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December 2011 Nurse Licensure Examination Schedule
December 2011 Nurse Licensure Examination:
Date of Examination: December 18 and 19, 2011
Deadline of Filing
Firstakers: October 21, 2011
Repeaters: September 16, 2011
Top the Board Exam!!!!
Home Treatment for Vaginitis
Vaginitis is any vaginal infection, inflammation or irritation that causes a change in normal vaginal discharge. General symptoms include a marked change in the amount, color, odor or consistency of the discharge, itching, painful urination, and pain during intercourse.
Among older women, yeast infections are the most common king of vaginitis. In addition to vaginal itching and painful urination, yeast infections cause a white, curdy “cottage cheese” discharge.
Post-menopausal women, who have lower estrogen levels, are more prone to vaginitis. Diabetes and the use of antibiotics or corticosteroids also increase risk.
Vaginitis is common and is not necessarily a symptom of a sexually transmitted disease. Some women seem more susceptible than others. An aggravating fact about vaginitis is that it can recur.
Prevention
- Wear cotton underpants. The organisms that cause vaginitis grow best in warm, moist places, and nylon underpants tend to trap heat and perspiration. Avoid clothing that is tight in the crotch and thighs.
- Wash your genital area once a day with a mild soap and warm water. Dry thoroughly.
- Avoid douching frequently. A healthy vagina will clean itself.
- Avoid feminine deodorant spray and other perfumed products. They irritate tender skin.
- Wipe from front to back after using the toilet to avoid spreading bacteria from the anus to the vagina.
- If you are taking antibiotics, include plenty of yogurt or buttermilk in your diet to help prevent a yeast infection.
- A bacterial or non-specific infection may go away by itself in three to four days.
- Avoid intercourse to give irritated vaginal tissues time to heal.
- Avoid scratching. Relieve itching with cold water compresses.
- Recurrent yeast infections may be treated with over-the-counter antifungal creams, Gyne-Lotrimin or Monistat.
Credits to and Copyright from: NursingCrib.com
Simple Bullets: Antacids
Antacids: raise the luminal pH 4 to give a very sticky gel that adheres strongly to the base of ulcer craters.
Sodium Bicarbonate: Also known as baking soda. It works quickly to neutralize acid. It is the only useful water-soluble antacid. It acts rapidly but has a transient action and absorbed bicarbonate in high dose may cause systemic alkalosis.
Magnesium Hydroxide: Mg hydroxide and magnesium trisilicate are insoluble in water and have a fairly rapid action. Magnesium has a laxative effect and may cause diarrhea
Aluminum Hydroxide: has a relatively slower action. Aluminum ions form complexes with certain drugs (tetracyclines) and tend to cause constipation. Mixtures of magnesium and aluminum compounds may be used to minimize the effects of motility.
Aluminum and Magnesium: Aluminum salts dissolve slowly in the stomach and work gradually, providing longer-lasting relief. Magnesium salts act quickly to neutralize acids. The effects of aluminum and magnesium balance each other so well; these types of antacids have long been considered an excellent treatment for digestive upset. However, in recent years there have been questions about the long-term safety of taking aluminum, which may deplete the body of phosphorus and calcium, increasing the risk of weak bones.
Calcium Carbonate: Also known as chalk, it acts quickly and neutralizes acids for relatively long periods of time.
Antacid Overuse
Can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying
Overuse can cause the following problems:
1. Aluminum hydroxide: Constipation and Hypophosphatemia, Osteomalacia
2. Magnesium Hydroxide: Diarrhea, Hypermagnesemia
3. Calcium Carbonate: Hypercalcemia, Rebound Acid ↑, Constipation, Renal Stones
4. Sodium Bicarbonate: Metabolic Alkalosis, Hypertension, Renal Failure
All Causes Hypokalemia
Do we have a Mnemonics for this? I have something for you!!!
Aluminum: AluMINIMUM amount of feces
Magnesium (MG): Must Go to the bathroom
Who says we can’t have our own mnemonics? LOLzZ Well, here we have:
Aluminum: (W)Ala Tae!
Magnesium; Magtatae!
Sharing knowledge can be so FUN!
Hope it can help!
ANTACIDS Related Questions:
A client says, “I take ½ teaspoon of baking soda in a glass of water when I get heartburn.” The nurse suggests that the client use an antacid preparation that contains aluminum hydroxide and magnesium such as MAALOX. This response is based on the fact that antacids:
a. Contain little if any sodium
b. Are readily absorbed by the stomach mucosa
c. Have no direct effect on systemic acid-base balance when taken as directed
d. Causes few side effects such as diarrhea or constipation when they are used properly.
NURSING REVIEW: Congestive Heart Failure Bullets
- Heart failure occurs when the heart’s pumping becomes impaired, resulting in inability to meet the body’s oxygen demands. The most common type of heart failure, left-sided failure, occurs when the left ventricle cannot contract sufficiently.
- Afterload is the amount of resistance the ventricle pumps against. In order to pump effectively, the ventricle must generate sufficient pressure to overcome this resistance.
- Left heart failure occurs when arteries downstream constrict, resulting in increased afterload: resistance too high for the ventricle to pump against.
- A heart attack can also cause left heart failure.
- In a failing heart, blood accumulates in the left ventricle causing pressure. This pressure, called preload, causes the ventricle to expand.
- Increased preload worsens the ventricle’s ability to pump. Accumulating blood stretches the cardiac muscle fibers, pulling myosin and actin filaments farther apart. When over-stretched, myosin molecules cannot connect with actin, the myosin–actin crossbridges cannot swivel.
- The inability of the crossbridges to swivel causes makes contraction weaker, reducing the likelihood that sufficient blood will be pumped. The progression of heart failure continues as blood accumulates.
- Built-up blood in the left ventricle causes a backup of blood throughout the pulmonary circuit, leading to pulmonary congestion. This associated congestion is responsible for left heart failure, also known as “congestive heart failure.”
- Blood build up in the lungs causes difficulty breathing, especially when a person is reclining. Pulmonary congestion also reduces the ability to oxygenate the blood, worsening systemic hypoxia.
- The progressive nature of congestive heart failure, if untreated, ultimately causes death.
