Online Nursing Practice Test about Pharmacology (11-15)

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11. A patient who is known to be a narcotic abuser is involved in an automobile accident and has extensive surgery. In planning for analgesia post-surgery, the nurse should be aware that this patient is likely to:

a) tolerate pain than a patient who is not a drug abuser
b) require greater doses of medication before pain is relieved
c) refuse medication to prove addiction is not a problem
d) tolerate oral medication better than intravenous doses

12. When a patient is taking an antianxiety drug, such as Alprazolam (Xanax), the nurse should instruct the patient to:

a) avoid alcoholic beverages
b) increase potassium intake
c) discontinue use of drugs like tylenol
d) check for signs of edema

13. A client is to receive morphine sulfate 10mg IM. The morphine for injection is available in 8 mg per 1 ml. How many ml should the client receive?

14. A newborn baby boy was given Aquamephyton. The mother asks the purpose of the medication. Which of the following is most appropriate explanation to the mother?

a) this is given to prevent infectious diseases in the future
b) this is given to prevent blood clot formation
c) this is given to enhance immune system function
d) this is given to prevent bleeding

15. The patient is admitted for treatment of Garamycin IV drip. After 24 hours of receiving the medication, which of the following laboratory results are to be checked? Select all that apply

a) BUN
b) creatinine
c) peak and through
d) glucose
e) protein
f) hemoglobin
g) CBC


11) B
- narcotic tolerance requires greater doses of the medication to obtain the desired therapeutic effect.

12) A
- alcohol is a CNS depressant. It enhances sedative effect of benzodiazepines like Alprazolam. Therefore, the patient should avoid alcoholic beverages when he is taking benzodiazepines.

13) 1.25 ml

D/S x dilution = quantity of drug

10 mg/8 mg x 1ml = 1.25 ml

14) D
- aquamephyton is a vitamin K preparation. It promotes synthesis of prothrombin and other clotting factors. Therefore, it will prevent bleeding.

15) A, B, C, E, F, G
- garamaycin is ototoxic, nephrotoxic, may cause agranulocytosis, thrombocytopenia, anemia, proteinura, and photosensitivity. Peak and through levels are determined to serve as basis for determining and adjusting dosage of the medication.

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Test Prep for Nursing Exam about Pediatric Nursing (41-45)

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41. Which of the following physical assessment findings is considered normal?

a) a 6-month old who is drooling
b) a 2-year old with pinkish color of the eyes
c) an 18-month old with no teeth
d) a 3-year old with dimpling in the spine

42. A pediatric nurse has received report from the previous shift. Which of the following patients should the nurse attend to first?

a) a 4-month old baby girl with ventricular septal defect (VSD) with heart murmurs
b) a 3-year old baby girl with Tetralogy of Fallot (TOF) with blue lips when crying
c) a 12-month old baby boy with coarctation of aorta (COA) who has weakness on the right extremity
d) a 10-month old baby boy with patent ductus arteriosus with positive babinski

43. A nurse is assigned in the pediatric unit. Which of the following patients should be assessed first by the nurse?

a) a 6-month old baby boy who vomited three times an hour ago
b) a 1-year old baby boy who cries when his mother leaves
c) a 2-month old baby girl with PR=122
d) a 9-month old baby boy who mobilizes through his abdomen

44. A 6-year old boy was diagnosed to have hemophilia. Which statement when made by the parents indicates correct understanding of the disease?

a) the child inherits the disease from the father
b) the child inherits the disease from the mother
c) the other sons and daughters are at risk to have the disease
d) the boy might not have any children in the future

45. A mother asks where to safely place her 5-year old child in the car. The appropriate response by the nurse is:

a) in the middle of the back seat, rear-facing, using a booster chair
b) in the middle of the back seat, front-facing, using a booster chair
c) in the front seat of the car, ensuring the presence of an airbag
d) in the front seat of the car, using a booster chair


41) A
- it is normal for a 6-month old child to still experience drooling. The sclera is white; pinkish color of the eyes indicates inflammation. Eruption of teeth starts at 5-7 months. An 18-month old child should have 12 teeth (age in months - 6 = number of teeth).
Dimpling in the spine indicates spina bifida occulta.

