OK I know this sounds stupid but I have a friend that gets really freaked out before big tests like finals, HESI, NCLEX, and usually we get together and a few days before I start throwing out random facts at her. On 2 different tests she said the only way she got several questions was from the random facts that I threw at her that she never would have thought of!
SOOOOO..... I thought that if yall wanted to do this we could get a thread going and try to throw out 5 random facts or "things to remember". NCLEX is coming and the more I try to review content the more I realize that I have forgotten so......here are my 5 random facts for ya:
OH and BTW these came from rationales in Kaplan or Saunders no made up stuff:
1️⃣ A kid with Hepatitis A can return to school 1 week within the onset of jaundice.
2️⃣ After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine.
3️⃣ Hyperkalemia presents on an EKG as tall peaked T-waves
4️⃣ The antidote for Mag Sulfate toxicity is ---Calcium Gluconate
5️⃣ Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact.
Oh, ohh, one more...
? Vasopressin is also known as antidiuretic hormone
hello everyone,,,i just took my exam and i went real slow but now im nervous because i ran out of time and that never happened to me before, i just kept thinking that i have enough time so im going to take my time to answer the questions carefully and i stopped at 195 questions, i dont know what to think because i dont know how they grade these exams nad computers make mistakes and i cant even see how my own exam is graded...
i have few questions have different opion with my friend , can you please answer it and give you reasons ?
1. client taking carbacot should :
a. take hard candy
b. take with a glass of water
c. after took the med , drink a glass of beer
d. take with meals
2. which of the following can contribute to diabetes melitus ?
a . obesity
b. hypertention
c. family history
d. sendentary life style
3. which of the following patients should the nurse see first ?
a. an elderly client with absent deep tendon reflex
b. copd client return from outside examination complaints of shortness of breath
c. a patient with peripheral artery disease complaints of coolness of the feet
d. postop patient just received pain med complaints of pain
4. when care for a patient with borderline personality disorder , the nurse should know :
a. have a trust relationship with the client
b. to prevent the patient's aggressive behavior
c. isolate the patient , to limit the group activity
d. prepare to deal the patient's emotional burst
1. i cant seem to answer it because the only carbacot that i know of is in iv form, in that case i would answer hard candy, but im not sure of this one.
2. all of them would indirectly contribute, but you can eliminate a, b and d already because the type of dm wasnt specified.
3. i'm leaning towards copd. i answered deep tendon at first but "elderly" made me doubt. i'm not sure. abcs also made me answer copd
4. my answer is a, primarily because b, c and d are nurse-centered or non-therapeutic.
i have few questions have different opion with my friend , can you please answer it and give you reasons ?
1. client taking carbacot should :
a. take hard candy
b. take with a glass of water
c. after took the med , drink a glass of beer
d. take with meals
i couldn't find anything with "carbacot" but came up with methocarbamol on google, which states it to be in the same category as robaxin, a muscle relaxant, it states to take it with food, so i guess d would be the answer here. (you can automatically take answer c out)
2. which of the following can contribute to diabetes melitus ?
a . obesity
b. hypertention
c. family history
d. sendentary life style
i am stumped at just a single answer for this question, for me all of the answer choices could equally contribute to dm.....
3. which of the following patients should the nurse see first ?
a. an elderly client with absent deep tendon reflex
b. copd client return from outside examination complaints of shortness of breath
c. a patient with peripheral artery disease complaints of coolness of the feet
d. postop patient just received pain med complaints of pain
patient a--this could be expected in the elderly, it would be a problem with high risk ob patients that are diagnosed with eclampsia or preeclampsia
patient b--i know that sob is to be expected with copd'ers....but any signs of sob should be assessed (possible answer choice)
patient c--patients with pad are expected to have poor circulation especially in their legs and pain (it takes oxygenated blood much longer to get to the lower extremities than the upper), but coolness could mean no pulse (ciculation issue), therefore (possible answer choice)
patient d--you will expect postop patients to have some pain, the patient just received pain meds, i wouldn't read too much into this option (in the real world, you would give the pain meds some time to kick in and work, and then if the pain hasn't subsided, then maybe further assessment is needed)
i couldn't really distinguish the actual answer, i'm not a genius when it comes to test questions, but i would consider b or c to be the answer.
