NCLEX RN Exam With Completed Solution

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NCLEX RN EXAM WITH COMPLETE SOLUTIONwhen fusing packed red blood cells, which solution is hung with the Y tubing? -answerO.9% sodium in water (NS)Severe Preeclampsia, what are expected findings? - answerproteinuria, facial edema,blurred visionDM and glucose monitoring, what will increase blood flow and decrease risk ofinfection, before taking the sample? - answerwashing clients hands with soap andwarm waterWhat is an expecting finding of Hyperthyroidism? - answerTremorsWhat is an expected finding of Hypothyroidism? - answerPeriorbital EdemaCoping Strategies - answerVerapamil - answerCCB, treats hypertension, angina, arrhythmia. Do not takewith Grapefruit (may cause hypotension).what should be administered for a Benzodiazepine overdose? - answerFlumazenilWhich side does a cane go on? Weak side or Strong side? - answerStrong sideNa+ - answerElectrohd.es, Sodium 136-145K+ - answerElect rolytes, Potassium 3.5-5

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Ca+4 - answerElectrolxt.es, Calcium 9-10.5pH - answerABG, 7.35-7.45PaCO2 - answerABG, 35-45HCO3 - answerABG, bicarbonate, 21-28PaO2 - answerABG, oxygen, 80-100SaO2 - answerABG, Oxygen Saturation, 95%-100%Hgb- answerCBC, Hemoglobin, 12-16 (F) 14rl8 (M)Het - answerCBC, Hematocrit, 42-52% (M) 37-47% (F)RBC - answer4.7 (M) 6.1 (F)WBC - answerCBC, White Blood Cell, 5000-10,000ESR - answererythrocyte sedimentation rate, < 20 mm/hrCholesterol, Total - answer< 200 (risk for cardiac or stroke > 150}Platelets - ans we rl 50,000-400,000

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PT - answer!! -12.5 secondstherapeutic range is 1.5 - 2 times the normalaPTT - answerpartial thromboplastin time, 30-40 secondstherapeutic range is 1 . 5 - 2 times the normalINR- answerO.7-1.8 (unless on drug, therapeutic range 2-3)Glucose, Fasting - answerEndocrine, 70-105HbAlc, glycosylated hemoglobin - answerEndocrine, Hemoglobin Ale, 4r6%under 6% for normalunder 7% for Diabetes ControlBUN - answerGU, 10-20Creatinine - answerGU, 0.6-1.2 (M) 0.5-1.1 (F)Creatinine Clearance Test - answerOO - 139 (M) 80-125 (F)calculation of GFRbest indicator of overall renal function

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What type of solution is TPN? - answerhypertonicHow can TPN be given and when is it prepared? - answerThrough a PICC line ortunneled catheter and prepared dailyWhich lab value is checked and how often, when TPN is initiated? - answerbloodglucose, every 4r6 hoursEvery 24 hours a new TPN bag is hung with a new filter. True or False? - answerTrueNon-Pharmocological Interventions: HOT - answenon for 15min, offfor 20min acts as an analgesia (pain relief)increase bloodflow relaxesmusclesdiminishes musclesspasms eases muscles &joint stiffnessNon-Pharmacclogical Interventions: COLD - answeron for 15min,off for 20min acts as an analgesia (pain relief)dec reases/preventsswelling diminishesmuscles spasmsDiseases that need Private rooms? - answeivaricella(chicken pox) herpes zoster (shingles)rubeola virus(measles)meningococcaldisease

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pneumoniarespiratory syncytial virus(RSV) rubellatuberculosis (TB)HIV/AIDS -answerstandardduration of illnessblood & body fluids, includingbreast milk hand hygienePPE if in contact with potential contaminated materialsVaricella (chicken pox) - answerstandard, Airborne,Contact Private Roomuntil lesions crust overleasions & respiratory secretionsppi who are pregnant or not had chicken pox of vaccine, should not care for clientClostridium difficile (C-diff) - answerstandard,Contact duration of illnessfeceshand hygienePPE {enteric} if contact with potentially contaminated materialsHepatitis A (HepA) - answerstandard, Contact (if fecalincontinence) until 7 days after onset of jaundiceContact precautions used with clients wearing diapers or incontinent, min of 1 weekdepending on

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ageHepatitis B (HepB) -answerstandard duration ofillnessblood & bodyfluids handhygienecontact for blood & body fluidsHepatitis C (HepC) - answerstandard (unlesshemodialysis) duration of illnessblood & bodyfluids handhygienecontact for blood & body fluidsHerpes Simplex Virus (HSV) -answerstandard, Contact recurrent oral, skin,genitaluntil lesions crustover fluid fromlesionshorizontal transmission: skin & secretionsvertical transmission: mother to child utero or birthCarbapenam-resistant entero bacteriacease (CRE) -answerstandard, Contact high mortality rateblood & body fluids,feces hand hygienecontact precautions