42) C
- weakness on an extremity needs to be investigated immediately because this indicates that a complication is occurring.

43) A
- an infant's fluid electrolyte balance can easily be upset, which may pose severe problems. Eighty percent of an infant's weight is fluid; most of the fluid is found in the ECF compartment which can be lost easily.

44) B
- hemophilia is X-linked disorder, which is inherited from the mother. Only the sons will have the disease, daughters are carriers of the traits.

45) B
- the recommended place of a child who is over 2 years of age or over 20 lbs. in weight, when riding a car is middle of the back seat, front-facing. Booster chair is to be used until the child is 6 years of age or below 60 lbs in weight.

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NCLEX Secrets - Neurology Board Review (51-55)

NCLEX Secrets - Neurology Board Review

51. A 75-year old woman is admitted to a nursing home with a diagnosis of primary dementia of the Alzheimer's type. In the nursing home, which of these behaviors of the client is of greatest danger to her?

a) she wanders into other patient's room
b) she climbs over the side rails of her bed
c) she eats the food off other resident's plates
d) she refuses to change her clothes

52. An elderly client is diagnosed with Alzheimer's disease. When planning care, the nurse should include which of these vital considerations?

a) allowing him to plan his own day
b) encouraging outside diversional activities
c) limiting his caloric intake
d) providing a calm, predictable environment

53. While in the dining room having lunch, a nursing home client with Alzheimer's disease suddenly begins shouting and banging on the table. Which action should be taken by the nurse first?

a) speak in a firm voice asking the client to stop the behavior
b) put the client in the corner of the dining room by himself
c) take the client back to his room to finish lunch
d) remove the lunch tray until the client can control himself

54. A patient with hepatic encephalopathy is given instructions regarding his diet. Which of the following foods should the patient avoid?

a) proteins
b) calcium
c) fats
d) carbohydrates

55. A male client, 89 years old who has a mild Alzheimer's disease was admitted 2 days ago. Which of the following signs and symptoms are expected in the client?

a) poor attention span
b) poor personal hygiene
c) unable to remember misplaced objects
d) irritable
e) intention tremors
f) shuffling gait

NCLEX Secrets - Neurology Board Review:

51) B
- falls is one of the greatest dangers among confused client.

52) D
- a simple, structured environment should be provided to the client with Alzheimer's disease to help him cope up with his/her memory loss.

53) C
- remove the client from the environment that may have triggered agitation. But continue provide care, like allowing him to finish his meal.

54) A
- the natural end-product of protein is ammonia. Increased ammonia production causes hepatic encephalopathy.

55) A, B, C, D
- the main problem with Alzheimer's disease is memory loss. Intention tremors and shuffling gait are manifestations of Parkinson's disease.

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NCLEX Review Questions on Cancer (26-30)

NCLEX Review Questions on Cancer

26. A 40-year old woman is admitted to the hospital for a radiation implant therapy to treat recently diagnosed cervical cancer. The most important consideration when planning care is her

a) level of anxiety
b) loss of income due to inability to work
c) support system
d) energy level to perform ADL's

27. When the nurse is discussing risk factors for cervical cancer, which of these women would be at greatest risk?

a) a 25-year old woman with family history of cancer and using birth control pills
b) a 50-year old woman who has several exposures to radiation and has chronic anemia
c) a 19-year old woman who initiated sexual intercourse early with multiple partners
d) a 60-year old woman who had smoked cigarettes for 5 years and used diaphragm for birth control

28. Which of the following nursing diagnoses would rank as the most important in the planning of care for a client in two weeks after the chemotherapy has begun?

a) potential for infection
b) activity intolerance
c) impaired skin integrity
d) self-esteem disturbance

