April 2008 NCLEX test takers, COME ON IN!

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Per the request of janina08 ;) I've started the April NCLEX takers support group. When do you take it? What are you using to study? Would anyone like to review any of the systems/meds that he/she feels weakest on? Let's keep each other in our prayers and good thoughts as we go through one of the biggest experiences of our lives. :) :nurse:

Specializes in ICU.
yes indeed very good summary..and im very thankful for this people.:bow:do you think we can remember all of this on nclex day?::mad:

I don't know! I copied it onto MS word and it was 88 pages..... I am going to go through it one by one and delete the things that I already am confortable with.... then just print out the sections that I am not comfortable with... and try to better understand those sections for NCLEX day. :typing

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Specializes in ICU.

:thankya:medications affecting the nervous system::thankya:

[color=maroon]

[color=maroon]parkinson's disease:

  • two main classes- meds that activate dopamine receptor and meds that block acetylcholine.
  • use- doesn't halt progress of pd but helps with symptoms- helps in ability to perform adl, absence of tremors and reduction of irritability and stiffness)
  • levadopa- protein decreases the effectiveness!
  • mirapex (causes sleep attacks)
  • congentin (causes atropine like effects- dry mouth, blurred vision:coollook:, urinary retention and constipation), causes drowsiness
  • symmetrel- (causes confusion and atropine like effects, discoloration of skin
  • sinemet (levadopa + carbidopa- causes abnormal movements and psychosis)
  • requip
  • parlodel
  • artane
  • side effects: n/v, dyskinesias (head bobbing:lol2:, tics, grimacing), orthostatic hypotension, discoloration of sweat, psychosis, tachycardia, activation of malignant melanoma.
  • medication holiday may be indicated

[color=maroon]antipsychotic:

  • convention antipsychotic drugs-
    • examples: thorazine, haldol, moban, navane, trilafon, prolixin.
    • side effects include extrapyramidal symptoms, acute dystonia (spasm of tongue, face, neck and back), parkinsonism, akathisia, causes neuron malignant syndrome (sudden high grade fever, muscle rigidity, changes in loc, coma), anticholinergic effects, hypotension, sedation, seizures, agranulocytosis, skin effects, sexual dysfunction, and finally dysrhythmias.

atypical antipsychotics drugs-

  • examples: clozaril, risperdal, zyprexa, seroquel, abilify. used for severe schizophrenia.
  • side effects: agranulocytosis, seizures, weight gain, diabetes, inflammation of the heart muscle:redbeathe

[color=maroon]depression:

  • antidepressants- tricyclic
    • examples- elavil, tofranil, sinequan
    • use: depression and bipolar disorder
    • side effects: hypotension, anticholinergic effects (think antidepressant and anticholinergic), sedation, toxicity
    • don't give with maois
    • don't give with antihistamines and other anticholinergic agents
    • therapeutic effect may take 1-3 wks. sudden discontinuation may cause relapse.

  • selective serotonin reuptake inhibitors:
    • examples: prozac, celexa, lexapro, paxil, zoloft
    • used for depression, ocd, bulimia, panic disorders and ptsd
    • side effects: sexual dysfunction, weight gain, serotonin syndrome (mental confusion, agitation, anxiety, hallucinations, hyperreflexia tremors), withdrawal syndrome, rash, fatigue
    • don't take with maois b/c increases risk of serotonin syndrome.
    • therapeutic effect may take 1-3 wks. sudden discontinuation may cause relapse.

  • maois
    • examples: nardil, marplan
    • used for atypical depression, ocd, bulimia
    • side effects: anxiety, orthostatic hypotension, hypertensive crisis due to intake of tyramine....
    • if hypertensive crisis occurs then give iv phentolamine!!!!!!!!!! (also can give sublingual nitro)
    • don't give to people with pheochromcytoma, heart failure, and renal insufficiency.
    • if you give with demerol it can cause hyperpyrexia.
    • clients should restrict food with tyramine including aged cheese, salami, avocados, bananas, protein, dietary supplements and red wine.

