Hi I'm a new graduate in nursing and now preparing for board exam.
I have a few questions. I have been doing review questions and theres just some things I don't get so below ill be posting review questions that I do not understand. I was wondering if theres anyone there that can help me under why this certain answer is right above the rest.
Mr. A with Hepatitis A and was given injection for pain. What you will do with the needle ? If biohazard container is not there?
Break the needle
Leave the needle and wait for container to arrive
Separate the needle from syringe and throw in the garbage cane
Recapped the needle
In this questions the answer is B leave the needle and wait for the container to arrive. to me that sounded wrong because I have been thought to never leave needles in the room and should always be thrown in the sharps container but since in this situation there is no sharps container I thought the best way is to recap the needle(thought I know this isnt good to because of needle stick injuries). can someone clarify this questions to me thank you.
After delivery mother is fine back to ward V/S stable lochia normal c/o of severe episiotomy pain what will the nurse do?
Apply analgesic cream
Give an ice pack to the episostomy area
Inform Doctor
Tell her to liedown in supine position for a few hours
Now for this questions the answer is also B give an ice pack to the episostomy area. can someone explain to me why an ice pack would be applied the only thing i can think of is because it will numb the area so it doesnt hurt.
A client is on oxygen how will you know what is danger to her?
The water tank in the humidifier is very low
The oxygen tank has been taken out from the holder
Patient in on comfortable position
Nurse are monitoring the patient continuously
For this question the answer is a the water tank is in the humidifier is very low. I read in another book with the same question and it said the answer is the oxygen tank has been taken out from the holder was the right answer. so really which one is the real answer?
So i just wanted to clarify a few things about those questions (I have many more but I don't wanna be posting a whole bunch of questions). Thank You!
Here's another questions that confused me
Mr. Emanual is on blood transfusion after 1 hour he got reaction client complained of back pain nausea and vomiting chills. What should the nurse do?
A. Stop the transfusion and inform the RN
B. Stop the transfusion call the DR immediately
C. Stop the transfusion and flush with NS
D. Stop transfusion and monitor vital signs
The answer is b stop the transfusion call the dr immediately. I know that if an allergic reaction happens your suppose to stop the blood transfusion but for this my answer was stop it then flush with NS. usually all the blood transfusion questions I have done always said the right answer was stop the infusion and administer NS because Blood transfusion can only be done with NS. so why would NS not be the answer and call the dr immediately be the right one.
With blood transfusion reactions, you stop the transfusion, remove the blood tubing, and start a NS infusion with new tubing. If you flush the blood tubing, you're just giving the patient even more of what they are reacting to.
With blood transfusion reactions, you stop the transfusion, remove the blood tubing, and start a NS infusion with new tubing. If you flush the blood tubing, you're just giving the patient even more of what they are reacting to.
ahhh ok, so thats what i thought it is a seperate line you have ready. So you prime with NS... and usually flush with NS... but the backup bag is there with a prepped line just in case :) and if a rx occirs you would start that NEW tubing (pre-primed) of NS.. got it.
With blood transfusion reactions you stop the transfusion, remove the blood tubing, and start a NS infusion with new tubing. If you flush the blood tubing, you're just giving the patient even more of what they are reacting to.[/quote']
This is correct.
Also remember that if there had been no reaction and you had NS connected to blood tubing, you WOULD have used the NS to flush the line.
I can't answer all these questions but when I was in a room and gave an injection once (the facility was very old) I forgot to take the yellow needle disposal container with me and there was none in the room (I was a student). I actually held the needle right out in front of me, checked the corridor/door etc BEFORE I walked out saying, 'used needle here, no disposal container, going to the med room' (where the disposal contaner was). Of course I got told off, but I thought that was safer. You don't ever leave a needle - used or not - out of your sight, you never re-cap needles (unless it's passive re-capping) and you aren't supposed to separate them. My hosp has yellow used needle bins in every room now, but I always take a kidney dish to put everything in for my injections, IVs etc and that works well. Just keep an eye on the kidney dish after you have used the needle (in case someone bumps into you) and that you don't touch any used needle or the syringe or cap or anything. Dispose of it immediately and you will be fine.
The pointof the ns hung with the blood is to ease the passing of the individual blood cells and minimize the risk of damaging the blood cells by having them collide with the tubing. You will run ns but only after you change out the tubing first. The answer choice made it seem as though you were going to flush the line which is always bad because you are pushing more bad blood into the pt. Always stop, change the tubing, start ns, notify md
It looks like all your questions have been answered already. However, I just want to give you a heads up for answering NCLEX questions which might just help you to pick the right answer.
