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COMPREHENSIVE—Succeed with comprehensive learning and practice tests
Wilda Rinehart
Diann Sloan
Clara Hurd
Score Higher on the NCLEX® Exams!
We provide you with the proven study tools and expert insight that will help you score higher on your exam.
CD Features Nearly 2,000 Questions!
The CD-ROM–based practice exam includes an interactive Computer Adaptive Test (CAT) engine powered by MeasureUp for a meaningful exam experience with approximately 2,000 questions.
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Pearson Education provides quality content, assessment tools, and educational services in all available media, spanning the learning curve from birth through college and beyond.
Rinehart and Associates is a leading provider of classroom training for students studying for the NCLEX® exams.
Wilda Rinehart has RN, BSN, MSN, FNC, and FPNP degrees. Her experience includes staff nurse in surgery, labor, and delivery; public-health nurse; and family-planning nurse practitioner. She also was an instructor of surgical and obstetrical nursing.
Diann Sloan has RN, BSN, MSN, FNC, as well as MS Ed., and PhD in Education degrees. She has worked as a staff nurse in surgical nursing, pediatrics, and neonatal intensive care and as a pediatric nurse clinician. She has also been an instructor of pediatric and psychiatric nursing.
Clara Hurd has RN, BSN, MSN, and GNC degrees. She is currently serving as an associate degree nurse educator at Northeast Mississippi Community College teaching medical-surgical content. She has 31 years of experience and has worked as a staff nurse in medical-surgical nursing and the surgical intensive care unit. Ms. Hurd has taught in associate and baccalaureate nursing programs.
Introduction
Study and Exam Preparation Tips
Part I: Exam Preparation
Chapter 1: Fluid and Electrolyte and Acid/Base Balance
Chapter 2: Care of the Client with Cardiovascular Disorders
Chapter 3: Care of the Client with Endocrine Disorders
Chapter 4: Care of the Client with Respiratory Disorders
Chapter 5: Care of the Client with Genitourinary Disorders
Chapter 6: Care of the Client with Integumentary Disorders
Chapter 7: Care of the Client with Sensory Disorders
Chapter 8: Care of the Client with Gastrointestinal Disorders
Chapter 9: Care of the Client with Hematological Disorders
Chapter 10: Caring for the Client with Disorders of the Neurological System
Chapter 11: Care of the Client with Immunologic Disorders
Chapter 12: Caring for the Client with Neoplastic Disorders
Chapter 13: Caring for the Client with Musculoskeletal and Connective Tissue Disorders
Chapter 14: Care of the Childbearing Client and the Neonatal Client
Chapter 15: Care of the Pediatric Client
Chapter 16: Care of the Client with Psychiatric Disorders
Chapter 17: Emergency Care
Chapter 18: Legal Issues in Nursing Practice
Chapter 19: Cultural Practices Influencing Nursing Care
Cultural Assessment
Part II: Final Review
Practice Exam I
Practice Exam II
Practice Exam III
Practice Exam IV: Management and Alternative Item Exam Questions
Answers to Practice Exam I
Answers to Practice Exam II
Answers to Practice Exam III
Answers to Practice Exam IV: Management and Alternative Item Exam Questions
Part III: Appendixes
Glossary
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Introduction
Organization
Instructional Features
Extensive Practice Test Options
Final Review
Other Valuable Tools
About the NCLEX Exam
Advice for Preparing for the Exam
Advice for Test Day
Hints for Using This Book
Contact the Author
Study and Exam Preparation Tips
Study Tips
Exam Prep Tips
Read the Question Carefully
Look for Keywords
Watch for Specific Details
Eliminate Options That Are Clearly Wrong or Incorrect
Look for Similar Options
Look for Opposite Answers
Part I: Exam Preparation
Chapter 1:
Fluid and Electrolyte and Acid/Base Balance
Total Body Water Calculation
Management of the Client with Imbalances in Fluid and Electrolytes
