NUR 2204C 2019 NCLEX RN Cram Sheet

NUR 2204C 2019 NCLEX RN Cram Sheet This NCLEX-RN cram sheet or cheat sheet can help you prepare as it contains condensed facts about the nurse licensure exam itself and key nursing information. When your time to take the NCLEX comes, you can write or transfer these vital information from your head to a blank sheet of paper provided by the testing center. Please download only at N as we continually update this cram sheet. 1. TEST INFORMATION • Six hours – the maximum time allotted for the NCLEX is 6 hours. • Take breaks – Take breaks if you need a time out or need to move around. First optional break is offered after 2 hours of testing, next is offered after 3.5 hours of testing. All breaks count to your allotted six hours. • 75/265 – the minimum number of question you can answer is 75 and a maximum of 265. Of the 75 questions, 60 will be scored question and the remaining 15 are pretest or unscored questions. • Read the question and answers carefully – do not jump into conclusions or make wild guesses. Read the entirety of the question including its choices before selecting your final answer. • Look for keywords – avoid answers with absolutes like always, never, all, every, only, must, except, none, or no. • Don’t read into the question – Never assume anything that has not been specifically mentioned and don’t add extra meaning to the question. • Eliminate answers that are clearly wrong or incorrect – to increase your probability of selecting the correct answer! • Watch for grammatical inconsistencies – Subjects and verbs should agree. If the question is an incomplete sentence, the correct answer should complete the question in a grammatically correct manner. • Rephrase the question – putting the question into your own words can pluck the unneeded info and reveal the core of the stem. • Make an educated guess – if you can’t make the best answer for a question after carefully reading it, choose the answer with the most information. • New question types – New question types are added on the test. These questions are found on the Special Research Section of the test, which pops up after the candidate finishes the exam. These do not count toward your score and are testing out the feasibility of the test question, not the test-taker. 2. NCLEX QUESTION TYPES • Multiple-Choice –These questions provide you with data about client situation and given four options to choose from. Most common question type. • Fill-in-the-Blank – This format is usually used for medication calculation or computing an IV flow rate. Type only a number for your answer in the box. Rounding an answer should be done at the end of the calculation or as what the question specifies. Type in the decimal point if necessary. • Multiple-Response – You’ll be asked to select all the option that relate to the information asked by the question. There may be two or more correct answers and no partial credit is given for correct selection. • Ordered-Response – In this format, you’ll be asked to use the computer mouse to drag and drop your nursing actions in order or priority. Based on the information presented, determine what you’ll do first, second, third, and so forth. Directions are provided with the question. • Figure or Hotspot – A picture or graphic will be presented along with a question. This could contain a chart, a table, or an illustration where you’ll be asked to point or click on a specific area. Figures may also appear along with a multiple-choice question. • Chart/Exhibit – A chart or exhibit is presented along with a problem. You’ll be provided with three tabs or buttons that you need to click to obtain the information needed to answer the question. • Graphic Option – In this format, options are pictures rather than text. Each option is preceded by a circle that you need to click to represent your answer. • Audio – In this format, you’ll be required to listen to a sound to answer the question. You’ll need to use the headset provided and click on the sound icon for it to play. You’ll be able to listen to the sound as many times as necessary. • Video – This will require viewing of an animation or video clip to answer the accompanying question. 