NURSING REVIEW: Celiac disease (Gluten-sensitive enteropathy)
Permanent inability to tolerate dietary gluten in the small intestines.
Manifestation:
Retarded growth
Laboratory Data:
Small bowel biopsy indicates abnormal mucosa
Nursing Diagnosis:
Altered Nutrition
Interventions:
Lifetime avoidance of:
Barley
Rye
Oats
Wheat (gluten-free diet)
Food which are allowed: corn, cereals, soybeans, rice. If the patient attends a party instruct th mother to prepare a homemade cake for the child to bring to the party since commercially prepared cakes are made of wheat. Refer the patients to geneticist.
Sample Question: Which of the following statements, if made by a parent of two-year-old child recently diagnosed with celiac disease, supports a nursing diagnosis of knowledge deficit?
A “I won’t have to make any major dietary changes until my child reaches puberty.”
B. “I have to keep my child on a gluten-free diet to prevent episodes of diarrhea.”
C. “I should read the labels on any processed foods I offer to my child.”
D. “I will need to notify my child’s school about the special diet.”
Answer: (A)
NURSING REVIEW MCH: Abruptio Placent Vs Placenta Previa
Abruptio Placenta
Premature partial or complete separation of the placenta
Manifestation:
Painful dark red vaginal bleeding
Laboratory Data:
Ultrasound detects retroplacental bleeding
Nursing Diagnosis:
Risk for fluid Volume Deficit
Intervention:
Sample Question: A 26-year-old woman who is hospitalized because of abruption placentae should be carefully assessed for which of the following complications?
A. Toxic Syndrome
B. Pulmonary Embolism
C. Cerebrovascular accident
D. Disseminated intravascular coagulation
Answer: (D)
Placenta Previa
Placenta attaches low in the uterus
Manifestation:
Panless bright red vaginal bleeding after the 7th month of pregnancy
Laboratory Data:
Ultrasound will show the location of placenta
Nursing Diagnosis:
Potential fluid volume deficit
Intervention:
Sample Question: Because a woman who is confirmed to be at 30 weeks gestation has sudden painless bright red vaginal bleeding, a nurse would suspect the woman is experiencing:
A. Abruptio Placenta
B. An ectopic pregnancy
C. Placenta Previa
D. A molar pregancy
Answer: (C)
Premature partial or complete separation of the placenta
Manifestation:
Painful dark red vaginal bleeding
Laboratory Data:
Ultrasound detects retroplacental bleeding
Nursing Diagnosis:
Risk for fluid Volume Deficit
Intervention:
- Maintain bedrest
- Administer fluids
- Provide psychological Support
Sample Question: A 26-year-old woman who is hospitalized because of abruption placentae should be carefully assessed for which of the following complications?
A. Toxic Syndrome
B. Pulmonary Embolism
C. Cerebrovascular accident
D. Disseminated intravascular coagulation
Answer: (D)
Placenta Previa
Placenta attaches low in the uterus
Manifestation:
Panless bright red vaginal bleeding after the 7th month of pregnancy
Laboratory Data:
Ultrasound will show the location of placenta
Nursing Diagnosis:
Potential fluid volume deficit
Intervention:
- Immediate bed rest
- Administer IV fluids as ordered
- Do not perform vaginal exam
Sample Question: Because a woman who is confirmed to be at 30 weeks gestation has sudden painless bright red vaginal bleeding, a nurse would suspect the woman is experiencing:
A. Abruptio Placenta
B. An ectopic pregnancy
C. Placenta Previa
D. A molar pregancy
Answer: (C)
NURSING REVIEW: Hepatic encephalopathy/coma
Decreasing Level of consiousness related to accumulation of ammonia.
Manifestation:
Personality changes; flapping tremors is a common sign
Laboratory Darta:
Elevated serum ammonia
Nursing Diagnosis:
Altered though process
Nursing Interventions:
- Monitor level of consciousness
- Maintain low protein diet
Sample Question:Which of the following is a sign of hepatic coma?
A. hand flapping
B. Diaphoresis
C. Progressive weakness
D. Easy fatigability
Answer: (A)
NURSING REVIEW: 10 Random Question
Question 1
The nurse is performing an assessment on a client who is cachectic and has developed an enterocutaneous fistula following surgery to relieve a small bowel obstruction. The client's total protein level is reported as 4.5 g/dl. Which of the following would the nurse anticipate?
A) Additional potassium will be given IV
B) Blood for coagulation studies will be drawn
C) Total parenteral nutrition (TPN) will be started
D) Serum lipase levels will be evaluated
Review Information: The correct answer is C: Total parenteral nutrition (TPN) will be started. The client is not absorbing nutrients adequately as evidenced by the cachexia and low protein levels. (A normal total serum protein level is 6.0-8.0 g/dl.) TPN will promote a positive nitrogen balance in this client who is unable to digest and absorb nutrients adequately.
Question 2
The nurse is assessing a comatose client receiving gastric tube feedings. Which of the following assessments requires an immediate response from the nurse?
A) Decreased breath sounds in right lower lobe
B) Aspiration of a residual of 100cc of formula
C) Decrease in bowel sounds
D) Urine output of 250 cc in past 8 hours
Review Information: The correct answer is A: Decreased breath sounds in right lower lobe. The most common problem associated with enteral feedings is atelectasis. Maintain client at 30 degrees of head elevation during feedings and monitor for signs of aspiration. Check for tube placement prior to each feeding or every 4 to 8 hours if the client is receiving continuous feeding.
Question 3
The nurse is preparing to take a toddler's blood pressure for the first time. Which of the following actions should the nurse perform first?
A) Explain that the procedure will help him to get well
B) Show a cartoon character with a blood pressure cuff
C) Explain that the blood pressure checks the heart pump
D) Permit handling the equipment before putting the cuff in place
Review Information: The correct answer is D: Permit handling the equipment before putting the cuff in place The best way to gain the toddler''s cooperation is to encourage handling the equipment. Detailed explanations are not helpful.
