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Saunders Comprehensive Review for the NCLEX-RN Examination (2010)

Saunders Comprehensive Review for the NCLEX-RN Examination (2010) is your shortcut to exam readiness, offering expert-selected questions and solutions.

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    Se | 8 W &8 | pr Se oS & SAUNDERS £X forthe ® == | LINDA ANNE SILVESTRI | | P Reflects the latest NCLEX-RN® test plan | PP Content review that you can use throughout nursing school PP Thousands of the highest quality review questions, | including alternate item formats PP CD features new audio and video questions COMPREHENSIVE Het f StudyXy

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    Downloaded from StudyXY.com ® + StudyXY Sd Ye. o> \ | iF ’ pr E \ 3 S Stu dy Anything This ContentHas been Posted On StudyXY.com as supplementary learning material. StudyXY does not endrose any university, college or publisher. Allmaterials posted are under the liability of the contributors. wv 8) www.studyxy.com

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    Comprehensive Review NCLEX-RN EXAMINATION

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    SAUNDERS Ps \ C h Ive Revi forthe ® = LINDA ANNE SILVESTRI, PhD, RN Instructor of Nursing Salve Regina University Newport, Rhode Island President Nursing Reviews, Inc. and Professional Nursing Seminars, Inc. Charlestown, Rhode Island Instructor: NCLEX-RN® and NCLEX-PN® Review Courses HERS

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    ELSEVIER 3251 Riverport Lane SAUNDERS St. Louis, Missouri 63043 SAUNDERS COMPREHENSIVE REVIEW FOR THE NCLEX-RN® ISBN: 978-1-4377-0825-7 EXAMINATION Copyright © 2011, 2008, 2005, 2002, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher, Details on how to seek permission, further information about the Publisher's permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www elsevier.com/ permissions This book and the individual contributions contained in it ate protected under copyright by the Publisher (other than as may be noted herein) Notices Knowledge and best practice in this field are constantly changing, As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindication. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein NCLEX® and NCLEX-RN" are registered trademarks and service marks of the National Council of State Boards of Nursing, Inc Nursing Diagnoses— Definitions and Classification 2009-2011 © 2009, 2007, 2005, 2003, 2001, 1998, 1996, 1994 to NANDA International. Used by arrangement with Wiley-Blackwell Publishing, a company of John Wiley & Sons, Inc. In order to make safe and effective judgments using NANDA diagnoses, it is essential that nurses refer to the definitions and defining characteristics of the diagnoses listed in this work ISBN: 978-1-4377-0825-7 Vice President and Publisher: Loren Wilson Senior Editor: Kristin Geen Acquisitions Editor: Nancy O'Brien Developmental Editor: Todd McKenzie Publishing Services Managers: Anne Altepeter, Jeff Patterson Senior Project Managers: Doug Turner, Clay Broeker Multimedia Producer: Sarah Spalding Fichom Designer: Margaret Reid Working together to grow libraries in developing countries Printed in the United States of America www.clsevier.com | www.bookaid.org | wwiw.sabre.org SEV BOOKAID Quatro Foot trdafin Last digit is the print number: 9 8 7 6 5 4 3 2 1 ELSEVIER inion Sabre Foundation | — StudyXY

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    To my parents— To my mother, Frances Mary, and in loving memory of my father, Arnold Lawrence, who taught me to always love, care, and be the best that I could be. And in loving memory of my sweet and loyal West Highland terrier Pynsea, who was always by my side as I created this publication. + StudyXY

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    To All Future Registered Nurses, Congratulations to you! You should be very proud and pleased with yourself on your most recent well- deserved accomplishment of completing your nursing program to become a registered nurse. I know that you have worked very hard to become successful and that you have proven to yourself that indeed you can achieve your goals. In my opinion, you are about to enter the most wonderful and rewarding profession that exists. Your willingness, desire, and ability to assist those who need nursing care will bring great satisfaction to your life. In the profession of nursing, your learning will be a lifelong process. This aspect of the profession makes it stimulating and dynamic. Your learning process will continue to expand and grow as the profession continues to evolve. Your next very important endeavor will be the learning process involved to achieve success in your examination to become a registered nurse. 1 am excited and pleased to be able to provide you with the Saunders Pyramid to Success products, which will help you prepare for your next important professional goal, becoming a registered nurse. I want to thank all of my former nursing students whom I have assisted in their studies for the NCLEX-RN exam for their willingness to offer ideas regarding their needs in preparing for licensure. Student ideas have certainly added a special uniqueness to all of the products available in the Saunders Pyramid to Success. Saunders Pyramid to Success products provide you with everything that you need to ready yourself for the NCLEX-RN exam. These products include material that is required for the NCLEX-RN exam for all nursing students regardless of educational background, specific strengths, areas in need of improvement, or clinical experience during the nursing program. So let's get started and begin our journey through the Saunders Pyramid to Success, and welcome to the wonderful profession of nursing! Sincerely, Linda Anne Silvestri