  • other antidepressants:
    • wellbutrin, remeron, effexor, vestra, desyrel-
    • used to treat depression and help in quitting smoking :smokin:
    • side effects: seizures, headache and constipation, dry mouth

[color=maroon]

[color=maroon]mood stabilizers

    • lithium, (levels should be monitored closely, meds taken 2-3 x per day, maintain adequate sodium intake)
    • valproic acid (depakote),
    • tegretol
    • side effects: diarrhea, tremors, polyuria, renal toxicity, goiter
    • don't give to women who are breast feeding

[color=maroon]

[color=maroon]benzodiazepines:

o examples: valium, xanax, ativan, librium

o used for anxiety, seizures, insomnia, muscle spasm, alcohol withdrawal, panic disorder

o causes cns depression, amnesia, anxiety, insomnia, teratogenesis, acute toxicity

o take with meals

o may get dependent on meds

[color=maroon]hypotonic non benzodiazepines:

o examples: ambien, sonata, lunesta, desyrel.

o used to manage insomnia :yawn:

o causes daytime sleepiness

o don't take with alcohol or other cns depressants :beer:

[color=maroon]anxiolytic:

o examples: buspar

o used for anxiety

o causes cns effects like lightheadedness, faintness, nausea

o take with meals

o effects may be seen in a week

[color=maroon]cns stimulants:

o examples ritalin, concerta, dexdrine, adderal, caffine

o used for adhd, narcolepsy, obesity, weight reduction

o side effects: cns stimulation (insomnia restlessness), weight loss, dysrhythmias chest pain

[color=maroon]cholinesterase inhibitors: (increases amount of acetylcholine (ach))

    • ex: neostigmine, physostigmine used for myasthenia gravis
    • side effects: increase gi motility, increase gi secretions, bradycardia and urinary urgency. other side effect is cholinergic crisis but antidote is atropine.
    • use cautiously in clients with seizure disorders, hyperthyroidism, pud and asthma, bradycardia and hypotension.

[color=maroon]antiepileptic-

    • use- control seizure
    • examples: phenobarbital (causes drowsiness and confusion, toxicity)
    • dilantin cns effects, nystagmus, gingival hyperplasia :yeah:, skin rash, tetrogenic, dysrhythmias, coorifice facial features)
    • valium- causes resp depression and amnesia. don't give if liver disorder!
    • ativan
    • tegretol (blood dyscrasis)
    • zarontin (only for absence seizures)
    • depakote (also known as valproic acid) causes pancreatitis and thrombocytopenia
    • neurontin (causes cns effects like nystagmus)
    • trileptal
    • klonopin
    • lamictal

  • neuromuscular blockading agents
    • use: promote muscle relaxation, promote spontaneous respirations in people on the vent, used to diagnose myasthenia gravis
    • tuborcurarune
    • succinylcholine (can lead to apnea, malignant hyperthermia, hyperkalemia)
    • pancuronium (pavulon)
    • general side effects: hypotension and respiratory arrest

  • local anesthetics:
    • lidocaine, pontocaine, and novocain. loc does not occur.... blocks pain in certain area. side effects are cns excitement, hypotension, prolong l&d, spinal headache and urinary rention

  • general anesthetics:
    • produces loc and loss of all sensation. side effects: hypotension, resp and cardio depression, malignant hyperthermia, hepatoxicity, gi content aspiration

  • muscle relaxants:
    • examples: valium
    • dantrolene (dantrium): treats malignant hyperthermia, causes hepatic toxicity
    • flexeril
    • skleaxin- hepatic toxicity
    • baclofen (lisoresal)- causes constipation and urinary retention!
    • don't take cns depressants when taking these meds :nono:

if anyone notices any major errors, or any additional information that you think we should know for the exam, please post on thread. :typing

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Specializes in Medical and general practice now LTC.

please can i remind everyone if posting stuff that is copied from books you need to be aware of copyright issues and terms of service

copyrighted material:

no "spreading of copyrighted material": please do not upload, attach or post anything that is copyright or licensed without prior consent of the owner. for example, if you want to post content from an online article, do not post the whole article, post a partial synopsis, and then a link to the source.

if it is not posted correctly then it will be removed from view

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Specializes in Pedia Cardio--- 6 yrs ago!.
Yes! I agree! I don't know why it takes me so long to do the questions.... I have a very limited attention span.... I am doing them in study mode and reading the rationale and strategy right after I answer the question..... I start around 12 but it takes my until about 4pm to finish.... in addition I have an 8 month old baby that just started crawling and loves to tear up all my papers! So that also makes the process a bit longer.... then in the evening I start studying Pharm! I just can't wait until this is OVER! I am getting tired of studying!! :bugeyes::uhoh21::no::stone

I know how you feel! LOL!:chuckle I have a toddler and a 6 yr-old who just loves to jump up and down the bed at a time when I really want to immerse myself into the rationales..not to mention the baby inside my tummy moves a lot...a whole lot!!! we will conquer this thing gen! even if this whole nclex enchilada sometimes drive us insane! :)

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i am taking the nclexrn end of this month need all the help i can get and support. i've a 10mth old baby and pregnant with the second baby. this will be my second time taking this exam. how are you studing any advise. i am using kaplan book for content review and saunders for question. i am very week in cardio and meds.

