Académique Documents
Professionnel Documents
Culture Documents
Copyright © 2015 by Regina Callion- ReMar Review LLC Warren, Ohio Email: www.remarreview@gmail.com | www.remarreview.com
This book, or parts thereof, may not be reproduced in any form without permission, except in the case of brief quotations embodied in
critical articles or reviews. The scanning, uploading, and distribution of this book via the Internet or any other means without the permission
of the publisher is illegal and punishable by law. Please purchase only authorized electronic editions, and do not participate in or encourage
piracy of copyrighted materials. Your support of the author’s rights is appreciated
1
ReMar Online Academy Table of Contents
2
Best Bet for Kids
AGE ACTIVITY NCLEX Tips
0-6 mths
6-9 mths
9-12 mths
1-3 yrs
3-6 yrs
7-12 yrs
12-18 yrs
3
Best Bet Practice Questions
ReMar Review
A 8 yearS old is in the hospital for a broken leg. He requests some activities to
keep him busy. Which activities would the nurse bring into the client’s room after
breakfast?
A teenager is admitted to the hospital with influenza. The teenager refuses to let
his friends come to visit. As the nurse you know this is a result of what?
4
Normal and High Risk Newborn
ReMar Review
Rate
Respirations
Muscle
Appearance
(color)
Reflex (Irritability)
Eyes: _______________________________________________________
Temperature:_________________________________________________
Abdomen:_____________________________________________________
Skin:__________________________________________________________
1. Temperature
2. Heart rate
3. Respirations
4. Blood pressure
5
NORMAL & HIGH RISK NEWBORN
ReMar Review
signs/symptoms: _________________________________________________
_______________________________________________________________
NCLEX Question:
A nursing student is giving a mother who has A.I.D.S. an IM injection and accidentally sticks
herself while injecting the mother. What should she do immediately?
1) Ask the charge nurse for the report forms that need to be filled out.
2) Start antibiotic treatment
3) Start antibiotic AZT treatment
4) Finish passing all her am medications before leaving the floor.
6
High Risk Newborn
ReMar Review
C. Spina bifida
ReMar Tip: Nutrition is a major concern for both of these birth defects
7
Infant Heart Defects
ReMar Review
2. 2.
3.
4.
3.
Emergency Position:
Disease to know
NCLEX QUESTION: An infant with Tetralogy of Fallot is discharged with a prescription for digoxin elixir.
The nurse should instruct the mother to:
8
Age Specific Nursing Care
ReMar Review
No matter the age all patients have the same rights for:
1.
2.
3.
4.
5.
6.
� Privacy
1.
2.
Position properly before oral medications and feeding due to risk for aspiration.
#1 fear of children________________________________
#1 fear of adults__________________________________
ReMar Tip: When kids this age get sick they tend to regress!
9
Age Group: 13-18
Goals:
Psych Priority:
1.
2.
10
Age Group: 40-60
Primary Prevention
Tertiary Prevention
Psych concerns:
Goals
11
Age Group 60-up
1.
2. 1. Communication:
2.
3. Prevention
3.
1.
2.
3.
12
National Pressure Ulcer Advisory Panel states the following:
13
Stage IV Full-thickness tissue loss with destruction, tissue
necrosis, or damage to
muscle, bone, or supporting structures. There may be
sinus tracts, deep pockets of
infection, tunneling, undermining, eschar (black scab-
like material), or slough (tan, yellow, or green scab-like
material).
Note: The pictures are not ReMar Review’s I got them from this great website. Source:
http://facilitywebsource.com/page/pressure-ulcers.html
◯◯
14
PREGNANCY
ReMar Review
Example: LMP was April 14, 2000 Estimated due date: _____________
1.) gravidity-_________________________________________________
2.) parity-___________________________________________________
A woman has 4 children (2 singles and a set of twins) her parity=
1) Morning sickness-
2) Backache-
3) Leg cramps-
4) Diet-
5) Anemia-
6)Kegel’s exercises-
15
PREGNANCY
ReMar Review
2.) Pre-eclampsia-
Treatment:
16
PREGNANCY
ReMar Review
G.) Labor-
2)Stop when?