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    About the Author RR a YeF "IONE atl As a native of Springfield, Massachusetts, I began N 13 Dr AN my teaching career as an instructor of medical-surgical — Ry RRA | nursing and leadership-management nursing in 1981 i 57 £5 1 . > at Baystate Medical Center School of Nursing. In 58a LD = + XT 1989, I relocated to Rhode Island and began teaching oR aS. » han he advanced medical-surgical nursing and psychiatric 4 fo ~ -N nursing to RN and LPN students at the Community p "5 College of Rhode Island. While teaching there, a group 4 - z of students approached me for assistance in preparing for the NCLEX examination. I have always had a very special interest in test success for nursing students because of my own personal experiences with testing. Linda Anne Silvestri. (Photo by Laurent W. Valliere.) Taking tests was never easy for me, and as a student I needed to find methods and strategies that would bring As a child, I always dreamed of becoming either a nurse ~~ success. My own difficult experiences, desire, and dedi- or a teacher. Initially I chose to become a nurse because cation to assist nursing students to overcome the obsta- 1 really wanted to help others, especially those who cles associated with testing inspired me to develop and were ill. Then I realized that both of my dreams could write the many products that would foster success with come true; I could be both a nurse and a teacher. So I testing. My experiences as a student, nursing educator, pursued my dreams. and item writer for the NCLEX exams aided me as I I received my diploma in nursing at Cooley Dickinson ~~ developed a comprehensive review course to prepare Hospital School of Nursing in Northampton, Mass- nursing graduates for the NCLEX examination. achusetts. Afterward, I worked at Baystate Medical Center Later, in 1994, I began teaching medical-surgical in Springfield, Massachusetts, where I cared for clients in ~~ nursing at Salve Regina University in Newport, Rhode acute medical-surgical units, the intensive care unit, the Island, and remain there as an adjunct faculty member. emergency department, pediatric units, and other acute I also prepare nursing students at Salve Regina Univer- care units. Later I received an associate degree from sity for the NCLEX-RN examination. Holyoke Community College in Holyoke, Massachusetts, I established Professional Nursing Seminars, Inc., in my BSN from American International College in Spring- 1991 and Nursing Reviews, Inc, in 2000. Both compa- field, Massachusetts, and my MSN from Anna Maria Col- nies are dedicated to conducting review courses for the lege in Paxton, Massachusetts, with a dual major in ~~ NCLEX-RN and the NCLEX-PN examinations and help- Nursing Management and Patient Education. I received ing nursing graduates achieve their goals of becoming my PhD in Nursing from the University of Nevada, Las registered nurses, licensed practical/vocational nurses, Vegas, and conducted research on self-efficacy and the or both. predictors of NCLEX success. I am also a member of the Today, 1 conduct review courses for the NCLEX Honor Society of Nursing, Sigma Theta Tau Interna- examinations throughout New England and am the tional, Phi Kappa Phi, the Western Institute of Nursing, successful author of numerous review products. I am the Eastern Nursing Research Society, National League so pleased that you have decided to join me on your for Nursing, and the Golden Key International Honour journey to success in testing for nursing examinations Society. and for the NCLEX-RN examination!