Question 4
A 35-year-old client of Puerto Rican-American descent is diagnosed with ovarian cancer. The client states, “I refuse both radiation and chemotherapy because they are 'hot.'” The next action for the nurse to take is to
A) document the situation in the notes
B) report the situation to the health care provider
C) talk with the client's family about the situation
D) ask the client to talk about concerns regarding "hot" treatments
Review Information: The correct answer is D: ask the client to talk about concerns regarding "hot" treatments The "hot-cold" system is found among Mexican-Americans, Puerto Ricans, and other Hispanic-Latinos. Most foods, beverages, herbs, and medicines are categorized as hot or cold, which are symbolic designations and do not necessarily indicate temperature or spiciness. Care and treatment regimens can be negotiated with clients within this framework.
Question 5
Which of the following drugs should the nurse anticipate administering to a client before they are to receive electroconvulsive therapy?
A) Benzodiazepines
B) Chlorpromazine (Thorazine)
C) Succinylcholine (Anectine)
D) Thiopental sodium (Pentothal Sodium)
Review Information: The correct answer is C: Succinylcholine (Anectine) Succinylcholine is given intravenously to promote skeletal muscle relaxation.
Question 6
Which statement made by a nurse about the goal of total quality management or continuous quality improvement in a health care setting is correct?
A) It is to observe reactive service and product problem solving
B) Improvement of the processes in a proactive, preventive mode is paramount
C) A chart audits to finds common errors in practice and outcomes associated with goals
D) A flow chart to organize daily tasks is critical to the initial stages
Review Information: The correct answer is B: Improvement of the processes in a proactive, preventive mode is paramount Total quality management and continuous quality improvement have a major goal of identifying ways to do the right thing at the right time in the right way by proactive problem-solving.
Question 7
The nurse admits a 2 year-old child who has had a seizure. Which of the following statement by the child's parent would be important in determining the etiology of the seizure?
A) "He has been taking long naps for a week."
B) "He has had an ear infection for the past 2 days."
C) "He has been eating more red meat lately."
D) "He seems to be going to the bathroom more frequently."
Review Information: The correct answer is B: "He has had an ear infection for the past 2 days." Contributing factors to seizures in children include those such as age (more common in first 2 years), infections (late infancy and early childhood), fatigue, not eating properly and excessive fluid intake or fluid retention.
Question 8
The nurse is caring for a client with Hodgkin's disease who will be receiving radiation therapy. The nurse recognizes that, as a result of the radiation therapy, the client is most likely to experience
A) high fever
B) nausea
C) face and neck edema
D) night sweats
Review Information: The correct answer is B: nausea Because the client with Hodgkin''s disease is usually healthy when therapy begins, the nausea is especially troubling.
Question 9
A client with a panic disorder has a new prescription for Xanax (alprazolam). In teaching the client about the drug's actions and side effects, which of the following should the nurse emphasize?
A) Short-term relief can be expected
B) The medication acts as a stimulant
C) Dosage will be increased as tolerated
D) Initial side effects often continue
Review Information: The correct answer is A: Short-term relief can be expected Xanax is a short-acting benzodiazepine useful in controlling panic symptoms quickly.
Question 10
While assessing the vital signs in children, the nurse should know that the apical heart rate is preferred until the radial pulse can be accurately assessed at about what age?
A) 1 year of age
B) 2 years of age
C) 3 years of age
D) 4 years of age
Review Information: The correct answer is B: 2 years of age A child should be at least 2 years of age to use the radial pulse to assess heart rate.
The nurse is performing an assessment on a client who is cachectic and has developed an enterocutaneous fistula following surgery to relieve a small bowel obstruction. The client's total protein level is reported as 4.5 g/dl. Which of the following would the nurse anticipate?
A) Additional potassium will be given IV
B) Blood for coagulation studies will be drawn
C) Total parenteral nutrition (TPN) will be started
D) Serum lipase levels will be evaluated
Review Information: The correct answer is C: Total parenteral nutrition (TPN) will be started. The client is not absorbing nutrients adequately as evidenced by the cachexia and low protein levels. (A normal total serum protein level is 6.0-8.0 g/dl.) TPN will promote a positive nitrogen balance in this client who is unable to digest and absorb nutrients adequately.
Question 2
The nurse is assessing a comatose client receiving gastric tube feedings. Which of the following assessments requires an immediate response from the nurse?
A) Decreased breath sounds in right lower lobe
B) Aspiration of a residual of 100cc of formula
C) Decrease in bowel sounds
D) Urine output of 250 cc in past 8 hours
Review Information: The correct answer is A: Decreased breath sounds in right lower lobe. The most common problem associated with enteral feedings is atelectasis. Maintain client at 30 degrees of head elevation during feedings and monitor for signs of aspiration. Check for tube placement prior to each feeding or every 4 to 8 hours if the client is receiving continuous feeding.
Question 3
The nurse is preparing to take a toddler's blood pressure for the first time. Which of the following actions should the nurse perform first?
A) Explain that the procedure will help him to get well
B) Show a cartoon character with a blood pressure cuff
C) Explain that the blood pressure checks the heart pump
D) Permit handling the equipment before putting the cuff in place
Review Information: The correct answer is D: Permit handling the equipment before putting the cuff in place The best way to gain the toddler''s cooperation is to encourage handling the equipment. Detailed explanations are not helpful.
Question 4
A 35-year-old client of Puerto Rican-American descent is diagnosed with ovarian cancer. The client states, “I refuse both radiation and chemotherapy because they are 'hot.'” The next action for the nurse to take is to
A) document the situation in the notes
B) report the situation to the health care provider
C) talk with the client's family about the situation
D) ask the client to talk about concerns regarding "hot" treatments
Review Information: The correct answer is D: ask the client to talk about concerns regarding "hot" treatments The "hot-cold" system is found among Mexican-Americans, Puerto Ricans, and other Hispanic-Latinos. Most foods, beverages, herbs, and medicines are categorized as hot or cold, which are symbolic designations and do not necessarily indicate temperature or spiciness. Care and treatment regimens can be negotiated with clients within this framework.
Question 5
Which of the following drugs should the nurse anticipate administering to a client before they are to receive electroconvulsive therapy?
A) Benzodiazepines
B) Chlorpromazine (Thorazine)
C) Succinylcholine (Anectine)
D) Thiopental sodium (Pentothal Sodium)
Review Information: The correct answer is C: Succinylcholine (Anectine) Succinylcholine is given intravenously to promote skeletal muscle relaxation.
