‫اوليس يجزي محسن اال باحسان‬

‫طمئن قلوب الناس ‪ .....‬أن الناس للناس‬

‫تحديث ‪15.01.2021‬‬

‫للملف تحديث اسبوعيا‬

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 ‫اوليس يجزي محسن اال باحسان‬
Question of 31.12.2020

1. Emphysema with hypercabnia appropriate oxygen treatment?!

20% via venture mask

2. Post operative patient with fracture is complaining of tingling and pain in his leg what the nurse action ?! Call the

doctor

3. Jaundice in the first 24 hours?! ABO compatibility

4. Newborn not able to stool meconium when immediate intervention?! 24 hours

5. What is the relationship between BLS & ALS ?! Maintain patent airway

6. Which organism make diarrhea in children?! Rota virus.

7. Relationship between HIV & AIDS?! Any-one can has HIV and progress to AIDS.

8. How to check the olfactory nerve for the patient?! Give him something he know and let him to smell

9. Early signs of increase intracranial pressure?! Restlessness and agitation

10. Patient have fever 38.8 and and urine specific gravity 1030 what nursing diagnosis?! Fluids volume deficit related to

fever

11. Patient came to the hospital with cataract what should I ask about?! Corticosteroid medications.

12. Patient with head stroke what’s the nursing diagnosis?! Fluid volume deficit

13. Situation about DKA?! 3 questions

(- symptoms )

( - priority assessment)

(- health teaching)

14. Situations about DVT?!

1- Risk factor of DVT. * patients immobility. * oral contraceptives pills. * obesity

2- How to prevent DVT?! * according to the selection

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15. Cerebellum responsible for Balance & posture

16. Situation about ( the patient with RS brain injury and left side deficit and dysphagia)

1- Nursing interventions (NPO , Swallowing )

2- Dysphagia complications all ( Neck Stiffness)

3- Which exercises will suitable for the patients. ( Comb hair and brush teeth)

17. Patient with UTI how to check the temperature?! Orally with glass thermometer

18. Patient take blood transfusion and has tachycardia, rash and dyspnea what the nurse action?! Stop transfusion and

inform the doctor

19. Normal range of potassium. 3.5 – 5.3

20. PH normal range. 7.35 – 7.45

21. Definition of P – Wave. Atrial depolarization

22. Temperature of enema. 99.9 F. ( 37.8 C )

23. What’s the goal between pulmonary edema and heart failure?! Increase Cardiac output ( repeated 2 times)

24. Pregnant woman complains that she can’t sleep at night as a nurse which suitable position?! Semi- Fowler position

25. Position after liver biopsy. Right- side position

26. Health education for miners disease patient. Move slowly when getting from the bed

27. Patient loss 400-500 ml of blood what’s indicated?! Decrease hematocrit & hemoglobin

28. Doctor inform the nurse that we will replace the patient from heparin to warfarin when can she stop heparin?!

Check INR therapeutic range

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29. Who determine fecal occult blood in stool?! Stool guaiac test

30. Which solution decrease osmosis pressure?! Hypertonic solutions

31. First sign of ineffective gas exchange. Restlessness

32. In respiratory problems what’s the priority nursing diagnosis?! Ineffective gas exchange

33. Priority nursing intervention for patient in febrile seizures. Maintain patent airway

34. Nursing intervention during seizures. Remove furniture and hazard objects

35. Patient with tracheostomy and it dislodge after put sterile dressing what’s the nurse should do ?! Use bag mask on

the mouth

36. How we can check if there is substance emphysema in patent with chest tube?! Palpate crepitus around chest tube

37. Definition of health promotion. Process of improve health and well

38. How to monitor fluid deficit?! Check intake and output

39. Patient with pernicious anemia which medication will take?! Vitamin B12

40. Patient with micro static anemia what should the nurse ask patient about?! Iron intake

41. Patient with calcium level is 22 which medication will take?! Calcitonin

42. In COPD patients why we not give high oxygen?! It increase the possibility to O2 toxicity

43. Who is responsible for the respiratory process?! Carbon dioxide

44. Patient with rheumatic fever. Increase ASO – Titer

45. Which bacteria cause glomerulonephritis. Group A- Streptococcus

46. Peptic perforation ulcer signs. Rigid & tender the abdomen

47. Shock definition. In adequate tissue perfusion

48. Nurse give the patient oral drug what should the nurse do?! Waiting with the patient until swallowing the

medication with water

49. After hysterectomy who do BSE?! Same day ever month

50. What’s the objective nurse observation?! Cloudy urine and fail smelling

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51. In the psychiatric unit the nurse talk with the patient about his childhood the patient started to talk about his work.

Loss of association

52. First aid KIT. With breakable key , disposable content and drugs with uses and functions

53. Paracetamol antidote. Acetylcystaine

54. After head trauma when the ICP increase?! From 24-72 hours

55. Patient with bed sores, obese and immobile what nursing diagnosis?! Impaired skin integrity related to immobility

56. The beast way to insure adequate breast feeding. The numbers of the diapers changed daily

57. Which help the nurse in the care plan?! The doctor and medical reports

58. In which situation need more standard precautions?! Vomiting the patient in chemotherapy session

59. Nurse assigned to HIV patient what should the nurse do?! Give the care for the patient and follow standard

precautions

60. Physician order pain medication which medicine should the nurse ask about?! Tramadol 500 mg twice per day

61. Patient came to emergency in car accident due to alcohol consumption, what should the nurse ask?! The last time

that the patient drink alcohol

62. Patient with osteoporosis what should the nurse expected in the care plan?! Weight bearing exercise

63. Child swallowing marble what indicates the child has total obstruction?! In ability to speak

64. Which patient can has orthostatic hypotension?! Patient in anti- hypertensive medication

65. After thoracentasis what’s the priority?! Change breath pattern

66. Signs of meningitis in newborn?! Fontanels bungle

67. As a nurse you heard the doctor talk to a senior nurse about the patient in front of the relative. Inter in the end of

taking and tell them about ( patient confidentiality)

68. Question about the nurse competency ?! Infection control

69. 65 old patient came to hospital with vomiting and diarrhea , the patient in diuretic and has hypokalemia what’s the

priority?! Insert IV cannula

70. Protrusion of CSF and spinal cord. Mylomeningiocyle

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71. Definition of thrombocytopenia. Abnormal low level of platelets

72. What should the nurse do to prevent air embolism all true expect. Make IV slowly infusion

73. Patient blood group is B -Ve take blood transfusion from B- Ve & O -Ve

74. Suprapubic catheter description. Thin and sterile insert to abdomen above pelvic bone directed in the bladder

75. Patient obese , cough and vomiting what’s the post operative complications. Wound dehiscence

76. When the nurse empty the urine bag what should do?! Observe check any kicking

77. Patient with ulcerative colitis what should do?! Monitor weight

78. Health education for the patient with cataract. Don’t pending and carry heavy

79. Instructions for the patient going to do ECG?! Restrict any drinks contain caffeine for 8 hours

80. Definition of multiple sclerosis ( not remember try to solve this question)

81. What should check for children after tonsillectomy?! Frequent swallowing

82. Patient will take penicillin and the nurse noted that the patient has allergies. Hold and inform the doctor to charge it

83. Types of primary prevention. Immunization

84. New equipment the nurse will use for the patient she don’t know how to use , what to do?! Read manual

instructions

85. Precautions for burn patients. Reverse isolation

86. Definition of chasmal breathing. Deep labored and gasping breathing

87. Instructions for hyperemesis gravidarum. Take small meals until tolerance

88. Health education for student about DM type 1. Should take the main and snake meals

89. Overloading circulation signs

90. Albteral action. Bronchodilator

91. situations about GERG?!

 Signs and symptoms Heart burn & regurgitation

 Nursing instructions Don’t lyingdown for 3 hours after eating

 Causes of aspiration in GERG. Due to reflux of gastric content

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92. Emphysema with hypercarbnia : appropriate oxygen treatment?
A. 3-5 lpm via nasal prong
B. 30% via venture mask
C. 2-4 lpm via nasal prong
D. 40% via venture mask

93. 3000 units heparin. Stock is 10,000U/ml, how many to give? 0.3 ml

94. Proper objective cues nursing documentation?

A. apple mass like upon palpitation
B. right lower quadrant pain in abdomen

95. Patient with Age Macular Degeneration. As a nurse what will you do/advice?.
A. Teach proper eye drop administration
B. Teach techniques that will maximize the remaining vision
C. Inform that laser therapy can be use
D. Tell patient that the condition is untreatable

96. What is Transient Ischemic Attack?.

A. Permanent neurological deficits
B. Temporary deficits that will resolve eventually

97. What is ascites? FLUID ACCUMULATION ON PERITONEAL CAVITY

98. When to perform breast self-examination for pre-menopausal woman

A. first day of menstruation
B. middle of menstruation
C. last day of menstruation( after period)

99. Infant with DM mother: what to expect for first 48 hours?.

A. high urine output
B. serum calcium greater than 7mg/dl
C. hematocrit greater than 65%
D. hypoglycemia

100. Blood transfusion: fluid to use?.

A. Normal saline
B. D5LR
C. D5Water

101. Child with cystic fibrosis without complication: what to do first?.

A. Cough
B. Deep breathing
C. Postural Drainage
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D. Bronchial tapping

102. Nurse underwent training about Evidenced-based guidelines: applies it appropriately by?.
A. sticking to nursing procedures in a book
B. looking to the effectiveness of nursing care to patient’s reaction
C. Adhering to hospital policy

103. Bacterial meningitis: what precaution?.

A. Airborne
B. Droplet
C. Isolation
D. Contact

104. Sign and symptoms of Pancreatitis – Vomiting with left quadrant pain radiating to back

105. Patient with hypocalcemia: route of calcitonin?.

A. IM
B. ID
C. IV. (in emergency )
D. SQ

106. Manifestations of MgSO4 toxicity?

A. Hypertension
B. Absence of knee jerk

107. Patient with pulmonary heart problem showing signs of short breath with pedal edema and bluish discoloration
on extremities?.
A. Cor pulmonale
B. Pulmonary edema

