.

polyneuritis
Degeneration of peripheral nerves primarily supplying the distal muscles of the extremities. It results in muscle weakness, with sensory loss and atrophy, and decreased or absent deep tendon reflexes.

polyphagia
Voracious or excessive eating before becoming satiated.

polyuria
The excessive excretion of urine from the kidneys.

postterm neonate
A neonate born after the onset of the 43rd week of pregnancy.

preeclampsia
An abnormal condition characterized by the development of hypertension during pregnancy, accompanied by edema or proteinuria, usually after the 20th week of gestation.

pressure ulcer
Localized area of skin breakdown occurring secondary to prolonged pressure. Necrotic tissue develops because the vascular supply to the area is diminished.

preterm neonate
A neonate born before the beginning of the 38th week of pregnancy.

primigravid
A woman who is pregnant for the first time.

Prinzmetal's angina
A variant of angina pectoris, a form of unstable angina, in which the attacks occur during rest. Attacks are indicated by an ST-segment elevation on an electrocardiogram.

productive cough
A mechanism by which the body clears the airway passages of secretions that normal mucociliary action doesn't remove; usually sudden, forceful, noisy expulsion of air from the lungs that contains sputum or blood (or both).

projection
False attribution of one's unacceptable feelings, impulses, or thoughts onto another.

pruritus
Itching; an unpleasant sensation that leads to rubbing or scratching the skin in an effort to obtain relief. Scratching the skin may lead to secondary infection.

pseudoparkinsonism
The development of a Parkinson-like disorder (neuromuscular disorder involving progressive muscle rigidity, akinesia, and involuntary tremors) due to psychotropic drug therapy.

puerperal
1. Of or pertaining to the period from the end of childbirth until involution of the uterus is complete (usually 3 to 6 weeks). 2. Of or pertaining to a woman (puerpera) who has just given birth to an infant.

pulmonary edema
An abnormal condition in which extravascular fluid is accumulated in lung tissues and alveoli.

pulse pressure
The numeric difference between the systolic and diastolic pressures, usually 30 to 40 mm Hg.

purulent
Containing or forming pus.

pyelonephritis
Inflammation of the kidney and its pelvis.

pyuria
The presence of pus in the urine, commonly a sign of urinary tract infection.



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Monday, October 20, 2008

Nursing Review Glossary - O

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obsessive-compulsive disorder
A disorder characterized by obsessive thoughts and compulsive behaviors that represent recurring efforts to control overwhelming anxiety, guilt, or unacceptable impulses that persistently enter the consciousness.

oliguria
A diminished flow of urine in relation to fluid intake; usually less than 400 ml in 24 hours. Also called hypouresis.

ophthalmia neonatorum
Eye infection occurring at birth or in the first month; most commonly caused by gonorrhea or chlamydia.

opioids
Opium-derived or synthetically produced drugs that alter pain perception, induce mental changes, promote deep sleep, depress respirations, constrict pupils, and decrease GI motility.

orthostatic hypotension
Abnormally low blood pressure that occurs when a person stands up. Also called postural hypotension.

osmolality
The concentration or osmotic pressure of a solution; expressed in osmoles of solute per kilogram of solvent.

osmolarity
The osmotic pressure of a solution expressed in osmoles of solute per liter of solution.

osteomalacia
Delayed or poor mineralization of bone; the adult equivalent of rickets. This condition is associated with anorexia, fracture, pain, weakness, and weight loss.

osteomyelitis
Inflammation of bone that results from a local or general infection of bone and bone marrow. The bacterial infection is caused by trauma or surgery, by direct extension from a nearby infection, or by introduction from the bloodstream.

osteoporosis
A disorder in which bone mass is reduced and fractures occur after minimal trauma. It occurs most commonly in postmenopausal women, sedentary or immobilized individuals, and persons on long-term steroid or heparin therapy.

otorrhea
A discharge from the ear, which may be serous, sanguineous, or purulent if the external or middle ear is infected.

ototoxicity
Harmful effect on the function of the eighth cranial nerve or hearing organs; most commonly associated with prescribed drugs.



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Sunday, October 19, 2008

Sample Nclex-RN Quiz Handouts: Physiological Integrity

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Sample NCLEX-RN Quiz: Physiological Integrity

1. A 65-year-old patient with pneumonia is receiving garamycin (Gentamicin). It would be MOST important for a nurse to monitor which of the following laboratory values in this patient?

(A) Hemoglobin and hematocrit.
(B) BUN and creatinine.
(C) Platelet count and clotting time.
(D) Sodium and potassium.


Question: Which lab values should you monitor for a patient receiving Gentamicin?

