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UPDATED NCLEX UWORLD (1720 QUESTIONS WITH CORRECT ANSWERS) 2024 REVISED EXAM GRADED 100% PASS . UPDATED NCLEX UWORLD (1720 QUESTIONS WITH CORRECT ANSWERS) 2024 REVISED EXAM GRADED 100% PASS .
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what medications interact with grapefruit? - Correct answer calcium channel blockers: diltiazem, nifedipine, verapamil, etc statins caffeine SSRIs be sure to practice math! - Correct answer stent placement using the femoral approach puts you at risk for retroperitoneal hemorrhage - Correct answer what are early signs of bleeding into the retroperitoneal space? - Correct answer hypotension, back pain, flank ecchymosis (grey turner sign), hematoma formation, diminshed distal pulses what is the grey-turner sign and what is it a sign of? - Correct answer bruising of the flanks and retroperitoneal hemorrhage and is a bluish color what are some physical signs of peripheral arterial disease? - Correct answer intermittent calf muscle pain?, rest pain, hair loss, decreased peripheral pulses, cool, dry, shiny skin, thick brittle nails, gangrene, ulcers (all of these are in the extremities) transplanted hearts are expected to be - Correct answer tachycardic like 90- what is the priority intervention for pain with sickle cell crisis and why? - Correct answer administer IV fluids to reduce blood viscosity and restore perfusion to areas affected by vasoocclusion
what is the purpose of continuous bladder irrigation? - Correct answer it is perscribed after TURP to prevent obstruction of urine outflow by removing clotted blood from the bladder what is the nurses care of monitoring CBI? - Correct answer monitor quality of drainage, titrate the inflow rate, and manurally irrigating as needed characteristics of a basilar skull fracture - Correct answer periorbital hematomas (raccoon eyes), csf fluid rhinorrhea, and battle sign (behind the ear bruising) immediate client care for basilar skull fracture - Correct answer cervical spime immobilization, close neurologic monitoring, and support of ABCs vomiting with intake may mean - Correct answer viral or bacterial infection tympanosomty tubes are placed for - Correct answer recurrent otis medias nurse actions during a seizure - Correct answer assist them to lie down is standing/sitting, put them on side for patent airway, loosen tight clothing, give oxygen as needed, remove objects from immediate area, document time and duration of seizure (for tests are done later to see which type of seizure and maybe what exacerates it) never put anything in mouth or restrain them since musclec ontractions can occur during a seizure what are some early symptoms of ICP? - Correct answer altered LOC, headache, abnormal reathing, rise in bp, slow pulse, vomiting client who has a TIA is often placed on - Correct answer prophylactic antithrombotic treatment like aspirin or clopidogrel glascow coma scale ranges from - Correct answer 3-15; 3 being worst 15 being best condition (8 or below in a coma) what are the 3 components? - Correct answer eye opening motor response verbal response
dont give morphine if RR under 12 bc it can cause - Correct answer respiratory depression airborne precautions - Correct answer tuberculosis, varicella, and rubeola (measles) wear N95 respirator (and other as needed like for splashes) ALSO (neg pressure room and HEPA) clients suspected are to wear a surgical mask after triage UAP soft wrist restraints can: - Correct answer do ROM exercises reapply wrist restraints report changes in skin to nurse turn/reposition client in bed a client with major depression and severe weight loss needs what type of diet? - Correct answer high in calories and protein, also foods that are easy to chew and dont require a lot of energy bc they may have a low energy level examples: while milk/dairy, granola muffins, pottoes, meat fish eggs, pasta also small frequent meals memorize MAOIs and remember - Correct answer they cant eat foods high in tyramine like aged cheese, yogurt, fermented foods, beer, red wine, cocolate, avocados do not give lasix to a pneumonia patient with fine crackles bc they dont result from heart failure or edema - Correct answer you can give pneumonia patient exportants, antibiotics, mucolytics, antipyretics, analgesics, and antinflammatories examples are - Correct answer Mucinex, Ibuprofin, decerebrate posturing (toes point down and amrs/legs straight out) is a sign of - Correct answer severe brain damage near drowning hypothermia - Correct answer warm iv fluids, blankets, and air also will find weak and thready pulse