1) First Stage
-Pre-Labor-____________________________________________________
-Transition- ___________________________________________________
2) Second Stage-
-Pushing/Birth- __________________________________________________
3)Third Stage-
-Deliver Placenta-________________________________________________
__________________________________________________
4) Fourth Stage
-Recovery- _______________________________________________________
_______________________________________________________
17
Pregnancy
ReMar Review
A.)Reassuring
B.)Non-reassuring
18
Pregnancy
ReMar Review
A.)Post-partum Assessment
Client Teaching:
19
Diets
ReMar Review
Soft
Bland
Low Protein
Low Sodium
High Fiber
Low Purine
High Protein Elderly & burn patients Foods are red meat, fish, &
beans. This is the focus
Diabetic
Celiac’s
20
Expected Changes During Aging
ReMar Review
As we age our bodies undergo certain physiological changes that are a natural part of growing old.
Respiratory
Integumentary
Reproductive
Musculoskeletal
Genitourinary
Gastrointestinal
Nervous
Sensory Vision
Hearing
Taste
Smell
21
Basic Care & Comfort 1
ReMar Review
B. Nutrition
22
Basic Care & Comfort 2
ReMar Review
Signs:
Cardiac Changes:
Labs to watch:
USG: normal 1.000 to 1.030 increases
Urine color: dark yellow color
BUN/ creatine ratio: Normal ratio is 10:1 to 15:1. Ratios greater than 20:1 blood is not getting to
the kidneys so it is either Dehydration or CHF
Common Causes:
ReMar’s Tip: Oral hydration can be just as effective as IV hydration if started early
enough.
NCLEX TIPS:
1.
2.
3.
23
Basic Care & Comfort 3
ReMar Review
A: Urine
NCLEX QUESTION: Why are UTI more common in women than men?
1. Start with an __________ __________. Ask patient to void then throw away.
24
Basic Care & Comfort 3
ReMar Review
B. Bowel
Listen for bowel sounds in all four quadrants for __________ ____________
Definition of constipation
Definition of diarrhea
When doing any enemas or digital removal of impaction watch out for:
__________________________________________________________________________
Guaiac Test
The nurse administering an enema to a patient knows that the tip of the tubing should be inserted into
the rectum while the patient is in a sitting position, as on the toilet.
A. True
B. False
25
Orthopedics
ReMar Review
1) Canes- The cane moves with the __________ leg. Then the
___________ leg follows.
1) Casts- Use_____________ to handle during 1st 24 hrs.
2-point- Move left crutch with right foot then right crutch
with left foot.
4-point- Move left crutch, then right foot, then move right
crutch and follow with left foot.
26
ORTHOPEDICS
ReMar Review
leg.
PO Crushed-
Liquid-
Ear Adult-
Child-
Enema
Eye
Gastric Tube
IM
Topical
Meds that……
Change color of urine
Change color of stool
Should always be
refrigerated
Should never be refrigerated
28
Antibiotics
ReMar Review
1.Aminoglycosides
2.
3.Tetracyclines
29
Central Lines
ReMar Review
Very Important to know what kind of line your patient has end in vena cava
Port-a-cath
Both are verified with a chest xray!
30
Total Parenteral Nutrition
ReMar Review
31
Pain Management
ReMar Review
Pain is _____________________.
Rating Technique
Adults
Babies/Children
Idiopathic Pain:
Patients ask for pain meds before time?
Give before ________________________________________________________________--
ReMar Tip: This is a lot of stuff to learn but you are doing great!
32
Substance Abuse
ReMar Review
Withdrawal symptoms:
Treatment:
Names to know
Wernicke’s syndrome:
Korsafoff’s psychosis:
Librium:
Room Assignment:
B. Narcotics-
Room Assignments:
Treatment:
33
Tonicity of IV Fluids
ReMar Review
Tonicity means:
Tonicity IV fluids
Hypotonic
Hypertonic
Isotonic
34
Blockers
ReMar Review
ACTION
EFFECTS
CONTRAINDICATIONS
4___________________
35
Easy NCLEX LABS
ReMar Review
36
Mg Important for nerves, muscles helps 1.6-2.6 mEq/L
neutralize acid in the stomach
Milk of magnesia
Creatinine Kidney test from muscle that has been 0.6-1.3 mg/dL
metabolized to waste products
High creatinine signals renal
failure
30-45 seconds
37
Partial Thromboplastin Blood thinner 1.5-2x longer
Time
ASPIRIN
38
Easy Electrolytes
ReMar Review
Potassium
3 T’s
Tetany
Calcium Twitches
Trousseau’s sign
What glands help absorb
calcium?