4. when care for a patient with borderline personality disorder , the nurse should know :
a. have a trust relationship with the client
b. to prevent the patient's aggressive behavior
c. isolate the patient , to limit the group activity
d. prepare to deal the patient's emotional burst
with psychosocial scenarios, it is always best to consider safety as a priority. out of the answer choices, i would choose answer b as to me this answer choice seems to keep the patient and everyone around safe if the patient's aggressive behavior does not escalate.
i am only trying to help, but my answer options may not be the correct ones or the correct rationales, but see if maybe someone else can come up with something that will sound more reasonable.
p.s. yes like the previous poster said, let us know when you have the right answers
* Intracellular fluid (ICF): fluid within cells; two thirds of body fluid is ICF
* Extracellular fluid,(ECF): fluid outside of cells; made up of two components, interstitial fluid (fluid surrounding cells) and fluid within vascular space (blood vessels)
* Fluid constantly moves among intracellular, interstitial, and vascular spaces to maintain maintain body fluid balance
* ICF is most stable and is fairly resistant to major fluid shifts
* Vascular fluid is least stable; it is quickly lost or gained in response to fluid in*take or losses
* Interstitial fluid is reserve fluid, replacing fluid either in blood vessels or cells, depending on need
Osmosis
* Osmosis is a major force in body fluid movement and intravenous (IV) fluid therapy; cell membranes and capillary membranes are semipermeable; water moves into and out of cells and capillaries by osmosis
Osmolality and osmotic pressure
* Osmolality is concentration of solute (particles) measured per kilogram of -water, While osmolarity is concentration of solute (particles) measured per liter of solution (solvent does not have to be water)
* Hypotonic: having a lower osmolality than normal plasma; water is pulled out of blood vessels into cells, resulting in decreased vascular volume and in*creased cell water
* Hypertonic: having a higher osmolality than normal plasma; water is pulled from cells into blood vessels, resulting in increased vascular volume and decreased cell water (see Table 54-1 for examples of hypertonic IV solution
EXCESS FLUID VOLUME (FLUID OVERLOAD)
1. A state in which rate of fluid intake or retention exceeds rate of fluid loss in body; goal is to restore fluid balance
2. Types of fluid volume excess (FVE)
* Isotonic fluid excess is caused by renal failure, heart failure, excess fluid in*take, high corticosteroid levels, or high aldosterone levels
* Hypotonic fluid excess (water intoxication) is caused by repeated plain water intake enemas or repeated plain water NG tube or bladder irrigations, overuse or excessive speed of hypotonic IV fluid infusions, excessive plain water intake (such as in extreme dieting), syndrome of inappropriate ADH secretion (SIADH), or psychogenic polydipsia
* Hypertonic: caused by excessive salt intake
HYPONATREMIA
* Hyponatremia is a serum sodium (Na+) level below 135 mEq/L (normal range 135-145 mEq/L)
* Obtain daily weights; a weight loss of more than 0.5 pounds in 24 hours is con*sidered to be caused by fluid loss
* Monitor for resolution of manifestations of hyponatremia, including CNS changes such as confusion, lethargy, and seizures
* Protect client from injury and maintain a safe environment if client experiences neurological changes due to hyponatremia
HYPERNATREMIA
* Hypernatremia is a serum Na+ level greater than 145 mEq/L (normal range 135-145 mEq/L)
* excess always exists in a hyperosmolar (osmotic pressure greater than normal plasma pressure) state
Nursing assessment
* Common signs are related to water shift from cells (cellular dehydration) vascular space and sodium's role in nerve impulse transmission and muscle contraction
* Neuromuscular: twitching, tremor and hyperreflexia, agitation and CNS irritability, hallucinations, seizures, coma
* GI: watery diarrhea, nausea, thirst
* Risk factors: age (very young or old), OTC or prescribed medications, high-sodium diet or excessive use of salt as flavoring