Question 6
Which statement made by a nurse about the goal of total quality management or continuous quality improvement in a health care setting is correct?
A) It is to observe reactive service and product problem solving
B) Improvement of the processes in a proactive, preventive mode is paramount
C) A chart audits to finds common errors in practice and outcomes associated with goals
D) A flow chart to organize daily tasks is critical to the initial stages
Review Information: The correct answer is B: Improvement of the processes in a proactive, preventive mode is paramount Total quality management and continuous quality improvement have a major goal of identifying ways to do the right thing at the right time in the right way by proactive problem-solving.
Question 7
The nurse admits a 2 year-old child who has had a seizure. Which of the following statement by the child's parent would be important in determining the etiology of the seizure?
A) "He has been taking long naps for a week."
B) "He has had an ear infection for the past 2 days."
C) "He has been eating more red meat lately."
D) "He seems to be going to the bathroom more frequently."
Review Information: The correct answer is B: "He has had an ear infection for the past 2 days." Contributing factors to seizures in children include those such as age (more common in first 2 years), infections (late infancy and early childhood), fatigue, not eating properly and excessive fluid intake or fluid retention.
Question 8
The nurse is caring for a client with Hodgkin's disease who will be receiving radiation therapy. The nurse recognizes that, as a result of the radiation therapy, the client is most likely to experience
A) high fever
B) nausea
C) face and neck edema
D) night sweats
Review Information: The correct answer is B: nausea Because the client with Hodgkin''s disease is usually healthy when therapy begins, the nausea is especially troubling.
Question 9
A client with a panic disorder has a new prescription for Xanax (alprazolam). In teaching the client about the drug's actions and side effects, which of the following should the nurse emphasize?
A) Short-term relief can be expected
B) The medication acts as a stimulant
C) Dosage will be increased as tolerated
D) Initial side effects often continue
Review Information: The correct answer is A: Short-term relief can be expected Xanax is a short-acting benzodiazepine useful in controlling panic symptoms quickly.
Question 10
While assessing the vital signs in children, the nurse should know that the apical heart rate is preferred until the radial pulse can be accurately assessed at about what age?
A) 1 year of age
B) 2 years of age
C) 3 years of age
D) 4 years of age
Review Information: The correct answer is B: 2 years of age A child should be at least 2 years of age to use the radial pulse to assess heart rate.
NURSING REVIEW: Diabetes Mellitus
Chronic Disorder of carbohydrates, protein and fat metabolism characterized by an imbalance between insulin supply and demand.
Manifestation
Polyuria, polydypsia, polyphagia and weightloss
Laboratory Data : Elevated FBS level
Intervention:
D - Diet 50-60% CHO (Protein), 20-30% FATS, 10-20% CHON (Carbohydrates).
I - Insulin
A - Antidiabetic Agents: Tolbutamide
B - Bloog Sugar Monitoring
E - Exercise
T - Transplant of the pancreas
E - Ensure adequate food intake
S - Scrupulous foot care
Sample Question: A 25-years-old Sarah, is seven weeks pregnant. She has had non insulin-dependent diabetes millitus (Type 2) since she was 16. A common symptom of pregnancy that could lead to problems for this woman is which of the following?
A. Urinary Frequency
B. Breast Enlargement
C. The presecense of chronic gonadotropin in the urine
D. Nausea
Answer (D)
MATERNITY NURSING REVIEW
1. You performed the leopold’s maneuver and found the following: breech presentation, fetal back at the right side of the mother. Based on these findings, you can hear the fetal heart beat (PMI) BEST in which location?
A.Left lower quadrant
B.Right lower quadrant
C.Left upper quadrant
D.Right upper quadrant
Answer: (B) Right lower quadrant Right lower quadrant. The landmark to look for when looking for PMI is the location of the fetal back in relation to the right or left side of the mother and the presentation, whether cephalic or breech. The best site is the fetal back nearest the head.
2. In Leopold’s maneuver step #1, you palpated a soft broad mass that moves with the rest of the mass. The correct interpretation of this finding is:
A.The mass palpated at the fundal part is the head part.
B.The presentation is breech.
C.The mass palpated is the back
D.The mass palpated is the buttocks.
Answer: (D) The mass palpated is the buttocks. The palpated mass is the fetal buttocks since it is broad and soft and moves with the rest of the mass.
3. In Leopold’s maneuver step # 3 you palpated a hard round movable mass at the supra pubic area. The correct interpretation is that the mass palpated is:
A.The buttocks because the presentation is breech.
B.The mass palpated is the head.
C.The mass is the fetal back.
D.The mass palpated is the fetal small part
Answer: (B) The mass palpated is the head. When the mass palpated is hard round and movable, it is the fetal head.
4. The hormone responsible for a positive pregnancy test is:
A.Estrogen
B.Progesterone
C.Human Chorionic Gonadotropin
D.Follicle Stimulating hormone
Answer: (C) Human Chorionic Gonadotropin Human chorionic gonadotropin (HCG) is the hormone secreted by the chorionic villi which is the precursor of the placenta. In the early stage of pregnancy, while the placenta is not yet fully developed, the major hormone that sustains the pregnancy is HCG.
5. The hormone responsible for the maturation of the graafian follicle is:
A.Follicle stimulating hormone
B.Progesterone
C.Estrogen
D.Luteinizing hormone
Answer: (A) Follicle stimulating hormone The hormone that stimulates the maturation if the of the graafian follicle is the Follicle Stimulating Hormone which is released by the anterior pituitary gland.
7. The most common normal position of the fetus in utero is:
A.Transverse position
B.Vertical position
C.Oblique position
D.None of the above
Answer: (B) Vertical position Vertical position means the fetal spine is parallel to the maternal spine thus making it easy for the fetus to go out the birth canal. If transverse or oblique, the fetus can’t be delivered normally per vagina.
8. In the later part of the 3rd trimester, the mother may experience shortness of breath. This complaint maybe explained as:
A.A normal occurrence in pregnancy because the fetus is using more oxygen
B.The fundus of the uterus is high pushing the diaphragm upwards
C.The woman is having allergic reaction to the pregnancy and its hormones
D.The woman maybe experiencing complication of pregnancy
Answer: (B) The fundus of the uterus is high pushing the diaphragm upwards From the 32nd week of the pregnancy, the fundus of the enlarged uterus is pushing the respiratory diaphragm upwards. Thus, the lungs have reduced space for expansion consequently reducing the oxygen supply.