1. Always assume that you are fully staffed, with all the LPN's, CNA's and transporters that you could ever possibly use.
2. Always assume, unless otherwise stated, that you have all the equipment, supplies and time in the world.
3. Never, ever read more into the question than what is there. Don't assume you have the fancy, self recapping needles (for example).
4. Very few CORRECT answers will be "ask another more experienced nurse", "Call the Doc", "Call the Pharm". Like another poster before me stated, they want to know what you will do.
5. If all answers seem wrong, always pick the answer that will cause the least amount of harm to your patient and to YOU.
6. Always think A,B,C - airway, breathing, circulation with each question
7. Next always remember Maslow's needs (basic needs most important with pychosocial needs lower in priority) so ponder the questions and the answers. Sometimes all the answers are right, but if you take the answer dealing with basic needs and safety over psychosocial, you will have picked the "correct" answer.
8. Remember, Safety, Safety, Safety first. Not just safety for the patient, but safety for yourself.
9. Ask yourself, "what will get my patient dead the quickest" lol and then do the opposite; even if it does not seem to make sense.
10. Pt. acuity and priority questions, again "what illness, procedure, disease, treatment...will kill my patient the quickest" and that is the pt. you see first.
Now, I just took NCLEX. If you get a strategies book, not a question and answer book you will do well. Of course, read the Q&A, but strategy is very important with this test. I did not think it was hard and was in and out in under an hour with only 75 questions. But strategy saved my life.
Ok, it is unethical to tell you exact questions which are on the test. However, the trend (after talking with friends and taking the test) you should study your isolation precautions and know at least three illnesses for which you would use each of the precautions. Delegation, study who and what you can legally and ethically delegate which tasks. Yes, it would make sense that an experienced LPN/LVN with 30+ years of exp. could do diabetic teaching, however not in the NCLEX world. Also, know your triage and disaster planning. Study your diets and which disease they are used, know what foods would be low/high in Na, K,etc...And just like all your instructors have told you, KNOW your normal Lab value ranges.
I wish you all the best! Relax, take your time, remember your strategies and give it your best shot. In the event that you don't do well, some of the best nurses you will ever have met, had to take the exam multiple times. This test, although important, does not measure how smart you are or what kind of a nurse you will be.
Love what RNjoin wrote.. I couldn't agree more.. I loved my Kaplan Strategies book... It helped when I had no clue what the question was asking or how to eliminate some of the other answers... Content is very important to know but on some questions, content alone will not help you answer correctly...Why, because the answer you want or think is right is never one of the choices...
Thank you to the poster that answered fully my response to NS with blood.. I had already went to bed sorry :) The tubing for blood is single tubing with two spikes on it; one for the blood and one for the NS. So that's why you wouldn't flush with NS because the tubing is full of blood and it would take several minutes for the blood to be flushed out leaving only NS..
On the blood transfusion question with the reaction............... NEVER flush the line if the pt is having a rxn!!!!!!!!!!!!!!!!!!!!!! NEVER NEVER NEVER!!!!!!!!!!! You will be giving them MORE of what is causing the problem in the first place!
ALWAYS ALWAYS ALWAYS stop the infustion first, disconnect the tubing and send the tubing and the remaining blood to the blood bank so they can evaluate and do what they need to do to see if there was something wrong with the blood given.
ETA: You keep NS going with the blood to keep it from clotting and willflush your line with NS after the transfusion, given there is no reaction, to keep your line, PIV, central or PICC, patent. If blood is left to sit it will clot very quickly.
Re: L&D question. The ice pack is the best answer becuase this is the least invasive, nonpharmacologic, nursing judgment/treatment available of the options. Ice is awesome for decreasing swelling and decreasing pain. If that doesn't help, then you can go on to other treatments.
I totally forgot about that.THANKS!.But i've also been thought that some iv lines have two ports one for just blood to go into and the other is for flushing normal saline. I remember having this discussion with the class and the teacher. There was two teacher there at the time and both had different opinion and explanation but the one i can remember clearly is that there are some iv lines with two ports so it would be okay to insert the NS.[/quote
PICC's and central lines can have more than one port on them. In that case, if the doctor wanted you to start NS, you would use the other port with normal IV tubing. You would still stop the blood and disconnect the tubing, save it and the remaining blood to send to blood bank.
Boog'sCRRN246, RN
784 Posts
With blood transfusion reactions, you stop the transfusion, remove the blood tubing, and start a NS infusion with new tubing. If you flush the blood tubing, you're just giving the patient even more of what they are reacting to.