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    . Contributors CONTRIBUTORS Mary C. Carrico, MS, RN Associate Professor of Nursing Sarah Hollenberg, RN West Kentucky Community and Technical College Nursing Graduate Paducah, Kentucky College of Nursing University of Missouri—St. Louis Patricia Delmoe, RN, MN St Louis, Missouri ® oo Nursing Faculty Maricopa Chapter 4: The NCLEX-RN™ Examination: Nursing Banner Boswell/Mesa From a Graduate's Perspective Mesa Community College Mesa, Arizona Bethany Hawes Sykes, EdD, RN, CEN, CCRN Adjunct Faculty Christine R. Durbin, PhD, JD, RN Department of Nursing Assistant Professor Salve Regina University School of Nursing Newport, Rhode Island Southern Illinois University Edwardsville Chapter 34: Health and Physical Assessment Edwardsville, Illinois of the Adult Client Tamara Gailey, MSN, RN Laurent W. Valliere, BS Nursing Instructor Vice President Great Basin College Professional Nursing Seminars, Inc. Elko, Nevada Charlestown, Rhode Island Chapter 3: Pathways to Success Miki Goodwin, PhD, RN, PHN Fast Track Program Coordinator Idaho State University ANCILLARY CO-AUTHOR Pocatello, Idaho Jacqueline B. Arnett, BSN, CPN ‘Wendy Greenspan, MSN, RN, CCRN Registered Nurse and Staff Development Coordinator Nursing Instructor Nursing Administration Department of Nursing Life Care Centers of America Rockland Community College Tucson, Arizona Suffern, New York Marilyn Johnessee Greer, MS, RN Associate Professor of Nursing ITEM WRITERS ~~~ Rockford College Jacqueline B. Arnett, BSN, CPN Rockford, Illinois Registered Nurse and Staff Development Coordinator Nursing Administration Kimberly Little, PhD, RN, CNE Life Care Centers of America Assistant Professor of Nursing Tucson, Arizona Cabarrus College of Health Sciences Concord, North Carolina

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    y Donna Russo, RN, MSN, CCRN, CNE Shannon Chase, RN Nursing Instructor Newport, Rhode Island ARIA Health School of Nursing Philadelphia, Pennsylvania Jane Anne Claffy, MSN, RNC Germantown, New York Julie Snyder, MSN, RN-BC Adjunct Faculty Alice D. Coomes, MSN, RN School of Nursing Owensboro, Kentucky Old Dominican University Norfolk, Virginia Barbara Cornett, PhD, CNS, RN, CHES Westerville, Ohio Sharon Souter, PhD, RN, CNE Dean and Associate Professor Gloria Coschigano, MSN, RN, CS Scott and White College of Nursing Valhalla, New York University of Mary Hardin-Baylor Belton, Texas Nancy Wilson Darland, MSN, RNC, CNS Ruston, Louisiana Linda Turchin, MSN, RN, CNE Assistant Professor Jean W. Davis, EdD, RN, CS Department of Nursing Miami Shores, Florida Fairmont State University Fairmount, West Virginia Jean DeCoffe, MSN, RN Milton, Massachusetts The author and publisher would also like to acknowledge the following individuals for contributions to the previous Carole A. Devine, MSN, RN editions of this book: Kingston, Rhode Island JoAnn Acierno, BSN, RN Katherine H. Dimmock, JD, EdD, MSN, RN Omaha, Nebraska Milwaukee, Wisconsin Marion G. Anema, PhD, RN Mary L. Dowell, PhD, RN, BC Nashville, Tennessee Belton, Texas Marianne P. Barba, MS, RN, CPC Julie Eggert, PhD, GNP-C, AOCN Coventry, Rhode Island Clemson, South Carolina Carol A. Baxter, EAD, RN Kerry H. Fater, PhD, RN, CS Lancaster, Pennsylvania North Dartmouth, Massachusetts Eloise M. Brotzman, MSEd, MSN, RNC Ginette G. Ferszt, PhD, RN, CS Bethlehem, Pennsylvania Kingston, Rhode Island Reitha Cabaniss, MSN, RN Katherine A. Fletcher, PhD, RN, CS Sumiton, Alabama Kansas City, Kansas Janice Almon Call, MSN, RN, C Cathy Fortenbaugh, MSN, RN, AOCN, CNS-C Gainesville, Texas Philadelphia, Pennsylvania Darlene Nebel Cantu, MSN, RNC Jane H. Freeman, EdD, RN San Antonio, Texas Jacksonville, Alabama Heather Carlson, RN Cynthia A. Gaudet, MSN, RN Newport, Rhode Island Springfield, Massachusetts Elizabeth M. Carson, EdD, RN Rita S. Glazebrook, PhD, RN, CNP Rockford, Illinois Northfield, Minnesota | Vv — StudyXY

