ATI NCLEX Review

Age to start colon cancer screening

45 and then every 10 years

condition that increases colon cancer risk

UC

treatment for upper airway infections (ex: croup)

racemic epi

when to give pre-op antibiotics

within 60 min of incision

When is rhogam given?

at 28 weeks during pregnancy and within 72 hours after birth

SJS symptom progression

flu like symptoms initially, and then painful rash on trunk of body and mouth

When does SJS progress to TENS

when it covers over 30% of the body

SJS initial treatments

Antiepileptic or bactrim in first couple weeks

Does informed consent require a witness?

Yes; nurse can serve as witness

Negligence legal definition

must cause harm/permanent injury and didn’t meet standard of care (others wouldn’t have made that same mistake)

Evacuation order for fire

most ambulatory first

first sign of digoxin toxicity

N/V

risk of heparin use

HIT (check platelets)

needle length for newborn IM injection

25 G, ⅝ in length

syringe volume for IV meds

at least 10 mL

positioning for removing IJ central line

have head lower than body

Reasons to switch from oral hypoglycemic to insulin

pregnancy and severe illness

what type of insulin is given IV push for hyperkalemia?

regular insulin

PTU indication and black box warning

hyperthyroidism and can cause acute liver failure

Hemolytic reaction symptoms

chills, fever, low back pain, tachycardia, tachypnea, hypotension

Get urine sample after to test for bilirubin

First sign of anaphylaxis

flushing of skin

Febrile blood infusion reaction criteria

temp must increase by at least 1°C

Nephrotoxic meds

• vancomycin, gentamacin

• IV contrast

• amphotericin b

• sulfamethoxazole-trimethoprim

• NSAIDS (ketorolac, naproxen)

Labs to monitor while on lithium

• thyroid

• sodium

• creatinine

Medications that can interact with lithium

• NSAIDS

• diuretics

• ACE inhibitors

Expected finding after laparoscopic procedure

abdominal pain/distension that radiates to shoulder

post-op instructions for any surgeries from the neck up

don’t want coughing, straining, N/V (increases pressure)

NMS symptoms

• stiffness

• fever

• tachycardia

isolation for Hep A

Don’t isolate for Hepatitis (unless type A and incontinent)

Disseminated herpes precautions

airborne and contact

Loop diuretics electrolyte imbalances

hyper GLU (glucose, lipids, uric acid)

HCTZ electrolyte imbalances

hyper GLUC (glucose, lipids, uric acid, calcium)

Only times to clamp chest tube

changing out system or assessing for air leak

Nutrition for cystic fibrosis

high fat, high calorie, high protein, high sodium

Normal stoma after creation and instructions

change appliance every 3-5 days, stoma protrudes 1-3 cm, wash using mild soap, change when ⅓ full

Kidney diet

limit protein, sodium, potassium, and phosphorus; fluid restrictions

levodopa/carbidopa type of diet required

low protein

ACEI/ARBSs dietary necessity

low potassium

Vaso-occlusive crisis treatment order

hydration, oxygen, pain control

Heat stroke symptoms and priority

temp over 104, confused, priority is cooling

2 approved IV fluids for addisonian crisis

NS or D5 normal saline

when to use LR

trauma, sepsis, and DKA

Weight gain to monitor in HF

2-3 lb/day or 3-5 lb/week

Dysphagia feeding instructions

• mechanical pureed diet

• put food at back of mouth

• sit up for 30 min after

• suction after eating

Presumptive signs of pregnancy

experienced by the woman, subjective

• Amenorrhea

• N&V

• Breast changes

• Urinary frequency

• Fatigue

• Fetal movement

• Uterine enlargement

• Braxton Hicks (patient)

Probable signs of pregnancy

objective

• Braxton Hicks (provider)

• Rebound of fetus

• Goodell’s sign (cervix)

• Softening of cervix

• Chadwick’s sign

• Bluish color of vagina/cervix

• Hegar’s sign

• Softening of lower uterine segment

• + Pregnancy Test

Positive signs of pregnancy

• visualization of fetus

• detection of fetal heart tones

• fetal movement felt by examiner

only medicine for bulimia nervosa

fluoxetine

Bupropion contraindications

seizures and eating disorders (causes weight loss)

rapid acting insulins

• lispro

• aspart

• glulisine

short acting insulin

regular

intermediate acting insulin

NPH

long acting insulins

• levemir

• glargine

• degludec

what types of insulin can be put in an insulin pump?