Magnesium
soDium sOdium
Sodium
Think _______
Lithium
39
DIABETES INSIPIDUS VS SYMPTOM OF INAPPROPRIATE ADH
ReMar Review
40
Positions
ReMar Review
Dorsal Recumbent
Fowlers
Lateral
Lithotomy
Prone
.
Supine
Trendelenburg
41
Disaster Management
ReMar Review
Triage:
42
Herbal Medications
ReMar Review
Garlic
Ginko Biloba
Echinacea
Ginger
Black Cohosh
43
Herbal Medications Practice Questions
ReMar Review
A. Your client is receiving chemotherapy for stage 1 prostate cancer. You ask him
to list his home medications, which herbal drug would you be concerned about?
1. Ginger
2. St. John’s Wort
3. Kava Kava
4. Echinacea
B. Your client is newly diagnosed with hemophilia. You are doing your education
on herbal medications and their drug interactions, which statement indicates your
client needs further instruction?
44
You are doing great!
THINK R.O.M.E.!
A.) How would you interpret this blood gas? pH 7.48 PaCO2 33 HCO3 30 PaO2 72
B.) How would you interpret this blood gas? pH 7.50 PaCO2 24 HCO3 16 BE-3
C.) How would you interpret this blood gas? pH 7.32 PaCO2 35 HCO3 18 PaO2 89
46
Blood Gas Interpretation Words
ReMar Review
47
Critically Think:
1) Which blood gas value would you expect to see in a client with acute renal
failure?
2) Which blood gas value would you expect to see in a client who was
hyperventilating?
3) Which blood gas value would you expect to see in a client who had
continuous gastric suctioning?
4) Which blood gas value would you expect to see with depressed respirations
from a drug overdose?
5) Which blood gas value would you expect to see in a client who entered into
a marathon and ran for 40 hours straight?
6) Which blood gas value would you expect to see in a client who currently has
a blood glucose level of 6?
48
CHEST TUBES
ReMar Review
Blood pressure
Heart rate
Lung expansion
Oxygenation
Jugular Veins
Deviated trachea and distended neck veins are late signs due to restricted blood flow.
B.) Chest tube Setup: All chest tube systems have these three chambers
Bubbling Bubbling
Continuous Continuous
Intermittent Intermittent
50
Chest Tubes
ReMar Review
________________.
51
Chest Tubes
ReMar Review
What kind of lung sounds would you expect to hear with a patient who needs a
chest tube?
When caring for a client with a chest tube what should the nurse do to evaluate
the effectiveness of the chest tube?
What should be done once the fluid in the water seal chamber no longer
fluctuates with inspiration/expiration?
After a patient has his chest tube removed by the physician which dressing should
the nurse have ready to place over the incision site?
52
Vent Alarms
ReMar Review
Youtube Help
H High Alarm
O Obstruction
L Low Alarm
D Disconnection
53
Congestive Heart Failure
ReMar Review
A.) CHF happens when the heart can’t pump enough blood to meet the
body’s needs.
B.) Tests
1.
2.
3.
C.) Medications
1.
2.
3.
4.
54
Congestive Heart Failure Practice Questions
1. Mr. Green is scheduled to receive furosemide 60mg IV BID for a diagnosis of congestive heart failure. The
medication will have which of the following effects? Select all that apply.
2. A 62 years old client presents with dyspnea and blue colored nails and lips. The client has a suspected
history of congestive heart failure and is admitted to emergency room. The client has not been compliant
with his medication regimen and states he has not taken his hydrochlorothiazide for 4 days. The nurse
should anticipate a diagnosis of which of the following?
Pneumonia
Pulmonary edema
Pneumothorax
Atelectasis
3. The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse
should check the:
Feet
Neck
Hands
Sacrum
Irregular pulse
4. You are teaching the parents of a child with congestive heart failure about fluid intake. Which statement
indicates understanding of monitoring fluid retention?
I will calculate all of the fluids that my child drinks as this is the best method to monitor fluid retention.
I will weigh each diaper daily as this is the best way to monitor fluid retention.