HYPOKALEMIA
* Hypokalemia is a serum potassium (K+) level below 3.5 mEq/L (normal range 3.5-5.1 mEq/L)
* Always use an infusion pump, paying attention to rate, intake, and output
* Never administer K+ by IV push or intramuscular routes because these methods can lead to fatal dysrhythmias
* Know signs and symptoms of hyperkalemia and report these to health care provider
HYPERKALEMIA
* Hyperkalemia is a serum K+ level greater than 5.1 mEq/L (normal range --3.5-5 1mEq/L)
* Actual hyperkalemia (K+ level in the ECF is elevated)
Nursing assessment
* Cardiovascular: irregular, slow heart rate, decreased BP, ECG changes (narrow, peaked T waves, widened QRS complexes, prolonged PR intervals, flattened P waves, frequent ectopy, ventricular fibrillation, and ventricular standstill)
* Respiratory: unaffected until levels are very high, leading to muscle weakness and paralysis and causing respiratory failure
* Neuromuscular: muscle twitching (early) and cramps, irritability, anxiety; a late sign is ascending flaccid paralysis involving arms and legs
* GI: hyperactive bowel sounds, diarrhea, nausea
Therapeutic management
* Decrease K+ intake: implement prescribed K+ restrictions; do not administer K+ supplements; refer client to dietitian to evaluate hidden dietary intake of K+
* Promote K+ excretion: increase urinary output and monitor adequate renal function
* Continued monitoring of client: serum K+ levels; report abnormals; assess car*diac status, and signs and symptoms of hyperkalemia and metabolic acidosis
* Whenever possible, determine and treat underlying cause to restore balance
* Dialysis may be performed for intractable conditions to prevent development of potentially lethal problems or if client's clinical condition warrants immediate intervention
* Monitor for response to therapeutic treatment
* Sodium polystyrene sulfonate (Kayexalate), to reduce K+ levels, can be given ei*ther orally or as an enema with an osmotic agent (sorbitol) to decrease possible constipation
* Intravenous medications
* Calcium gluconate
* Regular insulin and dextrose (usually 50%) solution (shifts K+ from ECF to ICF)
* Sodium bicarbonate
* K+-wasting diuretics (loop diuretics and thiazide and thiazide-like diuretics)
Client teaching
* Recognize predisposing factors
* Avoid foods that are high in K+
* Examine food labels and medication packages to determine K+ content
* Cardiovascular: decreased BP; ECG changes include prolonged QT interval and lengthened ST segment; cardiac arrest can occur
* Respiratory: laryngospasm can occur, leading to respiratory compromise and airway failure; respiratory arrest can occur
* Renal: low serum calcium levels are associated with renal failure; other elec*trolyte disturbances are seen in conjunction with clinical manifestations of renal failure
* Neuromuscular: paresthesias and tingling in hands and feet; muscle spasms of extremities and face; positive Chvostek's (twitching of cheek) and Trousseaus's sign (spasm of arm when BP cuff inflated); hyperactive reflexes and increased irritability and apprehension; mental status changes ranging from depression. memory impairment, delusion, and hallucinations, to convulsions
* GI: possible hyperactive bowel sounds and diarrhea, intestinal cramps
* Musculoskeletal: possible bone fractures due to demineralization; in children chronic hypocalcemia may retard growth and cause rickets; can lead to osteoma lacia and osteoporosis in adults
* Other systems: development of cataracts; dry, brittle nails and dry hair; com*plaints of bone pain; increased bleeding or bruising, bone thinning, and fractures
Therapeutic management
* Treatment focuses on restoring normal levels, preventing complications, and treating underlying problems
* Replacement therapies
* Calcium gluconate (more common) or calcium chloride (less common; irri*tating to vein) by slow IV push in an emergency; may give slow IV infusion of calcium gluconate until tetany has been controlled or until calcium reaches 8 to 9 mg/dL
* Daily oral doses of elemental Ca++, usually 1.0 to 3.0 grams/day
* Calcitriol, vitamin D supplements, or phosphorus-binding antacids based on need
