NCLEX-RN EXAM REVIEW TEST 2023

NCLEX-RN EXAM REVIEW TEST 2023 When selecting an NCLEX answer or determining the order of priority what should you remember or use and what is the exception? - CORRECT ANSWER-Use the ABC rule: Airway breathing, and circulation. The exception to the rule is with actual CPR, use C-AB for CPR. Also remember safety first and acute before chronic. If the pt. is not in distress then you assess. If the pt is in distress then you should do something. If the pt has diaphorisis you should always do something. How should you address questions related to Maslow's Hierarchy of Needs - CORRECT ANSWER-Address physiological needs first, followed by safety and security needs, love and belonging needs, self esteem needs and finally self actualization needs. *When a physiological need is not addressed in the question, look for the option that addresses safety. If a question is related to the nursing process, read the question to determine the step of the nursing process. What are the steps in the nursing process and what kind of question might be related to that step. - CORRECT ANSWER-Assessment question address the gathering and verification of data. Analysis questions require the nurse to: interpret data, collect additional information, identify and communicate nursing diagnoses and determine the health team's ability to meet the pts needs. Planning questions ask about determining, prioritizing, and modifying outcomes of care. Implementation questions reflect the management and organization of care and the assignment and delegation of tasks. Be prepared for questions on client teaching. Evaluation questions focus on comparing the actual outcomes of care with the expected outcomes and on communicating and documenting findings. What are the normal ranges for H&H? What are the nursing implications - CORRECT ANSWER-Hemoglobin - Male 14-18 Female 12-16 Newborn 14-24 High altitude living increases value, slight decrease during pregnancy. Drug therapy can alter values. Hematocrit - Male 42-52 Female 37-47 Newborn 44-64 Prolonged stasis from vasoconstriction secondary to the tourniquet can alter values. Abnormalities in RBC size may alter Hct values What are the normal ranges for WBC? What can increase values? What can decrease values? How long does the postpartum period of pregnancy affect normal ranges? What range is normal during the postpartum period? - CORRECT ANSWER-Both genders 5000- 10000 Newborn Anesthetics, stress, exercise, and convulsions can increased values. Drug therapy can decrease values. 24-28 hr postpartum: a count as high as 25000 is normal What are the normal ranges for RBC? What can increase levels What happens to levels during pregnancy? - CORRECT ANSWER-Males: 4.7-6.1 million Female: 4.2-5.4 million Exercise and high altitudes can cause an increase levels pregnancy usually lower values drug therapy can alter values Never draw a specimen from an arm with an infusing IV. What are the normal ranges for PLATELETS? What may increase values? What may decrease values? What drugs decrease values? - CORRECT ANSWER-Both Genders: - Living at high altitudes, exercising strenuously or taking oral contraceptives may increase values decreased values may be caused by hemorrhage, DIC, reduced production of platelets, infections, use of prosthetic heart valves, and drugs. Drugs that decrease platelets: acetaminophen, aspirin, chemotherapy, H2 blockers, INH, Levaquin, streptomycin, sulfonamides, thiazide diuretics. What are the normal ranges for K+? What should you keep in mind when getting a specimen? - CORRECT ANSWER-3.5-5 is normal range for potassium Exercise of the forearm with tourniquet in place may cause an increased level. Hemolysis of specimen can result in a falsely elevated value What are the normal ranges for Na+? What should you consider when collecting a specimen? - CORRECT ANSWER-136-145 is a normal sodium range Do Not collect from an arm with an infusing IV solution What are the normal ranges for Ca+? What type of drug can increase calcium levels? What are two tests with positive results that are associated with hypocalcemia? How do you preform the two tests? - CORRECT ANSWER-9-10.5 for adults. slightly lower in the elder Use of thiazide diuretics can cause increased levels of calcium Positive Chvostek and Trousseau tests are associated with hypocalcemia. • Chvostek sign: contraction of ipsilateral facial muscles when the facial nerve is tapped just in front of the ear. • Trousseau sign: carpopedal spasm elicited by inflating a sphygmomanometer above systolic BP for 3 minutes. What are the normal ranges for Mg+? What may high magnesium levels indicate? What may low magnesium levels indicate? - CORRECT ANSWER-1.7-2.2 A high magnesium level may indicate: Addison disease Chronic renal failure, Dehydration, Diabetic acidosis Oliguria A low magnesium level may indicate: Alcoholism Chronic diarrhea, Delirium tremens, Hemodialysis Hepatic (liver) cirrhosis, Hyperaldosteronism Hypoparathyroidism, Pancreatitis, Too much insulin Toxemia of pregnancy, Ulcerative colitis What are the normal ranges for Cl- - CORRECT ANSWER-98-106 is the normal range for chloride What are the normal ranges for ALP (alkaline phosphatase)? - CORRECT ANSWER30-120 slightly increased in the elderly What are the normal ranges for BUN? What does BUN stand for? What is the ratio of BUN-creatinine? What does it indicate? - CORRECT ANSWER-10-20 blood urea nitrogen BUN-creatinine ratio of 20:1 indicates adequate kidney functioning What are the normal ranges for Creatinine? What is the ratio of BUN-creatinine? What does it indicate? - CORRECT ANSWER-Male 0.6-1.2 Female 0.5-1.1 BUN-creatinine ratio of 20:1 indicates adequate kidney functioning What is the relationship of Ca+ and PO4? What is the relationship of Ca+ and pH? - CORRECT ANSWER-calcium and phosphorus have an inverse relationship: when calcium levels increase, phosphorus levels decrease, and vice versa. pH also affects the level of ionized calcium: As pH rises and blood becomes more alkalotic, calcium binds more easily with protein, causing the level of ionized calcium to drop. Conversely, when pH falls, causing acidosis, less calcium binds with protein, which raises the ionized calcium level What are the normal ranges for ABGs? (pH, pCO2, HCO3) - CORRECT ANSWER-pH (AC) 7.35-7.45 (AL) pCo2 (AL) 35 - 45 (AC) HCO3 (AC) 22 - 26 (AL) What are the normal ranges for PT? What is PT used to help regulate? What is the therapeutic range? - CORRECT ANSWER-11-12.5 is a normal PT range PT is used to help regulate Coumadin dosages. The therapeutic range: 1.5 to 2 times normal or control What are the normal ranges for INR? What type of patients should have individualized values What should the values be for those patients? - CORRECT ANSWER-0.8-1.1 normal INR Individualized values for pts with: Afib and DVT between 2.0 and 3.0 mechanical heart valves between 3.0 to 4.0 What are the normal ranges for PTT and aPTT? What do they help regulate? What is the therapeutic range? - CORRECT ANSWER-normal range PTT: 60-70 normal range aPTT: 30-40 Both PTT and aPTT are used to help regulate heparin dosages. Therapeutic range is 1.5 to 2.5 times normal or control What are the 7 Rights of medication administration? - CORRECT ANSWER-1. Right drug 2. right dose 3. Right route 4. Right time 5. Right patient