I will weigh the child each day at the same time as this is the best way to determine fluid retention.
I will listen to the lungs with my stethoscope as this is the best way to monitor fluid retention.
5. A client comes into the wellness clinic after being diagnosed with congestive heart failure. She complains of
becoming tired after only very little activity. Which activity suggestion would the nurse give to preserve energy and
decrease oxygen demands?
Setting a specific time during the day and accomplishing all daily tasks at one time.
Eating small frequent meals throughout the day.
Removing oxygen therapy during rest to build up a tolerance without it.
Exercise shortly after waking up in the morning when energy levels are highest.
55
Diagnostic Procedures
ReMar Review
Lumbar Puncture-__________________________________________________
Position_____________________________________________________
Pt. Teaching__________________________________________________
M.R.I.-____________________________________________________________
Position______________________________________________________
Pt. Teaching___________________________________________________
C.T.-_______________________________________________________________
Position______________________________________________________
Pt. Teaching__________________________________________________
EGD-______________________________________________________________
Position_______________________________________________________
Pt. Teaching___________________________________________________
Liver Biopsy-________________________________________________________
Position_______________________________________________________
Pt. Teaching___________________________________________________
Thoracentesis-_______________________________________________________
Position_______________________________________________________
Teaching______________________________________________________
56
LOWERING CHOLESTEROL
ReMar Review
The goal of therapy is to lower __________ _______________ and
_________________.
How to treat:
57
Ear Spotlight
ReMar Review
Meniere’s Disease: A _______ disease that occurs in the ______ ear resulting in
too much endolymphatic fluid.
Many factors: Viruses, Bacteria, allergies etc.
The cause of Meniere’s is __________.
3 main symptoms:
Diagnosis:
Diet:
Treatment:
Medical-
Surgical-
NCLEX Prep:
58
Diabetes Overview
ReMar Review
1. Age
2. Is body producing
insulin
3. Insulin dependent
4. Ketone production
- -
5. Treatment - -
- -
B.) Signs/Symptoms:
59
Diabetes Overview
ReMar Review
C.)Complications of Diabetes
Signs
D
Treatment
60
Diabetes Overview
ReMar Review
D.)Complications cont.
Cause
Signs
Treatment
1.) Hemoglobin A1C is a blood test used to determine blood sugar control
over___________ months. You want it to be less than______________.
61
Diabetes Overview
ReMar Review
Rapid Novolog
Short Novolin R
(Regular)
Intermediate NPH
Contraindicated Meds
1.
2.
3.
1) Diet
2) Exercise
62
Endocrine Review
ReMar Review
Hyperthyroidism Hypothyroidism
Signs: Signs:
Treatment: Treatment:
Precautions: Levothyroid/Synthroid
Or
63
Nursing Care: Nursing Care:
64
ENDOCRINE REVIEW
ReMar Review
Signs/symptoms: _____________________________________________________
__________________________________________________________________________
Treatment: ___________________________________________________________
(Remember never abruptly stop taking steroids teach client to taper the drug off)
65
THERAPEUTIC COMMUNICATION
ReMar Review
The purpose of using these strategies is to help your client express their feelings more
effectively.
Do This:
Don’t Do This:
Giving ________________________opinions
Changing _______________ _________________
____________________reassurance
________________________ with the client
On NCLEX Choose……
Never ask _________________________.
Open ended questions
Answers that focus on feelings
Answers that reflect or rephrase what client is saying
66
THERAPEUTIC COMMUNICATION
ReMar Review
Digoxin Parameters
Age Hold
Newborn
1-3 years
3-8 years
8-adult
Drug Antidotes
Needle Information
Intradermal
IM
67
Psych
ReMar Review Lesson
A.) Depression/Mania
Depression Mania
Signs
Similarities
Treatments
1) Delusions-
2) Hallucinations-
3) Neologism-
4) Echolalia-
5) Flight of Idea-
68
Psych
ReMar Review
Nursing Care:
3) __________________ _______________________________________.
4) ___________________ ______________________________________.
1.) Anxiolytics
2._______________________________________________________________
3._______________________________________________________________
4._______________________________________________________________
5._______________________________________________________________
69
Psych
ReMar Review
*Compazine and Promethazine in smaller
doses can be used as anti-emetics.