rapid and short acting

rapid acting insulin onset and peak

• onset: 15-30 min

• peak: 30 min-2.5 hour

short acting insulin onset and peak

• onset: 30 min- 1 hr

• peak: 1 hr-5 hours (say 2 for nclex)

intermediate acting insulin onset and peak

• onset: 1-2 hr

• peak: 6-14 hours

long acting insulin onset and peak

• onset: 1.5 hr

• peak: no peak, except for levemir, which peaks in 6-8 hr

• given 1-2 times a day

hypothyroid conditions

• Hashimoto

• myxedema coma

Airborne precautions

• N95 respirator

• private room

• negative airflow

• keep door closed

• surgical mask to client if leaving room

Droplet precautions

• standard mask

• private room, can cohort if same organism

PPE order of application

hands above head and then work upward (gown, mask, goggles, gloves)

PPE removal order

alphabetical (gloves, goggles, gown, mask)

airborne precaution diseases

• measles

• varicella

• TB

• disseminated herpes zoster

droplet precaution diseases

• streptococcal pharyngitis

• pneumonia

• scarlet fever

• rubella

• pertussis

• mumps

• pneumonia variations

contact precaution diseases

• varicella

• C. Diff

• Hep A (incontinent)

• herpes simplex

• herpes zoster

• MRSA

• RSV

• rotavirus

• samonellosis

• singellosis

• s. aureus

• VRE

CDC Reportable diseases

• AIDS/HIV

• Varicella

• Hep A, B, C

• Measles

• meningococcal

• Rubella

• Salmonellosis

• shigellosis

• TB

• VRE

normal adult blood pressure and hypotensive range

systolic: 90-120

diastolic: 60-80

normal adult temperature

36° to 38° C (96.8° to 100.4° F)

Pre-op checklist

• NPO

• baseline vitals

• medications (antibiotics)

• pregnancy test

• hold anticoagulants

• check for informed consent

desired lab values when on heparin and warfarin

• aPTT: 1.5 to 2.5x normal

• INR: 2-3

Post-op complications that can happen 48 hr after procedure

• atelectasis

• hypostatic pneumonia

• respiratory depression

• hypoxia

• nausea

• shock

post-op complication window: urinary retention

immediate to 3 days

post-op complication window: decreased paristalsis/paralytic ileus

2-4 days

post-op complication window: hemorrhage

entire time

post-op complication window: thrombophlebitis

1-2 weeks

post-op complication window: delayed wound healing

5-6 days

post-op complication window: infection

3-5 days

unique sign of fat embolism

petechiae

from long/flat bone break or crush

Antihypertensive medications

• ACE inhibitors (-pril)

• ARBS (-sartan)

• CCB (-dipine, -amil)

  • don’t give for HF

• alpha blockers (-sin)

• centrally acting alpha agonists

  • clonidine, guanfacine, methyldopa

• beta blockers (-lol)

• vasodilators

normal casual blood glucose level

under 200

toddler choking hazard foods

hard foods, difficult to chew, shaped like tubes

dumping syndrome diet instructions

• beverages between meals (not with)

• small, frequent meals

• low fiber

• high protein

• lay down between

how often do you change TPN tubing

every 24 hours

incomplete protein sources

• lentils

• vegetables

• grains

• nuts

• seeds

lithium toxicity symptoms

• Muscle weakness

• Polyuria

• Diarrhea

• Early: N/V

what can magnesium salts cause?

D

what can calcium salts cause?

C

what can aluminum salts cause?

C

Converting to child dosing from adult

use surface area ratio

What blood thinner cannot be used in pregnancy

warfarin

St. John wart use and side effects

used to treat depression

• Photosensitivity

• Tachycardia

• Skin rash

• GI distress

EC fluid loss due to V/D treatment

0.9% NS

Fat soluble vitamins

ADEK

Parkinson’s meds

• Dopamine Precursor= L-Dopa + Carbidopa

• COMT Inhibitors= Entacapone, Tolcapone

• DA Agonists (Non-Ergot)= Ropinirole, Pramipexole, Apomorphine

• MAO-B Inhibitors= Selegiline

General adverse effects of Parkinson’s drugs

• Behavioral/ Hallucinations

• Impulse Control

• Narcolepsy

• GI Symptoms

• Orthostatic Hypotension

Hep B vaccine allergy CI

yeast

BEERS list drugs

• anticholinergics

• opioids

• antihistamines

• diuretics

• benzodiazepines

• antipsychotics

• antihypertensives

• omeprazole

maximum potassium IV infusion rates

over an hour:

• peripheral line: 5-10 meq

• central lines: 20 meq

Phenytoin side effects

• gingival hypertrophy

• diplopia

• drowsiness

• hirsutism

• decreases effectiveness of digoxin, warfarin, and oral contraceptives