29. During the administration of a chemotherapeutic drug, the nurse observes that there is a lack of blood return from the intravenous catheter. The priority action by the nurse would be to

a) stop the administration of the drug immediately
b) reposition the client's arm and continue with the administration of the drug
c) apply a tourniquet to the patient's affected arm and notify the doctor
d) continue to administer the drug and assess for edema at the IV site

30. A patient who is receiving chemotherapy develops stomatitis. Which of the following actions would be priority for the nurse to incorporate into the plan of care?

a) rinse the patient's mouth with full strength hydrogen peroxide every 4 hours
b) use a soft toothbrush after each meal
c) provide hot tea with honey to soothe the patient's painful oral mucosa
d) use dental floss only

NCLEX Review Questions on Cancer:

26) A
- anxiety is the usual response to a change in life situation like undergoing treatment for cancer.

27) C
- early sexual intercourse and having multiple sexual partners pose highest risk to cervical cancer.

28) A
- chemotherapy causes immunosuppression. Therefore, the patient is at risk to develop infection.

29) A
- chemotherapeutic agents are irritating to tissues. Lack of blood return from the IV catheter indicates that it is out of vein. Therefore, administration of the drug should be stopped immediately.

30) B
- use soft toothbrush in a client with stomatitis to prevent further trauma and pain to the oral mucosa. Half-strength hydrogen peroxide is recommended to relieve stomatitis not full strength. Hot beverages will further cause irritation. Honey may support proliferation of microorganisms in the oral mucosa. Flossing may also cause trauma to the mouth and gums of the patient with stomatitis.

Go to the next page ---> NCLEX Review Questions on Cancer (31-35) 

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      Test Prep for Nursing Exam about Pediatric Nursing (36-40)

      36. Which of the following growth and development changes is not expected in an adolescent?

      a) growth of body hair
      b) voice changes
      c) loss of subcutaneous tissues
      d) increased activity of sweat glands and sebaceous glands

      37. A young mother brings her 6-month old daughter to the ER about midnight. The infant is not crying, but has bruises on her arms and legs. The baby is not able to sit even when held in an upright position. The mother says the baby fell out of her crib. The mother is quite non-committal about events leading up to the baby's fall. In order to complete the assessment, which of the following actions by the nurse is a priority?

      a) ask the mother to call her husband to the hospital
      b) determine whether the infant has any serious physical problems
      c) sit down and chat with the mother in order to reassure her
      d) order a blood level for alcohol on both parents

      38. A medical-surgical nurse is to work in a pediatric unit for 8 hours. Which of these patients should be assigned to her?

      a) a school-aged child with bronchial asthma and teenager who had an appendectomy 4 hours ago
      b) a 2-month old infant with cleft palate and a 3-year old with inguinal hernia
      c) a 4-year old male with nephrotic syndrome and a week old infant who just had a pylorotomy
      d) a 10-year old female with Down's syndrome admitted for pneumonia and a 3-year old with Tetralogy of Fallot who is scheduled for surgery the next day

      39. A mother calls the clinic and says her 6-year old son swallowed some toilet bowl cleaner. The nurse should tell the mother to do which of the following first?

      a) bring the child to the hospital
      b) give the child syrup of ipecac
      c) wrap a blanket around the child
      d) try to get the child to drink milk

      40. A new order is written for eardrops on a 3-year old child. Which nursing action has the lowest priority in preparation for this procedure?

      a) anticipate the need for assistance to restrain the child
      b) check the child's name bracelet before administration of the medication
      c) explain the purpose of the medication to the child
      d) check which ear is to receive the drops prior to instillation


      36) C
      - there is usually accumulation of subcutaneous tissues among adolescents

      37) B
      - when there is incongruence between the severity of injury and explanation of how the injury occurred, consider abuse. Serious physical problems support presence of abuse. Suspicion of abuse should be reported to the local authority.

      38) A
      - older children with medical-surgical conditions like asthma are more appropriate to be taken good care of by the medical-surgical nurse. This is similar to her training and experience.

      39) D
      - to neutralize the corrosive effect of the toilet bowl cleaner, try to get the child to drink milk. Do not induce vomiting when the ingested substance is corrosive. Therefore, do not give syrup of ipecac, an emetic.

