NCLEX TIPS 1.

When getting down to two answers, choose the assessment answer (assess, collect, auscultate, monitor, palpate) over the intervention except in an emergency or distress situation. If one answer has an absolute, discard it. Give priority to answers that deal directly to the patients body, not the machines/equipments. 2. Key words are very important. Avoid answers with absolutes for example: always, never, must, etc. 3. with lower amputations patient is placed in prone position. 4. small frequent feedings are better than larger ones. 5. Assessment, teaching, meds, evaluation, unstable patient cannot be delegated to an Unlicensed Assistive Personnel. 6. LVN/LPN cannot handle blood. 7. Amynoglycosides (like vancomycin) cause nephrotoxicity and ototoxicity. 8. IV push should go over at least 2 minutes. 9. If the patient is not a child an answer with family option can be ruled out easily. 10. In an emergency, patients with greater chance to live are treated first 11. ARDS (fluids in alveoli), DIC (disseminated intravascular coagulaton) are always secondary to something else (another disease process). 12. Cardinal sign of ARDS is hypoxemia (low oxygen level in tissues). 13. in pH regulation the 2 organs of concern are lungs/kidneys. 14. edema is in the interstitial space not in the cardiovascular space. 15. weight is the best indicator of dehydration 16. wherever there is sugar (glucose) water follows. 17. aspirin can cause Reyes syndrome (encephalopathy) when given to children 18. when aspirin is given once a day it acts as an antiplatelet.

19. use Cold for acute pain (eg. Sprain ankle) and Heat for chronic (rheumatoid arthritis) 20. guided imagery is great for chronic pain. 21. when patient is in distress, medication administration is rarely a good choice. 22. with pneumonia, fever and chills are usually present. For the elderly confusion is often present. 23. Always check for allergies before administering antibiotics (especially PCN). Make sure culture and sensitivity has been done before adm. first dose of antibiotic. 24. Cor pulmonale (s/s fluid overload) is Right sided heart failure caused by pulmonary disease, occurs with bronchitis or emphysema. 25. COPD is chronic, pneumonia is acute. Emphysema and bronchitis are both COPD. 26. in COPD patients the baroreceptors that detect the CO2 level are destroyed. Therefore, O2 level must be low because high O2 concentration blows the patients stimulus for breathing. 27. exacerbation: acute, distress. 28. epi always given in TB syringe. 29. prednisone toxicity: cushings syndrome= buffalo hump, moon face, high glucose, hypertension. 30. 4 options for cancer management: chemo, radiation, surgery, allow to die with dignity. 31. no live vaccines, no fresh fruits, no flowers should be used for neutropenic patients. 32. chest tubes are placed in the pleural space. 33. angina (low oxygen to heart tissues) = no dead heart tissues. MI= dead heart tissue present. 34. mevacor (anticholesterol med) must be given with evening meal if it is QD (per day). 35. Nitroglycerine is administered up to 3 times (every 5 minutes). If chest pain does not stop go to hospital. Do not give when BP is < 90/60. 36. Preload affects amount of blood that goes to the R ventricle. Afterload is the resistance the blood has to overcome when leaving the heart.

37. Calcium channel blocker affects the afterload. 38. for a CABG operation when the great saphenous vein is taken it is turned inside out due to the valves that are inside. 39. unstable angina is not relieved by nitro. 40. dead tissues cannot have PVCs(premature ventricular contraction. If left untreated pvcs can lead to VF (ventricular fibrillation). 41. 1 t (teaspoon)= 5 ml 1 T(tablespoon)= 3 t = 15 ml 1 oz= 30 ml 1 cup= 8 oz 1 quart= 2 pints 1 pint= 2 cups 1 gr (grain)= 60 mg 1 g (gram)= 1000 mg 1 kg= 2.2 lbs 1 lb= 16 oz * To convert Centigrade to F. F= C+40, multiply 9/5 and substract 40 * To convert Fahrenheit to C. C= F+40, multiply 5/9 and substract 40. 42. angiotensin II in the lungs= potent vasodialator. Aldosterone attracts sodium. 43. REVERSE AGENTS FOR TOXICITY heparin= protamine sulfate coumadin= vitamin k ammonia= lactulose acetaminophen= n-Acetylcysteine. Iron= deferoxamine Digitoxin, digoxin= digibind. Alcohol withdraw= Librium. - methadone is an opioid analgesic used to detoxify/treat pain in narcotic addicts. - Potassium potentiates dig toxicity. 44. heparin prevents platelet aggregation. 45. PT/PTT are elevated when patient is on Coumadin 46. cardiac output decreases with dysrythmias. Dopamine increases BP. 47. Med of choice for Vtach is lidocaine

48. Med of choice for SVT is adenosine or adenocard 49. Med of choice for Asystole (no heart beat) is atropine 50. Med of choice for CHF is Ace inhibitor. 51. Med of choice for anaphylactic shock is Epinephrine 52. Med of choice for Status Epilepticus is Valium. 53. Med of choice for bipolar is lithium. 54. Amiodorone is effective in both ventricular and atrial complications. 55. S3 sound is normal in CHF, not normal in MI. 56. give carafate (GI med) before meals to coat stomach 57. Protonix is given prophylactically to prevent stress ulcers. 58. after endoscopy check gag reflex. 59. TPN(total parenteral nutrition) given in subclavian line. 60. low residue diet means low fiver 61. diverticulitis (inflammation of the diverticulum in the colon) pain is around LL quadrant. 62. Appendicitis (inflammation of the appendix) pain is in RL quadrant with rebound tenderness. 63. portal hypotension + albuminemia= Ascites. 64. beta cells of pancreas produce insulin 65. Morphine is contraindicated in Pancreatitis. It causes spasm of the Sphincter of Oddi. Therefore Demerol should be given. 66. Trousseau and Tchovoski signs observed in hypocalcemia 67. with chronic pancreatitis, pancreatic enzymes are given with meals. 68. Never give K+ in IV push.