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Herpes Zoster (shingles) - answerstandard. Airborne,Contact Private Roomdisseminated or localized inimmunocompromised duration of illness orvisible lesionslesionsppi who never had chicken pox or vaccine should not care for clientRubeola virus (measles) - answerstandard,Airborne Private Roomduration of illnessrespiratorysecretionsvirus can live on infected surfaces upto 2 hoursMeningococcal disease - answerstandard,Droplet Private Roomuntil continuous 2 4 htherapy respiratorysecretionspostexposure prophylaxis to control outbreaksWhat is the antidote for Magnesium Sulfate? - answerCalcium GluconateWhat is the number one complication after insertion of an epidural catheter andwhat should the nurse do? - answerHTX and nurse should infuse isotonic IVsolutionSpecific Gravity Iurine) - answerUrinalysis, 1.005 - 1.02o

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Protein (urine) - aiiswerUnnaiysis, 0.8Glucose (urine) - answerless than 0.5 g/dayKetones (urine) - answerUrinalysis, nonepH (urine) - answer4.6 - 8WBC (urine) - answerO-3 (M) and 0-5 (F)What type of fluid am I?treatment of vascular system fluiddeficit concentration equal toplasmaprevent fluid shift, betweencompartments 0.9% NSLRD5W- answerlsotonicStays where "I" put it!What type of fluid am I?treatment of intracellular dehydration

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lower osmolality thanECF shiftsfluidfromECF to ICF 0.45% NS2.5% D in 45% NS - answerHypOtonicGo "O"ut of the vessel! and into cellsWhat type offluid am I?used only when serum osmolality’ iscritically low osmolality higher than ECFshifts fluid from ICF toECF D10W (10%dextrose in water) D50W(50% dextrose in water)D5NS (5% dextroseinNS)D5W in 0.45% NaCl (5% dextrosein1/2 NS) D5LR (5% dextrose in LR) -answerHypErto nic■E1'enter the vesse1!nasal cannula - answer!-6 LVmin 24-44%simpleface mask - answers-8 L/min 40-60%

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partial rebreather mask - answers-11 L/min 50-75%non-re breather mask - answer12 L/min 80-100%venturi mask - answers8 L/min 24-40%aerosol mask / face tent - answers-10 L/min 30-100%T-piece - answers-10 L/min 30-100%Hypokalemia - answerlow K+ (potassium)give K+**NEVER give IV push**"No P = No K+"risk factors:-adverse affects of medications (steroids, diuretics, digitalis, laxative abuse)-body fluid loss (vomit, diarrhea, wound drain, NG suction)-excessive diaphoresis-kidney disease-dietary7deficiency-alkalosisManifestations:-muscle weakness, cramping

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-fatigue-n/v-dysrhythmias-flat or inverted Twaves confusion,irritable decreasedbowel mobilityparesthesiainterventions:-monitor: respiratory, ECG, I&Os, HCO3 and pH,-initiate and monitor K4- replacement (oral, IV)-fall precautions-dietary-client educationHyperkalemia - answerhigh K+ {potassium)risk factors:-renal failure-adrenal insufficiency-acidosis-excessive K+ intake-medications (K+ sparing diuretics, ACE inhibitors)manifestations:-peaked T waves

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-ventricular dysrhythmias-increased bowl motility-muscle twitching (early}-muscle weakness (late}interventions:-monitor: ECG, bowel sounds-initiatedialysis-administer (kayexalate, 50% glucose with insulin,calcium gluconate, bicarbonate, loopdiuretics)Hyponatremia - answerlow Na+ (sodium}**risk of cerebral edema with hypertonic solutionsrisk factors-:-GI loss-SIADH-adrenal insufficiency-water intoxication-excessive diaphoresis-medications (diuretics,anticonvulsants, SSRIs,lithium)manifestations:-muscle cramps, twitching-weakness-confusion

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-lethargy-seizures-headache-n/v-anorexia-hypotension-tachycardia-weight gain, edemainterventions:-Na+ replacement (oral, GI tube, IV)-restrict oral fluid intake-daily weight-I&Os-medication (conivaptan hydrochloride: Vaprisol)Hypernatremia - answerhigh Na+ (sodium)risk factors:-water deficit-GI loss-hypertonic tube feedings-DI-burns-heatstroke

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