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NCSBN REVIEW EXAM 2024/2025
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o Change of Shift Transitions: IPASS(the)BATON
- Introduction
- Patient
- Assessment
- Situation
- Safety
The
- Background
- Actions
- Timing
- Ownership
- Next
Safety & Infection Control:
o Hepatitis A - transmitted via ingestion of fecal matter, close person-person contact, and
sexually through an infected person.
- Standard + contact precautions
- Low fat, high calorie/carbs/protein diet
- Eliminate all alcoholic beverages
o Hepatitis C – transmitted via ingestion of contaminated food/drink
o Emergency Triage Tags
- Red = immediate threats to life and require care right away. (Hypotension
and a sucking chest wound)
- Yellow = major injuries that need tx. within 30min.- 2 hrs. (open fracture)
- Green = injuries that can be delayed more than 2 hrs. (closed fractures)
- Black = tx. last because there is little to no chance of survival
o MRSA contact precautions
o Fire Safety
- R = remove/rescue pt.
- A = activate fire alarm
- C = contain fire (close doors/windows)
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- E = extinguish flames
o Do not induce vomiting for clients who have swallowed any substance containing an
acid (such as toilet bowel cleaners and swimming pool cleaners) or corrosive alkalis
(including oven cleaners, liquid drain cleaners, disk batteries, various household cleaners
and dishwasher detergents). Vomiting these substances may cause irreversible upper
respiratory damage.
o Most common injury by age group
- Infants – burns, falls, suffocation
- Toddlers/Preschool – burns, choking, falls, playground/street related,
poisoning
- School Age – automobile, drowning, sports related
- Adolescence - automobile, lifestyle choices, substance abuse
- Adults – lifestyle habits, smoking, stress related illness, substance abuse
- Elderly – automobile, burns, falls
o Standard Precaution – basic level of infection control precautions used in the care of all
patients
o Contact Precaution – gloves and gown. MRSA, resp. infection, skin infection, wound
infection, conjunctivitis, VRE (vancomycin resistant enterococcus) & C.diff. **with c.diff
you must was hands w/ soap & water – sanitizer does not kill these spores.
o Droplet Precaution – mask, gown, gloves. Sepsis, scarlet fever, streptococcal
pharyngitis, parvovirus B19, pneumonia, pertussis, flu, diphtheria, epiglottitis, rubella,
mumps, meningitis, adenovirus.
o Airborne Precaution – place pt. in airborne infection isolation room with negative
pressure. N95 mask. Ex. measles, chickenpox, TB, shingles
o Neutropenic Precaution – used with pt. with low WBC (less than
1500)/immunocompromised. PPE depends on nature of interaction and exposure to
blood/body fluids. Visitors usually restricted and pt. placed in private room.
o Order of donning PPE = gown, mask, goggles, gloves
o Removing PPE = gloves, goggles, gown, mask
o Incident Reports
- Not part of the pt. medical record!!!
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- Most cases is protected from discovery during legal investigation
- Should be filled out any time there’s a complaint, device malfunction, med
error, injury
- Must include: date – time – exact location – names involved/witnesses –
direct quotes from those involved – objective info. – who was notified –
orders received – corrective actions taken if done so
o When a med error is made, don’t immediately inform the client. Inform them 1-2 days
once condition is made sure to be stable and HCP/nurse manager are notified.
o Minimal Change Disease – kidney ds. In which large amounts of protein is lost in the
urine. Can lead to nephrotic syndrome kidney disorder causing the body to excrete
too much protein in the urine. Lots of swelling/edema.
Antepartum – Intrapartum – Postpartum:
o If mom is Rh – and baby is Rh +, mom will get RhoGam shot within 72 hrs. after birth
o If the baby is Rh – mom will not need second dose of RhoGam after birth
o Comb’s Test – used in the evaluation of a jaundiced infant and anemia.
- Direct test newborn’s blood sample taken from the cord.
- Rh- moms with Rh+ baby will cause a +Comb’s Test result… meaning the
baby will not develop jaundice or anemia
- Indirect test mother’s blood sample. A negative (normal) score indicates
the mother has not developed antibodies against the Rh+ baby and the
mother needs RhoGam
o Uterus/fundus should be felt at level of umbilicus 1-24 hrs. after birth
o Frequency – time from start of contraction to start of the next
o Duration – time when tensing of fundus first felt (start of contraction) & again as
relaxation occurs (end of contraction)
o Intensity – pressing fingertips into uterine fundus. Mild, moderate, or strong
o Fertility Methods
- The Calendar Method “rhythm method” or the “natural family planning”;
estimates date of ovulation based on length of cycle
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- Basal Body Temperature woman taking her temp. in the morning q.day
before getting out of bed; rise in temp. indicates ovulation
- Cervical Mucous Method identifies ovulation by the increase in &
“strechability” of mucous
- Symptothermal Method combination of all three
o Vasectomy - sx. Procedure to sterilize males. Does not do so instantly so other
methods needed until sperm count to 0
o Take 400-800 mcg. of folic acid daily to prevent birth defects
o Presumptive Pregnancy Finds
- Amenorrhea
- Fatigue
- N/V (morning sickness)
- Breast changes
- Elevation of basal body temp
- Skin changes
o Probably Pregnancy Finds
- Chadwick’s sign bluish color of vagina and cervix
- Hegar’s sign softening of the uterus
- Goodell’s sign softening of the cervix
o Positive Pregnancy Finds
- hCG testing
- fetal heart tones
- visualization of fetus
- palpating fetal movement
o Losing baby after 20th week is considered ‘stillborn’
o Rh- mom must receive RhoGam after a miscarriage
o Ectopic Pregnancy – when fertilization is implanted outside uterine cavity and in the
fallopian tube. Result of tubular obstruction or blockage that prevents normal transit.
Medical emergency!!!
- Missed pd
- Unilateral lower quadrant pain
- Rigid/tender abd.
- Possible shoulder pain
- Low hct.
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