3. VITAL SIGNS Heart rate 80 – 100 bpm Respiratory rate 12-20 rpm Blood pressure 110-120/60 mmHg Temperature 37 °C (98.6 °F) 4. HEMATOLOGY VALUES RBCs 4.5 – 5.0 million per mm3 WBCs 4,500 – 11,000 per mm3 Neutrophils 60 – 70% Lymphocytes 20 – 25% Monocytes 3 – 8% Eosinophils 2 – 4% Basophils 0.5 – 1% Platelets 150,000– 400,000 per mm3 Hemoglobin (Hgb) 12 – 16 gm (F); 14 – 18 gm (M). Hematocrit (Hct) 37 – 47 (F); 40 – 54 (M) 5. SERUM ELECTROLYTES Sodium 135 – 145 mEq/L Potassium 3.5 – 5.0 mEq/L Calcium 8.6–10 mg/dL Chloride 98 – 107 mEq/L Magnesium 1.2 – 2.6 mg/dL Phosphorus 2.7-4.5 mg/dL 6. ACID- BASE BALANCE Use the ABG Tic-Tac-Toe Method for interpreting. Learn about the technique at: ( pH 7.35 – 7.45 HCO3 22 – 26 mEq/L Pco2 35 – 45 mmHg PaO2 80–100 mmHg SaO2 95 This study source was downloaded by from CourseH on :13:06 GMT -05:00 This study resource was shared via CourseH NUR 2204C 2019 NCLEX RN Cram Sheet SOURCE: 2 7. CHEMISTRY VALUES Glucose 70 – 110 mg/dL BUN 7-22 mg/dL Serum creatinine 0.6 – 1.35 mg/dL LDH 100-190 U/L Protein 6.2 – 8.1 g/dL Albumin 3.4 – 5.0 g/dL Bilirubin 1.0 mg/dL Total Cholesterol 130 – 200 mg/dL Triglyceride 40 – 50 mg/dL Uric acid 3.5 – 7.5 mg/dL CPK 21-232 U/L 8. URINE TEST NORMAL VALUES Color Pale yellow Odor Specific aromatic odor, similar to ammonia Turbidity Clear pH 4.5 – 7.8 Specific gravity 1.016 to 1.022 Glucose 0.5 g/day Ketones None Protein None Bilirubin None Casts None to few Crystals None Bacteria None or 1000/mL RBC 3 cells/HPF WBC 4 cells/HPF Uric Acid 250–750 mg/24 hr 9. NORMAL GLUCOSE VALUES Glucose, fasting 70 – 110 mg/dL Glucose, monitoring 60 – 100 mg/dL Glucose tolerance test, oral • Baseline fasting 70 – 110 mg/dL • 30-min fasting 110 – 170 mg/dL • 60-min fasting 120 – 170 mg/dL • 90-min fasting 100 – 140 mg/dL • 120-min fasting 70 – 120 mg/dL Glucose, 2-hour postprandial 140 mg/dL 10. THERAPEUTIC DRUG LEVELS Acetaminophen (Tylenol) 10-20 mcg/mL Carbamazepine (Tegretol) 4 – 10 mcg/mL Digoxin (Lanoxin) 0.5 – 2.0 ng/mL Gentamycin (Garamycin) 5 – 10 mcg/ml (peak), 2.0 mcg/ml (valley) Lithium (Eskalith) 0.5 – 1.2 mEq/L Magnesium sulfate 4 – 7 mg/dL Phenobarbital (Solfoton) 15 – 40 mcg/mL Phenytoin (Dilantin) 10 – 20 mcg/dL Salicylate 100 – 250 mcg/mL Theophylline (Aminophylline) 10 – 20 mcg/dL Tobramycin (Tobrex) 5 – 10 mcg/mL (peak), 0.5 – 2.0 mcg/mL (valley) Valproic Acid (Depakene) 50 – 100 mcg/ml Vancomycin (Vancocin) 20 – 40 mcg/ml (peak), 5 to 15 mcg/ml (trough) 11. CARDIAC MARKERS Creatinine kinase (CK) 26 – 174 units/L • CK-MB 0%-5% of total • CK-MM 95%-100% of total • CK-BB 0% Troponin I 0.6 ng/mL ( 1.5 ng/mL indicates MI) Troponin T 0.1-0.2 ng/mL indicates MI Myoglobin 90 mcg/L; elevation indicates MI Atrial natriuretic peptides (ANP) 22 – 27 pg/mL Brain natriuretic peptides (BNP) 100 pg/mL 12. ANTICOAGULANT THERAPY Sodium warfarin (Coumadin) PT 10 – 12 seconds (control). The antidote is Vitamin K. INR (Coumadin) 0.9 – 1.2 Heparin PTT 30 – 45 seconds (control). The antidote is protamine sulfate. APTT 3 – 31.9 seconds Fibrinogen level 203 – 377 mg/dL 13. UNIT CONVERSIONS 1 teaspoon (t) 5 ml 1 tablespoon (T) 3 t (15 ml) 1 oz 30 ml 1 cup 8 oz 1 quart 2 pints 1 pint 2 cups 1 grain (gr) 60 mg 1 gram (g) 1,000 mg 1 kilogram (kg) 2.2 lbs 1 lb 16 oz Convert C to F multiply by 1.8 then add 32 Convert F to C: subtract 32 then divide by 1.8 14. MATERNITY NORMAL VALUES • Fetal Heart Rate: 120 – 160 bpm • Variability: 6 – 10 bpm • Amniotic fluid: 500 – 1200 ml • Contractions: 2 – 5 minutes apart with duration of 90 seconds and intensity of 100 mmHg. • AVA: The umbilical cord has two arteries and one vein. 15. APGAR SCORING • Appearance, Pulses, Grimace, Activity, Reflex Irritability. • Done at 1 and 5 minutes with a score of 0 for absent, 1 for decreased, and 2 for strongly positive. • Scores 7 and above are generally normal, 4 to 6 fairly low, and 3 and below are generally regarded as critically low. 16. EPIDURAL ANESTHESIA: STOP • STOP is a treatment for maternal hypotension after an epidural anesthesia. • Stop infusion of Pitocin. • Turn the client on her left side. • Oxygen therapy. • Push IV fluids, if hypovolemia is present. This study source was downloaded by from CourseH on :13:07 GMT -05:00 This study resource was shared via CourseH SOURCE: 3 17. PREGNANCY CATEGORY OF DRUGS • Category A – No risk in controlled human studies • Category B – No risk in other studies. Examples: Amoxicillin, Cefotaxime. • Category C – Risk not ruled out. Examples: Rifampicin (Rifampin), Theophylline (Theolair). • Category D – Positive evidence of risk. Examples: Phenytoin, Tetracycline. • Category X – Contraindicated in Pregnancy. Examples: Isotretinoin (Accutane), Thalidomide (Immunoprin), etc. • Category N – Not yet classified 18. DRUG SCHEDULES • Schedule I – no currently accepted medical use and for research use only (e.g., heroin, LSD, MDMA). • Schedule II – drugs with high potential for abuse and requires written prescription (e.g., Ritalin, hydromorphone (Dilaudid), meperidine (Demerol), and fentanyl). • Schedule III – requires new prescription after six months or five refills (e.g., codeine, testosterone, ketamine). • Schedule IV – requires new prescription after six months (e.g., Darvon, Xanax, Soma, and Valium). • Schedule V – dispensed as any other prescription or without prescription (e.g., cough preparations, Lomotil, Motofen). 