2024-2025 NCLEX Rationals and Study Guide with Answers (168 Solved Questions)

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Nclexrationalsandstudyguide100% VERIFIEDCORRECT ANSWERS2024/2025right occiput posterior positionwill have back pains with labor "back labor" positioning woman and hands and kneeswill relive some of the pressure and help facilitate rotation into an anterior position.Right occiput anterioroptimal for birthPredisposing factors for delirium are?advanced ageneurodegenerative disease (stroke, dementia)polypharmacyinfectionABG imabalanceSurgeryuntreated painoccipital transversewhen fetus remains in OP or OT position labor is prolonged. fetus will usually repositionto OA. manual rotation may berequired if this position persist.Agoraphobia

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fear or anxiety about being in certain situations or any physical spaces. they are highlyconcerned about having trouble escaping or being able to get help in the event of apanic attack.Hypertensive medications Contraindicated in Pregnancy that can have tetragenicaffects are?ACE inhibitors and ARB'sAcceptable abbreviation for documentationc/oacpcQIDcmUnacceptable abbreviations for documentationq1dqdqodSSRIuMust have a zero before decimal 0.05No trailing zeros after decimal 1.000Major complications of oligohydramnios are;Pulmonary hypoplasiaUmbilical cord compression*** additional staff will be needed during delivery in case of CPR

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Major complications of TNF inhibitor(inhibits inflammatoryresponse) drugs are;type of drugs?infectionsbone marrow suppressiontype of drugs include; infliximab, entanercept,side effects of furosemide in pt's chronic kidney disease would be ?ototoxicitywhat are the s/s of abstinence syndrome ?ANS: stuffynose, sweating, stuffy nose, sneezing, tachycardia, tachypneaCNS: irritability, high pitched crying, restless, abnormal sleep pattern, hypertonicityGI: poor feeding, vomiting, diarrhea,what are the 4 s/s of nephrotic syndrome?massive proteinuriahypoalbuminemiaedemahyperlipidemiawhat instruction do you give your patient prior to their colonoscopy procedure?Clear liquid diet the day beforeNPO 8-12 hours before examtake bowel cleansing agent day before (GoLYTELY)uterine fundus location during prenatal examafter 20 weeks gestation the fundus location = gestational age.

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intussesception is when one part of the intestine prolapses and then telescopesinto another part of the intestine. It is also the most frequent cause of bowelobstruction during infancy. what are the signs and symptoms to look out for.intermitten pain with legs drawn up.severe progressive pain with inconolable crying.ongoing obstruction leads to mucosal ischemia, and current jelly stools (mucusandbleeding mixed)pregnant women have a blood volume that increases between 40-45% to meetincreased O2 demands and nutritional demands for the fast growing fetus. whatis the normal hemoglobin, hematocrit, WBC, RBC and platelet count ?what are the signs of uterine rupture?abnormal FHR patterconstant abdominal painloss of fetal stationsudden cessation of uterine contractionsevere signs are hemorrhage, hypovolemic shock and maternal tachycardiaPolycythemia Vera is a chronic myloproliferation disorder in which the bonemarrow produces abnormal high amounts of RBC's. What is the danger with thisdisease and what is the treatment for it?the danger with this disease is blood clotting r/t increase viscosity of the bloodtx: periodic phlebotomy to remove 300-500 millimeters of blood until hematocrit andhemoglobin levels are meet.what are the common causes of bilateral neuropathy?

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Diabetic neuropathy *** most commonalcoholauto immune ( Guillian Barre syndrome)**always establish if the neuropathy pain was present before surgery to rule out if this isa surgical complicationlymph nodes are not normally palpable in adults... however what type of palpablenode would be considered a normal finding and why?lmyph nodes that are 05.-1 cm in size, firm, mobile and non-tender-this could be r/tsome type of trauma ie. masectomywhat is NOT considered a normal finding when palpating a lymph node?firm, hard, fixed nodes-r/t malignancytender node-r/t inflammationPurpura:a reddish-purple blotch on the skin that do not blanch with pressure due to bleedingunderneath the skin. this finding is significant and requires further assessment.S/S of hypoglycemia are?shakiness/trembling, palpitations, anxiety/arousal, restlessness, diaphoresis and pallor.-during hypoglycemia the body relates epinephrine ... in addition the brain is deprived ofglucose therefore LOC is altered with possible seizures, confusion, coma.what are the standard heparin doses when flushing CVC lines?2-3 mL containing 10 units/mL-100units/mLwhat is the normal CVP?

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if CVP is Low or High what does that indicate?Proximal port lumen is used to measure CVP since it is located in the right atrium2-6 mm Hg normal CVPLow CVP = hypovolemiaHigh CVP= right ventricular failure of fluid volume overloadLeoapolds maneuverused to detect fetal presentation by palpating the abdomenMcRoberts maneuversharply pressing the thigh into the abdomen to straighten out the sacrum. used forshoulder dystociaabciximabeptifibatidetirofibanwhat type of drugs are these and why are they used?what are the common side effects? contraindications? nursing interventions?Glycoprotein (GB) IIb/IIIa receptor inhibitorsplatelet inhibitors and are used to prevent occlusion of treated coronary arteryprocedures. they are also used to prevent ischemia.common side effects are bleeding and thrombocytopeniacontraindicated with traumatic procedures, IV lines and IM injections