Types of Intravenous Fluids
How the Body Regulates Electrolytes
How the Body Regulates pH
Key Concepts
Key Terms
Diagnostic Tests
Pharmacological Agents Used in the Treatment of Clients with Alterations in Fluids and Electrolytes
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 2:
Care of the Client with Cardiovascular Disorders
Hypertension
Diagnosing the Client With Hypertension
Managing the Client with Hypertension
Coronary Artery Disease
Atherosclerosis and Arteriosclerosis
Conduction System of the Heart
Heart Block
Cardiac Monitoring
Reading a ECG
Cardiac Dysrhythmias
Ventricular Tachycardia
Ventricular Fibrillation
Internal Cardiac Defibrillators
Cardiopulmonary Resuscitation
Angina Pectoris
Myocardial Infarction
Diagnosis of Myocardial Infarction
Management of a Client with Myocardial Infarction
Aneurysms
Inflammatory Diseases of the Heart
Infective Endocarditis
Pericarditis
Peripheral Vascular Disease
Varicose Veins / Thrombophlebitis
Raynaud’s Phenomenon
Buerger’s Disease
Key Concepts
Key Terms
Diagnostics
Pharmacological Agents Used in the Treatment of Clients with Cardiovascular Disorders
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 3:
Care of the Client with Endocrine Disorders
Pituitary Gland
Hypopituitarism
Hyperpituitarism
Disorders of the Posterior Pituitary Gland
Thyroid Disorders
Hypothyroidism
Hyperthyroidism
Parathyroid Disorders
Hypoparathyroidism
Hyperparathyroidism
Diabetes Mellitus
Hyperglycemia
Hypoglycemia
Managing Hyperglycemia and Hypoglycemia
Adrenal Gland
Adrenal Gland Disorders
Key Concepts
Key Terms
Diagnostics
Pharmacological Agents Used to Treat Clients with Endocrine Disorders
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 4:
Care of the Client with Respiratory Disorders
Noninfectious Disorders of the Lower Respiratory Tract
Chronic Bronchitis
Emphysema
Asthma
Pleurisy
Pulmonary Hypertension
Interstitial Pulmonary Disease
Sarcoidosis
Pulmonary Fibrosis
Occupational Pulmonary Disease
Infectious Disorders of the Lower Respiratory Tract
Pneumonia
Tuberculosis
Influenza
Life-Threatening Pulmonary Disorders
Acute Respiratory Distress Syndrome
Pulmonary Embolus
Pneumothorax
Hemothorax
Emerging Infections
SARS
Legionnaires’ Disease
Key Concepts
Key Terms
Diagnostic Tests
Pharmacological Agents Used in the Care of the Client with Disorders of the Respiratory System
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 5:
Care of the Client with Genitourinary Disorders
Renal Disorders
Acute Glomerulonephritis
Chronic Glomerulonephritis
Nephrotic Syndrome
Polycystic Kidney Disease
Hydronephrosis/Hydroureteronephrosis
Pyelonephritis
Acute and Chronic Renal Failure
Chronic Renal Failure
Peritoneal Dialysis
Hemodialysis
Renal Transplantation
Urinary Disorders
Cystitis
Urinary Incontinence
Urolithiasis
Genitourinary Disorders
Prostatitis
Benign Prostatic Hypertrophy
Erectile Dysfunction
Epididymitis
Priapism
Key Concepts
Key Terms
Diagnostics
Pharmacologic Agents for the Client with Genitourinary Disorders
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 6:
Care of the Client with Integumentary Disorders
Common Infections of the Integumentary System
Viral Infections
Fungal Infections
Bacterial Infections
Psoriasis
Pressure Ulcers
Burns
Burn Classifications
Burn Measurement with TBSA
Nursing Care for Burn Victims
Key Concepts
Key Terms
Diagnostic Tests
Pharmacological Agents Used in the Care of the Client with
Integumentary Disorders
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 7:
Care of the Client with Sensory Disorders
Disorders of the Eyes
Intraocular Disorders
Uveitis
Retinal Disorders
Refractive Errors
Traumatic Injuries
Ocular Melanoma
Disorders of the Ears
Otitis Externa
Otitis Media
Mastoiditis
Ménière’s Disease
Acoustic Neuroma
Otosclerosis
Presbycusis
Ear Trauma
Assisting Clients with Hearing Loss
Key Concepts
Key Terms
Diagnostic Tests
Pharmacological Agents Used in the Care of the Client with
Disorders of the Eyes and Ears
