NSG 123 Milestone Exam 1b Blueprint- HESI
|2026 Latest Update with Complete Solution-
Herzing
Family history‐questioning pre‐test item not graded
Ask about family health issues, family history of diseases, conditions to gather information on
what pt may be already genetically disposed to.
History ‐ mental illness pre‐test item not graded
Med admin‐client ID NSG122.07.02.04:
Identify the client by checking the name or arm brand.First identification is the patient's name
and second one is date of birth. The patient's full name is used. The middle name or initial
should be included to avoid confusion with other patients. In facilities using paper records, the
patient's full name, secondary identification number, and the primary care provider's name are
labeled on all sheets on the patient's chart, including the medical order sheet. Be extremely
careful when administering medications when there is more than one patient on the unit with
the same last name. Not only can the nurse give the wrong patient the wrong medication, but a
provider may enter an order in the wrong patient's medical record. A secondary identifier is
used when verifying the patient's identity.
Rights of administration- patient, drug, time, dose, route, documentation, reason, assessment,
response, education, right to refuse
Occluded IV NSG122.13.02.04 :
The main reason for IV occlusion is blood reflux. Or when blood backs up into the catheter. It
forms a thrombus. IV flow may cease if the clot obstructs the needle. Symptoms are local acute
tenderness, redness, edema of vein above the insertion site. Discontinue the infusion
immediately, apply warm compression , and avoid further use of the vein. Restart the infusion
in another vein.
Vital signs NSG121.04.03.02
B/P, pulse, temperature, pulse oximeter (sp02), pain level
Normal values of adult
B/P: 120/80
HR: 60-100
SP02: 95-100%
Temperature: 97 F - 99 F
Normal values of child
B/P: 95/57
HR: 70-115
SP02: 95-100%
Hypertension, one of the most common health problems, is blood pressure that is above
normal for a sustained period. A diagnosis of hypertension is made when the systolic pressure is
,130 mm Hg or higher or the diastolic pressure is 80 mm Hg or higher, The prevalence of
hypertension is greater in African American and Hispanic adults than in White adults
Hypotension is below normal blood pressure. Hypotension is blood pressure that is lower than
90/60 mm Hg. Hypotension occurs primarily as a result of the inability of the body's control
mechanisms to maintain or return blood pressure back to normal or the inability to do it quickly
enough. Can result from a disease process which might result from vasodilation of the
arterioles, failure of the heart to function as an effective pump, or loss of blood volume (such as
with a hemorrhage). A consistently low blood pressure is normal in some adults, with no signs
or symptoms. Hypotension is a medical concern if it causes signs or symptoms or is linked to a
disease or health process. The nurse should immediately report assessments of hypotension
and associated symptoms of dizziness, tachycardia, pallor, increased sweating, blurred vision,
nausea, and confusion
Orthostatic hypotension (postural hypotension) is a decrease in systolic blood pressure of ≥15-
20 mm Hg or a decrease in diastolic blood pressure of ≥10 mm Hg within three minutes of
standing when compared with blood pressure from the sitting or supine position
Pulse decreases as person ages due to decreased metabolic rate
Digoxin toxicity‐S&S NSG124.09.05.03 :
S/S- altered heart rate or rhythm, visual or GI disturbances, notify
healthcare provider if these occur
Elevated levels- dysrhythmias, visual disturbances (blurred vision, yellow tinge to vision,
appearance of halos around dark objects), nausea, vomiting and anorexia
Narrow therapeutic range- 0.5 to 0.8 ng/mL
KCl must be kept therapeutic at 3.5-5 mEq/L
Digoxin [Lanoxin] belongs to a family of drugs known as cardiac glycosides. Digoxin is indicated
for HF and for control of
dysrhythmias. When used for HF, digoxin can reduce symptoms, increase exercise tolerance,
and decrease hospitalizations. However, the drug does not prolong life. Furthermore, when
used by women, it may actually shorten life . Because benefits are limited to symptomatic relief
and because the risk of toxicity is substantial, digoxin is now considered a second-line drug for
treating HF.
MS Contin‐Chronic pain NSG124.02.03.01
In patients with chronic and increasing pain, such as occurs in some cases of cancer, pain
management requires a judicious choice of drugs used in a stepwise fashion to maximize the
reduction of pain. Usually tolerance to narcotic drugs develops in time, requiring an increase in
dosage to be effective. Eventually a new drug may be required
Non pharmaceutical interventions for chronic pain may include stress reduction and relaxation
therapy, distraction, applications of heat and cold, massage, physiotherapy modalities, exercise,
therapeutic touch, hypnosis imaging, and acupuncture .These measures may act in the spinal
cord at the “gate” or may modify pain perception and response in the brain. Many of these
strategies are believed to increase the levels of circulating endorphins that elevate the pain
tolerance. Also, maintenance of basic nutrition and activity levels as well as adequate rest
, assists people in coping with pain. Specialized clinics deal with certain types of pain such as
chronic back pain or temporal mandibular joint pain
MS long acting- morphine sulfate controlled release (MS contin)- extended release
Mimics endogenous opioid peptides at mu receptors of CNS
Respiratory depression, constipation, orthostatic hypotension, urine retention, sedation,
tolerance and dependence, pinpoint pupils
Taper
Low Sodium Diet NSG122.08.01.03 :
Low sodium diet is for patients with Hypertension, heart failure, chronic and acute renal failure
and hepatic failure. Low sodium diets contain fruits, vegetables, grains, meat, poultry, diary
products.