9. Which of the following findings in a woman would be consistent with a pregnancy of two months duration?
A.Weight gain of 6-10 lbs. and presence of striae gravidarum
B.Fullness of the breast and urinary frequency
C.Braxton Hicks contractions and quickening
D.Increased respiratory rate and ballottement
Answer: (B) Fullness of the breast and urinary frequency Fullness of the breast is due to the increased amount of progesterone in pregnancy. The urinary frequency is caused by the compression of the urinary bladder by the gravid uterus which is still within the pelvic cavity during the first trimester.
10. Which of the following is a positive sign of pregnancy?
A.Fetal movement felt by mother
B.Enlargement of the uterus
C.(+) pregnancy test
D.(+) ultrasound
Answer: (D) (+) ultrasound A positive ultrasound will definitely confirm that a woman is pregnant since the fetus in utero is directly visualized.
11. What event occurring in the second trimester helps the expectant mother to accept the pregnancy?
A.Lightening
B.Ballotment
C.Pseudocyesis
D.Quickening
Answer: (D) Quickening Quickening is the first fetal movement felt by the mother makes the woman realize that she is truly pregnant. In early pregnancy, the fetus is moving but too weak to be felt by the mother. In the 18th-20th week of gestation, the fetal movements become stronger thus the mother already feels the movements.
12. Shoes with low, broad heels, plus a good posture will prevent which prenatal discomfort?
A.Backache
B.Vertigo
C.Leg cramps
D.Nausea
Answer: (A) Backache Backache usually occurs in the lumbar area and becomes more problematic as the uterus enlarges. The pregnant woman in her third trimester usually assumes a lordotic posture to maintain balance causing an exaggeration of the lumbar curvature. Low broad heels provide the pregnant woman with a good support.
13. When a pregnant woman experiences leg cramps, the correct nursing intervention to relieve the muscle cramps is:
A.Allow the woman to exercise
B.Let the woman walk for a while
C.Let the woman lie down and dorsiflex the foot towards the knees
D.Ask the woman to raise her legs
Answer: (C) Let the woman lie down and dorsiflex the foot towards the knees Leg cramps is caused by the contraction of the gastrocnimeus (leg muscle). Thus, the intervention is to stretch the muscle by dosiflexing the foot of the affected leg towards the knee.
14. From the 33rd week of gestation till full term, a healthy mother should have prenatal check up every:
A.week
B.2 weeks
C.3 weeks
D.4 weeks
Answer: (A) week In the 9th month of pregnancy the mother needs to have a weekly visit to the prenatal clinic to monitor fetal condition and to ensure that she is adequately prepared for the impending labor and delivery.
15. The expected weight gain in a normal pregnancy during the 3rd trimester is
A.1 pound a week
B.2 pounds a week
C.10 lbs a month
D.10 lbs total weight gain in the 3rd trimester
Answer: (A) 1 pound a week During the 3rd trimester the fetus is gaining more subcutaneous fat and is growing fast in preparation for extra uterine life. Thus, one pound a week is expected.
16. In the Batholonew’s rule of 4, when the level of the fundus is midway between the umbilicus and xyphoid process the estimated age of gestation (AOG) is:
A.5th month
B.6th month
C.7th month
D.8th month
Answer: (C) 7th month In Bartholomew’s Rule of 4, the landmarks used are the symphysis pubis, umbilicus and xyphoid process. At the level of the umbilicus, the AOG is approximately 5 months and at the level of the xyphoid process 9 months. Thus, midway between these two landmarks would be considered as 7 months AOG.
17. The following are ways of determining expected date of delivery (EDD) when the LMP is unknown EXCEPT:
A.Naegele’s rule
B.Quickening
C.Mc Donald’s rule
D.Batholomew’s rule of 4
Answer: (A) Naegele’s rule Naegele’s Rule is determined based on the last menstrual period of the woman.
18. If the LMP is Jan. 30, the expected date of delivery (EDD) is
A.Oct. 7
B.Oct. 24
C.Nov. 7
D.Nov. 8
Answer: (C) Nov. 7 Based on the last menstrual period, the expected date of delivery is Nov. 7. The formula for the Naegele’s Rule is subtract 3 from the month and add 7 to the day.
19. Kegel’s exercise is done in pregnancy in order to:
A.Strengthen perineal muscles
B.Relieve backache
C.Strengthen abdominal muscles
D.Prevent leg varicosities and edema
Answer: (A) Strengthen perineal muscles Kegel’s exercise is done by contracting and relaxing the muscles surrounding the vagina and anus in order to strengthen the perineal muscles
20. Pelvic rocking is an appropriate exercise in pregnancy to relieve which discomfort?
A.Leg cramps
B.Urinary frequency
C.Orthostatic hypotension
D.Backache
Answer: (D) Backache Backache is caused by the stretching of the muscles of the lower back because of the pregnancy. Pelvic rocking is good to relieve backache.
21. The main reason for an expected increased need for iron in pregnancy is:
A.The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal requires about 350-400 mg of iron to grow
B.The mother may suffer anemia because of poor appetite
C.The fetus has an increased need for RBC which the mother must supply
D.The mother may have a problem of digestion because of pica
Answer: (A) The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal requires about 350-400 mg of iron to grow About 400 mgs of Iron is needed by the mother in order to produce more RBC mass to be able to provide the needed increase in blood supply for the fetus. Also, about 350-400 mgs of iron is need for the normal growth of the fetus. Thus, about 750-800 mgs iron supplementation is needed by the mother to meet this additional requirement.
22. The diet that is appropriate in normal pregnancy should be high in
A.Protein, minerals and vitamins
B.Carbohydrates and vitamins
C.Proteins, carbohydrates and fats
D.Fats and minerals
Answer: (A) Protein, minerals and vitamins In normal pregnancy there is a higher demand for protein (body building foods), vitamins (esp. vitamin A, B, C, folic acid) and minerals (esp. iron, calcium, phosphorous, zinc, iodine, magnesium) because of the need of the growing fetus.