19. MEDICATION CLASSIFICATIONS • Antacids – reduces hydrochloric acid in the stomach. • Antianemics – increases blood cell production. • Anticholinergics – decreases oral secretions. • Anticoagulants – prevents clot formation, • Anticonvulsants – used for management of seizures and/or bipolar disorders. • Antidiarrheals – decreases gastric motility and reduce water in bowel. • Antihistamines – block the release of histamine. • Antihypertensives – lower blood pressure and increases blood flow. • Anti-infectives – used for the treatment of infections, • Bronchodilators – dilates large air passages in asthma or lung diseases (e.g., COPD). • Diuretics – decreases water/sodium from the Loop of Henle. • Laxatives – promotes the passage of stool. • Miotics – constricts the pupils. • Mydriatics – dilates the pupils. • Narcotics/analgesics – relieves moderate to severe pain. 20. RULE OF NINES • For calculating Total Body Surface Area (TBSA) for burns: • Head and neck: 9% • Upper limbs: 18% (9% each) • Anterior torso: 18% • Posterior torso: 18% • Legs: 36% (18% each) • Genitalia: 1% 21. MEDICATIONS • Digoxin (Lanoxin) – Assess pulses for a full minute, if less than 60 bpm hold dose. Check digitalis and potassium levels. • Aluminum Hydroxide (Amphojel) – Treatment of GERD and kidney stones. WOF constipation. • Hydroxyzine (Vistaril) – Treatment of anxiety and itching. WOF dry mouth. • Midazolam (Versed) – given for conscious sedation. Watch out for (WOF) respiratory depression and hypotension. • Amiodarone (Cordarone) – WOF diaphoresis, dyspnea, lethargy. Take missed dose any time in the day or to skip it entirely. Do not take double dose. • Warfarin (Coumadin) – WOF for signs of bleeding, diarrhea, fever, or rash. Stress importance of complying with prescribed dosage and follow-up appointments. • Methylphenidate (Ritalin) – Treatment of ADHD. Assess for heart related side-effects and reported immediately. Child may need a drug holiday because the drug stunts growth. • Dopamine – Treatment of hypotension, shock, and low cardiac output. Monitor ECG for arrhythmias and blood pressure. • Rifampicin – causes red-orange tears and urine. • Ethambutol – causes problems with vision, liver problem. • Isoniazid – can cause peripheral neuritis, take vitamin B6 to counter. 22. DEVELOPMENTAL MILESTONES • 2 – 3 months: able to turn head up, and can turn side to side. Makes cooing or gurgling noises and can turn head to sound. • 4 – 5 months: grasps, switch and roll over tummy to back. Can babble and can mimic sounds. • 6 – 7 months: sits at 6 and waves bye-bye. Can recognize familiar faces and knows if someone is a stranger. Passes things back and forth between hands. • 8 – 9 months: stands straight at eight, has favorite toy, plays peek-a-boo. • 10 – 11 months: belly to butt. • 12 – 13 months: twelve and up, drinks from a cup. Cries when parents leave, uses furniture to cruise. This study source was downloaded by from CourseH on :13:07 GMT -05:00 This study resource was shared via CourseH SOURCE: 4 23. CULTURAL CONSIDERATIONS • African Americans – May believe that illness is caused by supernatural causes and seek advice and remedies form faith healers; they are family oriented; have higher incidence of high blood pressure and obesity; high incidence of lactose intolerance with difficulty digesting milk and milk products. • Arab Americans – May remain silent about health problems such as STIs, substance abuse, and mental illness; a devout Muslim may interpret illness as the will of Allah, a test of faith; may rely on ritual cures or alternative therapies before seeking help from health care provider; after death, the family may want to prepare the body by washing and wrapping the body in unsewn white cloth; postmortem examinations are discouraged unless required by law. May avoid pork and alcohol if Muslim. Islamic patients observe month long fast of Ramadan (begins approximately