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    EE - Kimberly Green, RN Dorothy Mae Mathers, MSN, RN Newport, Rhode Island Williamsport, Pennsylvania Karen Clark Griffith, PhD, RN Ellyn E. Matthews, PhD, RN, AOCN, CRNI Iowa City, lowa Denver, Colorado Sheila C. Grossman, PhD, APRN-BC Ellen C. McElroy, DSN, RN Fairfield, Connecticut Birmingham, Alabama Joyce Hammer, MSN, RN Susan A. Moore, PhD, RN Detroit, Michigan Memphis, TN Jacqueline Lynne Harris, MNSc, RN, ONC Jo Ann Barnes Mullaney, PhD, RN, CS Searcy, Arkansas Newport, Rhode Island Amy Zlomek Hedden, RN, MS, NP Betsy J. Nield, MS, RNC Bakersfield, California Warwick, Rhode Island Beverly K. Hogan, APRN, BC Tina Nink, MSN, RN, ENP Birmingham, Alabama Oglesby, Illinois Mary Ann Hogan, MSN, RN, CS Lolita T. O'Donnell, PhD, MSN, RN Amherst, Massachusetts Fairfax, Virginia Mary Kathleen Jackson, BSN, RN, CPN Kathleen A. Ohman, EdD, MS, RN, CCRN Whiteville, North Carolina St. Cloud, Minnesota Gail M. Johnson, EdD, MSN, RN, CNAA, BC Patricia A. Parsons, MSN, MS, RN Trenton, New Jersey Austin, Minnesota Juanita F. Johnson, PhD, RN Elizabeth Phillip, MSN, RN Shawnee, Oklahoma Bethlehem, Pennsylvania Katherine Theresa Jorgensen, MSN, RN, MA Tommie Wright Pniewski, MSN, RN, CNAA Vermillion, South Dakota Hopkinsville, Kentucky Katje A. Koning, RN Emily Porterfield, RN, LDN Storrs, Connecticut Greenville, North Carolina Elisa Mangosing Lemmon, MSN, RN, C Ethel Pruden, MSN, RN Newport News, Virginia Savannah, Georgia Teresa Leonard, MSN, RN, CCRN Marion Sawyier, MSN, RN Florence, Alabama Albuquerque, New Mexico Carol O. Long, PhD, RN Nancy Schlapman, PhD, RN Tempe, Arizona Kokomo, Indiana Marilyn Lusk, MSN, MS, RN Jane Schlickau, MN, RN, ARNP, CTN Kingman, Arizona Winfield, Kansas Lois S. Marshall, PhD, RN Joan Schmitke, DSN, APRN, FNP, BC Miami, Florida Richmond, Kentucky Linda Ann Martin, MSN, RN, APN-C Bruce Austin Scott, MSN, APRN, BC Trenton, New Jersey Stockton, California | ve TT StudyXY

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    A. Geneva Scott, MSN, RN, BSS Loretta A. Wack, MSN, PNP, FNP Weatherford, Texas Weyers Cave, Virginia Shirley Sherrick-Escamilla, PhD(c), MSN, RNC Mary Hauser Whitaker, MSN, RN Detroit, Michigan Richmond, Kentucky Shellie Simons, MS, RN Cheryle I. Whitney, MSN, RN Boston, Massachusetts The Woodlands, Texas Mary M. Smith, MSN, RN Chris Winkelman, RN, PhD, CNP, CCRN Charlotte, North Carolina Cleveland, Ohio Fran Soukup, RN, MSN, EdS Danette Wood, EdD, MSN, RN, CCRN Albany, New York Statesboro, Georgia Marian I. Stewart, MSN, RN Terry Yoesting, MS, RN Lynchburg, Tennessee Denison, Texas Linda D. Taylor, PhD(c), RN, OCN Rockford, Illinois CONSULTANTS Lynn Tesh, MSN, RN Nicole Marie Valliere, BSN, RN Asheboro, North Carolina Professional Nurse [—Pediatrics Hasbro Children’s Hospital Vicki L. Vann, MS, ARNP Providence, Rhode Island Tampa, Florida Dianne E. Ventrice Cheryl J. Vitacco-Grab, MSN, RNC Reference Consultant Lancaster, Pennsylvania Nursing Reviews, Inc. Charlestown, Rhode Island | Vv T= StudyXY