24. Which of the following signs will require a mother to seek immediate medical attention?
A.When the first fetal movement is felt
B.No fetal movement is felt on the 6th month
C.Mild uterine contraction
D.Slight dyspnea on the last month of gestation
Answer: (B) No fetal movement is felt on the 6th month Fetal movement is usually felt by the mother during 4.5 – 5 months. If the pregnancy is already in its 6th month and no fetal movement is felt, the pregnancy is not normal either the fetus is already dead intra-uterine or it is an H-mole.
25. You want to perform a pelvic examination on one of your pregnant clients. You prepare your client for the procedure by:
A.Asking her to void
B.Taking her vital signs and recording the readings
C.Giving the client a perineal care
D.Doing a vaginal prep
Answer: (A) Asking her to void A pelvic examination includes abdominal palpation. If the pregnant woman has a full bladder, the manipulation may cause discomfort and accidental urination because of the pressure applied during the abdominal palpation. Also, a full bladder can impede the accuracy of the examination because the bladder (which is located in front of the uterus) can block the uterus.
26. When preparing the mother who is on her 4th month of pregnancy for abdominal ultrasound, the nurse should instruct her to:
A.Observe NPO from midnight to avoid vomiting
B.Do perineal flushing properly before the procedure
C.Drink at least 2 liters of fluid 2 hours before the procedure and not void until the procedure is done D.Void immediately before the procedure for better visualization
Answer: (C) Drink at least 2 liters of fluid 2 hours before the procedure and not void until the procedure is done Drinking at least 2 liters of water 2 hours before the procedure will result to a distended bladder. A full bladder is needed when doing an abdominal ultrasound to serve as a “window” for the ultrasonic sound waves to pass through and allow visualization of the uterus (located behind the urinary bladder).
27. The nursing intervention to relieve “morning sickness” in a pregnant woman is by giving
A.Dry carbohydrate food like crackers
B.Low sodium diet
C.Intravenous infusion
D.Antacid
Answer: (A) Dry carbohydrate food like crackers Morning sickness maybe caused by hypoglycemia early in the morning thus giving carbohydrate food will help.
28. The common normal site of nidation/implantation in the uterus is
A.Upper uterine portion
B.Mid-uterine area
C.Lower uterine segment
D.Lower cervical segment
Answer: (A) Upper uterine portion The embryo’s normal nidation site is the upper portion of the uterus. If the implantation is in the lower segment, this is an abnormal condition called placenta previa.
29. Mrs. Santos is on her 5th pregnancy and has a history of abortion in the 4th pregnancy and the first pregnancy was a twin. She is considered to be
A.G 4 P 3
B.G 5 P 3
C.G 5 P 4
D.G 4 P 4
Answer: (B) G 5 P 3 Gravida refers to the total number of pregnancies including the current one. Para refers to the number of pregnancies that have reached viability. Thus, if the woman has had one abortion, she would be considered Para 3. Twin pregnancy is counted only as 1.
30. The following are skin changes in pregnancy EXCEPT:
A.Chloasma
B.Striae gravidarum
C.Linea negra
D.Chadwick's sign
Answer: (D) Chadwick's sign Chadwick's sign is bluish discoloration of the vaginal mucosa as a result of the increased vascularization in the area.
31. Which of the following statements is TRUE of conception?
A.Within 2-4 hours after intercourse conception is possible in a fertile woman
B.Generally, fertilization is possible 4 days after ovulation
C.Conception is possible during menstruation in a long menstrual cycle
D.To avoid conception, intercourse must be avoided 5 days before and 3 days after menstruation
Answer: (A) Within 2-4 hours after intercourse conception is possible in a fertile woman The sperms when deposited near the cervical os will be able to reach the fallopian tubes within 4 hours. If the woman has just ovulated (within 24hours after the rupture of the graafian follicle), fertilization is possible.
32. Which of the following are the functions of amniotic fluid? 1.Cushions the fetus from abdominal trauma 2.Serves as the fluid for the fetus 3.Maintains the internal temperature 4.Facilitates fetal movement
A.1 & 3
B.1, 3, 4
C.1, 2, 3
D.All of the above
Answer: (D) All of the above All the four functions enumerated are true of amniotic fluid.
33. You are performing abdominal exam on a 9th month pregnant woman. While lying supine, she felt breathless, had pallor, tachycardia, and cold clammy skin. The correct assessment of the woman’s condition is that she is
A.Experiencing the beginning of labor
B.Having supine hypotension
C.Having sudden elevation of BP
D.Going into shock
Answer: (B) Having supine hypotension Supine hypotension is characterized by breathlessness, pallor, tachycardia and cold clammy skin. This is due to the compression of the abdominal aorta by the gravid uterus when the woman is on a supine position.
34. Smoking is contraindicated in pregnancy because
A.Nicotine causes vasodilation of the mother’s blood vessels
B.Carbon monoxide binds with the hemoglobin of the mother reducing available hemoglobin for the fetus
C.The smoke will make the fetus and the mother feel dizzy
D.Nicotine will cause vasoconstriction of the fetal blood vessels
Answer: (B) Carbon monoxide binds with the hemoglobin of the mother reducing available hemoglobin for the fetus Carbon monoxide is one of the substances found in cigarette smoke. This substance diminishes the ability of the hemoglobin to bind with oxygen thus reducing the amount of oxygenated blood reaching the fetus.
35. Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy?
A.Large for gestational age (LGA) fetus
B.Hemorrhage
C.Small for gestational age (SGA) baby
D.Erythroblastosis fetalis
Answer: (C) Small for gestational age (SGA) baby Anemia is a condition where there is a reduced amount of hemoglobin. Hemoglobin is needed to supply the fetus with adequate oxygen. Oxygen is needed for normal growth and development of the fetus.
36. Which of the following signs and symptoms will most likely make the nurse suspect that the patient is having hydatidiform mole?
A.Slight bleeding
B.Passage of clear vesicular mass per vagina
C.Absence of fetal heart beat
D.Enlargement of the uterus
Answer: (B) Passage of clear vesicular mass per vagina Hydatidiform mole (H-mole) is characterized by the degeneration of the chorionic villi wherein the villi becomes vesicle-like. These vesicle-like substances when expelled per vagina and is a definite sign that the woman has H-mole.