Needed Info: Gentamicin: broad spectrum antibiotic. Side effects: neuromuscular blockage, ototoxic to eighth cranial nerve (tinnitus, vertigo, ataxia, nystagmus, hearing loss), nephrotoxic. Nursing responsibilities: monitor renal function, force fluids, monitor hearing acuity. Draw blood for peak levels 1 hr. after IM and 30 min - 1 hr. after IV infusion, draw blood for trough just before next dose.

(A) Hemoglobin and hematocrit — can cause anemia; less common
(B) BUN and creatinine — CORRECT: nephrotoxic; will see proteinuria, oliguria, hematuria, thirst, increased BUN, decreased creatine clearance
(C) Platelet count and clotting time — do not usually change
(D) Sodium and potassium — hypokalemia infrequent problem


2. A 22-year-old man is admitted to the hospital with complaints of fatigue and weight loss. Physical examination reveals pallor and multiple bruises on his arms and legs. The results of the patients tests reveal acute lymphocytic leukemia and thrombocytopenia. Which of the following nursing diagnoses MOST accurately reflects his condition?

(A) Potential for injury.
(B) Self-care deficit.
(C) Potential for self-harm.
(D) Alteration in comfort.

Question: What nursing diagnosis is seen with acute lymphocytic leukemia and thromocytopenia?

Needed Info: Thromocytopenia: decreased platelet count increases the patient's risk for injury, normal count: 200,000-400,000 per mm3. Leukemia: group of malignant disorders involving overproduction of immature leukocytes in bone marrow. This shuts down normal bone marrow production of erythrocytes, platelets, normal leukocytes. Causes anemia, leukopenia, and thrombocytopenia leading to infection and hemorrhage. Symptoms: pallor of nail beds and conjunctiva, petechiae (small hemorrhagic spot on skin), tachycardia, dyspnea, weight loss, fatigue. Treatment: chemotherapy, antibiotics, blood transfusions, bone marrow transplantation. Nursing responsibilities: private room, no raw fruits or vegs, small frequent meals, O2, good skin care.

(A) Potential for injury — CORRECT: low platelet increases risk of bleeding from even minor injuries. Safety measures: shave with an electric razor, use soft tooth brush, avoid SQ or IM meds and invasive procedures (urinary drainage catheter or a nasogastric tube), side-rails up, remove sharp objects, frequently assess for signs of bleeding, bruising, hemorrhage.
(B) Self-care deficit — may feel weak, doesn't address condition
(C) Potential for self-harm — implies risk for purposeful self-injury, not given any info, assumption
(D) Alteration in comfort — patient is not comfortable, and comfort measures would address problem


3. To enhance the percutaneous absorption of nitroglycerine ointment, it would be MOST important for the nurse to select a site that is

(A) muscular.
(B) near the heart.
(C) non-hairy.
(D) over a bony prominence.


Question: What is the best site for nitroglycerine ointment?

Strategy: Think about each site.

Needed Info: Nitroglycerine: used in treatment of angina pectoris to reduce ischemia and relieve pain by decreasing myocardial oxygen consumption; dilates veins and arteries. Side effects: throbbing headache, flushing, hypotension, tachycardia. Nursing responsibilities: teach appropriate administration, storage, expected pain relief, side effects. Ointment applied to skin; sites rotated to avoid skin irritaion. Prolonged effect up to 24 hours.

(A) muscular — not most important
(B) near the heart — not most important
(C) non-hairy — CORRECT: skin site free of hair will increase absorption; avoid distal part of extremities due to less than maximal absorption
(D) over a bony prominence — most important is that the site be non-hairy


4. A man is admitted to the Telemetry Unit for evaluation of complaints of chest pain. Eight hours after admission, the patient goes into ventricular fibrillation. The physician defibrillates the patient. The nurse understands that the purpose of defibrillation is to:

(A) increase cardiac contractility and cardiac output.
(B) cause asystole so the normal pacemaker can recapture.
(C) reduce cardiac ischemia and acidosis.
(D) provide energy for depleted myocardial cells.


Question: Why is a patient defibrillated?

Strategy: Think about each answer choice.

Needed Info: Defibrillation: produces asystole of heart to provide opportunity for natural pacemaker (SA node) to resume as pacer of heart activity.

(A) increase cardiac contractility and cardiac output — inaccurate
(B) cause asystole so the normal pacemaker can recapture — CORRECT: allows SA node to resume as pacer of heart activity
(C) reduce cardiac ischemia and acidosis — inaccurate
(D) provide energy for depleted myocardial cells — inaccurate


5. A patient is to receive 3,000 ml of 0.9% NaCl IV in 24 hours. The intravenous set delivers 15 drops per milliliter. The nurse should regulate the flow rate so that the patient receives how many drops of fluid per minute?