      40) C
      - a 3-year old child is still unable to comprehend the purpose of the medication. Explanation should be given to the parents.

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      Online Nursing Practice Test about Respiratory Diseases (41-45)

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      41. High pressure alarm still alarms after suctioning the client. What should the nurse do next?

      a) disconnect the client from mechanical ventilation and do manual resuscitation
      b) call the respiratory therapist
      c) call another nurse to be with the client while the nurse calls for the physician
      d) turn off the alarm

      42. Which of the following community-acquired pneumonias demonstrates the highest occurrence during summer and fall?

      a) pneumococcal pneumonia
      b) legionaire's pneumonia
      c) viral pneumonia
      d) mycoplasma pneumonia

      43. A client is admitted to an acute care facility with a tentative diagnosis of PCP (pneumocystis carinii pneumonia). She had lost 25 lbs. over the past 2 months and complains of anorexia. At this point, the highest priority goal is that the patient will

      a) increase nutrient intake
      b) have no further weight loss
      c) be free from infection
      d) maintain cardiopulmonary functioning

      44. A patient underwent a pneumonectomy and developed tension pneumothorax. Which of the following is an early indication of tension pneumothorax

      a) frothy, blood-tinged sputum
      b) trachea shifts toward unaffected side of the chest
      c) development of subcutaneous emphysema
      d) open, sucking chest wound

      45. The nurse is caring for a client on mechanical ventilator. The low-pressure alarm of the ventilator turns on. The most important nursing action is:

      a) prepare to suction the client
      b) check air leak from endotracheal tube
      c) check if the tube is kinked
      d) turn off the alarm


      41) A
      - oxygenation and ventilation are the priority among clients on mechanical ventilation

      42) B
      - legionaire's pneumonia is the highest in incidence during summer. Whereas, pneumococcal pneumonia is most common during winter.

      43) D
      - cardiopulmonary functioning is a priority in the patient with pneumocystis carinii pneumonia.

      44) B
      - mediastinal shift indicates pneumothorax. This causes airway obstruction.

      45) B
      - when the low-pressure alarm turns on, this indicates disconnection of tubings. So, appropriate nursing action is to check for air leak. When the high pressure alarm turns on, this indicates obstruction. It may be due to accumulation of mucous secretions, kinks along the tubing, or the client is biting the endotracheal tube.

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      Test Prep for Nursing Exam about Obstetric Nursing (36-40)


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      36. Several female patients want to have Papanicolaou examination. Who among these patients should the nurse advise not to have the examination? The patient who states

      a) the first day of my menstruation came this morning and I am bleeding profusely
      b) I am 21 years old, and have not had any sex at all
      c) I had the test 3 months ago and it was positive
      d) I have herpes simplex virus (HSV) and had sex 2 weeks ago

      37. A mother who has just delivered a term baby, wants to delay breastfeeding for 3 days. What is the best interpretation of this mother's behavior?

      a) she has knowledge deficit regarding breastfeeding
      b) she doesn't want to breastfeed her child
      c) she doesn't want to have bonding with her child
      d) she doesn't want to accept her responsibility of caring for her child

      38. A primigravid client at 8 weeks gestation tells the nurse that since having had sexual relations with a new partner 2 weeks ago, she has noticed flu-like symptoms, enlarged lymph nodes, and clusters of vesicles on her vagina. The nurse refers the client to a physician because the nurse suspects which of the following sexually transmitted diseases.

      a) gonorrhea
      b) chlamydia trachomatis
      c) syphilis
      d) herpes genitalis

      39. A middle-aged woman has just returned from the recovery room after a right mastectomy. A top priority in planning her care is to minimize the pain she is experiencing.

      a) risk for ineffective airway clearance
      b) alteration in comfort
      c) potential for injury
      d) alteration in nutrition

      40. A patient who is on her 39 weeks gestation comes to the hospital accopmpanied by her husband. She tells the nurse she thinks she is in labor. Which of the following questions should the nurse ask to help confirm if the patient is in true labor?

      a) do your contractions feel like severe menstrual cramps?
      b) do you feel pressure in your legs
      c) do you feel as if you can breathe easier?
      d) does your pain increase in intensity when you are moving around?


