[Solved] NCLEX HESI Exit and NCLEX Exam Gems

HESI Hints & NCLEX Gems

Answering NCLEX Questions
 Maslow’s Hierarchy of Needs
o Physiologic
o Safety
o Love and Belonging
o Esteem
o Self-actualization
 Nursing Process
o Assessment
o Diagnosis (Analysis)
o Planning
o Implementation (treatment)
o Evaluation
 ABCs
o Airway
o Breathing
o Circulation

Normal Values
 Hgb
o Males 14-18
o Females 12-16
 Hct
o Males 42-52
o Females 37-47
 RBCs
o Males 4.7-6.1 million
o Females 4.2-5.4 million
 WBCs
o 4.5-11k
 Platelets
o 150-400k
 PT (Coumadin/Warfarin)
o 11-12.5 sec (INR and PT TR = 1.5-2 times normal)
 APTT (Heparin)
o 60-70 sec (APTT and PTT TR = 1.5-2.5 times normal)
 BUN 10-20
 Creatinine 0.5-1.2
 Glucose 70-110
 Cholesterol < 200
 Bilirubin Newborn 1-12
 Phenylalanine
o Newborn < 2
o Adult < 6
 Na+ 136-145

,  K+ 3.5-5
o HypoK+
 Prominent U waves
 Depressed ST segment
 Flat T waves
o HyperK+
 Tall T-Waves
 Prolonged PR interval
 wide QRS
 Ca++ 9-10.5
o Hypocalcemia
 muscle spasms
 convulsions
 cramps/tetany
 + Trousseau’s OR + Chvostek’s
 prolonged ST interval
 prolonged QT segment
 Mg+ 1.5-2.5
 Cl- 96-106
 Phos 3-4.5
 Albumin 3.5-5
 Spec Gravity 1.005-1.030
 Glycosylated Hemoglobin (Hgb A1c):
o 4-6% ideal
o < 7.5% = OK (120 days)
 Dilantin TR = 10-20
 Lithium TR = 0.5-1.5

Antidotes
 Digoxin  Digiband
 Coumadin  Vitamin K (Keep PT and INR @ 1-1.5 X normal)
 Benzodiazapines  Flumzaemil (Tomazicon)
 Magnesium Sulfate  Calcium Gluconate?
 Heparin  Protamine Sulfate (Keep APTT and PTT @ 1.5-2.5 X normal)
 Tylenol  Mucomist (17 doses + loading dose)
 Opiates (narcotic analgesics, heroin, morphine)  Narcan (Naloxone)
 Cholinergic Meds (Myesthenic Bradycardia)  Atropine
 Methotrexate  Leucovorin

Delegation
 RN Only
o Blood Products (2 RNs must check)
o Clotting Factors
o Sterile dressing changes and procedures
o Assessments that require clinical judgment
o Ultimately responsible for all delegated duties
 Unlicensed Assistive Personnel

, o Non-sterile procedures
o Precautions & Room Assignments

Universal (Standard) Precautions (HIV initiated)
 Wash hands
 Wear Gloves
 Gowns for splashes
 Masks and Eye Protection for splashes and droplets
 Don’t recap needles
 Mouthpiece or Ambu-bag for resuscitation
 Refrain from giving care if you have skin lesion
Droplet (Respiratory) Precautions  Mask
 Sepsis
 Scarlet Fever
 Strep
 Fifth Disease (Parvo B19)
 Pertussis, Pneumonia, Influenza
 Diphtheria, Epiglottitis, Rubella, Rubeola, Meningitis, Mycoplasma, Adenovirus, Rhinovirus
 RSV (needs contact precautions too)
 TB  Respiratory Isolation
Contact Precautions  Universal + Goggles, Mask and Gown

No infection patients with immunosuppressed patients

Weird Miscellaneous Stuff
 Rifampin (for TB) … Rust/orange/red urine and body fluids
 Pyridium (for bladder infection) … Orange/red/pink urine
 Myesthenia Gravis
 Myesthenic Crisis
o Weakness with change in vitals (give more meds)
 Cholinergic Crisis
o Weakness with no change in vitals (reduce meds)
 Diabetic Coma vs. Insulin Shock
o Give glucose first – If no help, give insulin
 Lipitor (statins) in PMs only – No grapefruit juice
 Stroke
o Tongue points toward side of lesion (paralysis)
o Uvula deviates away from the side of lesion (paralysis)
 Stay in bed for 3 hours after first ACE Inhibitor dose
 Avoid Grapefruit juice with Ca++ Channel Blockers
 Anthrax = Multi-vector biohazard

 Pulmonary air embolism prevention
o Trendelenburg
o On left side (to trap air in right side of heart)
 Head Trauma and Seizures  Maintain airway
 Peptic Ulcers