* Thiazide diuretics may be used to decrease urinary excretion of calcium
Hypercalcemia
* Hypercalcemia: an abnormally elevated serum Ca++ level (>10.5 mg/dL); symp*toms may not appear until serum Ca++ level is higher than 12 mg/dL
* Predisposing clinical conditions
* Other risk factors
* Clients with cancer or known metastasis
* Clients with hyperparathyroidism
* Clients who are immobile due to clinical conditions or sedentary lifestyle
* Excessive dietary intake of Ca++ -rich foods
* Excessive intake of antacids for gastric distress
Nursing assessment
* Cardiovascular: hypertension, decreased ST segments and shortened QT inter*val on ECG, cardiac dysrhythmias such as heart block, and cardiac arrest
* Neuromuscular: headache and confusion, subtle changes in personality to acute psychosis, fatigue, decreased deep tendon reflexes (DTRs); impaired memory and bizarre behavior, lethargy, or coma (seizures are rare)
Therapeutic management
* Decrease Ca intake
* Limit milk and dairy products
* Eliminate use of calcium carbonate antacids until Ca++ levels return to no
* Promote calcium excretion
* Use loop diuretics, such as furosemide (Lasix) or ethacrynic acid (Edecrin 1. to promote increased urine output so that more Ca++ will be excreted
* Maintain hydration of 3,000 to 4,000 mL (3-4 L) of fluid/day; oral fluids should be high in acid-ash, such cranberry or prune juice
* Give 0.9% sodium chloride (NaCl) infusion of 300 to 500 mL/hr up to 6 liter as ordered until volume status restored, then 0.45 % NaCl may be used; watch for fluid overload as a complication of therapy, especially with preexisting cardiac or respiratory disease
* Corticosteroids to decrease GI absorption of Ca++ : prednisone 20 to 50 me PO BID is usual dose or 40 to 100 mg daily in four divided doses; may take 5 to 10 days for Ca++ levels to fall
* Chronic management of hypercalcemia is effective only with parathroidec*tomy for primary hyperparathyroidism
* Continued monitoring of client: strict I & 0, daily weight, serum Ca++ and phos*phorus levels, possible ECG monitoring
* Treatment of hypercalcemic crisis
* Isotonic saline (0.9% NaCl) at 300 to 500 mL/hr initially and up to 6 liters until intravascular volume restored or calcium level is 8 to 9 mg/dL
* Biphosphonates, such as pamidronate (Aredia) IV to inhibit bone resorption returns Ca++ to normal within 24 to 48 hours with effects lasting for weeks in most clients
* Plicamycin (Mithracin) IV to inhibit bone resorption specifically if hypercal*cemia induced by metastasis
* Salmon calcitonin may temporarily lower Ca++ level by 1 to 3 mg/dL in clients with severe hypercalcemia
* Phosphorus IV to decrease Ca++ because of inverse relationship in emergency situations only
* Dialysis: during oliguric/anuric stage, severe renal dysfunction can lead to life-threatening fluid and electrolyte imbalances
* Prevent injuries and maintain safe environment
* Monitor for pathologic fractures in clients with long-term hypercalcemia
* Assist client with mobility to prevent injury and maintain safety
Hypermagnesemia
* Hypermagnesemiaserum Mg++ level greater than 2.1 mEq/L (normal range 1.4-2.1 mEq/L)
* Nursing assessment
* Neuromuscular symptoms (most common): decreased DTRs and depressed neuromuscular activity; symptoms are similar to those seen in hyperkalemia
* Cardiovascular: hypotension, bradycardia, bradyarrhythmias, flushing and se tion of warmth, possible cardiac arrest
* ECG may show prolonged PR interval, widened QRS complex, and elevated T wave
* CNS: somnolence, weakness and lethargy, respiratory depression, and coma
* Therapeutic management
* Decrease Mg++ intake; withhold Mg++-containing drugs (antacids) and enemies
* Promote Mg++ excretion using diuretics (in stable renal function)
* Provide rehydration to promote increased urinary output and Mg++ excretion
* Emergency treatment includes IV calcium gluconate to antagonize effect of Mg" and counteract cardiac and respiratory symptoms
* Dialysis: in clients with renal failure, dialysis may be necessary for Mg'- re*moval; if hemodialysis is not feasible, peritoneal dialysis is an option
* Monitor I & O