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Monitor: blood counts (hemoglobin and platelet), heart rate and rhythm andsings ofbleeding.what do you do once the waveform on a Pulmonary artery catheter has been"wedged" ?once the waveform is "wedged" the ballot can be inflated. Do not inflate for more than10-15 seconds to avoid damage. lock the ballon port.What medications should be avoided in patients with chronic kidney disease?NSAID's = nephrotoxicalendronate (Fosamax)risedronate (Actonel)ibandronate (Boniva)what are the classifications of these medications? SE?BiophosphonatesMOA: decrease bone resorption tominimize the loss of bone density.Teaching: take this med with a full glass of water and remain in an upright position for atleast 30 min.what are the clinical manifestations of bacterial meningitis for infants <2 yrsfever or hypothermiairritability,frequent seizureshigh pitched crypoor feeding and vomitingnuchal rigiditypossible bulging fontenells

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what is the most common acute complications of bacterial meningitis?hydrocephalus-fluid in brain--> brain damage.long term complications includehearing loss, brain damage, learning disabilities.what are the immunization for a 6 month old child?use the mnemonic (Be DR HIP)Hep BDtapRV(rotovirus)Hib (hamephilus influenza)IPV (inactivated polio virus)PVC (pneumococcal conjugate virus)how often should IV catheters be removed or replaced?Q 76-96 hrs unless complications occur then remove sooner.explain the steps to a low pressure huff cough for patients with COPD1. position upright2. inhale through nose, then prolonged exhale through pursed lips for 3 breaths3. hold breath for 2 to 3 seconds while keeping throat open4. deeply inhale, lean forward then force out breath making a "ha!" sound: repeat 2X5. breath in deeply and give the last forced "ha!" coughnursing measures after tonsillectomy ;1. apply ice on neck2. analgesics (rectal/IV)3. Place on abdomen or side lying positionnursing teaching to parents after tonsillectomy;

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1. a low grade fever is expected2. child may report ear pain 5-10 days post op3. chewing gum can reduce muscle spasms4. observe for s/s of hemorrhage : irritable, constant swallowing, throat clearing ***contact HCP stat5. pt should not participate in strenuous activity up to 14 days post op r/t increase riskfor hemorrhage!6.. throat might be white with foul odor for the first 5-10 days post op... this is anexpected finding.interventions to manage lymphedema include;-massage are to help mobilize fluid-use intermittent compression sleeve-elevate arm above heart-isometric exercise-avoid IV on affected sidelow T4, and low T3 while TSH compensates and is elevated is indicative of whatdisorder?what are the s/s of this disorder?HypothyroidismSS: weight gain, confusion, hair loss, forgetfulness and cold intolerance, bradycardia,joint and muscle aches.what are some non-modifiable breast cancer risk factors?What are some modifiable breast cancer risk factors?non-modifiable:-hx of 1st degree relative with breast cancer

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-BRACA genetic mutation-hx of endometrial canver-menarche before age 12 and menopause after age 55modifiable:-hormone therapy-dietary fat intake-smoking, alcohol-postmenopausal weight gain-sedentary lifestylewhat of the signs when nearing death?mottling of the extremities (coolness/paleness)relaxed jaw (open mouth)difficulty maintaining body postureeyelids half openchyenne stokes (uneven respirations with apnea)clinical manifestations of asthma aspiration include;accessory muscle usechesttightnessdiminished breath soundshigh pitched wheezing on expirationtachypneacough and hyper sections of mucussplenic sequestration crisiswhen a large # of sickle cells get trapped in the spleen--> splenomegaly***this is an emergency that can leadto hypovolemic and hypotensive shock

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Nursing interventions to reduce the risk for aspiration for pt. with ENT feedinginclude;1. assess GI intolerance to tube feeding in regular intervals q4h (abd distention,2. assess tube placement3. keep hob >or equal to 30 degrees4. keep endotracheal cuff inflated5. suction any secretions6. use caution with sedatives7. avoid bolus tube feedinghirshburg's disease clinical manifestations of disease? and the fatalcomplications? what is the tx?occurs when a childis born with some sections of the distal large intestine missingnerve cells--> the anal splinter unable to relax. onset manifestations include; not able topass meconium within the expected 24-48 hrs. difficulty feeding, vomit of green bile.fatal complications include; enterocolitis, sepsis, death. enterocolitis--> fever, lethargy,explosive foul smelling diarrhea, rapidly worsening abdominal distention.tx: surgical removal of the affected area.reducing the risk for Diverticular episodes include thefollowing;since the etiology of this disease has been linked to chronic constipation-preventingconstipation would reduce the risk for diverticula forming and becoming inflamed.constipation prevention include, drinking lots of water, exercise, and increase in fibersfoods/supplements.Risk factors for cervical cancer inlude?-HPV infection-hx of STD's

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-early onset of sexual activity-multiple or high risk sexual partners-immunosuppression-low socioeconomic status-tobacco usecauses for respiratoryalkalosisfeverhyperventilationhypoxiahysteriaover ventilation by ventilatorspain*** if the pt. condition causes overstimulation of the respiratory system monitory pt. forrespiratory alkalosis.causes for respiratory acidosisasthmaatelectasisbrain traumabronchitisCNS depressantsemphysemahypoventilationpulmonary infections, edema, emboli*** if the pt. conditions causes an obstruction of the airway or depresses the respiratorysystem monitor pt for respiratory acidosis.causes for metabolicacidosis

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