108. Stoma on colostomy: blanche appearance?

A. irritation on gastric secretions
B. infection
C. poor oxygenation
D. Inadequate blood supplies

109. Biphasic defibrillator: initial amount joules?.

A. 50
B. 80
C. 200
D. 360

110. Patient with cataract: manifestations?

A. blurry of vision
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B. presence of floaters

111. Patient with xanthelasma: indicate?

A. high bilirubin
B. high cholesterol

112. Patient with cardiac problem of right back up flow of blood: manifest?.
A. dyspnea
B. crackles
C. pedal edema

113. Cystic fibrosis: contraindicated?

A. chest physiotherapy
B. postural drainage
C. steam inhalation

114. Patient for OR: morphine is given for?.

A. To relax muscle
B. induce amnesia
C. decrease oral secretion

115. Patient for ECT: atropine is given?. DECREASE ORAL SECRETIONS

116. Child with croup for discharge: parents teaching?

A. follow prescribed antibiotics
B. have cold mist tent while child is sleeping

117. Chemotherapy patient with vomiting: nursing intervention?.

A. provide mouth care and emotional support
B. give a good tasting snack to improve appetite

118. Purpose of Penicillin in Rheumatic fever?.

A. prevent cardiomyopathy
B. kill microorganism and cure the disease
C. prevent reinfection and recurrent of fever

119. Patient allergy to Penicillin : nurse must avoid?

A. Cephalosporin
B. quinolones

120. Patient with chest tube: tidying in water-seal bottle?

A. Documents normal finding
B. Contact physician
C. Check for leakage in the system
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121. Manifestation with hypothyroidism?.

A. mass on neck, weight loss, cold intolerance
B. weight gain, fatigue, hair loss

122. Patient post leg operation: best way to prevent thrombophlebitis?.

A. elevate leg with two pillows
B. apply leg stocking during night
C. massage frequently

123. Patient on Coumadin: what to check?.

A. APTT
B. CBC
C. PT/INR

124. Patient on digoxin and loop diuretic: what to check to prevent complication?.
A. potassium level
B. intake and output

125. Patient involved in car accident, taking digoxin: what you will do?
A. Check the pulse rate
B. Have the stand and take BP

126. Reason for false high BP reading?

A. wrong position of arm or leg
B. Un audible sound
C. cuff too loose

127. Drugs that can cause extrapyramidal symptoms?.

A. antidepressant
B. antipsychotic

128. Patient on dementia with agitation: what drug?.

A. Neuroleptics
B. antidepressant
C. mood stabilizers

129. Position of child with posterior upper lobe secretions?.

A. leaning forward with pillow
B. supine with legs elevated

130. Child with pyloric stenosis: manifestations?.

A. diarrhea
B. regurgitation
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C. projectile vomiting

131. Mother on early labor: what is your priority?

A. gather obstetric history
B. check fetal heart tone

132. Mother with child went to clinic: which you would be alarm?
A. skin rash
B. 2 days no passing of stool

133. During peritoneal dialysis what should the nurse consider?

A. Notify physician when the drainage bag is less than 200 ml
B. Have the patient move side to side if the drainage output is insufficient
C. Maintain supine position throughout the procedure

134. Patient on enema complain of abdominal cramps?.

A. stop and continue when subsides
B. put the solution on higher
C. slow rate

135. Patient with risk of for impaired skin integrity due to immobility: nursing objective?
A. monitor intake and output
B. absence of redness on skin

136. Old patient with Diabetes insipidus: expect?.

A. hyponatremia
B. High urine osmolality

137. Nitroglycerine given to angina?. DECREASE CARDIAC OCCLUSION

138. Digoxin toxicity: ECG shows?.

A. Elevated ST segment
B. Inverted T wave

139. What is first degree heart block? DELAY OF IMPULSE IN AV NODE

140. Patient on anticoagulant: needs further teaching if?
A. use electric razor
B. check feet for bruising
C. states that dark color urine is normal

141. Most common sign of fluid volume deficit?

A. thirst
B. poor skin turgor
C. dark colored urine?
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142. Diagnostic test to help diagn0se thalassemia?

A. PTT
B. HGB Electrophoresis
C. CBC

143. Lack of FOLIC ACID?

A. Neural tube defect

144. Single Simeon Palm Creases?

A. Down Syndrome
145. Hypokalemia?
A. Invert T wave or U wave

146. Manifestation of shock?

A. Increase BP
B. Low pulse
C. Cold clammy
D. Cheyne Stoke

147. Manifestation of Meningitis?

A. Photophobia
B. Neck rigidity
C. Unrelenting Headache
D. All of the above

148. BP Taking Loose Cuff?

A. False High Reading

149. Patient is bleeding but Stable what triage category?

A. Category 2

150. In what Stage Bacteria Proliferate?

A. Stage 3 – Granulation/proliferation

151. MRSA PPE

A. Gloves & Googles or Gloves & apron

152. hypochromic, microcytic RBCS –

a. iron deficiency anemia
b. Pernicious anemia
c. Aplastic anemia

153. Cataract -
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a. OHA,
b. antihistamine,
c. betablocker

154. Cataract – prevent vomiting (causes inc.IOP)

155. Mild diarrhea, dehydration in children –
A. avoid rice,
B. dry toast,
C. cracker,
D. diluted fruit juice

156. Medication for patient with ventricular tachycardia who is hemodynamically stable
A. Atenolol
B. Verapamil
C. Amiodarone
D. Lidocaine

157. Which of the following meds is given sublingually – Nitroglycerine

158. Chest pain worsens when drinking cold drinks – angina pectoris
159. Bladder cancer risk factors – SATA
a. Ulcerative colitis
b. Long term catheterization
c. Smoking
d. All

160. Which of the following vitamins is given for elderly because they have poor ability to store them
a. A
b. D
c. C
d. All

161. Immediate intervention for unconscious patient after vehicular accident.

a. Jaw thrust
b. Oxygen
c. Assess LOC

162. Position for obese pregnant who is restless and cannot sleep at night – dorsal recumbent position
163. Intervention during tube feeding.
a. heat solution to room temperature
b. position the head of the patient at minimum of 30 degrees

164. computation given:

250 mg, pt. bsa is .54, adult bsa is 1.73
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165. infant becomes jittery after delivery from an obese mother –

a. hypoglycemia, hypocalcemia(my answer)
b. hypoglycemia, hepercalcemia

166. Clinical manifestation of meningitis – delayed closure of anterior fontanelle

167. Symptom of meningitis.

a. Nuchal rigidity and fever(my answer)
b. High pitch cry

168. Which of the following is not a manifestation of patient with meningitis. – depressed fontanelle

169. Depression – thinking of ending his life(suicide)

170. Medication for depression – SSRI

171. Emotional stress(not a therapy) –

a. guided imagery
b. biofeedback
c. cognitive reframing(my answer)

172. research – pediatric patients half with nebulizer ,half with puff- experimental research

173. delusion of persecution – CIA –I understand but I don’t think it is true.

174. initial sign of airway obstruction in extubated patient – mild dyspnea, increased secretion ,inability to cough out

secretions

175. Situation - looseness of association

176. post CTT – palpate(crepitus) for subcutaneous emphysema

177. what is the purpose of patient controlled analgesia – patient can give his own medication

178. PCA(patient complains that the pain does not go away) –

a. Take vital signs, assess for post op complications(my answer)

b. Check the Machines,etc

179. Floater – I will do activities which I usually do from the ward where I was assigned
180. Saturated fat – SATA
a. Beef
b. Nuts

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c. Liver oil

181. 5 % Mafenide acetate – important consideration

a. Neutropenia
b. Liver function
c. Causes staining of linen.

182. Check the legs, lower extremities – what type of anemia

a. Thalassemia
b. Aplastic
c. Sickle cell

183. Basal cell carcinoma –

a. baldness of the hair
b. Oily hair
c. Daily washing

184. Assessment after thoracentesis –

a. periods of confusion
b. blood pressure

185. Seizure(bed) –
a. remove objects
b. o2

186. Seizure(going to the bathroom) – remove furniture

187. Meningitis(at risk for seizure) – pad the siderails

188. CVA with L sided weakness – pillow between legs

189. Post BKA position to avoid -

190. Cataract(prevent complication before the next visit –

a. avoid stairs
b. avoid 7 kg

191. infant with cleft palate(assess for history) – mother taker antiseizure medications

192. cleft palate – support to parents regarding nutrition – how to feed patient properly

193. soar throat..CGN(cause) – Group A Beta Hemolytic Streptococcus

194. Assessment after tracheostomy –

a. Drop in BP
b. Hoarseness of the voice
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195. Assessment(effectiveness of fluid resuscitation) – weigh the patient

196. O.S. –
a. right eye
b. left eye
c. both eyes

197. Normal occurrence in a pediatric patient – closure of foramen ovale

198. Maintain low oxygen concentration in COPD

a. Prevent oxygen toxicity
b. Maintain hypoxic demand

199. Stimulus for breathing – carbon dioxide

200. Lab(2 weeks infection) – increased ESR
201. Mumps(5 days) –
a. still contagious
b. not contagious

202. ABG result for patient with COPD – low PaO2

203. Absorption, distribution, etc of medication –
a. Pharmacokinetics
b. Pharmacodynamics

204. Diazepam(computation) – 0.6mL

205. Computation (PO meds) – 12 mL

206. Patient taking digoxin..hypokalemia – assess for kidney function

207. Initial sign of thromboangitis obliterans – finger stiffness

208. Risk factor for lung cancer – Smoking

209. Protrusion of the nerve roots –

a. Meningocele
b. Myelomeningocele
c. Spina bifida
d. Spina bifida occulta

210. Acid base imbalance – B. Serum K <3.5, Serum sodium >148

211. How to assess for cranial nerve 1 – olfactory

212. Stool exam for patient with melena – A. Guaiac test

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213. What is the purpose of a licensure – D. minimum level of competence