a client is not dead until warm and dead!!! - Correct answer nc sometimes a pt is so cold that a pulse cannot be felt intussusception causes intestinal obstruction - Correct answer ileum telescopes into cecum, pain obstruction, edema, compression of BVs, bowel ischemia, rectal bleeing (CURRANT JELLY stools) signs of intussusceotion - Correct answer inital periodic pain with legs drawn up to abdomen, pain is severe and progressive though, inconsolable crying, blood/mucousy stools "current jelly" how is it treated? - Correct answer an air enema guaifenesin (Mucinex) - Correct answer expecorant med that inc resp fluids and thins secretions to facilitate expectoration erythropoeitin Epogen - Correct answer stimulates bone marrow to make RBCs and combats the effects of chemo and used for kidney disease when is hemoccult done? - Correct answer when hidden (occult) blood is suspected due to dark and tarry stool treat intussusception with - Correct answer AIR ENEMA tetraology of fallot - Correct answer exacerbation can happen when infant or child cries, becomes upset, or is feeding you immediately place them in KNEE CHEST position hemolytic uremic syndrome - Correct answer life threatening complication of e. coli diarhea what are the signs? - Correct answer anemia (pallor), low platelets (petechiae and purpura, and acute kidney injury (low UO) cognitive behavioral therapy (CBT) 5 basic components - Correct answer education about pts disorder self observing and monitoring relaxation techniques cognitive restructuring
palpate gently using thumb and first 2 fingers normal calcium level - Correct answer 8.6-10. review heart rhythms - Correct answer lactated ringers is often used for burns - Correct answer addisons disease= hyperpigmentation of the skin - Correct answer what is one of the earliest signs of ICP? - Correct answer change in respsonsiveness what are some expected symptoms in a TBI? - Correct answer low grade constant HA, slowness in thinking, memory problems, loss of balance, poor coordination, constant exhaustion, inc sensitivity to light, and heightened irritability all symtpoms that can last up to 6 weeks bacterial meningitis - Correct answer high fever change in loc nuchal rigidity meningeal signs (positive kernig and brudzinski signs)-- treat with antibiotics what is the kernig sign? - Correct answer patient lies supine, thigh is flexed at right angle, and it hurts to extend leg what is the brudzinski sign? - Correct answer bending of neck causes flexion of knee and hip what are these 3 signs indicative of? - Correct answer meningitis client identifiers - Correct answer first and last name medical record number DOB expected term newborn findings - Correct answer plantar creases up entire sole presence of babinski
Epstein's pearls is the babinski sign present at birth? - Correct answer yes but it disappears at 1 year what does an absent babinski or weak reflex indicate? - Correct answer a neurological deficit babinski sign for a child less than 1 year - Correct answer great toe bends upward and smaller toes fan out. this is NORMAL babinski sign for child more than 1 year and an adult - Correct answer plantar flexion normal toe flexion (no babinski) what are epsteins pearls? - Correct answer white pearl like cysts on gum an palate that are benign and usually go away within a few weeks when does the umbilical cord detach from body? - Correct answer within 2 weeks jaundice in a newborn - Correct answer during first 24 hours: jaundice is pathological (r/t liver problems) after 24 hours: physiological jaundice r/t inc amount of unconjugated bilirubin in system infant formula key points - Correct answer never dilute or concentrate formula wash tops of forumla cans before opening unused prepare formula can be used for up tp 48 hours and then discarded after to warm prepared bottle, place in pan of hot water never microwave formula any forumula left over should be thrown out immediately when done long term management of hyptertension - Correct answer important to take bp meds as perscribed
onset of tpe 2 diabetes - Correct answer after age 40 medicine healers are important part of native american culture - Correct answer be mindul of a patients spirtual needs. allow them to do rituals first thing to do if a pt is in ventricular tachycardia? - Correct answer assess them for a pulse (bc they can either have a pulse or not) how to treat unstable client in vtach with a pulse? - Correct answer synchronized cardioversion how to treat stable client in vtach with a pulse? - Correct answer antiarrythmic meds like amidorone when to initiate cpr and defibrillation with a client in VT? - Correct answer only if there is no pulse what is in the lpn scope of practice? - Correct answer monitor RN findings reinforce education routine procedures like catheterization most medication administrations ostomy care tube patency and enteral feeding specific assessments notify hcp if child temp is over 100.4 after immunizations - Correct answer what are common SE of immunizations? - Correct answer mild fever and soreness and redness at injection site anorexia/fussiness in the first 24 hours GP llb/llla receptor inhibitors (abciximab, etc) can cause serious BLEEDING - Correct answer careful monitoring of puncture site after percutaneous coronary intervention signs of internal bleeding and to watch carefully when GP llb/llla receptor inhibitors are given - Correct answer hypotension, tachycardia, changes in heart rhythm, blood in urine, abom/back pain, mental status changes, black tarry stools