(A) 21
(B) 28
(C) 31
(D) 42

Question: How should you regulate the IV flow rate?

Strategy: Use formula and avoid making math errors.

Needed Info: total volume x the drop factor divided by the total time in minutes.

(A) 21 — inaccurate
(B) 28 — inaccurate
(C) 31 — CORRECT: 3,000 x 15 divided by 24 x 60
(D) 42 — inaccurate


Sample Nclex-RN Quiz Handouts: Physiological Integrity Provided by Nurse Shecater! Thank you!


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Nursing Review Glossary - N

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nebulizer
A device that employs a baffle to produce a fine aerosol spray consisting of particles less than 30 micrometers in diameter.

necrotizing enterocolitis
GI disorder commonly associated with premature infants and characterized by diffuse or patchy intestinal necrosis and sometimes accompanied by sepsis.

negative nitrogen balance
Increased rate of protein breakdown when compared to protein synthesis; nitrogen excretion that exceeds nitrogen intake.

neglect
A form of abuse involving the failure to protect a person from injury or meet the person's physical, emotional, or medical needs.

nephrectomy
The surgical removal of a kidney, usually done to remove a tumor, drain an abscess, or treat hydronephrosis.

nephrotic syndrome
A clinical classification including all kidney diseases characterized by marked proteinuria, hypoalbuminemia, and edema.

neurotransmitter
Any one of a group of substances that act on a target nerve cell to excite or inhibit transmission of nerve impulses; substances include norepinephrine, acetylcholine, and dopamine.

nystagmus
Involuntary, rapid movements of the eyeball that may be horizontal, rotatory, vertical, or mixed.



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Saturday, October 18, 2008

NASOGASTRIC TUBE INSERTION (A SELF-INSTRUCTIONAL PACKAGE)

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Nursing Review Glossary - M

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mammogram
A radiograph of the breast; used for diagnostic purposes.

mammography
Radiography of the mammary gland to identify benign and malignant neoplastic processes.

mastectomy
The surgical resection of a breast; usually performed to remove a malignant tumor.

mastitis
Inflammation of the mammary gland; usually caused by streptococcal or staphylococcal infection and infrequent breast-feeding.

meconium
A dark, greenish black material that occurs in the intestines of a fetus that forms the first stools of a neonate. The fluid is thick and sticky and is composed of intestinal gland secretions, some amniotic fluid, and intrauterine debris.

megaloblastic anemia
A hematologic disorder that is characterized by the production and peripheral proliferation of megaloblasts.

Ménière's disease
A labyrinthine dysfunction that produces severe vertigo, sensorineural hearing loss, and tinnitus.

metabolic acidosis
A condition resulting from excessive accumulation of acid or depletion of bicarbonate.

metabolic alkalosis
A clinical state marked by decreased amounts of acid or increased amounts of base bicarbonate.

milieu
A therapeutic environment, typically used as part of inpatient psychiatric therapy.

mitral stenosis
Obstruction of blood flow from the left atrium to the left ventricle due to thickening and contracting of the mitral valve leaflets; consequently, left atrial volume and pressure rise and the chamber dilates. Greater resistance to blood flow causes pulmonary hypertension, right ventricular hypertrophy, and right-sided heart failure.

muscular dystrophy
A group of degenerative genetic diseases characterized by weakness and the progressive atrophy of skeletal muscles with no evidence of nervous system involvement.

myalgia
Diffuse muscle pain or tenderness associated with many infectious diseases.

myasthenia gravis
An abnormal muscle weakness and fatigability, especially in the muscles of the face and throat, resulting from a defect in the conduction of nerve impulses at the myoneural junction.

mycoplasmal pneumonia
A contagious respiratory disease caused by Mycoplasma pneumoniae, characterized by a sore throat, dry cough, fever, malaise, and myalgia.

myeloma
Osteolytic neoplasm consisting of a protrusion of cells typical of the bone marrow.

myelomeningocele
The protrusion of a hernial sac containing a portion of the spinal cord, its meninges, and cerebrospinal fluid through a congenital defect in the vertebral column.

myxedema
A disorder that results from hypofunction of the thyroid. Signs and symptoms include enlarged tongue, slowed speech, moon face, drowsiness, cold intolerance, hair loss, and anemia.

myxedema coma
A rare, serious form of hypothyroidism that usually results from lack of treatment or mistreatment, severe stress (from infection, exposure to cold, or trauma), or the use of sedatives or anesthetics in a client being treated for hypothyroidism.