37. Upon assessment the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP) 5 months ago, fetal heart beat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition?
A.Hydatidiform mole
B.Missed abortion
C.Pelvic inflammatory disease
D.Ectopic pregnancy
Answer: (A) Hydatidiform mole Hydatidiform mole begins as a pregnancy but early in the development of the embryo degeneration occurs. The proliferation of the vesicle-like substances is rapid causing the uterus to enlarge bigger than the expected size based on ages of gestation (AOG). In the situation given, the pregnancy is only 5 months but the size of the uterus is already above the umbilicus which is compatible with 7 months AOG. Also, no fetal heart beat is appreciated because the pregnancy degenerated thus there is no appreciable fetal heart beat.
38. When a pregnant woman goes into a convulsive seizure, the MOST immediate action of the nurse to ensure safety of the patient is:
A.Apply restraint so that the patient will not fall out of bed
B.Put a mouth gag so that the patient will not bite her tongue and the tongue will not fall back
C.Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration
D.Check if the woman is also having a precipitate labor
Answer: (C) Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration Positioning the mother on her side will allow the secretions that may accumulate in her mouth to drain by gravity thus preventing aspiration pneumonia. Putting a mouth gag is not safe since during the convulsive seizure the jaw will immediately lock. The mother may go into labor also during the seizure but the immediate concern of the nurse is the safety of the baby. After the seizure, check the perineum for signs of precipitate labor.
39. A gravido-cardiac mother is advised to observe bedrest primarily to
A.Allow the fetus to achieve normal intrauterine growth
B.Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother
C.Prevent perinatal infection
D.Reduce incidence of premature labor
Answer: (B) Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother Activity of the mother will require more oxygen consumption. Since the heart of a gravido-cardiac is compromised, there is a need to put a mother on bedrest to reduce the need for oxygen.
40. A pregnant mother is admitted to the hospital with the chief complaint of profuse vaginal bleeding, AOG 36 wks, not in labor. The nurse must always consider which of the following precautions:
A.The internal exam is done only at the delivery under strict asepsis with a double set-up
B.The preferred manner of delivering the baby is vaginal
C.An emergency delivery set for vaginal delivery must be made ready before examining the patient D.Internal exam must be done following routine procedure
Answer: (A) The internal exam is done only at the delivery under strict asepsis with a double set-up Painless vaginal bleeding during the third trimester maybe a sign of placenta praevia. If internal examination is done in this kind of condition, this can lead to even more bleeding and may require immediate delivery of the baby by cesarean section. If the bleeding is due to soft tissue injury in the birth canal, immediate vaginal delivery may still be possible so the set up for vaginal delivery will be used. A double set-up means there is a set up for cesarean section and a set-up for vaginal delivery to accommodate immediately the necessary type of delivery needed. In both cases, strict asepsis must be observed.
NURSING BULLETS: Hypertension
- Blood pressure is blood flow, the volume of blood pumped out of the heart per beat, multiplied by arteriolar resistance to the blood flow.
- Blood flow depends on the rate of heart beats and the volume of blood pumped out with each beat. If rate or volume increases, blood pressure goes up. Likewise, increased resistance raises blood pressure, as when arteries downstream from the heart constrict. Over time, high blood pressure, or hypertension, damages many organs.
- First, the heart works harder to pump out more blood or against higher resistance.
- The heart then requires more oxygen, and is more susceptible to angina or a heart attack.
- Second, arteries and arterioles can be damaged.
- Arteriosclerosis results when blood moves through arteries and arterioles at high pressure, damaging the vessel.
- White blood cells are drawn to the damaged area to form a plaque.
- Third, kidneys can be damaged.
- The capillaries of the kidney are delicate. Continually subjected to high blood pressure, they break down, becoming permeable to proteins and other molecules.
- The kidney’s tubules can become clogged, decreasing the kidney’s ability to make urine. Also, the proteins injure the capillaries’ membranes, causing more damage and worsening the situation.
- Fourth, the retina of the eye can be damaged if its delicate capillaries are damaged.
- Localized hemorrhages can occur, causing scarring and formation of new, imperfect capillaries to replace the old ones.
- Finally, the blood vessels of the brain can be injured.
- High blood pressure can cause clots to break off from atherosclerotic plaques, blocking blood flow to the rest of the brain. This is called a thrombotic stroke.
- Continual exposure to high pressure may also cause a blood vessel to burst, leading to a hemorrhagic stroke.
NURSING BULLETS: Immune System
- The immune response involves white blood cells called lymphocytes. The most important are B and T cells.
- Each B and T cell is programmed to recognize and respond to one specific protein, called an antigen. Different antigens are present on cell membranes. When lymphocytes encounter their specific antigens, they bind in a “lock and key” manner and destroy the cell.
- B cells respond by transforming into antibody-secreting cells. Their antibody binds to the antigen, causing its destruction. Some B cells remain in circulation, carrying the memory of that antigen.
- T cells respond by transforming into helper, cytotoxic, or memory cells.
- T helper cells help B cells change into antibody secreting cells. Without helper T cells presenting antigens to a B cell, the B cell does not respond.
- Cytotoxic T cells act alone, without B cells. The cells destroyed by cytotoxic T cells are those infected by a virus or a cancer cell changed by mutation.
- T cells can become memory cells and remain in the circulation for years, ready to respond again if their antigen should appear.
- The first time B and T cells are exposed to a specific antigen, the response takes weeks. If re-exposure occurs, B and T memory cells respond immediately to destroy the invader.
- Normally, the immune response is well controlled. If not, autoimmune disease may occur, and self-antigens may be attacked.
NURSING REVIEW ASSESSMENT PART I
If you are going to take your test today, will you be able to pass...let's see, try answering some sample questions below...Get a piece of paper and answer the following questions...
PART I: INNOVATIVE ITEMS
What should the nurse do to prepare a client for amniocentesis?
Write A if the statement is true and B if not.
1. Ask the client to void
2. Instruct the client to drink 1L of fuild
3. Ask the client to lie on her left side
4. Assess fetal heart rate
5. Insert an IV catheter
6. Monitor maternal vital signs
Identify the area where the nurse should place the stethoscope to best hear the murmur in aortic stenosis.