* Identify risk factors such as antacid use, laxative use, diabetic instability. and renal failure
* Promote client safety
Hypochloremia
* Hypochloremia: a serum chloride (Cl-) level that falls below 95 mEq/L (normal range 95-708 mEq/L)
Hyperchloremia
* Hyperchloremia: a serum Cl- level greater than 108 mEq/L (normal range 95--108 mEq/L)
Hypophosphatemia
* Hypophosphatemia: serum phosphorus level of less than 2.5 mg/dL (normal range 2.5-4.5 mg/dL)
HYPERPHOSPHATEMIA
* Hyperphosphatemia: serum phosphorus level of greater than 4.5 mg/dL (normal range 2.5-4.5 mg/dL)
Nursing assessment
* Most signs relate to the development of hypocalcemia or soft tissue calcification
* ECG changes and conduction disturbance, tachycardia
* Calcium phosphate deposits in nonosseous sites such as the kidney and heart
* Numbness and tingling around the mouth and in the fingertips, muscle spasm. and tetany from the increased phosphorus and corresponding decreased Ca++
* Anorexia, nausea, vomiting
Therapeutic management
* Restrict or eliminate phosphorus in diet, phosphorus-containing medications x enemas
* Administer phosphate binding agents
* Perform renal dialysis in clients with renal failure
* Treat concurrent hypocalcemia
* Monitor renal function carefully, particularly urine output, BUN, creatinine
* Monitor I & 0; keep clients well hydrated- pay particular attention to types of fluids being ingested (avoid carbonated beverages, which are high in phosphates)
* Monitor for signs and symptoms of tetany, such as positive Trousseau's and Chvostek's signs
* Digoxin: therapeutic range is 0.5 to 2.0 ng/mL; early signs of toxicity include nausea, vomiting, anorexia; abdominal pain, bradycardia, other dysrhythmias, and visual disturbances (yellow to green halos) may occur
* Quinidine: therapeutic range is 2 to 6 mcg/mL; signs of toxicity include tinni*tus, hearing loss, visual disturbances, nausea, dizziness, widened QRS, ventric*ular dysrhythmias
Electrolytes: normal levels of sodium (135-145 mEg/L), potassium (3.5-5.1 mEg/L), calcium (8.6-10.2 mg/dL), and magnesium (1.8-2.6 mg/dL) are essential for proper cardiac function; cardiac disorders and medications can alter elec*trolyte balance;
* Potassium (K+): hypokalemia such as with diuretic therapy increases risk of dig*italis toxicity, ventricular dysrhythmias; hyperkalemia from renal disease or ex*cess potassium supplements can lead to ventricular dysrhythmias and asystole;
* Sodium (Na+): hyponatremia with long-term diuretic therapy; hypernatremia could occur with excess saline IV infusion
* Calcium: cardiac effects of hypocalcemia include ventricular dysrhythmias, prolonged QT interval and cardiac arrest; hypercalcemia shortens QT inter*val and causes AV block, digitalis hypersensitivity, and cardiac arrest
* Magnesium: cardiac effects of decreased magnesium include ventricular tachycardia and fibrillation, while increased magnesium causes bradycardia, hypotension, prolonged PR and QRS intervals
Serum lipid profile: a measurement used to determine risk of developing athero*sclerosis
* Includes total serum cholesterol (
* High-density lipoproteins (HDL): transport cholesterol to liver for excretion ("good" cholesterol); normal is 30 to 70 mg/dL
* Low-density lipoproteins (LDL): transport cholesterol to peripheral tis*sues ("bad" cholesterol) and increases risk of heart disease; normal is under 130 mg/dL
Electrocardiography
* A graphic recording of electrical activity of heart; diagnoses myocardial is*chemia, injury, and necrosis areas of cell death (MI); hypertrophy, electrolyte im*balance and effects of antidysrhythmic drugs
* Resting electrocardiogram (ECG): represents a single recorded picture of elec*trical activity of heart
* Holter monitoring: continuous ambulatory ECG monitoring over time (usual 24 hours) with small, timed, portable ECG recording device
* Stress test: continuous multilead ECG monitoring during controlled and super*vised exercise, usually on treadmill
Echocardiography: an ultrasound that evaluates structure and function of heart chambers and valves
Phonocardiography: a graphic recording of heart sounds with simultaneous ECG; is not painful