214. Assessment for elderly taking meds in tablet form – ability to swallow

215. CVA(problem in nutrition) – dysphagia

216. Predisposing factors of obese patient(family is same as her) – genetic, family history

217. Husband with diabetic wife(cannot follow diet modification) –reassess need for change of diet

218. Primary level of prevention – immunization

219. HIV(correct statement )-

a. Anyone can be infected with HIV
b. There are more infected male than female

220. HIV – maintain standard precaution

221. Need for additional PPE other than gloves – patient with cancer undergoing irradiation therapy

222. Specimen collection for urinalysis –

a. aseptic technique
b. sterile technique

a. Birth weight –doubles at 6 months, triples at 12 months

b. ADHD(intervention) – isolate patient for inappropriate behavior

223. Which of the followings orders would you question the physician –
a. Methadone
b. Meperidine
c. Propoxyphene
d. Tramadol 500
224. Important consideration in urine collection urinalysis – time it is collected (urine decomposes over time)

225. Evidence based practice – research based practice

226. Purpose of EBP – show effort for continuing education

227. Hospital Survey show support

a. Because it is required
b. If you have extra time to participate in the survey

228. Protect the patient rights (EXCEPT) – decide for medical interventions

229. Enema in children –temperature of solution 105-125 degrees F

230. M.I(prevent increased demand for oxygen) –

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a. Prevent rise in heart rate
b. Maintain total blood volume

231. Female catheterization – dorsal recumbent position

232. Resistance, pain during catheterization – deflate the balloon then reinsert

233. Ensure proper emptying(patient with catheter) – prevent kinks in the tubing

234. Differentiate race from culture – C. culture –. social norms…race- physical characteristics

235. After percutaneous liver biopsy – pillow under the right costal margin

236. Nutrition(DM I) – meals and snacks in regular basis

237. Obese, 70 yrs.old develops pressure ulcer – Nsg Dx: Impaired Skin Integrity

238. Patient with cough, secretions –Nsg Dx: ineffective airway clearance

239. Supervisor discussing regarding patients condition in public – interrupt and move to a private place

240. Delivery of placenta – gentle firm massage over the abdomen

241. Important question for patient with alcohol – when was the last time you drink alcohol?

242. Competence of registered nurse in the ward – infection control techniques

243. Not included in tetralogy of fallot – transposition of great vessels

244. Drugs that eliminates potassium – diuretics

245. Temperature taking for elderly patient – tympanic(ear using infrared light)

246. Functions of a registered nurse –

247. Linking theory – reflective practice

248. Perforated ulcer- rigid abdomen

249. Foul smelling wound dressing post op – what is the initial intervention

250. 2 days post arthroplasty patient had leg cramps, edema, cannot move leg – notify the physician

251. Vomiting(contraindicated for patients post abdominal surgery) – causes wound dehiscence

252. Startle reflex – moro reflex

253. ERP(estrogen receptor CHON) patient with breast cancer –

254. 35% burn patient experiencing tachycardic,tachypneic) – hypovolemia

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255. Dry fire extinguisher –
a. Paper
b. Electrical
c. Flammable liquids
256. Latex gloves(allergy) – except –apply lotion, petroleum jelly prior wearing of gloves

257. MRI- assess allergy to shellfish

258. What is the medical term used to describe the swashing sound you can hear when you auscultate the carotid
artery ?
A. Murmur
B. Rhales
C. Bruit
D. Crackles

259. You inserted a nasogastric tube for a patient after abdominal surgery .to examine the tube for placement you
can do anyone of the following except:
A. A-Request an x-rya for the patients abdomen
B. B- Aspirate gastric juice and analyse it
C. C- Put the external end of the tube in a dish filled with water and wait to see the bubbles
D. D- By using 50cc syringe ,Push air into stomach while auscultation of the stomach

260. Who is responsible for nurse`s compelency?

A. University he graduated from
B. the nurse
C. Nursing Board
D. Supervisor

261. What is the normal range for serum potassium K+?

A. 2.5-3
B. 3.5-5
C. 5.5-7.2
D. 6.5-8.3

262. What is the normal range for oxygen saturation ?

A- 60-69%
B- 70-79%
C- 80-89%
D- 94- 98%

263. The doctor ordered Digoxin 0.125 tablet .you`ve got only 0.250mg tablet .what should you do?
A. Give 1/4 tab .Digoxin
B. Give 1/2 tab .Digoxin
C. Give 2 tab .Digoxin
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D. Give 1 ml of Digoxin Elixir (Syrup)

264. A patient complains of anemia was ordered to receive 2 units of blood .his blood group is AB- the only blood
group which cant donate for him is ?
A- AB+
B- A-
C- O+
D- B+

265. The nurse assesses pain in 9 years old child who experienced a radius fracture .What is the suitable for
assessment of pain in this child ?
A. Faces pain scale
B. Colored Analogue scale
C. Numerical rating Sale
D. Verbal rating Scale

266. A nurse is preparing for a defibrillation for a patient who suffers from ventricular tachycardia ,the D/C shock
device is biphasic ,what is the initial dose he can deliver?
A. 50 Joules
B. 100 Joules
C. 200 Joules
D. 360 Joules

267. People suffers from hypoglycemia when blood sugar falls below :
A. Below 180 mg /DL
B. Below 160 mg /DL
C. Below 140 mg /DL
D. Below 72 mg /DL

268. The doctor ordered to administer iv fluid to the patient 3000 cc/24hours , if the drop factor was 10 drop/ml
.how many drops/minute should the nurse give?
A. 21 drops/min Volume x drop factor
B. 42 drops/min
C. 85 drops/min Time (minutes)
D. 125 drops/min
3000*10 = 20.83
24*60
269. A child who underwent tonsillectomy .One of the most common complications is hemorrhage .How can the
nurse know if the child suffers from hemorrhage?
A. The child swallows frequently.
B. The child refuses to eat .
C. The child cry's loudly

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D. The child`s puls is 160pbm

270. A pediatric nurse examines a newborn , she noted that he has an opening in lower back contains bulging of
nerves , roots , and spinal cord covering , what is the name of this disorder ?
A. Spinal bifida
B. Meningocele
C. Spinal bifida acicula
D. Myelo Meningocele

271. A nurses reviews a patient`s file she read that the patient`s is infected with human papilloma virus (HPV).the
nurse knows that this kind of viruses is linked to :
A. Cervical cancer
B. colon cancer
C. breast cancer
D. Bladder cancer

272. The nurse closed the curtains before changing dressing of a patient who under want a major abdominal surgery
yesterday .this is an example of any ethical principle?
A. Confidentiality
B. Dignit
C. Consent form
D. Justice

273. Which of the following is an example of a hypotonic solution?

A. Normal Saline 0.9%
B. Normal Saline 0.45%
C. Normal Saline 5%
D. Normal Saline 10%

274. When is comb`s test positive ?

A. The mother`s bloods is –ve , baby is +ve
B. The mother`s bloods is +ve , baby is -ve
C. The mother`s bloods is –ve , baby is -ve
D. The mother`s bloods is +ve , baby is +ve

275. When caring for a patient suffers from pleural effusion , What is the best test to diagnose pleural effusion ?
A. Chest CT Scan
B. Chest X-ray
C. Chest MRI
D. Carotid angiography

276. A patient admitted to the surgical ward after a head trauma .at the second day , he suddenly complains of
slurred speed and fainting , the nurse came to see him after calling by his daughter , What should the nurse do first?
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A. Call the neurosurgeon
B. Complete a neurological assessment
C. Prepare the patient for urgent surgery
D. Record changes and observe the patient for another 2hours

277. A child started to have a seizure in the hospital , What should the nurse do initially ?
A. Prevent bitting the tongue by using tongue depressor
B. Use a suction device to remove excessive secretion
C. Remove the child to safer place
D. Adminster O2 by nasal canula

278. The rule of nine is used to : for burns quickly estimated

279. When discovering a medication error, the nurse's FIRST action is to?
A. Call the nurse supervisor

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B. Call the physician
C. Fill out a medication error reporting form
D. Assess the patient's condition

280. While preparing for a kidney biopsy the nurse should position the patient:
A. Prone with a sandbag under the abdomen
B. Lateral opposite to biopsy site
C. Supine in bed with knee flexion
D. Lateral flexed knee-chest

281. A patient with a central venous line develops sudden clinical manifestations that include a decrease in blood
pressure, an elevated heart rate, cyanosis, tachypnea, and changes in mental status. Which of the following is the
most likely cause of these symptoms?
A. An air embolism
B. Circulatory overload
C. Venous thrombosis
D. Developing bacteremia

282. Order: 1000 ml of D5W to run for 12 hours. Using a micro drip set calculate the drops per minute (gtts/min):
A. 20 gtts/min ( 1000 x 15 ) / ( 12x60) = 21.8ggt/min
B. 45 gtts/min
C. 60 gtts/min
D. 83 gtts/min

283. A patient voided a urine specimen at 9:00 AM. The specimen should be sent to the laboratory before:
A. 9:30 AM
B. 10:00 AM
C. 10:30 AM
D. 11:00 AM

284. An 84-year-old man has arthritis and is admitted for a severely edematous knee. The physician orders heat
packs every 2 hours and you feel this order may worsen the tissue congestion. An appropriate nursing action would
be:
A. Contact the physician and discuss your concerns about the order
B. To include the order in the nursing care plan and monitor outcome
C. Complete an incident report form and document concerns in the nursing notes
D. Involve the patient by asking what his treatment preference is

285. The minimal amount of urine that a post-operative patient weighing 60 kgs should pass is?
A. 120 ml/hr
B. 90 ml/hr
C. 60 ml/hr
D. 30 ml/hr