Insulin glargine‐teaching NSG124.07.01.03
U-100 insulin glargine [Lantus, Basaglar] is a modified human insulin with a prolonged duration
of action (up to 24 hours). The drug is indicated for once-daily subQ dosing to treat adults and
children with type 1 diabetes and adults with type 2 diabetes. That being said, some patients
require twice-daily administration to achieve a full 24 hours of basal coverage. Dosing may be
done any time of day (morning, afternoon, or evening), but should be done at the same time
every day, if possible. The drug should not be mixed with other insulins, and it should never be
given IV
Onset about 1 hour, no peak
Acetaminophen jaundice NSG124.03.03.03
The principal feature of acetaminophen overdose is hepatic necrosis. Severe poisoning can
progress to hepatic failure, coma, and death. Will occur with alcohol consumption (less than 3
drinks a day)
Early symptoms of poisoning (jaundice, nausea, vomiting, diarrhea, sweating, abdominal
discomfort) belie the severity of intoxication. It is not until 48 to 72 hours after drug ingestion
that overt indications of hepatic injury appear.
4000mg dose a day max
Jaundice is yellowing of the skin/ eyes due to hepatic failure
Treat overdose with Acetylcysteine (Mucomyst)
Rifampin‐oral contraceptive NSG124.06.01.02
Rifampin [Rifadin] equals isoniazid in importance as an anti-TB drug. Rifampin is a broad-
spectrum antibiotic.
Rifampin is a powerful inducer of CYP1A2, CYP2A6, CYP2B6, CYP2C19, CYP2C8, CYP2C9, and
CYP3A4 cytochrome P450 isoenzymes. As a result, it can hasten the metabolism of many drugs,
thereby reducing their effects. This interaction is of special concern with oral contraceptives,
warfarin (an anticoagulant), and certain protease inhibitors and NNRTIs used for HIV infection.
|2026 Latest Update with Complete Solution-
Herzing
Family history‐questioning pre‐test item not graded
Ask about family health issues, family history of diseases, conditions to gather information on
what pt may be already genetically disposed to.
History ‐ mental illness pre‐test item not graded
Med admin‐client ID NSG122.07.02.04:
Identify the client by checking the name or arm brand.First identification is the patient's name
and second one is date of birth. The patient's full name is used. The middle name or initial
should be included to avoid confusion with other patients. In facilities using paper records, the
patient's full name, secondary identification number, and the primary care provider's name are
labeled on all sheets on the patient's chart, including the medical order sheet. Be extremely
careful when administering medications when there is more than one patient on the unit with
the same last name. Not only can the nurse give the wrong patient the wrong medication, but a
provider may enter an order in the wrong patient's medical record. A secondary identifier is
used when verifying the patient's identity.
Rights of administration- patient, drug, time, dose, route, documentation, reason, assessment,
response, education, right to refuse
Occluded IV NSG122.13.02.04 :
The main reason for IV occlusion is blood reflux. Or when blood backs up into the catheter. It
forms a thrombus. IV flow may cease if the clot obstructs the needle. Symptoms are local acute
tenderness, redness, edema of vein above the insertion site. Discontinue the infusion
immediately, apply warm compression , and avoid further use of the vein. Restart the infusion
in another vein.