      36) B
      - papanicolaou examination is done in all sexually active women at any age. If the woman is not sexually active, baseline examination is at age 40.

      37) A
      - the mother needs to know that breastfeeding is best started as soon as possible to stimulate milk production and to promote bonding between the mother and the child.

      38) D
      - herpes genitalis is characterized by clusters of vesicles in the vaginal area. Trachomatis infection is often asymptomatic in women, but symptoms may include yellowish discharge and dysuria. Some women have no symptoms of gonorrhea. Others may experience vaginal itching and a thick purulent vaginal discharge. Syphilis is characterized by painless chanchroid.

      39) B
      - comfort is being free from pain. Alteration in comfort indicates presence of pain.

      40) D
      - in true labor, pain is intensified by walking. In false labor, pain is relieved by walking.

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      Online Nursing Practice Test about Gastrointestinal Diseases (31-35)

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      31. Which of the following interventions does the nurse expect to give to a client after gastrointestinal series?

      a) analgesic
      b) laxative
      c) antiemetic
      d) sedative

      32. The client has been diagnosed to have acute pancreatitis. Which of the following is not a component of nursing care for the client?

      a) administer morphine sulfate for pain
      b) administer calcium supplement as ordered
      c) administer digestive enzymes with each meal and snack
      d) administer IV therapy as ordered

      33. The client has been diagnosed to have VRE (Vancomycin-resistant enterocolitis). Which of the following is appropriate nursing action when caring for the client?

      a) wear mask when entering the client's room
      b) wear gloves when caring for the client
      c) wear mask and gloves when performing procedures to the client
      d) wear gown and mask when caring for the client

      34. A patient was diagnosed to have Laennec's cirrhosis. Which of the following symptoms should be assessed first?

      a) inability to write
      b) jaundice
      c) increased BUN
      d) ascites

      35. A nurse assists a physician in performing a liver biopsy. After the procedure, which of the following positions should the nurse place the patient?

      a) prone position
      b) supine position
      c) right side-lying position with a pillow under the puncture site
      d) left side-lying position with a pillow under the puncture site


      31) B
      - BaSO4 which is used as the contrast medium in gastrointestinal series, causes constipation. Therefore, laxative will be administered after the procedure as ordered.

      32) A
      - morphine SO4 is contraindicated in a client with acute pancreatitis because it causes spasm of the sphincter of Oddi and the pancreas. Demerol is the drug of choice to relieve pain in acute pancreatitis.

      33) B
      VRE is characterized by diarrhea. Contact precaution should be implemented, which includes use of gloves and gown when caring for the patient.

      34) A
      - inability to write indicates presence of asterixis (flapping tremors) this may signal impending hepatic encephalopathy. This is an assessment priority in a client with liver cirrhosis.

      35) C
      - right side-lying position is intended to apply pressure at the puncture site, and thereby preventing bleeding after liver biopsy.

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      Online Nursing Practice Test about Pharmacology (6-10)

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      6. The client has hepatic encephalopathy. She is receiving lactulose. What is the expected outcome of the medication?

      a) increased level of awareness
      b) increased albumin levels
      c) increased number of stools
      d) increased serum protein levels

      7. The nurse is preparing to administer Terbutaline (Brethine) to a multigravid client in preterm labor. Before administering this drug intravenously, the nurse should assess which of the following?

      a) hematocrit level
      b) weight gain
      c) urinary output
      d) heart rate

      8. The physician orders Betamethasone (Celestone) for a 34-year old multigravid client at 32 weeks gestation who is experiencing preterm labor. The nurse explains that this drug is given for which of the following reasons?

      a) to enhance fetal lung maturity
      b) to counter the effects of tocolytic therapy
      c) to treat chorioamnionitis
      d) to decrease neonatal production of surfactant

