MORE NCLEX PREP

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MORE NCLEX PREP

• Positioning
• Management of Care
• Terminology

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Position Questions

• Remember way back to issues of immobility
• Ask yourself Are you preventing or promoting?
• Think about A and P---Review Texts!!
• Position terms--more memorization!

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Terms to remember

• Position
• Flat-supine
• Dorsal recumbent
• Side lateral
• Sims
• Fowlers

• Reason
• No hip flexion,better blood low
• Supine, knees bent-comfort
• Oral secretion drainage
• Oral secretion drainage,?abd. Tension
• ?venous return, lung expansion

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• Feet, Legs elevated
• Trendelenburgs
• Modified Trendelenburgs
• Extremity elevation
• Lithotomy
• Prone
• Knee-chest

• ?Blood return, ? pressure to lumbarsacral area
• CVP insertion
• ? venous return, used in SHOCK
• ? venous return, ?Blood return to extremity
• ? vaginal opening
• ? hip extension, hard in ?, resp. failure
• ? visualization of rectum

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Tips regarding positioning questions..

• Dont know? Cant remember THINK about the
  procedure, figure it out
• Do some memorizing.LIST!
• Use A and P concepts to think through
• Picture it. Visualize the position.

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Examples.

• The nurse cares for a 36 year old woman after a
  lumbar laminectomy. Which of the following
  statements BEST describes the method of turning a
  patient after a lumbar lami?

• A. HOB is ?30, pt. locks knees when turning.
• B.Pillow placed between legs, body turned as
  unit.
• C.Pt. straightens back, grasps side rail on
  opposite side of bed.
• D.HOB is flat, Pt. bends knees, rolls to side.

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Strategies.

• Are we promoting or preventing anything?
• Promoting a straight back
• Think A and P . A lami . Removes one or more
  vertebral laminae. Post lami, back needs to be
  straight.
• Which answer promotes straight back?

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Again...

• The nurse cares for a 36 year old woman after a
  lumbar laminectomy. Which of the following
  statements BEST describes the method of turning a
  patient after a lumbar lami?

• A. HOB is ?30, pt. looks knees when turning.
• B.Pillow placed between legs, body turned as
  unit.
• C.Pt. straightens back, grasps side rail on
  opposite side of bed.
• D.HOB is flat, Pt. bends knees, rolls to side.

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One more on positioning.

• The nurse cares for a 38 yo man post
  -appendectomy. The pt. continues to complain of
  discomfort after receiving a narcotic. Which of
  the following measures would be MOST appropriate
  for the nurse to do?

• A. Notify the physician.
• B. Place the pt. in Fowlers position.
• C. Massage his abdomen.
• D. Provide him with reading material.

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Management of Care

• Huge issue..per feedback, many questions..

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Whos in charge here?

• Delegation
• Supervision
• Rules of Management

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Very specific NCLEX Rules..

• 1. Do not delegate the functions of
• Assessment
• Evaluation
• Nursing judgement
• You cannot give those responsibilities to someone
  else...

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Management Rules.

• 2. This is not the Real World!!!
• In the test environment its Ivory Tower
• Time
• Ask yourself, Is this textbook nursing???????

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More Rules to go by.

• 3. Delegate activities for stable, predictable
  patients.
• If there is instability or if youre not sure of
  outcome..
• Dont delegate !!!

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Rules of the road.

• 4. Delegate activities that involve standard,
  unchanging procedures.
• Examples
• bathing, feeding, dressing,
• transferring of patients
• any complexity, complicatedness--DONT
  DELEGATE!!!!!

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One more.

• Remember Priorities..When deciding what to
  delegate
• Maslows hierarchy
• the ABCs
• Safety
• Stable vs Unstable

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TIP

• You can only see one patient and do one activity
  at a time when searching for correct NCLEX
  answer.
• ( No multi-tasking!)

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More, more, more..

• Which of the following tasks is appropriate for
  the nurse to delegate to an experienced nurse
  assistant?
• A. Obtain a 24 hr. diet recall from a newly
  admitted Pt. with anorexia nervosa.

• B. Obtain a clean catch urine specimen for a Pt.
  with a possible UTI.
• C. Observe the _at_and characteristics of the
  returns from continuous bladder irrigation for a
  post-op TURP. Pt.
• D. Observe a newly diagnosed diabetic Pt.
  practice shots into an orange.

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Practice makes perfect.

• Which of the following patients should the nurse
  on a pediatric unit assign to an LPN?
• A. 3 yo F admited with a larnygotracheogronchtiss
  who has a tracheostomy.

• B. A 5 yo F admitted after a gastric lavage for
  Tylenol ingestion.
• C. A 6yoM admitted for a fracture of the femur in
  balanced suspended traction.
• D. A 10 yo boy admitted for observation after an
  asthma attack.