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286. When caring for a patient with impaired mobility that occurred as a result of a stroke (right sided arm and leg
weakness). The nurse would suggest that the patient use which of the following assistive devices that would provide
the best stability for ambulating?
A. Crutches
B. Single straight-legged cane
C. Quad cane
D. Walker

287. While assessing a patient, the nurse learns that he has a history of allergic rhinitis, asthma, and multiple food
allergies. The nurse must:
A. Be alert to hypersensitivity response to the prescribed medication
B. Encourages the patient to carry an epinephrine kit in case of an allergic reaction
C. Advise the patient to use aspirin in case of febrile illnesses
D. Admit the patient to a single room with limited exposure to health care personnel

288. A patient who has just had a miscarriage at 8 weeks of gestation is admitted to hospital. In caring for this
patient, the nurse should be alert for signs of:
A. Dehydration
B. Subinvolution
C. Hemorrhage
D. Hypertension

289. The nurse should observe for which of the following symptoms in a patient who has just undergone a total
thyroidectomy:
A. Weight gain
B. Depressed reflexes
C. Muscle spasm and twitching
D. Irritable behavior

290. A patient is ordered 75mg of pethidine which comes in an ampoule of 100mg/2ml. What would the nurse do
with the remaining pethidine after drawing up the required dose?
A. Lock up the remaining dose in the medication cupboard to use later
B. Ask a fellow staff nurse to witness the disposal of the remaining drug
C. Use the remaining dose within 2 hours for another patient
D. Pour the remaining dose down the nearest sink

291. A patient is to receive 50mL of fluid in 1/2 hour (30 min). The infusion pump should be set to deliver how many
milliliters per hour?
A. 25 ml/hr
B. 50 ml/hr
C. 75 ml/hr
D. 100 ml/hr

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292. A male patient with a right pleural effusion noted on a chest X-ray is being prepared for thoracentesis. The
patient experiences severe dizziness when sitting upright. To provide a safe environment, the nurse assists the
patient to which position for the procedure?
A. Prone with head turned toward the side supported by a pillow
B. Sims’ position with the head of the bed flat
C. Right side-lying with the head of the bed elevated 45 degrees
D. Left side-lying with the head of the bed elevated 45 degrees

293. After application of a cast in the upper extremity, the patient complains of severe pain in the affected site.
Which of the following would the nurse initiate?
A. Administer analgesics as ordered
B. Assess neurovascular status
C. Notify his physician
D. Pad the edges of the cast

294. The best dietary advice a nurse can give to a woman diagnosed with mild pregnancy- induced hypertension is
to:
A. Follow a strict low salt diet
B. Restrict fluid intake
C. Increase protein intake
D. Maintain a well-balanced diet

295. A nurse has been working in a general hospital on the same medical unit for 6 years. The Behavioral Unit is
desperately short staffed and the nurse is asked to work her shift in this other unit. What would be the expected
response of the nurse to this request?
A. "I will go to the unit and hopefully the behavioral health staff members will assist me with my assignment."
B. "I cannot go. I have no previous behavioral health experience. I do not want to reduce the quality of patient
care."
C. "I have no previous behavioral health experience. I am willing to go and help with any duties that are similar
to those I perform on my unit."
D. "I should not be expected to float to another unit without a proper orientation. I will fill out an incident report if
I am sent there."

296. A patient is to receive 25mg/hr of an aminophylline infusion. The solution prepared by the pharmacy contains
500mg of aminophylline in 1000ml of D5W. How many milligrams are available per ml?
A. 0.25 mg/ml
B. 0.5 mg/ml
C. 1 mg/ml
D. 2 mg/ml

297. A patient with pneumonia is coughing up purulent thick sputum. Which one of the following nursing measures is
most likely helpful to loosen the secretions?
A. Postural drainage
B. Breathing humidified air
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C. Percussion over the affected lung
D. Coughing and deep breathing exercises

298. A 21 year old woman is being treated for injuries sustained in a car accident. The patient has a central venous
pressure (CVP) line in-situ. The nurse recognizes that CVP measurements:
A. Estimate Cardiac output
B. Assess myocardial workload
C. Determine need for fluid replacement
D. Determine ventilation - perfusion mismatch

299. A construction worker was brought to the emergency department and admitted with the diagnosis of heat
stroke due to strenuous physical activity during hot weather conditions. Which action should the nurse take?
A. Immediately immerse the patient in cold water to reduce the patient's temperature
B. Administer an antipyretic such as aspirin or acetaminophen
C. Place ice packs to the neck, axillae, scalp and groin
D. Encourage foods and oral fluids that contain carbohydrates and electrolytes

300. Thirty minutes after starting a blood transfusion a patient develops tachycardia and tachypnea and complains of
chills and low back pain. The nurse recognizes these symptoms as characteristic of:
A. Circulatory overload
B. Mild allergy
C. Febrile response
D. Hemolytic reaction

301. As a part of the treatment given to a child with leukemia the child is placed on reverse barrier isolation to:
A. Protect the child from injury
B. Protect the child from infectious agents
C. Provide the child with a quiet environment
D. Keep the child away from other children

302. The rationale for having the patient void before an abdominal paracentesis procedure is to:
A. Minimize discomfort
B. Avoid abdominal distention
C. Prevent bladder puncture
D. . Reduce infection rate

303. The best time for the nurse to teach an anxious patient about the patient controlled analgesic (PCA) pump
would be during which of the following stages of patient care?
A. Post-operative
B. Pre-operative
C. Intraoperative
D. Post anesthesia

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304. To maintain the airway and promote respiratory function, the best position for the nurse to place the
unconscious patient in the Post Anesthesia Care Unit (PACU) is:
A. A. Supine
B. Lateral
C. Trendlenburg
D. Fowler's

305. When the post-operative patient returns to the surgical unit, the priority is to:
A. Assess the patient's pain
B. Measure the patient’s vital signs
C. Monitor the rate of the IV infusion
D. Check the physician’s post-operative orders

306. When taking routine post-operative observations on a patient who underwent an exploratory laparotomy, the
nurse plans to monitor which important finding over the next hour?
A. Serosanguinous drainage on the surgical dressing
B. Blood pressure of 105/65 mmHg
C. Urinary output of 20 mls in the last hour
D. Temperature of 37.6 °C

307. A patient has been taking Aluminum Hydroxide daily for 3 weeks. The nurse should be alert for which of the
following side effects?
A. Constipation
B. Flatulence
C. Nausea
D. Vomiting

308. A patient with severe, protracted vomiting will often have what electrolyte abnormality?
A. Decreased potassium and decreased chloride
B. Increased sodium and decreased chloride
C. Increased potassium and increased sodium
D. Decreased sodium and increased chloride

309. A 13 year old girl with manifestations of rheumatic heart disease is admitted to hospital. Which of the following
laboratory blood findings would confirm that she likely has had a streptococcal infection within the past two weeks?
A. Decreased leukocyte count
B. Elevated hemoglobin count
C. Elevated ASO titer
D. Decreased ESR

310. To prevent post-operative thrombophlebitis, which one of the following measures is effective?
A. Elevation of the leg on two pillows
B. Using of compression stocking at night
C. Massage the calf muscle frequently
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D. Performing leg exercises

311. The mother of a child with nephrotic syndrome asks why her child must be weighed each morning. The nurse's
response should be based on the fact that this is important to determine the:
A. Nutritional status
B. Water retention
C. Medication doses
D. Blood volume

312. A deficiency of which of the following vitamins can affect the absorption of calcium?
A. Vitamin C
B. Vitamin B6
C. Vitamin D
D. Vitamin B12

313. The nurse should place the automatic external defibrillator (AED) electrodes on the patient's anterior chest with
one electrode placed:
A. Below the left clavicle and one below the right nipple
B. On the right mid-axillary line and the other at mid-sternum
C. Below the right clavicle and one below the left nipple
D. On the mid-axillary line and one at the sternal notch

314. When caring for a patient with hepatic encephalopathy the nurse may carry out the following orders: give
enemas, provide a low protein diet, and limit physical activities. These measures are performed to:
A. Minimize edema
B. Decrease portal pressure
C. Reduce hyperkalemia
D. Decrease serum ammonia

315. Collection urine bag should be emptied as necessary and at least every 8 - 9 hours to prevent:
A. Pooling of urine in the tube
B. Reflux of urine into the bladder
C. Pulling on catheter
D. Bacterial contamination

316. The best example of documentation of patient teaching regarding wound care is:
A. "The patient was instructed about care of wound and dressing changes"
B. "The patient demonstrated correct technique of wound care following instruction"
C. "The patient and family verbalize that they understand the purposes of wound care"
D. "Written instructions regarding wound care and dressing changes were given to the patient"

317. The nurse teaches a patient recovering from a total hip replacement that it is important to avoid:
A. Putting a pillow between the legs while sleeping
B. Sitting with the legs crossed
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C. Abduction exercises of the affected leg
D. Bearing weight exercises on the affected leg for 6 weeks

318. Which of the following actions is the most appropriate when the nurse is responding to a patient during a tonic-
clonic seizure?
A. Restrain the patient
B. Protect the patient from harm
C. Minimize noise and light stimulus
D. Apply oxygen by mask or nasal cannula

319. The patient did not sleep well last night and is anxious about having a bronchoscopy later this morning. The
priority nursing intervention would be to:
A. Reassure and encourage expression of feelings
B. Administer the premedication a little earlier
C. Keep the patient occupied until the procedure
D. Explain the purpose of the bronchoscopy

320. The nurse should suspect that a patient has bleeding in the upper gastrointestinal tract when the color of the
patient's stool is:
A. Yellow
B. Black
C. Clay
D. Red

321. The police bring a prisoner into the emergency department who is in severe pain. When the nurse is assigned to
this patient, the nurse should:
A. Ignore the prisoner because he deserves to be in pain
B. Give the prisoner the minimum amount of pain medication ordered
C. Tell the prisoner to be quiet, as he is disturbing the other patients
D. Implement nursing interventions to relieve the prisoner's pain