7. Write A, B, C, or D.
Valium can be given to which of the following patients:
Write A if the statement is true and B if not.
8. 35-year-old with hepatic encephalopathy
9. 40-year-old with insomnia
10. 25-year-old in Russel's traction
11. 23-year-old with agoraphobia
12. 17-year-old with seizure
In patient who is being given magnesium sulfate, which of the following should the nurse to monitor:
Write A if the statement is true and B if not.
13. Knee Jerk Reflex
14. Bowel function
15. Urine Output
16. Hypothermia
17. Hypocalcemia
18. Serum potassium levels
19. Which of the following diagnostic test will confirm a diagnosis of myocardial infarction (MI)?
Put a check to all that apply:
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PART I: INNOVATIVE ITEMS
What should the nurse do to prepare a client for amniocentesis?
Write A if the statement is true and B if not.
1. Ask the client to void
2. Instruct the client to drink 1L of fuild
3. Ask the client to lie on her left side
4. Assess fetal heart rate
5. Insert an IV catheter
6. Monitor maternal vital signs
Identify the area where the nurse should place the stethoscope to best hear the murmur in aortic stenosis.
7. Write A, B, C, or D.
Valium can be given to which of the following patients:
Write A if the statement is true and B if not.
8. 35-year-old with hepatic encephalopathy
9. 40-year-old with insomnia
10. 25-year-old in Russel's traction
11. 23-year-old with agoraphobia
12. 17-year-old with seizure
In patient who is being given magnesium sulfate, which of the following should the nurse to monitor:
Write A if the statement is true and B if not.
13. Knee Jerk Reflex
14. Bowel function
15. Urine Output
16. Hypothermia
17. Hypocalcemia
18. Serum potassium levels
19. Which of the following diagnostic test will confirm a diagnosis of myocardial infarction (MI)?
Put a check to all that apply:
- [] a. ALT
- [] b. Serum troponin
- [] c. Serum myoglobin
- [] d. Urinalysis
- [] e. EEG
- [] f. 24-hour creatinine clearance
THE PASSING SCORE IS 14 out of a total score of 20. If you adid not get a passing score, It's time for you to subscribe these website =)
Comment Below: Write your Name or Email in facebook and I'll message you the answers. I'm online 24/7 =) Cheers!
Cerebrovascular Accident (CVA) Pathophysiology
Cerebrovascular accident or stroke (also called brain attack) results from sudden interruption of blood supply to the brain, which precipitates neurologic dysfunction lasting longer than 24 hours. Stroke are either ischemic, caused by partial or complete occlusions of a cerebral blood vessel by cerebral thrombosis or embolism or hemorrhage (leakage of blood from a vessel causes compression of brain tissue and spasm of adjacent vessels). Hemorrhage may occur outside the dura (extradural), beneath the dura mater (subdural), in the subarachnoid space (subarachnoid), or within the brain substance itself (intracerebral).
Risk factors for stroke include transient ischemic attacks (TIAs) – warning sign of impending stroke – hypertension, arteriosclerosis, heart disease, elevated cholesterol, diabetes mellitus, obesity, carotid stenosis, polycythemia, hormonal use, I.V., drug use, arrhythmias, and cigarette smoking. Complications of stroke include aspiration pneumonia, dysphagia, constractures, deep vein thrombosis, pulmonary embolism, depression and brain stem herniation.
Some Test Taking Techniques!
When taking a test, you should realize that no matter how much you prepare yourself, there would always be questions that will cover concepts that you DO NOT KNOW, in which case you need to rely on your ability to make an educated guess. Thus, it is essential that you apply some techniques in analyzing questions. Here are some of these techniques...
1. Identify the topic of question. Ask yourself "What is the nursing concept the the question is asking?"
2. When a question asks you to establish priorities for the patient, use Maslow's hierarchy of needs as your framework. Remember. Maslow says, "physiologic needs first".
3. When a question as you to prioritize nursing interventions, use the nursing process as your framework. Remember: assessment is first step of nursing process.
4. Always think of safety when selecting correct answers for the exam. Focus on what is safe for your patient.
5. Do everything by the book! All correct answers are based on textbook theoretical nursing practice. Don't let your clinical experience influence your answer. Stick to what is ideal as described in textbooks.
6. Watch out for responses which are considered non-therapeutic like: "Don't worry; "Why"; " Authoritarian answers"; "Focus on the nurse"; "Focus on the doctor answers"; "Pay particular attention to therapeutic phases like: "It seems..."; "It sounds..."; "Tell me..."
7. On questions pertaining to delegation and supervision know what to delegate. Usually, assessment, teaching or evaluation of nursing care cannot be delegated.
8. Pray. It really works.
Nursing Trends
Nursing Trends is a free online nursing review and web-based learning site designed to increase the capacity of nurses in overcoming the examinations necessary to achieve the ultimate goal of nursing career. It offers a complete learning content organized according to the latest test plan to enhance and even accelerate their knowledge and skills.
Unique blend of free online nursing review questions guarantee your success to pass the NLE, NCLEX and IELTS. System simulation company will guide you throughout your preparation until it is 100% equipped and ready to take the exam.
Mission Statement
To provide high quality service, support and review free online reviewer.
To help nurses, both local and international, pass the required exams with confidence and pride.
Looking for the best review of non-linear editing online?
NLE Review Online review online web-based for nurses is designed to help you prepare and pass the nursing licensure exam real. The review only online program that will help take your achievement to be a registered nurse.
We offer high quality nonlinear editing online training / review for nurses. Subscribe now hurry and start your review online instantly!
Unique blend of free online nursing review questions guarantee your success to pass the NLE, NCLEX and IELTS. System simulation company will guide you throughout your preparation until it is 100% equipped and ready to take the exam.
Mission Statement
To provide high quality service, support and review free online reviewer.
To help nurses, both local and international, pass the required exams with confidence and pride.
Looking for the best review of non-linear editing online?
NLE Review Online review online web-based for nurses is designed to help you prepare and pass the nursing licensure exam real. The review only online program that will help take your achievement to be a registered nurse.
We offer high quality nonlinear editing online training / review for nurses. Subscribe now hurry and start your review online instantly!
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