      9. Which of the following comments indicates that a client understands the nurse's teaching about Sertraline (Zoloft)?

      a) this medicine will probably cause me to gain weight
      b) this medicine can cause delayed ejaculations
      c) dry mouth is a permanent side effect of Zoloft
      d) I can take my medicine with St. John's wort

      10. When the nurse begins to give the patient a prescribed medication, the patient says, "You are poisoning me with the pills you are giving me." Which of these responses by the nurse is most appropriate?

      a) tell me why you think I am doing that to you
      b) this isn't the first dose I've given you
      c) I'll get a fresh package of pills so you can see me open the sealed package
      d) are the other nurses giving you these pills?


      6) A
      - lactulose inhibits ammonia formation and relieves hepatic encephalopathy

      7) D
      - terbutaline, a beta-adrenergic agonist may cause tachycardia.

      8) A
      - betamethasone enhances fetal lung maturity. Thereby, increasing chance of fetal survival if preterm delivery is inevitable.

      9) B
      - Zoloft, an antidepressant can cause decreased libido and sexual dysfunction. It can also cause loss of appetite and weight loss.

      10) C
      - if a client believes that he is being poisoned, allow him to see that the medications are opened in his presence.

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      NCLEX Secrets - Neurology Board Review (46-50)

      NCLEX Secrets - Neurology Board Review

      46. Which of the following assessment findings indicated increased intracranial pressure? Select all that apply

      a) headache
      b) tachycardia
      c) slow respiration
      d) narrowing of pulse pressure
      e) slow, bounding pulse
      f) hyperthermia

      47. Which of the following nursing measures should be included when caring for a client with Parkinson's disease?

      a) put color on rails in going upstairs
      b) provide high toilet seat
      c) provide soft mattress
      d) apply restraints to reduce tremors

      48. Michael suddenly went into seizures. To protect a child from injury the nurse should:

      a) retrain the child's arm and legs
      b) place a tongue blade in the child's mouth
      c) place a pillow under the child's head
      d) provide a waterproof pad for the bed

      49. The first nursing priority when providing nursing care for Michael is to:

      a) administer antibiotic as ordered as soon as possible
      b) keep the room quiet and dim
      c) explain all the procedures to the patients
      d) begin low-flow oxygen per mask

      50. Which room should the nurse assign to Ashley?

      a) room 201 with Joey, age 2 who underwent surgery for repair of hernia
      b) room 206 with Rica, age one who had pneumonia
      c) room 210 with Jack age 2 who has cerebral palsy
      d) room 214 with no roommate

      NCLEX Secrets - Neurology Board Review:

      46) A, C, E, F
      - increased ICP is characterized by headache, nausea and vomiting, diplopia, increased systolic BP, slow respiration, slow bounding pulse, widening of pulse pressure, hyperthermia/hypothermia, altered LOC, papilledema, lateralizing sign.

      47) B
      - the client with Parkinson's disease experiences stiffness/rigidity due to inadequate dopamine production. Dopamine is a neurotransmitter that promotes muscle relaxation. High toilet seat facilitates the client's ability to sit during elimination.

      48) C
      - the child should never be restrained during a seizure because such action by the nurse can cause fracture of the bones. Tongue blade must not be inserted when the child is already having a seizure because of the risk of injury. Placing waterproof pad at this time is no longer advisable. It is correct to slip pillow under the head to protect the head of the child from banging on any hard object.

      49) A
      - the priority is to treat the patient with antibiotics at the soonest time possible because the longer the disease goes on without treatment, the greater the risk of seizures and of permanent neurologic damage, such as hearing loss, brain damage, blindness, loss of speech, learning disabilities and behavior problems. Non-neurologic complications may include kidney and adrenal gland failure. Bacterial infections of the central nervous system progress quickly. Within hours of the onset of symptoms, the disease can lead to shock and death.