2.) Phenothiazines-
Route:
Examples of typical psych drugs: Haloperidol (haldol) Thiothixene (navene) Perphenazine (trilafon),
Chlorpromazine (thorazine)
Nursing Assessments:
Nursing Care:
70
Psych
ReMar Review
Examples: Clozapine (clozaril) Olanzapine (zyprexa) Risperidone (resperda) Quetiapine (seroquel) Aripiprazole
(abilify) KNOW THESE MEDICATIONS!
1)
2)
3)
ReMar’s NCLEX tip: When your patient is on an atypical antipsychotic medication monitor them for
agranulocytosis (low WBC’s). If they have agranulocytosis they will complain of fever, body aches,
chills, sore throat etc. Basically signs of the flu
71
Psych
ReMar Review
4.) Antidepressants
These drugs block M.A.O. enzyme that breaks down epinephrine, dopamine,
serotonin which leads to depression. They also block tyramine which puts client at
risk for a hypertensive crisis.
Mar____________
Nar____________
Par____________
_________________________________________________________________
__________________________________________________________________
72
Psych
ReMar Review
Grains
Vegetables
Fruits
Dairy
Sweets/Oils
Condiments
73
Psych
ReMar Review
5.) Antidepressants
-S.S.R.I. (Selected Serotonin Reuptake Inhibitors)
These drugs inhibit the reuptake of serotonin.
Side Effects:
_________________________________________________________________
__________________________________________________________________
Prozac-
Celexa-
Zoloft-
Effexor-
Contraindications:
Client Teaching:
1)_________________________________________________________________
2) All S.S.R.I. may cause _______________________________________________
Symptoms: S A D Head
74
EKG Overview
ReMar Review The NCLEX may give you a question with rhythm
strips that look just like this. You must be able to
identify what they are and/or treatment.
Rules: _No treatment needed for this patient, do not give any meds_
75
The saw tooth pattern looks like shark teeth. So
Atrial Flutter= ____________________________________ think I see a shark and my heart flutters!
Ventricular: variable
Ventricular irregular
**Slow the ventricular rate by using: diltiazem, verapamil, digitalis, or beta blocker
76
Ventricular Tachycardia= ________________________________________
Ventricular: 100-200
6. What is the length of the QRS Wide greater than 0.10 sec
complexes
Treatment: ___________________________________________________
Asystole= ___________________________________________________
Treatment: __________________________________________________
*If the monitor says asystole but the patient is clearly alive then check for
__________________ _____________________________
A client is having frequent premature ventricular contractions. A nurse would place priority on
assessment of which of the following items?
ReMar Review Youtube Channel has free videos on: Sinus, Atrial, & Ventricular Tachycardia
78
Isolation Precautions
ReMar Review
Contact Disease:
__________________________________________________________________
Droplet Disease:
__________________________________________________________________
Airborne Disease:_______________________________________________
Cohort Tip:
79
ISOLATION PRECAUTIONS
ReMar Review
Pick the precaution (standard, contact, droplet, airborne) for each disease.
Disease Precaution
AIDS
Diarrhea
Hepatitis C
C-difficile
Rota virus
Shigellosis
Head Lice
Epiglottitis
Influenza (seasonal)
Meningitis
Monkey Pox
Rubeola (Measles)
80
Isolation Practice Questions
ReMar Review
A nurse manager reports for duty and has to evaluate each nurse’s assignment. A nurse
has a client with A.I.D.S. and the nurse manager is evaluating his care by the healthcare
team. She should intervene when she sees which situation?
A 7 year old client is being admitted to the pediatric unit. What personal protective
equipment must be placed outside the room when the nurse sees the client is
diagnosed with varicella?
A. Standard
B. Droplet
C. Contact
D. Airborne
A. Standard
B. Droplet
C. Contact
D. Airborne
81
ACCIDENT & ERROR PREVENTION
ReMar Review
B. Error Prevention
1. Restraints-
Prescriptions have
1.
2.
3.
4.
2. Charting-
3. Incident Reports
82
CASE MANAGEMENT
ReMar Review
*This makes sense because nurses are on the front lines doing the most assessment,
they are able to tell what the patient needs.
Collaboration means working with MD, OT, RT, PT, & Social workers.