Vital signs NSG121.04.03.02
B/P, pulse, temperature, pulse oximeter (sp02), pain level
Normal values of adult
B/P: 120/80
HR: 60-100
SP02: 95-100%
Temperature: 97 F - 99 F
Normal values of child
B/P: 95/57
HR: 70-115
SP02: 95-100%
Hypertension, one of the most common health problems, is blood pressure that is above
normal for a sustained period. A diagnosis of hypertension is made when the systolic pressure is
,130 mm Hg or higher or the diastolic pressure is 80 mm Hg or higher, The prevalence of
hypertension is greater in African American and Hispanic adults than in White adults
Hypotension is below normal blood pressure. Hypotension is blood pressure that is lower than
90/60 mm Hg. Hypotension occurs primarily as a result of the inability of the body's control
mechanisms to maintain or return blood pressure back to normal or the inability to do it quickly
enough. Can result from a disease process which might result from vasodilation of the
arterioles, failure of the heart to function as an effective pump, or loss of blood volume (such as
with a hemorrhage). A consistently low blood pressure is normal in some adults, with no signs
or symptoms. Hypotension is a medical concern if it causes signs or symptoms or is linked to a
disease or health process. The nurse should immediately report assessments of hypotension
and associated symptoms of dizziness, tachycardia, pallor, increased sweating, blurred vision,
nausea, and confusion
Orthostatic hypotension (postural hypotension) is a decrease in systolic blood pressure of ≥15-
20 mm Hg or a decrease in diastolic blood pressure of ≥10 mm Hg within three minutes of
standing when compared with blood pressure from the sitting or supine position
Pulse decreases as person ages due to decreased metabolic rate
Digoxin toxicity‐S&S NSG124.09.05.03 :
S/S- altered heart rate or rhythm, visual or GI disturbances, notify
healthcare provider if these occur
Elevated levels- dysrhythmias, visual disturbances (blurred vision, yellow tinge to vision,
appearance of halos around dark objects), nausea, vomiting and anorexia
Narrow therapeutic range- 0.5 to 0.8 ng/mL
KCl must be kept therapeutic at 3.5-5 mEq/L
Digoxin [Lanoxin] belongs to a family of drugs known as cardiac glycosides. Digoxin is indicated
for HF and for control of
dysrhythmias. When used for HF, digoxin can reduce symptoms, increase exercise tolerance,
and decrease hospitalizations. However, the drug does not prolong life. Furthermore, when
used by women, it may actually shorten life . Because benefits are limited to symptomatic relief
and because the risk of toxicity is substantial, digoxin is now considered a second-line drug for
treating HF.
MS Contin‐Chronic pain NSG124.02.03.01
In patients with chronic and increasing pain, such as occurs in some cases of cancer, pain
management requires a judicious choice of drugs used in a stepwise fashion to maximize the
reduction of pain. Usually tolerance to narcotic drugs develops in time, requiring an increase in
dosage to be effective. Eventually a new drug may be required
Non pharmaceutical interventions for chronic pain may include stress reduction and relaxation
therapy, distraction, applications of heat and cold, massage, physiotherapy modalities, exercise,
therapeutic touch, hypnosis imaging, and acupuncture .These measures may act in the spinal
cord at the “gate” or may modify pain perception and response in the brain. Many of these
strategies are believed to increase the levels of circulating endorphins that elevate the pain
tolerance. Also, maintenance of basic nutrition and activity levels as well as adequate rest
, assists people in coping with pain. Specialized clinics deal with certain types of pain such as
chronic back pain or temporal mandibular joint pain
MS long acting- morphine sulfate controlled release (MS contin)- extended release
Mimics endogenous opioid peptides at mu receptors of CNS
Respiratory depression, constipation, orthostatic hypotension, urine retention, sedation,
tolerance and dependence, pinpoint pupils
Taper
Low Sodium Diet NSG122.08.01.03 :
Low sodium diet is for patients with Hypertension, heart failure, chronic and acute renal failure
and hepatic failure. Low sodium diets contain fruits, vegetables, grains, meat, poultry, diary
products.
Insulin glargine‐teaching NSG124.07.01.03
U-100 insulin glargine [Lantus, Basaglar] is a modified human insulin with a prolonged duration
of action (up to 24 hours). The drug is indicated for once-daily subQ dosing to treat adults and
children with type 1 diabetes and adults with type 2 diabetes. That being said, some patients
require twice-daily administration to achieve a full 24 hours of basal coverage. Dosing may be
done any time of day (morning, afternoon, or evening), but should be done at the same time
every day, if possible. The drug should not be mixed with other insulins, and it should never be
given IV
Onset about 1 hour, no peak
Acetaminophen jaundice NSG124.03.03.03
The principal feature of acetaminophen overdose is hepatic necrosis. Severe poisoning can
progress to hepatic failure, coma, and death. Will occur with alcohol consumption (less than 3
drinks a day)
Early symptoms of poisoning (jaundice, nausea, vomiting, diarrhea, sweating, abdominal
discomfort) belie the severity of intoxication. It is not until 48 to 72 hours after drug ingestion
that overt indications of hepatic injury appear.
4000mg dose a day max
Jaundice is yellowing of the skin/ eyes due to hepatic failure
Treat overdose with Acetylcysteine (Mucomyst)
Rifampin‐oral contraceptive NSG124.06.01.02
Rifampin [Rifadin] equals isoniazid in importance as an anti-TB drug. Rifampin is a broad-
spectrum antibiotic.
Rifampin is a powerful inducer of CYP1A2, CYP2A6, CYP2B6, CYP2C19, CYP2C8, CYP2C9, and
CYP3A4 cytochrome P450 isoenzymes. As a result, it can hasten the metabolism of many drugs,
thereby reducing their effects. This interaction is of special concern with oral contraceptives,
warfarin (an anticoagulant), and certain protease inhibitors and NNRTIs used for HIV infection.
