NCLEX STUDY FROM MARK KLIMEK EXAM QUESTIONS AND ANSWERS
If the pH and the BiCarb are both in the same direction then it is? - CORRECT ANSWER✅✅Metabolc
If the pH is up it is? - CORRECT ANSWER✅✅Alkalosis
As the pH goes so goes my patient except for? - CORRECT ANSWER✅✅Potassium
If the pH is down it is? - CORRECT ANSWER✅✅Acidosis
If the pH is up my patient with show signs and symptoms of? - CORRECT ANSWER✅✅Increase... like
tachycardia,diarrhea and borborygmi
If the pH is down my patient will show signs and symtoms of? - CORRECT ANSWER✅✅Decrease... like
decreased output, bradycardia and constipation
If my pH is up my potassium (K+) is ? - CORRECT ANSWER✅✅Down
If my pH is down my potassium (K+) is? - CORRECT ANSWER✅✅Up
If my patient is overventilating I should choose? - CORRECT ANSWER✅✅Respiratory Alkalosis
If my patient is underventilating I should choose? - CORRECT ANSWER✅✅Respiratory Acidosis
If my patient has prolonged gastric vomiting or suction I choose? - CORRECT ANSWER✅✅Metabolic
Alkalosis
If it is not lung or prolonged vomiting or suctioning I choose? - CORRECT ANSWER✅✅Metabolic
Acidosis
,Kussmal Respirations - CORRECT ANSWER✅✅Metabolic Acidosis ( Remember MacKussmal
Before measuing ABGs you should check what? - CORRECT ANSWER✅✅Allen's test. Should be positive.
Pt makes a fist and pressure is applied to the ulnar and the radial arteries Ulnar pressure is released and
color should return in 7 seconds (means it's positive and OK to take ABG's).
Definition of Compensation - CORRECT ANSWER✅✅PH is normal! It is never compensated if it is
abnormal.
If PH normal - CORRECT ANSWER✅✅look in the direction it is going. Closer to Acidic? (7.35) acidosis.
Then look at Bicarb & figure out which is abnormal. If Bicarb is out of range, it's metabolic acidosis.
If C02 is abnormal, it's Respiratory Acidosis :)
If your pt is acidotic and you need to pick a symptom - CORRECT ANSWER✅✅Pick the symptom where
everything is DOWN. ( And vice Versa)
Ex: 2 degree Morbitz Type 2 BLOCK. <---- Down direction
If you don't know what causes an acid base balance, pick - CORRECT ANSWER✅✅Metabolic Acidosis
If in doubt in ABGs, always pick - CORRECT ANSWER✅✅Headache, nausea, weakness & numbness+
tingling. It can be either up or down.
High pressure alarms are triggered when? - CORRECT ANSWER✅✅They cannot push air in
High pressure alarms are caused by what three types of obstructions? - CORRECT ANSWER✅✅Kinking,
Water in dependant loops and mucus in the airway.
If kinking in the tube is present you? - CORRECT ANSWER✅✅Unkink
,If water is present in the dependant loops you? - CORRECT ANSWER✅✅Open system and empty water.
If mucus is present you? - CORRECT ANSWER✅✅Turn them, cough and have them deeo breath first. If
ineffective you then suction.
Don't suction unless - CORRECT ANSWER✅✅Coughing & deep breathing is deemed inappropriate.
In order to suction, you must be able to hear - CORRECT ANSWER✅✅Mucus in the lung
Low pressure alarms are triggered when? - CORRECT ANSWER✅✅It is to easy to push air in.
Low pressure alarms are normally caused by? - CORRECT ANSWER✅✅Disconnection
If the tubing is disconnected you? - CORRECT ANSWER✅✅Reconnect
If O2 sensor line is disconnected you? - CORRECT ANSWER✅✅Reconnect
In a vented client respiratory alkalosis means the vent setting may be too? - CORRECT ANSWER✅✅High
In a vented client respiratory acidosis means the vent may be too? - CORRECT ANSWER✅✅Low
What do you do if the patients disconnected tube is on the floor? - CORRECT ANSWER✅✅Bag them,
(call for help) get new tube and then reconnect.
First question to ask if the low pressure alarm sounds - CORRECT ANSWER✅✅Where is the tubing?!
HOLD - CORRECT ANSWER✅✅H- High Pressure
O- Obstruction
, L- Low
D- Disconnections
Never put anything in YOUR scope of practice - CORRECT ANSWER✅✅On anyone else
Make sure your answer is - CORRECT ANSWER✅✅PATIENT FOCUSED.
TAKE CARE OF YOUR PATIENT!
Don't answer based on staff, building, machine, etc.
PATIENT FIRST.
What does wean mean? - CORRECT ANSWER✅✅Decrease Gradually
What do you do if the patients disconnected tube is on the chest? - CORRECT ANSWER✅✅Reconnect ...
if its above the waist its ok.
Remember is PSYCH if you are asked to Prioritize, Don't forget - CORRECT ANSWER✅✅MASLOW!
1. Physiological
2. Safety
3. Comfort - Includes pain
4. Psychological
5. Social
6. Spiritual
When prioritizing, always use Maslow + ABCs - CORRECT ANSWER✅✅For one patient. Don't if you have
more than one patient.
What is the biggest problem in abuse? - CORRECT ANSWER✅✅Denial
To treat denial you need to? - CORRECT ANSWER✅✅Confront them.