Coronary angiography and arteriography is an invasive procedure during which physician injects dye into coronary arteries and immediately takes a series of x-ray films to assess structure of the arteries
Cardiac catheterization:
* Insertion of a catheter into heart and surrounding vessels to obtain diagnostic information about heart structure and function (see also Chapter 48)
Radionuclide tests
* Safe, nonpainful methods of evaluating left ventricular muscle function and
coronary artery blood distribution; radionuclide contrast is injected via
Hemodynamic monitoring
* Measurement of pressures of heart and calculation of hemodynamic parameters
* Central venous pressure (CVP) monitoring: monitors fluid volume status in those who are not candidates for more invasive pulmonary artery pressure monitoring
* Long catheter is inserted with tip lying in superior vena cava at juncture with right atrium
* Measures pressure that indicates right heart filling pressure; does not mea*sure left heart pressures
* Normal CVP is 2 to 8 cm H20 or 2 to 6 mmHg; decreased CVP indicates hy*povolemia; increased CVP indicates hypervolemia or right heart failure
* Pulmonary artery pressure (PAP) monitoring: appropriate for critically ill clients requiring more accurate assessments of left heart pressures (cardiac surgery, shock, serious MI)
* Pulmonary artery (Swan-Ganz) catheter has tip in pulmonary artery
* Pressure measurement obtained after catheter tip is wedged in small pul*monary artery (called pulmonary capillary wedge pressure, or PCWP); is a good indicator of left ventricular end diastolic pressure (LVEDP)
* Allows calculation of actual cardiac output and other hemodynamic parame*ters at frequent intervals in critically ill clients
* Nursing responsibilities in hemodynamic monitoring: position transducer at level of right atrium (left midaxillary line, fourth intercostal space—phlebostatic axis); level CVP or pulmonary artery catheter (Swan-Ganz) transducer to this point each shift and before each measurement; maintain patency of catheter with a constant small amount of fluid delivered under pressure
COMMON NURSING TECHNIQUES AND PROCEDURES
Dysrhythmia monitoring
* Continuous ECG monitoring in one lead with portable telemetry unit; indicated for high-risk clients undergoing surgery, those with cardiac disease, and those undergoing procedures or receiving medications affecting heart
* Lead placements (ECG continuous monitors have 3 leads or 5 leads)
a. Placement of leads with 3-lead monitor are below right clavicle (right arm), below left clavicle (left arm), and at lowest rib, left midclavicular line (left leg)
Preparation of client: explain procedure and reassure client that he or she will not receive electrical impulses or shocks; identify proper placement, cleanse ski] with soap and water, shave hairy areas, use alcohol or skin prep according to agency policy, dry with cloth or gauze, and apply fresh electrodes
Interpretations of ECG patterns originating in the sinus node
* Sinus rhythm is normal
* Sinus tachycardia (normal ECG complex with rate greater than 100)
* Sinus bradycardia (normal ECG complex with rate lower than 60)
* Sinus arrhythmia (normal ECG complex with irregular pattern)
* Nursing and therapeutic interventions: with sinus arrest, tachycardia, or bradycardia, assess for signs of inadequate cardiac output and tissue perfu*sion, including changes in blood pressure, activity tolerance, and level of con*sciousness (LOC); identify and treat cause of sinus tachycardia; atropine and possible pacemaker indicated for symptomatic or extreme low rates (
ECG patterns originating in the atria
* Premature atrial contraction (PAC)
* Atrial tachycardia
* Atrial flutter
* Atrial fibrillation
* Nursing and therapeutic interventions: carotid massage, synchronized car*dioversion, antidysrhythmia medications including beta-blockers, calcium channel blockers, and digoxin; anticoagulant therapy to reduce the risk of thrombin
ECG patterns originating from the AV node
* Junctional (nodal) tachycardia
* First-degree heart block
* Second-degree heart block, Mobitz type I (Wenckebach)