thrombocytopenia - Correct answer low platelet count; so this increases risk for bleeding what is SIADH? - Correct answer high antidiuretic hormone production leads to water retention increased total body water DILUTIONAL HYPONATREMIA -will see signs of fluid volume overload, changes in loc, weight gain w/o edema, hypertension, tachycardia -seizure precautions what can hyponatremia cause? - Correct answer SEIZURES, confusion, neurologic complications institute seizure precautions treatment of SIADH - Correct answer fluid restriction less than 1000 ml per day oral salt tablets to inc serum sodium hypertonic saline (3%) or NS IV and/or vasopresson receptor antagonists to decrease renal response to ADH so a pt with SIADH - Correct answer does not need extra fluid needs salt seizure precautions strict I/Os RACE for FIRES in a hospital - Correct answer R: rescue any pts in immediate danger and move them to safety A: alarm- sound alarm C: confine fire by closing all doors to all rooms E: extinguish fire with extinguisher what is asystole? - Correct answer complete absence of ventricular electrical activity in the heart. no ventricular contraction occurs client is pulseless, apneic, and unresponsive how to treat asystole? - Correct answer CPR
how to measure how to safely transfer a pt the first time - Correct answer assess if they can bear weight assess whether they are cooperative 1 gram of weight is equal to how many ml of fluid? - Correct answer 1 what is adeaute UO for an infant? - Correct answer 2 ml/kg/hr how to measure UO in diapers? - Correct answer subtract the weight of the diaper when dry from its weight when wet how often and where is growth hormone replacement given to a child? - Correct answer daily sub q injections tretment is most successful when it begins early in a child's life, as soon as growth delays are noted when is replacement therapy usually stopped? - Correct answer when bone growth stops or when paretns determine what is the classic sign of a tenson pneumothorax? - Correct answer mediastinal shift and tracheal deviation why does tension pneumothorax cause hypotension? - Correct answer bc the heart and great vessels are compressed/shifted anc cardiac output is reduced it is LIFE THREATENING what is the treatment for tension pneumothorax? - Correct answer emergency large bore needle decompression chest tube if injury to the spinal cord, what important precaution to take? - Correct answer hard cervical collar and backboard major depressive disorder demonstrates - Correct answer loss of appetite, weight loss, and insomnia or hypersomnia sleep disturbances how to help improve sleep - Correct answer dont nap during day
physical activity at least 5 hours before bed 20 mins of natural sunlight avoid caffeine after noon avoid alcohol or smoking at bedtime relaxing activity before bed decrease environmental stimuli avoid heavy meals or large amounts of fluid at bedtime warm milk or small carbs before bed what can a baby born to an opioid dependent mom have? - Correct answer neonatal abstinence syndrome. the baby experiences opiod withdrawal 24-48 hrs after birth wht are symptoms of withdrawal from opioid in infants? - Correct answer the baby is HYPERSENSITIVE irritability high pitched cry jitteriness sneezing diarrhea vomiting poor feeding tx: opiod therapy like methadone or morphine what is the nursing care focus for this? - Correct answer reduce stimulation promote nutrition and comfort after feeding an infant, what does placing it in the side lying position do - Correct answer promotes gastric emptying and reduces the risk of vomiting what is the blood loss amount to be considered postpartum hemorrhage (PPH)? - Correct answer >500 ml after vaginal birth
1000 ml after c-section what is uterine atony? - Correct answer a soft boggy poorly contracted uterus and most commonly causes early PPH