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 8:
Care of the Client with Gastrointestinal Disorders
Peptic Ulcer Disease
Types of Ulcers
Diagnosis of Ulcers
Treatment of Ulcers
Inflammatory Bowel Disorders
Chron’s Disease
Ulcerative Colitis
Management of the Client with Inflammatory Bowel Disease
Diverticular Disease
Management of the Client with Diverticulitis
Hemorrhoids
Appendicitis
Peritonitis
Intestinal Obstruction
Esophageal Disorders
GERD
Hiatal Hernia
Diseases Associated with the Liver
Hepatitis
Cirrhosis
Acute Pancreatitis
Diagnosis of Pancreatitis
Treatment of Pancreatitis
Cholecystitis/Cholelithiasis
Symptoms of Cholecystitis and Cholethiasis
Diagnosis of Cholecystitis/Cholethiasis
Treatment of Cholecystitis
Treatment of Cholethiasis
Food-Borne Illnesses
Key Concepts
Key Terms
Diagnostic Tests
Pharmacological Agents Used in the Care of the Client with Disorders of the Gastrointestinal System
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 9:
Care of the Client with Hematological Disorders
Anemia
Pernicious Anemia
Aplastic Anemia
Sickle Cell Anemia
Iron Deficiency Anemia
Thalassemia
Polycythemia Vera
Hemophilia
Transfusion Therapy
Transfusion Reactions
Key Concepts
Key Terms
Diagnostic Tests for Review
Pharmacological Agents Used in Hematological Disorders
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 10:
Caring for the Client with Disorders of the Neurological System
Neurological Assessment
Cranial Nerve Assessment
Glasgow Coma Scale
Intracranial Pressure Monitors
Brain Injuries
Epidural Hematomas
Subdural Hematoma
Intracerebral Hematomas
Treatment of Hematomas
Increased Intracranial Pressure
Brain Tumors
Treatment of Brain Tumors
Care of the Client with Intracranial Surgery (Craniotomy)
Cerebrovascular Accident/Stroke
Ischemic Stroke
Hemorrhagic Stroke
Seizures
Types of Seizures
Treatment of Seizure Clients
Status Epilepticus
Parkinson’s Disease
Meningitis
Autoimmune Neurological Disorders
Multiple Sclerosis
Myasthenia Gravis
Guillain-Barré
Degenerative Neurological Disorders
Spinal Cord Injuries
Treatment of Spinal Cord injuries
Potential Complications with SCI Clients
Intervertebral Disk Disease
Diabetes Insipidus
Key Concepts
Key Terms
Diagnostics
Pharmacological Agents Used in the Care of Clients with Neurological Disorders
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 11:
Care of the Client with Immunologic Disorders
Diagnoses
HIV Prevention
Standard Precautions
Airborne Transmission—Based Precautions (Second Tier of CDC Guidelines for Infection Control)
Droplet Transmission—Based Precautions (Second Tier of CDC
Guidelines for Infection Control)
Contact Transmission—Based Precautions (Second Tier of CDC Guidelines for Infection Control)
Treatments After Occupational Exposure
Management of the Client with HIV
Key Concepts
Key Terms
Diagnostic Tests
Pharmacological Agents Used in the Care of the Client with Immunologic Disorders
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 12:
Caring for the Client with Neoplastic Disorders
American Cancer Society’s Seven Warning Signs of Cancer
The Four Major Categories of Cancer
Risk Factors for Specific Cancers
Cancer Prevention
Major Types of Cancer
Colorectal Cancer
Lung Cancer
Prostate Cancer
Breast Cancer
Other Major Cancers
General Interventions for Clients with Cancer
Radiation
Chemotherapy
Total Parenteral Nutrition
Neoplastic Associated Disorders and Emergencies
Bone Marrow (Stem Cell) Transplantation
Types of Transplants
Nursing Care After Transplantation
Key Concepts
Key Terms
Diagnostic Tests
Pharmacologic Agents Used in the Care of the Client with Specific Neoplastic Disorders
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 13:
Caring for the Client with Musculoskeletal and Connective Tissue Disorders
Fractures
Major Fracture Sites
General Treatment for Fractures
Common Complications Associated with Fractures
Osteoporosis
Osteoarthritis
Diagnosis of Osteoarthritis
Treatment of the Client with Osteoarthritis
Fibromyalgia
Ankylosing Spondylitis