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Prioritizing..

• A home care nurse is planning her visits for the
  day. Which of the following patients should the
  nurse visit first?
• A. a 62 yo man 2 days after an inguinal hernia
  repair.

• B. A 40 yo F with type I diabetes with a foot
  ulcer.
• C. A 76 yo M with chronic COPD.
• D. A 50 yo F three days after a right mastectomy?

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One more...

• After receiving report from the night shift
  nurse, which of the following patients should the
  nurse see first?
• A. A 31 yo F refusing Carafate before breakfast.

• B. A 40 yo M with left sided weakness asking for
  assistance to the bedside commode.
• C. A 52 yo F complaining of fever and chills who
  is scheduled for surgery.
• D. A 65 yo M with a NG tube who had a bowel
  resection yesterday.

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TERMS AND ABBREVIATIONS...
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ACETONURIA

• ACETONE IN THE URINE

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CHOLURIA

• BILE IN THE URINE

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DIPLOPIA

• DOUBLE VISION

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ENURESIS

• BED-WETTING

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Abduction

• To move away from the midline

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DYSURIA

• Painful urination

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CORYZA

• WATERY DRAINAGE FROM THE NOSE

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FETID

• FOUL SMELLING

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EMETIC

• AGENT GIVEN TO PRODUCE VOMITING

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ERUCTATION

• BELCHING

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HELIOTHERAPY

• USING SUNLIGHT AS A THERAPEUTIC AGENT

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LOCHIA

• DRAINAGE FROM THE VAGINA AFTER DELIVERY

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ASPHYXIA

• SUFFOCATION

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EUPNEA

• NORMAL BREATHING

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ANKYLOSES

• STIFF JOINT

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GAVAGE

• FORCED FEEDING THROUGH A TUBE IN THE STOMACH

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MUCOPURULENT

• DRAINAGE CONTAINING MUCOUS AND PUS

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GUSTATORY

• DEALING WITH TASTE

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GLYCOSURIA

• GLUCOSE IN THE URINE

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ACTH

• ADRENOCORTICOTROPHIC HORMONE

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EXOPHTHALMOS

• ABNORMAL PROTRUSION OF THE EYEBALL

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HEMOPTYSIS

• SPITTING OF BLOOD

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ACS

• Acute compartment syndrome

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MENORRHAGIA

• PROFUSE MENSTRATION

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Ca, ca

• Calcium, Cancer

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MYDRIASIS

• DIALTION OF PUPIL

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PEDICULI, PEDICULOSIS

• LICE

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PRONATION

• TO TURN DOWNWARD

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MONOPLEGIA

• PARALYSIS OF ONE LIMB

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HYPERNEA

• RAPID BREATHING

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PTOSIS

• DROOPING EYELID

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ACE

• ANGIOTENSIN CONVERTING ENZYME

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ANA

• ANTINUCLEAR ANTIBODY

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STERTOROUS

• SNORING

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SUPPURATING

• DISCHARGING PUS

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D C

• DILATION AND CURETTAGE

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CMV

• CYTOMEGALOVIRUS INFECTION

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STRABISMUS

• SQUINTING

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MICTURATE

• URINATE

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CAPD

• CONTINUOS AMBULATORY PERITONEAL DIALYSIS

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VESICLE

• FLUID FILLED BLISTERS

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AFP

• ALPHA-FETOPROTEIN

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BSA

• BODY SURFACE AREA

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URTICARIA

• HIVES OR WHEALS, ERUPTION ON SKIN OR MUCOUS
  MEMBRANES

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PAROXYSM

• COMING IN SEIZURES

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APC, VPC

• ATRIAL PREMATURE CONTRACTION, VENTRICULAR
  PREMATURE CONTRACTION

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PND

• PAROXYSMAL NOCTURNAL DYSPNEA

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ALL

• ACUTE LYMPHOCYTIC LEUKEMIA

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CTS

• CARPAL TUNNEL SYNDROME

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DJD

• DEGENERATIVE JOINT DISEASE

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HLA

• HUMAN LEKOCYTE ANTIGEN

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ESRD

• END STAGE RENAL DISEASE

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HHNC

• HYPERGLYCEMIA HYPEROSMOLAR NONKETOTIC COMA

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NSAIDS

• NONSTEROIDAL ANTI-INFLAMATORY DRUGS

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IBS

• IRRITABLE BOWEL SYNDROME

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KS

• KAPOSIS SARCOMA

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MAO

• MONOAMINE OXIDASE INHIBITORS

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OS, OD, OU

• OS- LEFT EYE
• OD- RIGHT EYE
• OU-BOTH EYES

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PAD

• PERIPHERAL ARTERY DISEASE

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WHO

• WORLD HEALTH ORGANIZATION