take a laxative like milk of magnesia to help expel barium drink plenty of fluids to promote hydration and eat a high fiber diet make sure directions given from nurse to uap are specific and explicit - Correct answer GCS score of 8 or below is classified as what? - Correct answer a coma when you are 8, intubate - Correct answer Amyotrophic lateral sclerosis (ALS) typical symptoms - Correct answer limb weakness, dysarthria (difficulty speaking), and dysphagia what is trismus? - Correct answer LOCKJAW inablity to open the mouth due to a tonic contraction of the chewing muscles scarlett fever - Correct answer sandpaper skin rash and fever peritonsillar abcess? a collection of pus - Correct answer a serious complication that can reuslt from tonsilities symptoms include fever, sore throat, dysphagia, trismus, muffled voice, uvula deviation, pooling of saliva normal pH - Correct answer 7.35-7. paÓ - Correct answer 80- PaCÓ - Correct answer 35- HCǑ - Correct answer 22- Ó sat - Correct answer 95- ABG values that mean ARF are what? - Correct answer PaÓ less than or equal to 60 and PaCÓ greater than or equal to 50 what type of med is clopidogrel? - Correct answer antiplatelet and should be stopped 5-7 days before surgery
NSAIDS should also be stopped 7 days before surgery to prevent excess bleeding - Correct answer ginko= bleeding - Correct answer what does foul smelling lochia suggest? - Correct answer endometrial infection what are other signs of endometrial infection? - Correct answer maternal fever, tachycardia, and uterine pain/tenderness WBC is usually elevated up to what during the first 24 hours postpartum? - Correct answer up to 30,000. temperature is also elevated pinworm infection - Correct answer anal itching thats worse at night how much folic acid do pregnant women need daily? - Correct answer min of 400 mcg what foods have folic acid? - Correct answer green leafy vegetables are an excellent source others are beans, rice, peanut butter, and fortified cereals what is topical capsaicin cream (Zostrix)? - Correct answer OTC analgesic that relived minor pain like osteoarthritis special instrution: wait 30 mins after massaging cream into hands before washing orthodox jews cant take capsules why? - Correct answer the gelatin is not kosher (fit to be consumed) what is the most accurate indicator of fluid loss or gain? - Correct answer daily weight what are some risk factors for respiratory depression? - Correct answer elderly underlying pul disease post surgery obesity
how should IV potassium be administered? - Correct answer must be given in an infusion pump so the rate can be regulated. not by gravity infusion. it should also always be diluted symptoms of cold stress in a newborn - Correct answer irritability, lethargy, decreased temp, hypoxia, bradycardia, weak suck and cry, emesis, hypoglycemia whos at a high risk fr cold stress and why? - Correct answer premature babies due to decreased brown adipose tissue do babies shiver to produce heat? - Correct answer no what is red man syndrome and what does it haooen from - Correct answer rapid infusion of vancomycin- flushin, erythema, pruritis on face neck and chest what is wound evisceration? - Correct answer protrusion of internal organs thru the wall of an incision. placing them in low fowlers with the knees bent helps reduce the tension on the wound dont forget to always assess first - Correct answer what should always be at beside for a gastric lavage? - Correct answer intubation and suction supplies why is it done and how soon after overdose? - Correct answer remove toxins and irrgate stomach and within one hour after overdose manisfestions of OA - Correct answer pain exacerbted by weight bearing crepitus morning stiffness dec joint mobility and rom atrophy of the muscles during pregnancy, why are women in a hypercoaguble state? - Correct answer to protect them from hemorrhage but there is a risk for DVT ambulate the pt soon after childbirth
who should get the flu vaccine? - Correct answer all pts 6 months old or greater unless pt has life threatening allergy to the vaccine or one of its ingredients symptoms of addisonian crisis - Correct answer sudden drop in bp, tachycardia, hypoglycemia, abdom pain, and weakness how to treat - Correct answer give IV hydrocortisone warfarin - Correct answer blocks the availibility of vitamin k and reduces risk of stroke venous thrombosis or PE what is the fluid of choice for the rapid correction of hypotension? - Correct answer 0.9 sodium chloride what is nitroglycerin used for? - Correct answer its a vasodilator that restores myocardial perfusion s/s of dig toxicity - Correct answer visual changes n/v confusion lethargy weakness cardac arrythmias take pulse and withold which med if less than 60? - Correct answer digoxin antihypertensives are held before dialysis - Correct answer never clamp a chest tube during transport of a pt. what may it cause? - Correct answer tension pneumothorax cuz the air has no way to escape what is parallel play that toddlers do? - Correct answer play alongside rather than with other children how to asisst a blind pt with walking? - Correct answer walk slightly ahead of them and to the side, and let them grab onto your elbow