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Specializes in Cardiac/Telemetry.
i am taking the nclexrn end of this month need all the help i can get and support. i've a 10mth old baby and pregnant with the second baby. this will be my second time taking this exam. how are you studing any advise. i am using kaplan book for content review and saunders for question. i am very week in cardio and meds.

:icon_hug: Welcome kcjo. You're in luck because we're reviewing those exact things right now. :) Go back a few pages and you'll see both meds and a small cardiac review.

I'll be posting more cardiac information some time tonight. I have to study for a couple of hours before going to church, but I'll be back later. :)

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Here is a question to solve:

"....The physician orders codeine 60 mg and aspirin grains XPO every four hours, as needed for pain. Each codeine tablet contains 15 mg of codeine. Each aspirin tablet contains 325 mg of aspirin. Which of the following should the nurse administer?

A) 2 codeine tablets and 4 aspirin tablets

B) 4 codeine tablets and 3 aspirin tablets

c) 4 codeiene tablets and 2 aspirin tablets

d) 3 codeine tablets and 3 aspirin tablets"

1 grain = 60 mg

Which one do you think is the correct answer? And can you show your work as to how you got that answer?

Work Cited:

Irwin, B. J.; Burckhardt, J.A. NCLEX-RN: Strategies for the Registered Nursing Licensing Exam 2008-09 edition. Question # 7. Page 183.

By the way the correct answer is: 3)

Someone please show me as to how you got that answer. Thanks

And thank you to everyone for posting tonns of valuable information.

Hm... I cannot post information like this guys even if I cite the work? I just read Silverdragon's post. Hm....

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i know codeine is right 4 tablets..but aspirin i think there's a typo error i am not sure but ive met this question too and i can't even figured it out..can anyone help.thanks

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Specializes in ICU.

I don't know either?

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just a thought. I took the Nclex RN yesterday. The computer shut off at 75 questions. I felt completely beat up when I walked out of there. I spent the better part of the evening last night totally freaked out and read hundreds of posts on here with every one filled with speculation about the types of questions that mean you passed, how many questions mean you passed....etc. All the things people said they had and didnt pass, I had. These posts totally heightened my anxiety level.

The moral of the story, it doesnt matter what kind of questions you get...everyone gets lots of priority questions because that is the current trend in the medical world, I had 6 math questions, (many posts stated that if you get math questions thats a bad sign) all of them critical care math and must have gotten some of them wrong to keep getting them. As it turns out, I spoke to someone at pearson vue and they indicated that the type of math questions you get can be easy or difficult depending on where you are on the scale when you get the questions. I had a whole array of different questions....and I PASSED!! The only statement that has been made on here that feels at all accurate is that for the machine to cut off at 75, you have to be either way above or way below the minimum competency level for the computer to think that there is no way you could either pass or fail even with 160 additional questions. The whole point of questions beyond 75 are so the computer can get a more accurate picture of whether you can pass or not. It just means that you were more on the borderline of the minimum competency level at 75 so it was giving you more questions to prove your competency level. I hope this helps.

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is this the question with the Xgrain of asa and available is 325 mg's of aspirin and codeine 15 mgs order is for 60 from Kaplan book? if it is, 1 grain is 60 mgs and if the order is for X (10) grains that is 600 mgs of asa so the answer is 2 aspirins. it isnt exactly 625. does this help?

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"....The physician orders codeine 60 mg and aspirin grains XPO every four hours, as needed for pain. Each codeine tablet contains 15 mg of codeine. Each aspirin tablet contains 325 mg of aspirin. Which of the following should the nurse administer?

A) 2 codeine tablets and 4 aspirin tablets

B) 4 codeine tablets and 3 aspirin tablets

c) 4 codeiene tablets and 2 aspirin tablets

d) 3 codeine tablets and 3 aspirin tablets"

1 grain = 60 mg

ok: obviously 15 mg 4 tablets = 60 mgs for codeine

f0r the ASA: 1gr = 60 mg / order is for asa 10 grains which is 600 mgs (10 grains X 60 mgs = 600 mgs). the two asa tabs = 650 mgs. while it is not exactly 600, it is the closest answer

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