      50) D
      - Bacterial meningitis is a highly contagious. Therefore the patient must be placed in a private room to prevent transmitting it to other patients. Nurses who will be in contact with patients with meningitis should wear mask, the mask should be discarded right away when it gets moist or wet. The different types of bacterial meningitis are:
      • Pneumococcus - this bacterium is the most common cause of meningitis in adults and children. It most often occurs when the bacterium Streptococcus pneumoniae (pneumococcus), the same bacterium that causes pneumonia and ear infections, enters the bloodstream and migrates to the brain and spinal cord. Mode of transmission is the same as pneumonia: droplet, direct contact and through respiratory discharges.
      • Meningococcus - this bacterium is another common cause of meningitis in children under age 5, in teens and in young adults. Meningococcal meningitis commonly occurs when bloodstream. It's highly contagious and may cause localized epidemics in college dormitories, boarding schools and on military bases. Five strains of the Neisseria meningitidis bacterium cause meningococcal meningitis. Mode of transmission is by direct contact and respiratory droplets. This type of meningitis is communicable until the meningococci are no longer present from nose and mouth. Prophylactic treatment is Rifampicin taken for 4 days at a dose of 20 mg/kg/day.
      • Haemophilus - the Haemophilus influenzae (H. influenzae) bacterium is the leading cause of bacterial meningitis in children under age 5. The use of the Hib vaccine prevents this type of meningitis. When it occurs, it tends to follow an upper respiratory infection, ear infection (otitis media) or sinusitis. Mode of transmission is by droplet infection and discharges from nose and throat during the infectious period. This type of meningitis is no longer communicable 48 hours after starting antibiotic therapy.

      Go to the next page ---> NCLEX Secrets - Neurology Board Review (51-55)  

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        NCLEX Review about Cardiac Nursing (31-35)

        NCLEX Review about Cardiac Nursing

        31. Left-sided congestive heart failure is most often associated with which of the following manifestations?

        a) dyspnea
        b) distended neck vein
        c) hepatomegaly
        d) pedal edema

        32. A client with chest pain is admitted to the emergency department. He states that his chest pain was not relieved after taking 3 nitroglycerine tablets at home. Which of the following is the best initial nursing action?

        a) administer the prescribed analgesic
        b) give nitroglycerine sublingually
        c) monitor blood pressure
        d) monitor ECG

        33. After cardiac catheterization, which of the following findings should the nurse report to the physician?

        a) pain on the groin when changing positions
        b) the client denies tingling sensation in the extremity
        c) the client verbalizes that she experienced flushing sensation during the procedure
        d) the toenail blanches on compression and pinkish color returns after 1 to 3 seconds

        34. After cardiac catheterization that involves femoral artery, which of the following actions by the RN needs intervention by the charge nurse?

        a) the RN monitors the client's vital signs
        b) the RN applies small ice pack over the puncture site
        c) the RN elevates the head of the bed to sitting position as requested by the client
        d) the RN immobilizes the affected extremity in extension

        35. An elderly client who had suffered a severe heart attack says to the nurse, "I have a living will and my children do not agree with what I have decided. I hope you nurses and doctors will abide by my wishes." Which of these responses by the nurse is best?

        a) your wishes are the most important
        b) do you expect your children to be here when you have to make decisions?
        c) you and your children should really decide together
        d) it's always best to reconsider your decisions

        NCLEX Review about Cardiac Nursing:

        31) A
        - left-sided congestive heart failure is characterized by signs and symptoms due to: a. pulmonary edema ("left" - "lung"), b. cellular hypoxia, c. RAAS activation --> hypertension and hypokalemia.
        Choices B, C, D are signs and symptoms of right-sided CHF.

        32) A
        - relief of chest pain is a priority in myocardial infarction. Pain increases cardiac workload and may lead to shock. Morphine sulfate is the drug of choice.

        33) A
        - pain in the groin after cardiac catheterization may indicate hematoma at the site. This indicates bleeding at the site and compression of blood vessels by the hematoma may occur. his in turn, may cause circulatory impairment in the area.