Gout
Rheumatoid Arthritis
Lupus Erythematosus
Musculoskeletal Surgical Procedures
Fractured Hip and Hip Replacement
Total Knee Replacement
Amputations
Key Concepts
Key Terms
Diagnostics
Pharmacologic Agents Used in Musculoskeletal and Connective Tissue Disorders
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 14:
Care of the Childbearing Client and the Neonatal Client
Prenatal Care
Signs of Pregnancy
Prenatal Diet and Weight Maintenance
Measuring Fetal Heart Tones
Prelabor Testing
Intrapartal Care
Stages of Labor
Important Terms You Should Know
Complications Associated with Pregnancy
Cardiac Disease During Pregnancy
Diabetes in Pregnancy
Preeclampsia
Ectopic Pregnancy
Hydatidiform Mole
Incompetent Cervix
Types of Abortions
Placenta Previa
Abruptio Placenta
Complications Associated with Labor and Delivery
Post-Term Labor and Birth
Precipitate Delivery
Cord Prolapse
Cesarean Birth
Assisted Birth
Fetal Monitoring
Pharmacologic Management of Labor
Postpartum Care
Newborn Care
Terms Associated with the Normal Newborn
Rh Incompatibility
Women’s Health Issues
Pelvic Inflammatory Disease
Menopause
Maternal Infections
Methods of Contraception
Key Concepts
Key Terms
Diagnostic Tests
Pharmacological Agents Used in the Care of the Obstetric Client
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Resource List
Chapter 15:
Care of the Pediatric Client
Growth and Development
Infant (28 Days to 1 Year)
Toddler (1—3 Years)
Preschooler (3—5 Years)
School Age (6—12 Years)
Adolescence (12—18 Years)
Caring for the Child with Respiratory Disorders
Upper Airway Infections
Lower Airway Infections
Long-Term Respiratory Disorders
Cystic Fibrosis (Mucoviscidosis)
Caring for the Child with Gastrointestinal Disorders
Disorders of Motility
Structural Defects
Obstructive Disorders
Inflammatory and Parasitic Disorders
Malabsorptive/Metabolic Syndromes
Ingestion of Hazardous Substances
Caring for the Child with Cardiovascular Disorders
Congenital Heart Defects
Acquired Heart Disease
Caring for the Child with Genitourinary Disorders
Obstructive Uropathy
External Defects (Hypospadias, Epispadias, Exstrophy of the Bladder)
Epispadias/Exstrophy of the Bladder
Caring for the Child with Neoplastic Disorders
Leukemia
Wilms’ Tumor (Nephroblastoma)
Retinoblastoma
Neuroblastoma
Osteosarcoma and Ewing’s Sarcoma
Rhabdomyosarcoma
Surviving Childhood Cancer
Caring for the Child with Cerebral Disorders
Intracranial Infections (Encephalitis and Bacterial Meningitis)
Reye’s Syndrome
Caring for the Child with Integumentary Disorders
Eczema (Atopic Dermatitis)
Scabies
Pediculosis Capitis (Head Lice)
Lyme Disease
Rocky Mountain Spotted Fever
Caring for the Child with Communicable Disease
Caring for the Child with Musculoskeletal Disorders
Congenital Clubfoot
Developmental Hip Dysplasia
Osteogenesis Imperfecta
Legg-Calvé-Perthes Disease (Coxa Plana)
Scoliosis
Juvenile Rheumatoid Arthritis (Juvenile Idiopathic Arthritis)
Caring for the Child with Neuromuscular Disorders
Cerebral Palsy
Neural Tube Defects
Spina Bifida
Muscular Dystrophies
Caring for the Abused and Neglected Child
Key Concepts
Key Terms
Diagnostics
Pharmacological Agents Used in the Care of Pediatric Clients
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 16:
Care of the Client with Psychiatric Disorders
Anxiety-Related Disorders
Generalized Anxiety Disorder
Post-Traumatic Stress Disorder
Dissociative Identity Disorder
Somatoform Disorder
Panic Disorder
Phobic Disorders
Obsessive-Compulsive Disorder
Personality Disorders
Cluster A
Cluster B
Cluster C
Managing Clients with Personality Disorders
Psychotic Disorders
Schizophrenia
Bipolar Disorders
Substance Abuse
Alcoholism
Chemical Dependence
Psychological Disorders of Childhood and Adolescence
Conduct Disorder
Oppositional Defiant Disorder
Attention Deficit Hyperactive Disorder
Eating Disorders
Key Concepts
Key Terms
Diagnostics
Pharmacological Agents Used in the Care of the Client with Psychiatric Disorders
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 17:
Emergency Care
The ABCDs of Emergency Care
Airway
Breathing
Circulation
Deficits
Obtaining Client Information
Trauma
Head Injuries
Chest Injuries
Abdominal Injuries
Documenting and Protecting Forensic Evidence
Poisoning
Poisonous Stings and Bites
Bioterrorism
Chemical and Biological Agents
Nuclear Warfare
Triage Categories for Disaster Victims
Key Concepts
Key Terms
Diagnostics
Pharmacological Agents Commonly Used in ER Treatment
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 18:
Legal Issues in Nursing Practice
Types of Laws
Statutory Laws/Regulatory Laws
Civil Laws
Criminal Laws
Common Laws
Code of Ethical Behavior in Nursing Practice
Legalities That Affect Nursing Practice
Negligence
Malpractice
Assault
Tort
Fraud
Witnessing Consent for Care
Managing Client Care
Key Terms
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Chapter 19:
Cultural Practices Influencing Nursing Care
Cultural Assessment
Understanding Client Beliefs
Working with Clients Who Speak Different Languages
Healthcare of Hispanics/Latinos
Time Considerations
Use of Nonverbal/Verbal Communication
Childbirth and Pain Response
Healthcare of Native Americans and Alaskan Natives
Time Considerations
Use of Nonverbal/Verbal Communication
Childbirth and Pain Response
Healthcare of Asian-Americans
Time Considerations
Use of Nonverbal/Verbal Communication
Childbirth and Pain Response
Healthcare of Arab-Americans
Time Considerations
Use of Nonverbal/Verbal Communication
Childbirth and Pain Response
Nursing Plan Dietary Considerations Across Cultures
Religious Beliefs and Refusal of Care Considerations
Key Terms
Apply Your Knowledge
Exam Questions
Answers to Exam Questions
Suggested Reading and Resources
Part II: Final Review
Fast Facts
The NCLEX® Exam Prep
Practice Exam I
Fluid and Electrolytes and Acid/Base Balance
Care of the Client with Cardiovascular Disorders
Care of the Client with Endocrine Disorders
Care of the Client with Immunological Disorders
Care of the Childbearing Client and the Neonatal Client
Practice Exam II
Care of the Client with Respiratory Disorders
Care of the Client with Genitourinary Disorders
Care of the Client with Integumentary Disorders
Care of the Client with Sensory Disorders
Care of the Pediatric Client
Care of the Client with Psychiatric Disorders
Emergency Care
Practice Exam III
Care of the Client with Musculoskeletal and Connective Tissue Disorders
Care of the Client with Gastrointestinal Disorders
Care of the Client with Neoplastic Disorders
Care of the Client with Neurological Disorders
Care of the Client with Hematological Disorders
Practice Exam IV: Management and Alternative Item Exam Questions
Management Questions
Alternative Items
Answers to Practice Exam I
Answers at a Glance to Practice Exam I
Answers with Explanations
Fluid and Electrolytes and Acid/Base Balance
Care of the Client with Cardiovascular Disorders
Care of the Client with Endocrine Disorders
Care of the Client with Immunologic Disorders
Care of the Childbearing Client and the Neonatal Client
Answers to Practice Exam II
Answers at a Glance to Practice Exam II
Answers with Explanations
Care of the Client with Respiratory Disorders
Care of the Client with Genitourinary Disorders
Care of the Client with Integumentary Disorders
Care of the Client with Sensory Disorders
Care of the Pediatric Client
Care of the Client with Psychiatric Disorders
Emergency Care
Answers to Practice Exam III
Answers at a Glance to Practice Exam III
Answers with Explanations
Care of the Client with Musculoskeletal and Connective Tissue Disorders
Care of the Client with Gastrointestinal Disorders
Care of the Client with Neoplastic Disorders
Care of the Client with Neurological Disorders
Care of the Client with Hematological Disorders
Answers to Practice Exam IV: Management and Alternative Item Exam Questions
Answers to Management Questions
Alternative Item Answers
Part III: Appendixes
Appendix A: Things You Forgot
Appendix B: Need to Know More?