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    Reviewers Jacqueline B. Arnett, BSN, CPN Paula Cox-North, MN, NP-C Registered Nurse and Staff Development Coordinator Pacific Medical Centers Nursing Administration Department of Gastroenterology Life Care Centers of America School of Nursing Tucson, Arizona University of Washington Seattle, Washington Cynthia Elnora Ashby, MS, RN Adjunct Faculty Christine R. Durbin, PhD, JD, RN Ashby Educational Assessment Program Assistant Professor The University of Houston Victoria at Cinco Ranch School of Nursing Houston, Texas Southern Illinois University Edwardsville Edwardsville, Illinois Marilee Aufdenkamp, MS, RN Assistant Professor Susan C. Engle, MSN, RN School of Nursing Professor Creighton University Department of Health Occupation Omaha, Nebraska Napa Valley College Napa, California Susan F. Beasley, MSN, RN, CNE Douglas A. Fabick, BS, RN, CEN Nursing Faculty © . Tennessee ACLS Regional Faculty Department of Nursing N . Chair of Northeast Tennessee ECC Technical College of the Lowcountry . Volunteer Department Beaufort, South Carolina . - American Heart Association . Kingsport, Tennessee Mary C. Carrico, MS, RN Associate Professor of Nursing Tamara Gailey, MSN, RN West Kentucky Community and Technical College Nursing Instructor Paducah, Kentucky Great Basin College Elko, Nevada Olivia Catolico, PhD, CNL, RN, BC Associate Professor Susan Johnson Garbutt, DNP, RN, CIC Department of Nursing LL RN Program Director Dominican University of California Galen School of Nursing San Rafael, California St. Petersburg, Florida Claire Cottrell, RN, MSN Cené L. Gibson, MSN, ARNP Nursing Instructor Family Nurse Practitioner Associate Degree Nursing Division Regional Clinical Coordinator Mississippi Gulf Coast Community College Frontier School of Midwifery and Family Nursing, Perkinston, Mississippi Oklahoma City, Oklahoma I~ StudyXY

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    A ‘Wendy Greenspan, MSN, RN, CCRN Joshua J. Neumiller, PharmD, CDE, CGP, FASCP Instructor of Nursing Assistant Professor of Pharmacotherapy Department of Nursing Department of Pharmacotherapy Rockland Community College Washington State University Suffern, New York Spokane, Washington Marilyn Johnessee Greer, MS, RN Deborah Palada, MSN, APRN, CPNP Associate Professor of Nursing Pediatric Nurse Practitioner Department of Nursing Department of Pediatrics Rockford College St. Mary's Hospital Rockford, Illinois Jefferson City, Missouri Sheila Grossman, PhD, FNP, APRN-BC Brenda Pavill, PhD, RN, ENP, IBCLC Professor and Coordinator Associate Professor FNP Track School of Nursing School of Nursing University of North Carolina, Wilmington Fairfield University Wilmington, North Carolina Fairfield, Connecticut Suzanne Pellar, MS, RN, CNS-BC Deborah Hamolsky, MS, RN, AOCNS Assistant Professor of Nursing Clinical Nurse Purdue University North Central Carol Franc Buck Breast Care Center Westville, Indiana Helen Diller Family Comprehensive Cancer Center University of California, San Francisco Barbara D. Powe, PhD, RN San Francisco, California Director Underserved Population Research Sarah M. Howell, MSN, RN Behavioral Research Center Assistant Professor of Nursing American Cancer Society Department of Nursing Atlanta, Georgia Mississippi University of Women Columbus, Mississippi Catherine Napoli Rice, EdD, RN Associate Professor Cheryl A. Lehman, PhD, RN, CRRN, CNS Department of Nursing Associate Professor/Clinical Western Connecticut State University Acute Nursing Department Danbury, Connecticut School of Nursing University of Texas Health Science Center Dottie Roberts, MSN, MACI, RN, CMSRN, OCNS-C at San Antonio Nursing Instructor San Antonio, Texas South University Columbia, South Carolina Sue Ann McCann, MSN, RN, DCN CTCL and Research Coordinator Katherine Roberts, MSN, RN Department of Dermatology and Nursing Assistant Professor of Nursing University of Pittsburg Medical Center Department of Nursing Pittsburg, Pennsylvania Lamar University Beaumont, Texas Mariann Montgomery, MSN, RN, CNE Assistant Professor Jana C. Saunders, PhD, RN, CNS Department of Nursing Professor Kent State University Tuscarawas Health Sciences Center New Philadelphia, Ohio Anita Thigpen Perry School of Nursing Texas Tech University Sherry Neely, MSN, RN, CRNP Lubbock, Texas Associate Professor Department of Nursing Butler County Community College Butler, Pennsylvania

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