If the pH and the BiCarb are both in the same direction then it is? - CORRECT ANSWER✅✅Metabolc
If the pH is up it is? - CORRECT ANSWER✅✅Alkalosis
As the pH goes so goes my patient except for? - CORRECT ANSWER✅✅Potassium
If the pH is down it is? - CORRECT ANSWER✅✅Acidosis
If the pH is up my patient with show signs and symptoms of? - CORRECT ANSWER✅✅Increase... like
tachycardia,diarrhea and borborygmi
If the pH is down my patient will show signs and symtoms of? - CORRECT ANSWER✅✅Decrease... like
decreased output, bradycardia and constipation
If my pH is up my potassium (K+) is ? - CORRECT ANSWER✅✅Down
If my pH is down my potassium (K+) is? - CORRECT ANSWER✅✅Up
If my patient is overventilating I should choose? - CORRECT ANSWER✅✅Respiratory Alkalosis
If my patient is underventilating I should choose? - CORRECT ANSWER✅✅Respiratory Acidosis
If my patient has prolonged gastric vomiting or suction I choose? - CORRECT ANSWER✅✅Metabolic
Alkalosis
If it is not lung or prolonged vomiting or suctioning I choose? - CORRECT ANSWER✅✅Metabolic
Acidosis
,Kussmal Respirations - CORRECT ANSWER✅✅Metabolic Acidosis ( Remember MacKussmal
Before measuing ABGs you should check what? - CORRECT ANSWER✅✅Allen's test. Should be positive.
Pt makes a fist and pressure is applied to the ulnar and the radial arteries Ulnar pressure is released and
color should return in 7 seconds (means it's positive and OK to take ABG's).
Definition of Compensation - CORRECT ANSWER✅✅PH is normal! It is never compensated if it is
abnormal.
If PH normal - CORRECT ANSWER✅✅look in the direction it is going. Closer to Acidic? (7.35) acidosis.
Then look at Bicarb & figure out which is abnormal. If Bicarb is out of range, it's metabolic acidosis.
If C02 is abnormal, it's Respiratory Acidosis :)
If your pt is acidotic and you need to pick a symptom - CORRECT ANSWER✅✅Pick the symptom where
everything is DOWN. ( And vice Versa)
Ex: 2 degree Morbitz Type 2 BLOCK. <---- Down direction
If you don't know what causes an acid base balance, pick - CORRECT ANSWER✅✅Metabolic Acidosis
If in doubt in ABGs, always pick - CORRECT ANSWER✅✅Headache, nausea, weakness & numbness+
tingling. It can be either up or down.
High pressure alarms are triggered when? - CORRECT ANSWER✅✅They cannot push air in
High pressure alarms are caused by what three types of obstructions? - CORRECT ANSWER✅✅Kinking,
Water in dependant loops and mucus in the airway.
If kinking in the tube is present you? - CORRECT ANSWER✅✅Unkink
,If water is present in the dependant loops you? - CORRECT ANSWER✅✅Open system and empty water.
If mucus is present you? - CORRECT ANSWER✅✅Turn them, cough and have them deeo breath first. If
ineffective you then suction.
Don't suction unless - CORRECT ANSWER✅✅Coughing & deep breathing is deemed inappropriate.
In order to suction, you must be able to hear - CORRECT ANSWER✅✅Mucus in the lung
Low pressure alarms are triggered when? - CORRECT ANSWER✅✅It is to easy to push air in.
Low pressure alarms are normally caused by? - CORRECT ANSWER✅✅Disconnection
If the tubing is disconnected you? - CORRECT ANSWER✅✅Reconnect
If O2 sensor line is disconnected you? - CORRECT ANSWER✅✅Reconnect
In a vented client respiratory alkalosis means the vent setting may be too? - CORRECT ANSWER✅✅High
In a vented client respiratory acidosis means the vent may be too? - CORRECT ANSWER✅✅Low
What do you do if the patients disconnected tube is on the floor? - CORRECT ANSWER✅✅Bag them,
(call for help) get new tube and then reconnect.
First question to ask if the low pressure alarm sounds - CORRECT ANSWER✅✅Where is the tubing?!
HOLD - CORRECT ANSWER✅✅H- High Pressure
O- Obstruction
, L- Low
D- Disconnections
Never put anything in YOUR scope of practice - CORRECT ANSWER✅✅On anyone else
Make sure your answer is - CORRECT ANSWER✅✅PATIENT FOCUSED.
TAKE CARE OF YOUR PATIENT!
Don't answer based on staff, building, machine, etc.
PATIENT FIRST.
What does wean mean? - CORRECT ANSWER✅✅Decrease Gradually
What do you do if the patients disconnected tube is on the chest? - CORRECT ANSWER✅✅Reconnect ...
if its above the waist its ok.
Remember is PSYCH if you are asked to Prioritize, Don't forget - CORRECT ANSWER✅✅MASLOW!
1. Physiological
2. Safety
3. Comfort - Includes pain
4. Psychological
5. Social
6. Spiritual
When prioritizing, always use Maslow + ABCs - CORRECT ANSWER✅✅For one patient. Don't if you have
more than one patient.
What is the biggest problem in abuse? - CORRECT ANSWER✅✅Denial
To treat denial you need to? - CORRECT ANSWER✅✅Confront them.