322. The nurse is preparing teaching plans for several patients. The nurse should recognize which of the following
patients is at greatest risk for fluid and electrolyte imbalance?
A. A 2-year-old patient who is receiving gastrostomy feedings
B. A 20-year-old patient with a sigmoid colostomy
C. A 40-year-old patient who is 3 days post-operative with an ileostomy
D. A 60-year-old patient who is 8 hours post-renal arteriography

323. The patient with liver cirrhosis receives 100 ml of 25% serum albumin intravenously. Which of the following
findings would best indicate that the albumin is having its desired effect?
A. Decreased blood pressure
B. Increased serum albumin level
C. Increased urine output
D. Improved breathing pattern
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324. The apical pulse can be best auscultated at the:

A. Left 2nd intercostal space lateral to the mid clavicular line
B. Left 2nd intercostal space at the left sternal border
C. Left 5th intercostal space at the mid clavicular line
D. Left 5th intercostal space at the mid axillary line

325. Which of the following tasks requires specialized education and should be performed by the nurse only after
the training has been completed?
A. Administering a dose of promethazine (Phenergan) via intravenous push (IVP)
B. Applying a transdermal fentanyl (Duragesic)
C. Instilling tobramycin (Tobrex) ophthalmic solution
D. Beginning an intravenous infusion of cyclophosphamide (Cytoxan)

326. An elderly patient is admitted to the hospital with swollen ankles. The best way to limit edema of the feet is for
the nurse to:
A. Restrict fluids
B. Apply bandages
C. Elevate the legs
D. Do passive range of motion exercises (ROM)

327. A patient is diagnosed with diabetic ketoacidosis. The nurse would expect the physician to prescribe:
A. Regular insulin IV
B. NPH insulin SC
C. Glucagon IM
D. Mixed insulin SC

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Very important points

REVIEWER:

1. Hemicolectomy, what to assess?

 Possible complications from a right hemicolectomy include infection of the wound or chest
area, bleeding, bowel damage and blood clots.
 The clots, which tend to form in the leg, can present a serious danger if they move to the
lungs, a condition known as pulmonary embolism. Leakage at the site of the join may occur as
well, but laparoscopy runs no greater complication rate than standard surgery.
 Patients should expect some recovery issues following a hemicolectomy. The bowel
usually takes several days to resume performance, and at first the patient may experience
slight bleeding. Bowel irregularity may require some modifications to the diet.

2. APGAR Score
Adaptation 0 1 2
Heart Rate Absent Slow; <100 >100
Respiratory Effort Absent Weak cry Strong cry
Muscle Tone Limp Some flexion of extremities Active motion
Reflex irritability No response Grimace Cry
Color Cyanotic pale Body pink, extremities cyanotic Completely pink

3. Coumadin, what to assess before and after giving to patient?

 Bleeding, INR, PT

4. Description of Quickening (maternal nursing)

 Fetal movements felt by the mother, 4-5 months (16-20 weeks)

5. Manic Episode- give food patient can carry around

 Set limit for behavior.

 Communicate in non-argumentative manner.
 Advise all caregivers to approach client in a consistent manner.
6. Spontaneous Abortion, what to expect as signs and symptoms
 Vaginal bleeding
 Passage of clots or tissue through the vagina occurs.
 Low uterine cramping or contractions occur.
 Hemorrhage and shock can occur.

7. Nystagmus
 Involuntary eye movement
 Dancing eyes
 Jerking eyes

8. Pediatric Calculation of drugs

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9. Tetralogy of Fallot - signs and symptoms

 4 defects (VSD, pulmonary stenosis, overriding aorta, rt ventricular hypertrophy)

 Infants
 Acutely cyanotic at birth or may have mild cyanosis that progresses over first year
of life as the pulmonic stenosis worsens.
 A characteristic murmur is present.
 Acute episode of cyanosis and hypoxia (hyper cyanotic spells), called blue spells or
tet spells, occur when the infant’s oxygen requirements exceed the blood supply
(usually during crying or after feeding).
 Children
 With increasing cyanosis, squatting, clubbing of the fingers and poor growth may
occur.
 Surgical tx
 Palliative shunt – increases pulmonary blood flow and increases oxygen saturation
in infants who cannot undergo primary repair. Provides blood flow to the pulmonary
arteries from the left or right subclavian artery.

10. Wound Dehiscence - description

 Separation of the wound edges at the suture line.
 Occurs 6-8 days post-op.
 Appearance of underlying tissues through the wound.

11. Pulmonary Embolism

 Pulmonary embolism occurs when a thrombus that forms in a deep vein detaches and
travels to the right side of the heart and then lodges in a branch of the pulmonary artery.
 Deep vein thrombosis
 Prolonged immobilization
 Surgery
 Obesity
 Pregnancy
 CHF
 Advanced age
 History of thromboembolism
 Fat emboli can occur as a complication following a fracture of a flat bone
 Treatment
 Preventing venous status
 Range of motion exercises
 Early ambulation
 Use of anti-embolic or pneumatic compression stockings
 Assessment findings
 Blood tinged sputum
 Chest pain
 Cough
 Cyanosis
 Distended neck veins
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 Dyspnea accompanied by anginal and pleuritic pain, exacerbated by inspiration
 Hypotension
 Wheezes on auscultation
 Shallow respirations
 Tachypnea and tachycardia

12. Post tonsillectomy management

 Position client prone or side-lying to facilitate drainage.
 Have suction equipment available, but do not suction unless there is an airway obstruction.
 Monitor signs of hemorrhage (frequent swallowing)
 If hemorrhage occurs turn the client to the side position and notify the physician.
 Discourage coughing or clearing the throat.
 Provide clear, cool, non citrus and non carbonated fluids.
 Avoid milk products initially because they will coat the throat.
 Avoid red liquids, which will simulate the appearance of blood if the child vomits.
 Do not give any straws, forks, or sharp objects to child that can be put to mouth.
 Tylenol (acetaminophen) for sore throat
 Instruct the client to notify the physician if bleeding, persistent earache or fever occurs.

13. Post thyroidectomy management

 Monitor for respiratory distress
 Have a tracheostomy set, oxygen, and suction at the bedside.
 Monitor surgical site for edema and for signs of bleeding; check dressing anteriorly and the
back of the neck.
 Limit client talking, and assess level of hoarseness.
 Monitor for laryngeal nerve damage, as evidenced by respiratory obstruction, dysphonia,
high-pitched voice, stridor, dysphagia, and restlessness.
 Monitor for signs of hypocalcemia and tetany, which can be due to trauma to the
parathyroid gland
 Prepare to administer calcium gluconate as prescribed for tetany.
 Monitor for thyroid storm
 Elevated temperature
 Tachycardia
 Systolic hypertension
 Nausea, vomiting, and diarrhea
 Agitation, tremors, anxiety
 Irritability, agitation, restlessness, confusion, and seizures as the condition
progresses
 Delirium and coma

Parathyroid gland removes what to expect?

 Hypocalcemia crisis as evidenced by tingling and twitching in the extremities and face.
 Assess for positive trousseau’s or chvostek’s sign, which signals the potential for tetany.
 Monitor for change in voice pattern and hoarseness.
 Monitor for laryngeal nerve damage.
 Instruct the client in the administration of calcium and vitamin D supplements as prescribed.
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14. Use of Laryngoscope

 For tracheal intubation

15. Post ET intubation, what to expect and observed after?

 Auscultation of all lung fields to confirm adequate air exchange

 Auscultation of the epigastrium to confirm the absence of disturbance of the gastric fluids
during ventilation
 Observation of bilateral expansion of the thorax during ventilation
 Use of end tidal CO2 detection

16. Post ECT- proper positioning

 Lateral position
 INDICATION: for major depression

17. Asthma pathophysiology - narrowing of airway

18. Parkinson’s Disease

 A generative disease caused by the depletion of dopamine, which interferes with the
inhibition of excitatory impulses.
 Results in a dysfunction of the extrapyramidal system.
 Slow progressive disease that results in a crippling disability.
 The debilitation can result in falls, self-care deficits, failure of body systems, and
depression.
 Mental deterioration occurs late in the disease.
 Assessment
 Bradykinesia, abnormal slowness of movement, and sluggishness of physical and
mental responses.
 Akinesia
 Monotonous speech
 Handwriting that becomes progressively smaller
 Tremors in hands and finger at rest (pill rolling)
 Tremors increasing when fatigued and decreasing with purposeful activity or sleep
 Rigidity with jerky interrupted movements
 Restlessness and pacing
 Blank facial expression-mask like facies
 Drooling
 Difficulty in swallowing and speaking
 Loss of coordination and balance.
 Shuffling steps, stooped position, and propulsive gait
 Intervention
 Assess neurological status
 Assess ability to swallow and chew
 Provide high calorie, high protein, high fiber soft diet with small frequent feedings.
 Increase fluid intake to 2L/day
 Monitor constipation
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 Promote independence along with safety measures
 Avoid rushing the client with activities
 Assist in ambulation and provide assistive devices
 Administer anticholinergic medication to treat tremors and rigidity and to inhibit
action of acetylcholine
 Administer antiparkinsonian meds to increase the dopamine in the CNS
 Avoid vit B6 and monoamine oxidase inhibitors

19. Definition of Patients Autonomy

 Respect for an individual’s right to self-determination.

20. Drug over dosage as ordered by Dr. - proper management of nurse

 If client is awake, induce vomiting and administer activated charcoal
 If client is comatose, clear airway, intubate, provide gastric lavage with activated charcoal,
use seizure precautions, prepare for possible dialysis
 Central nervous system depressants
 Flumazenil (romazicon) intravenously
 Opioids
 Naloxone (Narcan)

21. Pt. is pregnant with bleeding, what hormone is responsible?

 progesterone

22. Pregnant woman 26 weeks, what to give? Heparin or Coumadin?

 Heparin – because its molecular size is too large to pass the placental barrier.