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Friday, October 17, 2008

Nursing Review Glossary - L

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laminectomy
Surgical removal of the bony arches of one or more vertebrae; performed to relieve spinal cord compression or to remove a displaced intervertebral disk.

lead poisoning
Poisoning caused by the ingestion or absorption of lead or one of its salts. Signs and symptoms include loss of appetite and weight, anemia, constipation, insomnia, headache, dizziness, irritability, a blue line at the margin of the gums, and peripheral neuropathy.

lethargy
A feeling or condition of sluggishness, apathy, or inactivity.

lipodystrophy
Any disturbance in fat metabolism.

living will
A witnessed document indicating a client's desire to be allowed to die a natural death rather than be kept alive by heroic, life-sustaining measures. The will applies to decisions that will be made after a terminally ill client is incompetent and has no reasonable possibility of recovery.

lochia
The vaginal discharge present during the first several weeks after delivery.

lochia alba
A creamy white, brown, or colorless discharge consisting mainly of serum and white blood cells; typically stops flowing at about 6 weeks postpartum.

lochia rubra
Present during the first 3 to 4 postpartal days; it’s bloody and may contain mucus, tissue, debris, and small clots.

lochia serosa
A pink or brownish discharge persisting for 5 to 7 days postpartum.

Logan bar
Apparatus used to protect the surgical incision after cleft lip repair.

Logan bow
A wire U-shaped apparatus taped to both cheeks of an infant or toddler following cleft lip repair to protect the surgical site.

lumbar puncture
Fluid withdrawal from the subarachnoid space of the lumbar region of the spinal canal, usually between the third and fourth lumbar vertebrae, for diagnostic or therapeutic purposes. Also called spinal tap.

lymphangiography
A diagnostic radiographic evaluation of lymphatic system filling after injection of a contrast medium into a lymphatic vessel of each foot or hand.

lymphedema
Edema of an arm or leg caused by the buildup of interstitial fluid as a result of lymphatic inflammation or obstruction or a lymph node disorder.



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Thursday, October 16, 2008

Quick Pharma Review for Nclex

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Peripheral vascular disease - patient should sit with feet flat on floor to prevent hypereflexion of the knee

Myelominigocele - baby should like on abdomen with head to the side

Tegretol - interferes with actino of hormonal contraceptives, should use alternate type of birth control

Clozapine (Clozaril) - antipsychotic, treats schizophrenia, potential to suppress bone marrow and cause agranulocytosis (look for sore throat and fever)

Bucks traction - remove foam boots 3x/day to inspect skin, turn client to unaffected side, dorsiflex foot on affected side, elevate foot of bed

phlebitis - tenderness and redness at IV insertion site and redness proximally along the vein. Remove the IV adn apply warm soaks

Vancomycin can cause "Red man Syndrome" = decreased BP and flushing of face and neck --> give antihistamine. Also watch for liver damage with this one.


INSULIN:

Rapid: (Lispro) Onset: <15min Peak: 1hr Duration : 3hr

Short: (Regular) Onset: 1/2hr-1hr Peak: 2-3 hr Duration: 4-6 hr

Intermediate: (NPH or Lente) Onset: 2hr Peak: 6-12 Duration: 16-24

Long Acting: (Ultralente) Onse:t 4-6 hr Peak: 12-16hr Duration: >24 hrs

Very Long: (Lantus) Onset: 1 hr Peak: NONE Duration: 24 hr continuous


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Nursing Review Glossary - K

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Kawasaki disease
A febrile, multisystem disorder affecting the small to medium-size vessels, primarily of the lymph nodes, most commonly in children before puberty; usually follows exposure to an infection. Also called mucocutaneous lymph node syndrome.

Kegel exercises
Exercises involving alternate contraction and relaxation performed to strengthen the perineal muscles.

kernicterus
A neurologic syndrome resulting from deposition of unconjugated bilirubin in the brain cells and characterized by severe neural symptoms.

Kernig's sign
Elicitation of resistance and hamstring muscle pain when the examiner attempts to extend the knee while the hip and knee are both flexed 90 degrees.

Kussmaul's respirations
Abnormally deep, gasping type of respirations resulting from air hunger; associated with severe diabetic acidosis and coma.



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Wednesday, October 15, 2008

Sample Nclex-RN Quiz Handouts: Psychosocial Integrity

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Sample NCLEX-RN Quiz: Psychosocial Integrity

1. An adolescent male being treated for depression arrives with his family at the Adolescent Day Treatment Center for an initial therapy meeting with the staff. The nurse explains that one of the goals of the family meeting is to encourage the adolescent to:

(A) trust the nurse who will solve his problem.
(B) learn to live with anxiety and tension.
(C) accept responsibility for his actions and choices.
(D) use the members of the therapeutic milieu to solve his problems.