69. mineral corticoids are give in Addisons disease. 70. Diabetic ketoacidosis (DKA)= when body is breaking down fat instead of sugar for energy. Fats leave ketones (acids) that cause pH to decrease. 71. DKA is rare in diabetes mellitus type II because there is enough insulin to prevent breakdown of fats. 72. Sign of fat embolism is petechiae. Treated with heparin. 73. for knee replacement use continuous passive motion machine. 74. give prophylactic antibiotic therapy before any invasive procedure. 75. glaucoma patients lose peripheral vision. Treated with meds 76. cataract= cloudy, blurry vision. Treated by lens removal-surgery 77. Co2 causes vasoconstriction. 78. most spinal cord injuries are at the cervical or lumbar regions 79. autonomic dysreflexia ( life threatening inhibited sympathetic response of nervous system to a noxious stimulus- patients with spinal cord injuries at T-7 or above) is usually caused by a full bladder. 80. spinal shock occurs immediately after spinal injury 81. Multiple sclerosis= myelin sheat destruction, disruption in nerve impulse conduction. 82. myasthenia gravis= decrease in receptor sites for acetylcholine. Since smallest concentration of ACTH receptors are in cranial nerves, expect fatigue and weakness in eye, mastication, pharyngeal muscles. 83. Tensilon test given if muscle is tense in myasthenia gravis. 84. Guillain-Barre syndrome= ascending paralysis. Keep eye on respiratory system. 85. parkinsons = RAT: rigidity, akinesia (loss of muscle mvt), tremors. Treat with levodopa. 86. TIA (transient ischemic attack) mini stroke with no dead brain tissue 87. CVA (cerebrovascular accident) is with dead brain tissue.

88. Hodgkins disease= cancer of lymph is very curable in early stage. 89. Rule of NINES for burns Head and Neck= 9% Each upper ext= 9% Each lower ext= 18% Front trunk= 18% Back trunk= 18% Genitalia= 1% 90. Birth weight doubles by 6 month and triple by 1 year of age. 91. if HR is <100 do not give dig to children. 92. first sign of cystic fibrosis may be meconium ileus at birth. Baby is inconsolable, do not eat, not passing meconium. 93. heart defects. Remember for cyanotic -3Ts( Tof, Truncys arteriosus, Transposition of the great vessels). Prevent blood from going to heart. If problem does not fix or cannot be corrected surgically, CHF will occur following by death. 94. with R side cardiac cath=look for valve problems 95. with L side in adults look for coronary complications. 96. rheumatic fever can lead to cardiac valves malfunctions. 97. cerebral palsy = poor muscle control due to birth injuries and/or decrease oxygen to brain tissues. 98. ICP (intracranial pressure) should be <2. measure head circonference. 99. dilantin level (10-20). Can cause gingival hyperplasia 100. for Meningitis check for Kernigs/ Brudzinskis signs. 101. Wilms tumor is usually encapsulated above the kidneys causing flank pain. 102. hemophilia is x-linked. Mother passes disease to son. 103. when phenylalanine increases, brain problems occur. 104. Bucks traction= knee immobility

105. Russell traction= femur or lower leg 106. Dunlap traction= skeletal or skin 107. Bryants traction= children <3y, <35 lbs with femur fx. 108. place apparatus first then place the weight when putting traction 109. placenta should be in upper part of uterus 110. eclampsia is seizure. 111. a patient with a vertical c-section surgery will more likely have another c-section. 112. perform amniocentesis before 20 weeks gestation to check for cardiac and pulmonary abnormalities. 113. Rh- mothers receive rhogam to protect next baby. 114. anterior fontanelle closes by 18 months. Posterior 6 to 8 weeks. 115. caput succedaneum= diffuse edema of the fetal scalp that crosses the suture lines. Swelling reabsorbs within 1 to 3 days. 116. pathological jaundice= occurs before 24hrs and last7 days. Physiological jaundice occurs after 24 hours. 117. placenta previa = there is no pain, there is bleeding. Placenta abruption = pain, but no bleeding. 118. bethamethasone (celestone)=surfactant. Med for lung expansion. 119. dystocia= baby cannot make it down to canal 120. pitocin med used for uterine stimulation 121. Magnesium sulfate(used to halt preterm labor) is contraindicated if deep tendon reflexes are ineffective. If patient experiences seizure during magnesium adm. Get the baby out stat (emergency). 122. Do not use why or I understand statement when dealing with patients 123. milieu therapy= taking care of patient/environment

124. cognitive therapy= counseling 125. crisis intervention=short term. 126. FIVE INTERVENTIONS FOR PSYCH PATIENTS -safety -setting limits -establish trusting relationship -meds -leas restrictive methods/environment. 126. SSRIs (antidepressants) take about 3 weeks to work. 127. Obsession is to thought. Compulsion is to action 128. if patients have hallucinations redirect them. In delusions distract them. 129. Thorazine, haldol (antipsychotic) can lead to EPS (extrapyramidal side effects) 130. Alzheimers disease is a chronic, progressive, degenerative cognitive disorder that accounts for more than 60% of all dementias