23. Nephrotic syndrome- nursing management

 A set of clinical manifestations arising from protein wasting caused by diffuse glomerular
damage
 Assessment
 Proteinuria
 Hypoalbuminemia
 Edema
 Hyperlipidemia
 Waxy pallor to the skin
 Anemia
 Anorexia
 Malaise
 Irritability
 Amenorrhea or abnormal menses
 Hematuria may be present
 Intervention
 Monitor vital signs
 Monitor intake and output
 Bed rest is necessary if severe edema is present
 Instruct the client in a normal to low-protein diet as prescribed, with adequate
carbohydrate and calorie intake
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 Monitor daily weight
 Provide a mild sodium restriction as prescribed
 Monitor potassium level, potassium may be restricted from the diet if the potassium
rises
 Administer diuretics as prescribed
 Administer corticosteroids and cytotoxic medications as prescribed
 Administer plasma volume expanders, such as albumin, plasma, and dextran, to
raise the osmotic pressure
 Administer anticoagulants as prescribed for those clients who develop renal vein
thrombosis

24. Moro Reflex- description

 The new born symmetrically abducts and extends the arms.
 The newborn fans the fingers out and forms a C with the thumb and the forefinger.
 The newborn adducts the arms to an embracing position and returns to a relaxed flexion
state.
 Moro’s reflex is present at birth; a complete response may occur up to 8 weeks.

25. AIDS- CD4 Cells

 Your immune system contains different types of cells that help protect the body from
infection. One of these types of specialized cells are called the CD4 or T-cells. HIV attacks
these types of cells and uses them to make more copies of HIV. And in doing so, HIV weakens
the immune system, making it unable to protect the body from illness and infection

26. Rooting Reflex - description

 Newborn turns head toward the nipple, opens the mouth, takes hold of the nipple, and
sucks.
 Rooting reflex usually disappears after 3 to 4 months but may persist for up to 1 year.

27. WBC slightly elevated, indicates what?

 The White Blood Cell (WBC) Count measures two components: the total number of WBC's
(leukocytes), and the differential count. The differential count measures the percentages of
each type of leukocyte present. WBC's are composed of granulocytes (neutrophils,
eosinophils, and basophils) and non-granulocytes (lymphocytes and monocytes). White blood
cells are a major component of the body's immune system. Indications for a WBC count
include infectious and inflammatory diseases; leukemia and lymphoma; and bone marrow
disorders.
 The WBC count is used to determine the presence of an infection or leukemia. It is also
used to help monitor the body’s response to various treatments and to monitor bone
marrow function.

28. Liver Biopsy positioning

 During the procedure
 Supine with the right side of the upper abdomen exposed
 Client’s right arm is raised and extended over the left shoulder behind the head.

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 The liver is located on the right side and this position provides for maximal exposure
of the right intercostal space.
 After the procedure
 Assist the client into a right lateral (side lying) position.
 Place a small pillow or folded towel under the puncture site for at least 3 hours to
provide pressure to the site and prevent bleeding.

29. Renal Calculi – Nursing . Diagnosis (urolithiasis)

 Fluid and electrolyte imbalances
Metabolic acidosis (primary base bicarbonate deficiency)
Metabolic alkalosis (primary base bicarbonate excess)
Psychosocial aspects of care

30. Post Endoscopy what to check after?

 GAG REFLEX, client must be NPO until gag reflex returns (1-2 hours)
 Monitor for signs of perforation (pain, bleeding, unusual difficulty swallowing, elevated
temperature)
 Maintain bed rest for the sedated client until alert
 Lozenges, saline gargles, or oral analgesics can relieve minor sore throat, after the gag
reflex returns.

31. Hepatitis A
 Formerly known as infectious hepatitis
 Commonly seen during the fall and early winter
 Transmission
 Fecal-oral route
 Person-to-person contact
 Parenteral
 Contaminated fruits, vegetables, or uncooked shellfish
 Contaminated water or milk
 Poorly washed utensils
 Incubation period is 2-6 weeks, infectious period is 2-3 weeks before and 1 week after
development of jaundice
 Infectious period is 2-3 weeks before and 1 week after development of jaundice
 IgM and IgG elevation, indicate infection and inflammation
 Prevention
 Strict hand washing
 Stool and needle precautions
 Treatment of municipal water supplies
 Serological screening of food handlers
 Hepatitis A vaccine (havrix)
 Immunoglobulin vaccine

32. Wound dressing

33. Proper handling of Soiled Linen

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34. Obese patient for turning - call for help

35. Wound - what kind of dressing to be used

36. Infiltration- Nursing management

 Stop infusion and remove the IV device immediately
 Do not rub an infiltrated area, which can cause the development of a hematoma
 Elevate the extremity and apply compresses (warm or cool, depending on the IV solution
that was infusing and the physician’s order) over the affected area.
 Document the assessment of the infiltration, its effect and the action taken

37. Ileostomy - Blanched color indicates what (stoma)

 Red or Pink – indicates high vascularity, normal color
 Pale Pink – indicates low hemoglobin and hematocrit levels
 Purple-blue-black – indicates compromised circulation, requiring physician notification.

38. Why avoid massaging bony prominence?

 May damage underlying tissue
 Inflammation may occur
 High risk for pressure ulcer

39. Compound (open) Fracture- what to do with bleeding

 Cover the wound with a sterile dressing.
 Splint the extremity

40. Swollen Ankles- proper positioning

 Place leg at an elevated level, usually above the level of the heart
 Do not place pressure on the injured ankle

41. Regular Insulin and NPH - proper mixing

 Draw up the regular insulin first before the NPH

42. Mother with gestational Diabetes- what to advised

 Occurs in pregnancy (2nd or 3rd trimester) in client not previously diagnosed as diabetic and
occurs when the pancreas cannot respond to the demand for more insulin.
 Include diet, insulin (if diet cannot control blood glucose levels), exercise, and blood
glucose determinations to maintain blood glucose levels between 65-130mg/dL.
 Observe for signs of hyperglycemia, glycosuria and ketonuria and hypoglycemia.
 Monitor weight
 Increase calorie intake as prescribed, with adequate insulin therapy so that glucose will
move into the cells.
 Assess for signs of maternal complications such as preeclampsia (hypertension,
proteinuria, and edema)
 Monitor signs of infection
 Instruct the client to report burning and pain on urination, vaginal discharge or itching, or
any other signs of infection to the health care provider.
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 Assess fetal status and monitor for signs of fetal compromise.

43. Pre- eclampsia diet

 Increase dietary protein and carbohydrates with no added salt

44. Digoxin Toxicity

 is a poisoning that occurs when excess doses of digoxin (aka digitalis) are consumed
acutely or over an extended period of time.
 The therapeutic level for digoxin is 0.8-2.0 mg/mL.
 Low serum potassium increases the risk of digoxin toxicity and cardiac dysrhythmias. The
classic arrhythmia is a paroxysmal atrial tachycardia with block.
 Symptoms include fatigue, nausea/vomiting, changes in heart rate and rhythm, loss of
appetite (anorexia), diarrhea, visual disturbances (yellow or green halos around objects),
confusion, dizziness, nightmares, agitation, and/or depression, as well as a higher acute sense
of sensual activities.
 The primary treatment of digoxin toxicity is digoxin immune Fab. Digoxin should not be
given if the apical heart rate is below 60 BPM (beats per minute).
 Other treatments that may be tried to treat life-threatening arrhythmias, until digoxin
Immune Fab is acquired are magnesium, phenytoin, and lidocaine[1]
 atropine is also used in cases of Brady arrhythmia
45. Pancreatitis
 Is an acute or chronic inflammation of the pancreas with associated escape of pancreatic
enzymes into surrounding tissue.
 Acute pancreatitis occurs suddenly as one attack or can be recurrent with resolutions.
 Chronic pancreatitis is a continual inflammation and destruction of the pancreas, with scar
tissue replacing pancreatic tissue.
 Precipitating factors
 Trauma
 Use of alcohol
 Biliary tract disease
 Viral or bacterial disease
 Hyperlipidemia
 Hypercalcemia
 Cholelithiasis
 Hyperparathyroidism
 Ischemic vascular disease
 Peptic ulcer disease

46. Glucagon
 A hormone secreted by the alpha cells of the islets of Langerhans in the pancreas.
 Increases blood glucose by stimulating glycogenolysis in the liver.
 Can be administered intravenously, subcutaneously and intramuscularly.
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 Used to treat insulin-induced hypoglycemia when the client is semiconscious or
unconscious and is unable to ingest liquids.
 Blood glucose level begins to increase within 5-20 minutes after administration.

47. Atenolol
 beta-blocker
 treat angina (chest pain)
 treat hypertension (high blood pressure)
 prevent heart attack

48. Renin Angiotensin

 a hormone system that regulates blood pressure and water (fluid) balance.
 When blood volume is low, the kidneys secrete renin.
 Renin stimulates the production of angiotensin. Angiotensin causes blood vessels to
constrict, resulting in increased blood pressure.
 Angiotensin also stimulates the secretion of the hormone aldosterone from the adrenal
cortex.
 Aldosterone causes the tubules of the kidneys to increase the reabsorption of sodium and
water into the blood. This increases the volume of fluid in the body, which also increases blood
pressure.
 If the renin-angiotensin-aldosterone system is too active, blood pressure will be too high.
 There are many drugs that interrupt different steps in this system to lower blood pressure.
These drugs are one of the main ways to control high blood pressure (hypertension), heart
failure, kidney failure, and harmful effects of diabetes.[2][3]

49. CPR ratio for adult

 30 compression:2 breaths – 1 rescuer

50. Tetanus Toxoid – doses

 Must be given to patient without vaccine

51. Unconscious patient in AE, what’s your 1st intervention?

51. Heat stroke management

52. Burn Patient with stridor – management

53. Definition of Accountability

 A moral concept that involves acceptance by the professional nurse of the consequences
of decision or action.
 Is the process that mandates that individuals are answerable for their actions and have an
obligation (or duty) to act.