Question: What is the goal of family therapy?

Needed Info: Symptoms of depression: a low self-esteem, obsessive thoughts, regressive behavior, unkempt appearance, a lack of energy, weight loss, decreased concentration, withdrawn behavior.

(A) trust the nurse who will solve his problem — not realistic
(B) learn to live with anxiety and tension — minimizes concerns
(C) accept responsibility for his actions and choices — CORRECT
(D) use the members of the therapeutic milieu to solve his problems — must do it himself


2. A 23-year-old-woman comes to the emergency room stating that she had been raped. Which of the following statements BEST describes the nurse's responsibility concerning written consent?

(A) The nurse should explain the procedure to the patient and ask her to sign the consent form.
(B) The nurse should verify that the consent form has been signed by the patient and that it is attached to her chart.
(C) The nurse should tell the physician that the patient agrees to have the examination.
(D) The nurse should verify that the patient or a family member has signed the consent form.


Question: What is your responsibility concerning informed consent?

Needed Info: Physician's responsibility to obtain informed consent.

(A) The nurse should explain the procedure to the patient and ask her to sign the consent form — Physician should get patient to sign consent
(B) The nurse should verify that the consent form has been signed by the patient and that it is attached to her chart — CORRECT
(C) The nurse should tell the physician that the patient agrees to have the examination — Physician should explain procedure and get consent form signed
(D) The nurse should verify that the patient or a family member has signed the consent form — must be signed by patient unless unable to do


3. The nurse cares for an elderly patient with moderate hearing loss. The nurse should teach the patient's family to use which of the following approaches when speaking to the patient?

(A) Raise your voice until the patient is able to hear you.
(B) Face the patient and speak quickly using a high voice.
(C) Face the patient and speak slowly using a slightly lowered voice.
(D) Use facial expressions and speak as you would normally.


Question: What should you do to communicate with a person with a moderate hearing loss?

Needed Info: Presbycusis: age-related hearing loss due to inner ear changes. Decreased ability to hear high sounds.

(A) Raise your voice until the patient is able to hear you — would result in high tones patient unable to hear
(B) Face the patient and speak quickly using a high voice — usually unable to hear high tones
(C) Face the patient and speak slowly using a slightly lowered voice — CORRECT: also decrease background noise; speak at a slow pace, use nonverbal cues
(D) Use facial expressions and speak as you would normally — nonverbal cues help, but need low tones


4. A 52-year-old man is admitted to a hospital after sustaining a severe head injury in an automobile accident. When the patient dies, the nurse observes the patient's wife comforting other family members. Which of the following interpretations of this behavior is MOST justifiable?

(A) She has already moved through the stages of the grieving process.
(B) She is repressing anger related to her husband's death.
(C) She is experiencing shock and disbelief related to her husband's death.
(D) She is demonstrating resolution of her husband's death.


Question: What is the reason for the wife's behavior?

Needed Info: Stages of grief: 1) shock and disbelief, 2) awareness of pain and loss, 3) restitution. Acute period: 4-8 weeks, usual resolution: 1 year.

(A) She has already moved through the stages of the grieving process — takes one year
(B) She is repressing anger related to her husband's death — not accurate; second stage: crying, regression
(C) She is experiencing shock and disbelief related to her husband's death — CORRECT: denial first stage; inability to comprehend reality of situation
(D) She is demonstrating resolution of her husband's death — too soon


5. After two weeks of recieving lithium therapy, a patient in the psychiatric unit becomes depressed. Which of the following evaluations of the patient's behavior by the nurse would be MOST accurate?

(A) The treatment plan is not effective; the patient requires a larger dose of lithium.
(B) This is a normal response to lithium therapy; the patient should continue with the current treatment plan.
(C) This is a normal response to lithium therapy; the patient should be monitored for suicidal behavior.
(D) The treatment plan is not effective; the patient requires an antidepressant.


Question: Is the depression normal, or something to be concerned about?

(A) The treatment plan is not effective; the patient requires a larger dose of lithium — not accurate
(B) This is a normal response to lithium therapy; the patient should continue with the current treatment plan — does not address safety needs
(C) This is a normal response to lithium therapy; the patient should be monitored for suicidal behavior — CORRECT: delay of 1-3 weeks before med benefits seen
(D) The treatment plan is not effective; the patient requires an antidepressant — normal response


Sample Nclex-RN Quiz Handouts: Psychosocial Integrity Provided by Nurse Shecater! Thank you!


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