NCLEX CRITICALLY THINKING APRIL 20TH
You are caring for a patient who has had an exacerbation of his heart failure. The
patient has crackles ¾ up each lung. What is your priority assessment?
A. Blood pressure
B. Saturation
C. Urinary output
D. Skin integrity
They are in heart failure and the UO is what will make a difference in their
condition. Need to get the fluid off. This is left sided heart failure because it is
building up in the lungs. You need to give them diuretics to get that fluid off the
body.
1) You are caring for a patient who is a renal patient. Doc has given your
patient a 1200ml fluid restriction per day. How many (CCs) would your
patient be allowed from 0700-1500.
A. 400ml
B. 500ml
C. 600ml
D. 700ml
C because half the fluids be given for the 2 meals. Fluid restriction should be
monitored for low NA, renal failure and heart failure.
2) You are assessing your patient. You note in the history your patient has
parathyroid disease. The patient is displaying a positive Chovstek and
Trousseau signs. What electrolyte are you worried about being off?
A. High sodium
B. High magnesium
C. Low magnesium
D. Low calcium
Calcium level 8-10, it is nerve excitability in the cheek. Trousseau sign is the
blood pressure hand curls in. Medications that cause low calcium phenytoin,
phenobarbital, rifampim (orange urine), corticosteroids.
, 3) You are caring for a patient on the medical-surgical floor. The patient is
receiving erythropoietin. You know that the following makes erythropoietin.
A. The urinary system
B. Lymphatic system
C. Parathyroid
D. Endocrine
A because its produced by the kidneys.
4) You have just received report. You are to give Vancomycin to a patient with
MRSA. You have checked the patient’s BUN and Creatinine. The BUN
result is 14. The creatinine result is 0.9. You know you should expect to do
what according to these lab results.
A. Hold the medication and call the doctor
B. These are normal labs and you should proceed with the order.
C. Call the pharmacist and ask about renal dosing
D. Check the patients I & O.
BUN – 10 -20
Creatinine 0.6 – 1.2
Vanc is a powerful antibiotic.
5) The above patient is to receive the third dose of Vancomycin. What do you
know needs to be done? (SATA)
A. Draw a trough 30 minutes before you start the Vancomycin. Draw a peak
1-hour after the Vancomycin is infused.
B. You know the trough level refers to the amount of time for dosing
intervals and the peak refers to the dose of the medication being
delivered.
C. Draw a peak 30 minutes before you start the Vancomycin. Draw a trough
1-hour after the Vanc is infused.
D. Neither if the doctor doesn’t order.
Trough levels are collected just prior to a person's next vancomycin dose. Peak
levels are collected 1 to 2 hours after the completion of the
intravenous vancomycin dose. The pharmacy orders the peak and trough and they
will change the time and dose if they are not in normal range.
You are caring for a patient who has had an exacerbation of his heart failure. The
patient has crackles ¾ up each lung. What is your priority assessment?
A. Blood pressure
B. Saturation
C. Urinary output
D. Skin integrity
They are in heart failure and the UO is what will make a difference in their
condition. Need to get the fluid off. This is left sided heart failure because it is
building up in the lungs. You need to give them diuretics to get that fluid off the
body.
1) You are caring for a patient who is a renal patient. Doc has given your
patient a 1200ml fluid restriction per day. How many (CCs) would your
patient be allowed from 0700-1500.
A. 400ml
B. 500ml
C. 600ml
D. 700ml
C because half the fluids be given for the 2 meals. Fluid restriction should be
monitored for low NA, renal failure and heart failure.
2) You are assessing your patient. You note in the history your patient has
parathyroid disease. The patient is displaying a positive Chovstek and
Trousseau signs. What electrolyte are you worried about being off?
A. High sodium
B. High magnesium
C. Low magnesium
D. Low calcium
Calcium level 8-10, it is nerve excitability in the cheek. Trousseau sign is the
blood pressure hand curls in. Medications that cause low calcium phenytoin,
phenobarbital, rifampim (orange urine), corticosteroids.
, 3) You are caring for a patient on the medical-surgical floor. The patient is
receiving erythropoietin. You know that the following makes erythropoietin.
A. The urinary system
B. Lymphatic system
C. Parathyroid
D. Endocrine
A because its produced by the kidneys.
4) You have just received report. You are to give Vancomycin to a patient with
MRSA. You have checked the patient’s BUN and Creatinine. The BUN
result is 14. The creatinine result is 0.9. You know you should expect to do
what according to these lab results.
A. Hold the medication and call the doctor
B. These are normal labs and you should proceed with the order.
C. Call the pharmacist and ask about renal dosing
D. Check the patients I & O.
BUN – 10 -20
Creatinine 0.6 – 1.2
Vanc is a powerful antibiotic.
5) The above patient is to receive the third dose of Vancomycin. What do you
know needs to be done? (SATA)
A. Draw a trough 30 minutes before you start the Vancomycin. Draw a peak
1-hour after the Vancomycin is infused.
B. You know the trough level refers to the amount of time for dosing
intervals and the peak refers to the dose of the medication being
delivered.
C. Draw a peak 30 minutes before you start the Vancomycin. Draw a trough
1-hour after the Vanc is infused.
D. Neither if the doctor doesn’t order.
Trough levels are collected just prior to a person's next vancomycin dose. Peak
levels are collected 1 to 2 hours after the completion of the
intravenous vancomycin dose. The pharmacy orders the peak and trough and they
will change the time and dose if they are not in normal range.