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 Involves assuming only the responsibilities that are within one’s scope of practice and not
assuming responsibility for activities in which competence has not been achieved.
 Involves admitting mistakes rather than blaming others and evaluating the outcomes on
one’s own actions.
 Includes a responsibility to the client to be competent, to render nursing services in
accordance with standards of nursing practice, and to adhere to the professional ethics code.

54. Hydrocephalus for baby - what to expect with vital signs

55. VP Shunting - proper explanation to parents

 Ventriculoperitoneal shunt, the CSF drains into the peritoneal cavity from the lateral
ventricle.

56. Sympathetic stimulation what to expect with vital signs?

57. Nursing Diagnosis for Obese with sacral sore

58. Paracentesis, proper instruction to patient

 Transabdominal removal of fluid from the peritoneal cavity for analysis
 Pre procedure
 Obtain informed consent
 Have client void before the start of procedure to empty bladder and to move
bladder out of the way of the paracentesis needle.
 Measure abdominal girth, weight, and baseline vital signs.
 Note that the client is positioned upright on the edge of the bed with the back
supported and the feet resting on a stool (Fowler’s position is used for the client
confined to bed).
 Post procedure
 Monitor vital signs
 Measure fluid collected, describe, and record.
 Label fluid samples and send to the laboratory for analysis.
 Apply a dry sterile dressing to the insertion site; monitor site for bleeding
 Measure abdominal girth and weight.
 Monitor for hypovolemia, electrolyte loss, mental status changes, or
encephalopathy.
 Monitor for hematuria caused by bladder trauma.
 Instruct the client to notify the physician if the urine becomes bloody, pink, or red.

59. Procedure needs patient on NPO.

60. Nursing intervention when the baby has seizure on the crib
 Safety

61. Pt. complained of gas cramps post op. Nursing intervention towards the patient.
 Early ambulation

62. Patient with upper GI bleeding expected color of the stool

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63. Angina Pectoris

 Chest pain resulting from myocardial ischemia caused by inadequate myocardial blood and
oxygen supply.
 Caused by an imbalance between oxygen supply and demand.
 Causes include obstruction of coronary blood flow because of atherosclerosis, coronary
artery spasm, and conditions increasing myocardial oxygen consumption.
 The goal of treatment is to provide relief of an acute attack, correct the imbalance between
myocardial oxygen supply and demand, and prevent the progression of the disease and further
attacks to reduce the risk of MI.

64. Patient with Frothy sputum. Indication?

 One of the main signs of pulmonary edema is a white or pink-tinged frothy sputum, which is
expelled while coughing.
 Pulmonary edema, which is the collection of fluids in the lungs, can be caused bye heart
disease, allergies, injuries, stroke, infection and other conditions.
 The frothy sputum may be accompanied by wheezing and bubbling sounds when, bluish
nails and lips, sweating, and a rapid heartbeat.

65. Pt. with skeletal traction, how to maintain alignment?

 Maintain proper body alignment.
 Ensure that the weights hang freely and do not touch the floor.
 Do not remove or lift the weights without a physician’s order.
 Ensure that pulleys are not obstructed and that ropes in the pulleys move freely.
 Place knots in the ropes to prevent slipping.
 Check the ropes for fraying.

66. How would you know Coumadin is effective?

 Warfarin suppresses coagulation by acting as an antagonist of vitamin K.
 Warfarin is used for long-term anticoagulation.
 Warfarin prolongs clotting time and is monitored by the prothrombin time (PT)
 Warfarin is used mainly to prevent thromboembolic conditions such as thrombophlebitis,
pulmonary embolism, and embolism formation caused by atrial fibrillation, thrombosis, MI, or
heart valve damage.
 Warfarin usually is given for 2-3 months after a MI to decrease the incidence of DVT and
thromboembolism.
 Normal PT is 9.6 to 11.8 seconds.
 Warfarin sodium prolongs the PT.
 Normal INR is 1.3 to 2.
 Warfarin antidote is vitamin K (phytonadione, aquamephyton).

67. ICP of 12mmHg, what does it mean?

 Normal ICP is 7-15mmHg

68. Best intervention for Nursing Diagnosis Altered Cerebral perfusion

69. During NGT insertion patient became cyanotic, what is your intervention?
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 Pull out NGT immediately
 Oxygen administration

70. During inflation of Foley Catheter balloon, patient complained of pain, what is your intervention?
 Aspirate the fluid, advance the catheter farther, and reinflate the balloon

71. Nursing management if patient asked why he is rescheduled for another Laparoscopy? ex. call
the Doctor

72. The nurse is present during consent signing to...?

 Witness

73. Patient is scheduled for Caesarian section, priority nursing intervention?

74. Nurse manager prepare d medication and asked you to administer, what is your response?
 You only give medication that you have prepared or double checked

75. You are about to give the medicine, the label is not clear. What will you do?
 Send back to pharmacy.

76. You entered your documentation to wrong chart, what is your intervention?

77. Most therapeutic intervention for patient with Hyperkalemia?

 Diuretics
 D50/50 + insulin
 Calcium gluconate

78. Patient with Thalassemia. What you need to check?

 Hemoglobin, alpha and beta hemoglobin
 Blood transfusion therapy
 Iron therapy
 inherited autosomal recessive blood disease.
 In thalassemia, the genetic defect which could be either mutations or deletion results in
reduced rate of synthesis or no synthesis of one of the globin chains that make un hemoglobin.
 Reduced synthesis or no synthesis of one of the globin chains can cause the formation of
abnormal hemoglobin molecules, thus causing anemia, the characteristic presenting symptom
of the thalassemia.

79. Patient with Thalassemia receiving Deferral, why?

 The primary treatment is regular blood transfusions, usually every four weeks.
 In addition to the blood transfusions, doctors recommend injections of Desferal to help the
body flush out the extra iron created by the new blood. The injections are given under the skin
from a small pump 5 to 7 nights a week.
 Desferal, deferoxamine mesylate USP, is an iron-chelating agent, available in vials for
intramuscular, subcutaneous, and intravenous administration.
 Additionally, splenectomy (removal of the spleen), bone marrow transplants and chelation
therapy are being researched as possible treatments for thalassemia.
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80. Why we need to empty the urine collection bag?

81. Why elder patients are prone to UTI?

 Urinary stasis
 Low estrogen for menopausal women

82. Signs and symptoms of severe Anemia?

 Fatigue
 Shortness of breath
 Dizziness
 Headache
 Coldness in the hand and feet
 Pale skin
 Chest pain

83. Patient for urinalysis but not able to submit the sample immediately, what is the proper
intervention?

84. The baby is jaundice for 24 hours. What does it mean?

 Normal physiological jaundice appears after first 24 hours in full term neonates.
 After the first 48 hours in premature neonates.
 Jaundice occurring before this time (pathological jaundice) may indicate early hemolysis of
red blood cells and must be reported to the physician.
 Physiological jaundice peaks about the 5th day of life (indirect bilirubin level: 6-7mg/dL)

85. What to give to patient taking INH?

 Isoniazid (Laniazid, Nydrazid), also known as isonicotinylhydrazine (INH), is anorganic
compound that is the first-line antituberculosis medication in prevention and treatment

86. Patient is positive to Tuberculin test. What is the confirmation test?

 The Mantoux test (also known as the Mantoux screening test, Tuberculin Sensitivity
Test, Pirquet test, or PPD test for Purified Protein Derivative) is a diagnostic tool
fortuberculosis.

87. Patient came after insertion of PICCO or CVC catheter at antecubital fossa. What is your
intervention?

88. What to instruct the patient to avoid Lipodystrophy?

 A lipodystrophy can be a lump or small dent in the skin that forms when a person keeps
performing injections in the same spot. These types of lipodystrophies are harmless. People
who want to avoid them can do so by changing (rotating) the places where they perform
injections.

89. Stress depends to individual perception.

90. Nurse giving palliative care to pt. with cancer. What is your therapeutic approach?

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91. Patient with Asthma. What to expect with ABG result?

 Elevated PC02
 Decreased P02
 Respiratory acidosis

92. Patient with COPD. What to check about the status?

 Oxygenation
 tachypnea, a rapid breathing rate
 wheezing sounds or crackles in the lungs heard through a stethoscope
 breathing out taking a longer time than breathing in
 enlargement of the chest, particularly the front-to-back distance (hyperaeration)
 active use of muscles in the neck to help with breathing
 breathing through pursed lips
 increased anteroposterior to lateral ratio of the chest (i.e. barrel chest)

93. Mother taking care of baby with Gastroenteritis. What is the proper handling of the mother when
changing diaper?
 Proper hand washing

94. Least priority for pt with Hepa A

95. Patient with pre-eclampsia understand the teaching or disease if stated....?

96. Why not to give Tetracycline to child below 12 years old?

 Teeth stain (permanent)
 Affects the growth of teeth and bones

97. Why need to avoid physical activities for pt. with Rheumatic fever?
 Acute rheumatic fever is an inflammation that may affect many parts of the body.
 It can be a complication of streptococcal pharyngitis (strep throat), a type of bacterial
infection of the throat.
 ASO titer - test
 Single or repeated episodes of rheumatic fever can lead to chronic rheumatic heart
disease.

98. The child taking Vincristine. What laboratory needs to check?

 an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Vincristine is classified
as a plant alkaloid
 Low blood counts. Your white and red blood cells and platelets ma temporarily decrease.
 This can put you at increased risk for infection, anemia and/or bleeding.