* Second-degree heart block, Mobitz type II
* Third-degree (complete) heart block
* Nursing and therapeutic interventions include monitoring and observation, atropine, isoproterenol or pacemakers for symptomatic heart block (external or transthoracic, temporary, or permanent)
ECG patterns originating from the ventricles
* Premature ventricular contraction (PVC)
* Ventricular tachycardia (VT)
* Ventricular fibrillation (VF)
Nursing and therapeutic interventions: for PVCs monitor for signs of de*creased cardiac output; instruct client to avoid caffeine and nicotine; with VI assess immediately to determine LOC and if client has stable BP and pulse.1 stable, treat with lidocaine, procainamide, and finally defibrillation; if diem becomes unconscious or unstable or has pulseless VT or VF, immediate defibrillation is required
Aneurysms
* Do not palpate the mass because pressure on the weakened vessel can lead to rupture and hemorage.
i have few questions have different opion with my friend , can you please answer it and give you reasons ?
1. client taking carbacot should :
a. take hard candy
b. take with a glass of water
c. after took the med , drink a glass of beer
d. take with meals
2. which of the following can contribute to diabetes melitus ?
a . obesity
b. hypertention
c. family history
d. sendentary life style
3. which of the following patients should the nurse see first ?
a. an elderly client with absent deep tendon reflex
b. copd client return from outside examination complaints of shortness of breath
c. a patient with peripheral artery disease complaints of coolness of the feet
d. postop patient just received pain med complaints of pain
4. when care for a patient with borderline personality disorder , the nurse should know :
a. have a trust relationship with the client
b. to prevent the patient's aggressive behavior
c. isolate the patient , to limit the group activity
d. prepare to deal the patient's emotional burst
thanks therooftop and jadu1106 !
here is my point of view :
1. i have the same idea with jadu1106 , carbacot , muscle relaxant , can easily eliminate option 3, this med have s/e : nausea , vomiting , so i will chose option 4 .
2. my answer is option 3 , b/z not mentined what type of dibetes melitus , option 1, 2, 4 , related to type 2 dm
3. my doubt is between option 1 and 2, option 4 can eliminate first , expected after operation ; option 3, eliminate second , coolness is expected with peripheral artery disease ; option 1, i can not make sure absent of deep tendon reflex is expected in elderly client ,as jadu1106 's point of view , it is expected in elderly client with absent deep tendon reflex , i will choose option 2 , think abc , airway problem first , but my friend said it is normal for a copd client after outside activity to have shortness of breath , any one will give your ideas ?
4. option 3, first eliminate , b/z should not isolate client and limit activity ; from the remaining options i will think about patient's safty first , i will choose option 2, but my friend think option 1 have a trust relationship should be the answer choice .
that's my view and explaination , any one have your different point of view ? welcome to give your ideas !
I have main Saunders,Complete course online of Kaplan,3500 online questions,I bought a book: Prioritization,Delegation&Assignment.
as I,it's different. I fail my first on 03,July. This is my second tried. One month ago I charged my working schedule from f-t to p-t. It is you have to spend a lot of time to review books and practise questions.You have to remember details for everything.
Good luck to you!!
whats f-t to p-t? how many months u spent in studying before taking nclex rn test? thanks for advice...
d1206
40 Posts
hello everyone,,,i just took my exam and i went real slow but now im nervous because i ran out of time and that never happened to me before, i just kept thinking that i have enough time so im going to take my time to answer the questions carefully and i stopped at 195 questions, i dont know what to think because i dont know how they grade these exams nad computers make mistakes and i cant even see how my own exam is graded...