        34) C
        - avoid acute hip flexion after cardiac catheterization involving the femoral artery to prevent circulatory impairment. HOB may be elevated only up to 30 deg for the first 6 to 8 hours

        35) A
        - the client's wishes are primary considerations in living will.

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        Online Nursing Practice Test about Pharmacology (1-5)


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        1. Which of the following laboratory results shows adverse effect of garamycin?

        a) elevated SGOT and SGPT
        b) decreased wbc count
        c) increased platelet count
        d) elevated BUN and serum creatinine

        2. The client is on heparin therapy. Which of the following health teaching is essential?

        a) use a safety razor to shave
        b) use a soft sponge toothbrush
        c) take ecotrin for pain
        d) use compression support stockings

        3. Which of the following medications would the nurse be prepared to administer to a client in liver failure?

        a) neomycin and lactulose
        b) phenytoin sodium
        c) diazepam
        d) phenobarbital

        4. What is the difference between epidural analgesia and analgesia given through intravenous route?

        a) epidural analgesia has longer effect in the body
        b) epidural analgesia has more sedative effect
        c) epidural analgesia is more effective in relieving pain
        d) epidural analgesia has fewer side effects

        5. A client is receiving Synthroid. Which of the following assessment data indicates that the client is experiencing a side effect of the drug?

        a) muscle weakness and fatigue
        b) headache and lethargy
        c) tachycardia and weight loss
        d) anorexia and obesity


        1) D
        - garamycin is an aminoglycoside. It is nephrotoxic and ototoxic. Nephrotoxicity is indicated by elevated BUN and serum creatinine.

        2) B
        - heparin is an anticoagulant. Avoid factors that may cause bleeding. Use soft bristled/soft sponge toothbrush to prevent gum bleeding. Ecotrin (ASA) may cause bleeding. Electric razor, and not safety razor is recommended to prevent trauma.

        3) A
        - neomycin and lactulose block ammonia formation. These are indicated to relieve hepatic encephalopathy. Neomycin reduces colonic bacteria which are responsible for ammonia formation. Lactulose acidifies the colon and inhibits formation of alkaline ammonia.

        4) A
        - epidural analgesia has longer effect on the body.

        5) C
        - synthroid is a thyroid preparation. This may cause hypersensitivity of the thyroid gland as manifested by tachycardia and weight loss.

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        NCLEX Preparation Course - Critical Thinking Exercises VI (Answers 11-20)

        Here are the Questions to NCLEX Preparation Course - Critical Thinking VI (11-20) -->

        11) B
        - application of warm compress relieves joint pains in a client with sickle cell anemia. Warm compress also thins the blood. This prevent further accumulation of clumped RBC's in the joints. The management for sickle cell anemia HHOP - Hydration, Heat application, Oxygenation, Pain medication.

        12) D
        - the client with SLE experience joint pain. ROM exercises will help relieve the pain. Exposure to sunlight should be avoided by the client with SLE to prevent exacerbation of signs and symptoms.

        13) D, E, F, G
        - these are not included when giving information about hepatitis A.
        Choices A, B, C are to be included when giving health teachings to a client with hepatitis A.

        14) A, B, C, F
        - thse are appropriate interventions for a patient with Addison's disease which is hyposecretion of the adrenal cortex hormones. Low secretion of glucocorticoid: hypoglycemia, low resistance to infection; low secretion of mineralocorticoid ( aldosterone): loss of sodium and water, hypotension, retention of potassium.

        15) C
        - assess the client first, before implementation

        16) A
        - the post CVA client requires services of different members of the health team during rehabilitation.

        17) D
        - herbal medicines believed to relieve menstrual cramps are Black Cohosh, Evening Primrose and Dong quai.

        18) A
        - after herniorrhaphy, straining at stool should be avoided to prevent weakening of the repair. Increasing fluid intake prevents constipation.

        19) B
        - aspiration causes airway obstruction that may lead to death. Therefore, this should be given highest priority. (ABC is priority).

        20) A
        - the nurse should take the BP on the other arm. Hypocalcemia is manifested by bilateral carpopedal spasm.

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