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NCLEX PN Review
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NCLEX PN Review NCLEX PN Review NCLEX PN Review
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NCLEX PN ReviewList the 3 levels of disaster management - ANSWER Disaster Preparedness
Disaster Response
Disaster Recovery
List examples of the three levels of prevention in disaster management - ANSWER Primary: assist
with development of plan, training/education plan, train/educate personnel and public
Secondary: triage, treatment shelter supervision
Tertiary: follow-up recovery assistance, prevention fo future disasters
Define triage - ANSWER To sort or categorize
Identify three bioterrorism agents - ANSWER Anthrax
Pneumonic plague
Botulism
Smallpox
Inhalation tularemia
Viral hemorrhagic fever
ricin
sarin
radiation
Acute Pain - ANSWER warns that something is wrong and usually is sudden and localized (usually can
identify a precipitating event)
1. chest pain may indicate myocardial hypoxia or other related thoracic structures - for example,
broken ribs, intercostal muscles or pulmonary or pleural origin
2. Abdominal pain may reflect pathology from underlying structures - for example, gallbladder,
hepatic, gastric or renal problems
Signs of Acute Pain - ANSWER increased heart rate and cardiac output
Increased blood pressure
Pupillary Dilation
,Palmar sweating and Diaphoresis
Hyperventilation
Hypermotility
Escape behavior
Anxiety state
Chronic pain - ANSWER is insidious and may persist for greater than 3 months
Signs of Chronic Pain - ANSWER sleep disturbances
irritability
appetite disturbances
Constipation
Psychomotor retardation
Pain intolerance
social withdrawal
Mental depression
Gate control theory - ANSWER it is thought that stimulation of large, fast-conducting sensory fibers
oppose input from small pain fibers, thus blocking pain perception.
Endorphin/Enkephalin theory - ANSWER endorphins and enkephalins are naturally occurring
neurotransmitters that bind with opiate receptors in the CNS and modulate pain
Intractable Pain - ANSWER includes persistent and intense pain caused by invasive, degenerative or
neurologic conditions for example, cancer, arthritis, phantom limb, nerve entrapment, or neuralgias
Referred Pain - ANSWER perceived at a site remote from its source
Deep structures may share the same dermatomes as superfiical areas - for example, MI pain referred
down medial aspect of left arm
Other referred pain may not share innervations along the same dermatome - for example, angina
pain referred to the jaw
,Hesi hint for pain #1 - ANSWER a subjective assessment of pain can be collected by asking the
patient to rate his or her pain on a scale from 0-10, where 0= no pain and 10= the worst pain
possible
Hesi hint for pain #2 - ANSWER for narcotic-induced respiratory depression, naloxone (Narcan) 0.1 -
0.4 mg IV can be given every 2 to 3 minutes as needed, until 1 mg is achieved
Hesi hint for pain #3 - ANSWER use complement or noninvasive methods for pain management
when possible
relaxation exercises
distraction
imagery
biofeedback
interpersonal skills
physical care: altering positions, touch, hot and cold applications (as ordered by HCP)
Hesi hint for pain #4 - ANSWER narcotic analgesics are preferred for pain relief because they bind to
the various opiate receptor sites in the CNS.
Morphine is often the preferred narcotic.
Narcotic antagonists block the attachment of narcotics to the receptors, such as nalaxone (Narcan).
Once Narcan has been given, additional narcotics cannot be given until the Narcan effects have
passed
What modalities are associated with the gate control theory - ANSWER Massage, heat and cold
application, acupuncture, TENS
What modalities are thought to increase the production of endogenous opiates - ANSWER
Acupuncture, administration of placebos, TENS
What six factors should the nurse include when assessing the pain experience - ANSWER Location,
intensity, comfort measures, quality, chronology, and subjective view of pain
, What mechanism is involved in the reduction of pain through the administration of nonsteroidal
antiinflammatory medications - ANSWER NSAIDs act by a peripheral mechanism at the level of
damaged tissue by inhibiting prostaglandin synthesis and other chemical mediators involved in pain
transmission
If narcotic agonist/antagonist drugs are administered to a patient already taking narcotic drugs, what
may be the result - ANSWER Initiation of withdrawal symptoms
List four side effects of narcotic medications - ANSWER Nausea/vomiting
Constipation
CNS depression
Respiratory depression
What is the antidote for narcotic-induced respiratory depression - ANSWER Naloxone (Narcan)
What is the first sign of tolerance to pain analgesics - ANSWER Decreased duration of drug
effectiveness
Which route of administration for pain medications has the quickest onset and the shortest duration
- ANSWER Intravenous push or bolus
List the six modalities that are considered noninvasive, nonpharmacologic pain relief measures -
ANSWER heat and cold application
TENS
massage
distraction
relaxation techniques
biofeedback techniques
Hesi hint #1 grief and dying - ANSWER HCP may refer patients to hospice during the dying process.
The goal of hospice is to provide the highest quality of end-of-life care for dying individuals.
The care includes comfort and support for the individual as well as for the family.
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