NCLEX QUESTION:
1. A 14 years old male is newly diagnosed with cystic fibrosis. The nurse is a team
manager along with a physician, respiratory therapist, and social worker. Which of
the following actions represents the nurse’s role as a patient advocate?
83
LEGAL EAGLE
ReMar Review
___________________________________________________________________
84
Delegation
ReMar Review
RN
LPN Aide
No:
85
Delegation Practice Questions
ReMar Review
A. Who would be the most appropriate to feed a confused elderly client who can become combative?
1.) RN
2.) LPN/LVN
3.) Nurse’s Aide
4.) Physical Therapist
B. Who would be most appropriate to assist a client ambulating down the hall for the first time after a
hip replacement?
1.) RN
2.) LPN/LVN
3.) Nurse’s Aide
4.) Speech Therapist
C. Your client is terminally ill and only is expected to live a few hours. The doctor orders comfort care
only. The client requests a bath, what is the best response by the nurse.
1. “I will give you a bath as soon as I pass my morning medications.”
2. “I will have the senior nursing student bath you this morning.”
3. “I am afraid a bath will not be needed today as you have no visitors.”
4. “ I will have the LPN bath you and then care for you the rest of the day.”
D. As part of the nurse’s aide daily tasks she should complete the following tasks.
Select all that apply
E. A nurse is caring for a client with increased intracranial pressure, the client suddenly becomes
unresponsive. A code is called and the nurse calls for assistance, who is most appropriate to gather the
code cart?
86
Prioritization
ReMar Review
All the answers will seem right but only one is the PRIORITY
A.) Example: A new nurse working in the emergency room department reports for
duty. Four patients arrive at the same time, who should she see first?
1) A 100 years old female with a temperature of 102 and diarrhea.
2) A 55 years old male with severe abdominal pain from a kidney stone.
Reverse Priority
1.
2.
3.
Go over answers
87
Priority Practice Questions
ReMar Review
1. You are a nurse working in the emergency department at your local hospital. Four patients
approach the triage desk at the same time. List the order in which you will assess these patients.
a. A 50 years old female with moderate abdominal pain and occasional vomiting
b. A 9 years old irritable female with a nuchal rigidity, petechiae, and a fever
c. A 22 years old jogger with a twisted ankle, having a pedal pulse and no bruising
d. A 19 years old male with a bandaged head wound
2. A nurse has just finished inserting an indwelling catheter and checked that it was in the
proper position. Which is the priority nursing action?
A. Collect a sterile urine specimen while the tubing is free from bacteria and first urine
is available.
B. Document the procedure in a nursing note.
C. Check the patient’s vital signs to assess whether the procedure was tolerated well.
D. Delegate to the unlicensed personnel staff to record the amount of collected urine
to assess the effectiveness of the indwelling catheter.
3. These patients present to the ED complaining of acute abdominal pain. Prioritize them in order
of severity.
A. 22 years old college student complaining of severe, intermittent cramps with three episodes of
watery diarrhea, 2 hours after eating
B. A 22 years old female with a low-grade fever, left lower quadrant tenderness, nausea and an
inability to eat for the last 3 days. COLON
C. A 12 years old female with moderate left upper quadrant pain, vomiting small amounts of yellow
bile, and worsening symptoms over the past 3 days LIVER PANCREAS STOMACH LFT KIDNEY
D. A 56 years old male with a pulsating abdominal mass and sudden onset of pressure-like pain in
the abdomen and flank within the past hour
______ , ______, _______, _______
88
Priority Practice Questions
ReMar Review
A. Administer the pain medication as prescribed to keep the pain level within normal range
B. Administer the packed red blood cells to prevent hemorrhaging
C. Check the bandage for excessive drainage
D. Check the IV placement for patency in case of an emergency situation
THE NEXT QUESTION IS BASED OFF OF QUICK FACTS 2.0 YOU ALL SHOULD GET IT RIGHT!
5. A new nurse is preparing to administer blood to a client. The nurse verifies the order
and the client’s blood type. The nurse should use which of the following to administer
the blood.
6. A 3 year old is admitted to the emergency room with a sudden temperature of 102. F,
sore throat, and drooling saliva. The child is leaning forward and will not lie down for an
exam. Which of the following should the nurse do next?
89
Tips to Master NCLEX
ReMar Review
90