99. Priority care for pt. with DM and problem in sensory perception

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100. Signs of Neurovascular compromise

 Trauma
 Burns
 Post surgery
 In traction

101. What to ask if patient has Cataract before taking any medicines?
 Call his attention

102. Patient taking Corticosteroids. What important instruction to give?

 Don’t stop the medicine abruptly, this may cause liver/kidney damage

103. Why avoid routinely elevating the above knee amputation?

 Elevation can cause flexion contracture of the hip joint

104. Patient taking Coumadin. He needs further instruction if says the ff:?

105. Mother gave birth to baby with Gestational Diabetes. The nurse should monitor the baby for
signs of?
 Hypoglycemia
 Respiratory distress
 Excess growth
 jaundice

106. Signs and symptoms of Alcohol withdrawal

 anorexia ( nausea and vomiting may occur)
 anxiety
 easily startled
 hyper alertness
 hypertension
 insomnia
 irritability
 jerky movements
 possibly experiences hallucinations, illusions, or vivid nightmares
 Possible reports a feeling of shaking inside
 Seizures (usually appear 7-48 hours after cessation of alcohol)
 Tachycardia
 Tremors

107. Patient with history of alcohol abuse admitted in AE after car accident. The nurse should assess
for?
 Slurred speech
 Uncoordinated movements
 Unsteady gait

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 Restlessness
 Belligerence
 Confusion
 Depression
 Wernicke’s encephalopathy, causing confusion, ataxia, and abnormal eye movement
 Hepatitis
 Pancreatitis
 Anemia

108. Patient with Stroke affects the patient by?

109. What is the importance of exercise for pt with DM?

 Lowers blood glucose level
 Reduces cardiovascular risks
 Improves circulation and muscle tone.
 Decreases total cholesterol and triglyceride levels
 Encourages weight loss

110. What to avoid if patient is post surgery of hip fracture?

 Prevent flexion or external or internal rotation
 Do not turn patient on affected side unless prescribed

111. Hip fracture- nursing intervention

 Maintain leg and hip in proper alignment
 Prevent flexion or external or internal rotation
 Turn the client from back to unaffected side
 Do not position patient to the affected side unless prescribed by the physician
 Maintain leg abduction to prevent internal or external rotation
 Use a trochanter roll to prevent external rotation
 Ensure that the hip flexion angle does not exceed 60-80 degrees
 Elevate the head of the bed 30-45 degrees for meals only
 Avoid weight bearing on the affected side

112. Patient is for removal of ICD, what to instruct?

 Take a deep breath and hold it when removing the tube
 After removal, ask client to take a deep breath, exhale and bear down

113. Which one to aspirate first? Regular or NPH insulin?

 Regular insulin

114. You give Pethidine to pt. What will you do with the remaining?

115. The child weight 35kg and needs to receive 5mg/kg of antibiotic How much you will give?
 175mg

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116. 50 units HR in 50ml NS running in 10ml/hr. How many units is remaining?

117. The order is 4mmol KCL. The label read 18mmol. How many ml you will give or incorporate?
 18mmol in what

118. Doctor order Coumadin15mg and Paracetamol 625mg. Coumadin 3mg and Paracetamol@
325mg as stock dose.
 Coumadin (5 tabs)
 Paracetamol (2 tabs)

119. Which one is Plasma Expander?

 Crystalloids
 Normal saline
 Hypertonic saline (3%)
 Half normal saline
 8.4% bicarbonate solution
 Mannitol 20%
 Dextrose 5%
 Lactated ringer
 Colloids
 Albumin
 Heat starch
 Dextran

120. Albumin is given to pt with Liver Cirrhosis. How would you know Albumin is effective?
 Normal albumin level (3.5-5g/dl)

121. Effective therapy for Alzheimer’s

 Identify and reinforce retained skills
 Provide continuity of care
 Orient client to the environment
 Furnish environment with familiar possessions
 Acknowledge the client’s feelings
 Assist the client and family members to manage memory deficits and behavior changes
 Encourage the family members to express feelings about caregiving
 Provide caregiver support and identify the resources and support groups available
 Monitor activities of daily living
 Remind client how to perform self care activities
 Maintain independence
 Provide consistent routines
 Provide exercise such as walking with an escort
 Avoid activities that tax the memory
 Allow plenty of time to complete a task
 Use constant encouragement in a step-by-step approach
 Provide activities that distract and occupy time, such as listening to music, coloring, and
watching television
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 Provide mental stimulation with simple games or activities
 Provide safe environment, close supervision
 Use firm volume and a low pitched voice to communicate
 Stand directly in front of the client and maintain eye contact

122. Lanoxin computation

123. MgSO4 computation

124. Morphine Sulfate computation

125. ECG Tracing of MI patient that is fatal

 VT and VF

126. Duodenal Ulcer, what kind of pain patient may complain?

 Heartburn
 Severe stomach pain
 Burning sensation felt at the back of the throat

127. BP 120/70 after 30 min 112/60 HR 72, what is your intervention?

128. Best position for infant with Ventricular septal defect?

 A VSD is an abnormal opening between the right and left ventricles
 Many VSD close spontaneously during the first year of life in children having small or
moderate defects
 A characteristic murmur is present; CHF is common
 Non-surgical treatment: device closure during cardiac catheterization may be possible
 Surgical treatment: open repair is done with cardiopulmonary bypass
 Squat position is the recommendation so that the oxygenated blood will be directed to the
brain instead of the extremities

129. Patient admitted with Suicidal attempt. What is your priority intervention?
 Close monitoring

130. Obsessive Compulsive, provide support

 Do not interrupt the compulsive behaviors
 Allow time for the client to perform the compulsive rituals
 Provide for client safety related to the behaviors
 Implement a schedule for the client that distracts from the behaviors
 Set limits on the rituals that may interfere with the client’s physical well being to protect the
client from physical harm
 Encourage the client to verbalize concerns
 Establish a written contract that will assist the client to decrease the frequency of
compulsive behaviors gradually

131. Patient with thick sputum, how to help to loosen up secretions?

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132. The nurse is planning to have piggyback running to patient line. The first line has NS. What is
the best way to hang the piggyback?

133. Patient with Pulmonary Edema. What to expect with lung sounds?
 Pulmonary edema is usually caused by heart failure. As the heart fails, pressure in the
veins going through the lungs starts to rise.
 As the pressure in these blood vessels increases, fluid is pushed into the air spaces
(alveoli) in the lungs. This fluid interrupts normal oxygen movement through the lungs,
resulting in shortness of breath
 Crackles in the lungs called rales
 wheezing

134. A female 45 y/o, healthy without complaints of health problem. What is the nursing responsibility
with her?

135. Patient with meningitis is irritable. What is the best intervention?

 Meningitis is inflammation of the arachnoid and pia mater of the brain and spinal cord.
 Meningitis is caused by bacterial and viral organisms, although fungal and protozoal
meningitis also occurs.
 Predisposing factors:
 Skull fractures
 Brain and spine surgery
 Sinus or upper respiratory infections
 Use of nasal sprays
 Individual with compromised immune system
 Cerebrospinal fluid is analyzed to determine the diagnosis and the type of meningitis.
 Transmission is by direct contact, including droplet spread
 Assessment
 Mild lethargy
 Memory changes
 Short attention span
 Personality and behavior changes
 Severe headache
 Generalized muscle aches and pains
 Nausea and vomiting
 Fever and chills
 Tachycardia
 Deterioration in the level of consciousness
 Photophobia
 Signs of meningeal irritation such as nuchal rigidity
 Red, macular rash with meningococcal meningitis
 Abdominal and chest pain with viral meningitis
 Interventions
 Monitor vital signs and neurological signs
 Assess for signs of increasing ICP
 Initiate seizure precautions
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 Monitor for seizure activity
 Monitor for signs of meningeal irritation
 Perform cranial nerve assessment
 Assess peripheral vascular status
 Maintain isolation precautions as necessary with bacterial meningitis
 Maintain urine and stool precautions with viral meningitis
 Maintain respiratory isolation for the client with pneumococcal meningitis
 Elevate the head of the bed 30 degrees, and avoid neck flexion and extreme hip
flexion
 Prevent stimulation and restrict visitors
 Administer analgesics as prescribed
 Administer antibiotics as prescribed

136. Patient is receiving Loop diuretics. What to expect?

 Loop diuretics inhibit sodium and chloride reabsorption from the loop of henle and the distal
tubule.
 Loop diuretics have little effect on the blood glucose; however, they cause depletion of
water and electrolytes, increased uric acid levels, and the excretion of calcium
 Loop diuretics are more potent than the thiazide diuretics, causing rapid diuresis, thus
decreasing vascular fluid volume, cardiac output, and blood pressure.
 Loop diuretics are used for hypertension, edema associated with CHF, hypercalcemia, and
renal disease.
 Use loop diuretics with caution in the client taking digoxin or lithium.
 Use loop diuretics with caution in the client on aminoglycosides, anticoagulants,
corticosteroids, or amphotericin B.
 Side effects
 Hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia
 Hypochloremia
 Thrombocytopenia
 Hyperuricemia
 Orthostatic hypotension
 Skin disturbances
 Ototoxicity and deafness
 Thiamine deficiency
 Dehydration
 Intervention
 Monitor vital signs
 Monitor weight
 Monitor urine output
 Monitor electrolytes, calcium, magnesium and uric acid levels
 Check the peripheral extremities for edema
 Monitor for signs of digoxin or lithium toxicity if the client is on these medications
 Instruct the client to take the medication in the morning to avoid nocturia and sleep
interruption
 Instruct the client in how to record the BP
 Instruct the client to eat foods rich in potassium
 Instruct the client to avoid gastrointestinal upset food
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 ‫اوليس يجزي محسن اال باحسان‬
 Instruct the client to change positions slowly to prevent orthostatic hypotension
 Administer IV furosemide slowly because hearing loss can occur if injected rapidly

137. Patient with Streptococcal infection, what laboratory finding should be checked?

138. Nursing intervention for patient with severe Hyperthermia

 Maintain patent airway
 Initiate seizure precaution
 Monitor intake and output and assess skin and mucous membranes for signs of
dehydration
 Monitor lung sounds
 Monitor for dysrhythmias
 Assess peripheral pulses for systemic blood flow
 Induce normothermia with fluids, cool baths, fans, or hypothermia blanket

139. Most common complication of intubation

 Broken tooth

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