Appendix C: Calculations
Appendix D: Most-Prescribed Medications in the United States
Appendix E: Alphabetical Listing of Nursing Boards in the United States and Protectorates
Appendix F: What’s on the CD-ROM
Glossary
0789735962, TOC, 3/1/2007
PrintNumber | ErrorLocation | Error | Correction | DateAdded |
---|---|---|---|---|
2nd | p. 53 | The client should be taught to remain as still as possible during ECG assessment and should be positioned in a semireclined position. For continuous ECG monitoring, the use of limb leads is not recommended because limb movement causes an inaccurate reading. Continuous ECG readings are most commonly done using the MCL (modified chest lead) system, which incorporates only three leads. The negative electrode is placed just below the left mid-clavicle area and the positive electrode is placed in the V? position. The V1 position is located at the fourth intercostals position at the sternal border. V2 is placed at the fourth intercostals space at the left sternal border. V3 is located midway between V2 and V4. V5 is located at the fifth intercostals space at the anterior axillary line. V6 is located at the fifth intercostals space at the midaxillary line. The ground electrode can be placed anywhere but is usually placed under the right clavicle. For accuracy of chest lead placement, the clients chest hair should be clipped with scissors rather than shaved because shaving can abrade the skin. |
The client should be taught to remain as still as possible during ECG assessment and should be positioned in a semireclined position. For continuous ECG monitoring, the use of limb leads is not recommended because limb movement causes an inaccurate reading. Continuous ECG readings are most commonly done using the MCL (modified chest lead) system, which incorporates only three leads. The negative electrode is placed just below the left mid-clavicle area and the positive electrode is placed in the V2 position. The V1 position is located at the fourth intercostals position at the sternal border. V2 is placed at the fourth intercostals space at the left sternal border. V3 is located midway between V2 and V4. V5 is located at the fifth intercostals space at the anterior axillary line. V6 is located at the fifth intercostals space at the midaxillary line. The ground electrode can be placed anywhere but is usually placed under the right clavicle. For accuracy of chest lead placement, the clients chest hair should be clipped with scissors rather than shaved because shaving can abrade the skin. |
9/14/2007 |
2nd | p. 60 | If Coumadin (sodium warfarin) is ordered, the nurse should check or prothrombin time (PT). The control level for a prothrombin time is 1012 seconds. The therapeutic level for Coumadin should be from one and a half to two times the control. The antidote for Coumadin is vitamin K. The international normalizing ratio (INR) is done for oral anticoagulants. The therapeutic range is 23. If the level exceeds 7, watch for spontaneous bleeding. |
If Coumadin (sodium warfarin) is ordered, the nurse should check the prothrombin time (PT). The control level for a prothrombin time is 1012 seconds. The therapeutic level for Coumadin should be from one and a half to two times the control. The antidote for Coumadin is vitamin K. The international normalizing ratio (INR) is usually done for oral anticoagulants. The therapeutic range is 23. If the level exceeds 7, watch for spontaneous bleeding. |
9/14/2007 |
2nd | p. 60 | An exercise electrocardiography test, also known as the stress test or exercise tolerance test, helps to determine the function of the heart during exercise. The client is instructed to eat a light meal and refrain from smoking or consuming caffeine the morning of the test. Prior to the test, the cardiologist assesses the heart using an ECG tracing and blood pressure monitor. The client then walks on the treadmill or bicycle at a steadily progressing rate of speed of 1 to 10 miles per hour and can also be adjusted from flat to inclined. She is asked to report any shortness of breath or chest pain. Abnormalities can then be assessed. The client continues the test until: |
An exercise electrocardiography test, also known as the stress test or exercise tolerance test, helps to determine the function of the heart during exercise. The client is instructed to eat a light meal and refrain from smoking or consuming caffeine the morning of the test. Prior to the test, the cardiologist assesses the heart using an ECG tracing and blood pressure monitor. The client then walks on the treadmill or bicycles at a steadily progressing rate of speed of 1 to 10 miles per hour and can also be adjusted from flat to inclined. She is asked to report any shortness of breath or chest pain. Abnormalities can then be assessed. The client continues the test until: |
9/14/2007 |
2nd | p. 79 | 4. The client being treated with lisinopril (Zestril) develops a hacking cough. The nurse should tell the client to: A. Take the medication at night to control the problem. B. Take cough medication to control the problem C. Stop the medication D. Report the problem to the doctor |
4. The client being treated with lisinopril (Zestril) develops a hacking cough. The nurse should tell the client to: A. Take half the dose to control the problem. B. Take cough medication to control the problem C. Stop the medication D. Report the problem to the doctor |
9/14/2007 |
2nd | p. 81 | 4. Answer D is correct. A hacking cough is a common side effect and should be reported to the doctor. The client should not be told to half the dose since this can result in an elevated blood pressure, so answer A is incorrect. Answer B is incorrect because taking a cough medication will mask the symptom of the allergy. Answer C is incorrect because although the client stops taking the medication, this answer states that the client can report the finding to the doctor at the time of the scheduled visit. He should report this finding immediately. |
4. Answer D is correct. A hacking cough is a common side effect and should be reported to the doctor. The client should not be told to half the dose since this can result in an elevated blood pressure, so answer A is incorrect. Answer B is incorrect because taking a cough medication will mask the symptom of a possible allergic reaction. Answer C is incorrect because although the client stops taking the medication, this answer states that the client can report the finding to the doctor at the time of the scheduled visit. He should report this finding immediately. |
9/14/2007 |