mid-October); people suffering from chronic illnesses, pregnant women, breast-feeding, or menstruating don’t fast. Females avoid eye contact with males; use same-sex family members as interpreters. • Asian Americans – May value ability to endure pain and grief with silent stoicism; typically family oriented; extended family should be involved in care of dying patient; believes in “hot-cold” yin/yang often involved; sodium intake is generally high because of salted and dried foods; may believe prolonged eye contact is rude and an invasion of privacy; may not without necessarily understanding; may prefer to maintain a comfortable physical distance between the patient and the health care provider. • Latino Americans – May view illness as a sign of weakness, punishment for evil doing; may consult with a curandero or voodoo priest; family members are typically involved in all aspects of decision making such as terminal illness; may see no reason to submit to mammograms or vaccinations. • Native Americans – May turn to a medicine man to determine the true cause of an illness; may value the ability to endure pain or grief with silent stoicism; diet may be deficient in vitamin D and calcium because many suffer from lactose intolerance or don’t drink milk; obesity and diabetes are major health concerns; may divert eyes to the floor when they are praying or paying attention. • Western Culture – May value technology almost exclusively in the struggle to conquer diseases; health is understood to be the absence, minimization, or control of disease process; eating utensils usually consists of knife, fork, and spoon; three daily meals is typical. 24. COMMON DIETS • Acute Renal Disease – protein-restricted, high-calorie, fluid-controlled, sodium and potassium controlled. • Addison’s disease – increased sodium, low potassium diet. • ADHD and Bipolar – high-calorie and provide finger foods. • Burns – high protein, high caloric, increase in Vitamin C. • Cancer – high-calorie, high-protein. • Celiac Disease – gluten-free diet (no BROW: barley, rye, oat, and wheat). • Chronic Renal Disease – protein-restricted, low-sodium, fluid-restricted, potassium-restricted, phosphorusrestricted. • Cirrhosis (stable) – normal protein • Cirrhosis with hepatic insufficiency – restrict protein, fluids, and sodium. • Constipation – high-fiber, increased fluids • COPD – soft, high-calorie, low-carbohydrate, high-fat, small frequent feedings • Cystic Fibrosis – increase in fluids. • Diarrhea – liquid, low-fiber, regular, fluid and electrolyte replacement • Gallbladder diseases – low-fat, calorie-restricted, regular • Gastritis – low-fiber, bland diet • Hepatitis – regular, high-calorie, high-protein • Hyperlipidemias – fat-controlled, calorie-restricted • Hypertension, heart failure, CAD – low-sodium, calorierestricted, fat-controlled • Kidney Stones – increased fluid intake, calciumcontrolled, low-oxalate • Nephrotic Syndrome – sodium-restricted, high-calorie, high-protein, potassium-restricted. • Obesity, overweight – calorie-restricted, high-fiver • Pancreatitis – low-fat, regular, small frequent feedings; tube feeding or total parenteral nutrition. • Peptic ulcer – bland diet • Pernicious Anemia – increase Vitamin B12 (Cobalamin), found in high amounts on shellfish, beef liver, and fish. • Sickle Cell Anemia – increase fluids to maintain hydration since sickling increases when patients become dehydrated. • Stroke – mechanical soft, regular, or tube-feeding. • Underweight – high-calorie, high protein • Vomiting – fluid and electrolyte replacement This study source was downloaded by from CourseH on :13:07 GMT -05:00 This study resource was shared via CourseH SOURCE: 5 25. POSITIONING CLIENTS • Asthma – Orthopneic position where patient is sitting up and bent forward with arms supported on a table or chair arms. • Post Bronchoscopy – flat on bed with head hyperextended. • Cerebral Aneurysm – high Fowler’s. • Hemorrhagic Stroke – HOV elevated 30 degrees to reduce ICP and facilitate venous drainage. • Ischemic Stroke – HOB flat. • Cardiac Catheterization – keep site extended. • Epistaxis – lean forward. • Above Knee Amputation – elevate for first 24 hours on pillow, position on prone daily for hip extension. • Below Knee Amputation – foot of bed elevated for first 24 hours, position prone daily for hip extension. • Tube feeding for patients with decreased LOC – position patient on right side to promote emptying of the stomach with HOB elevated to prevent aspiration. • Air/Pulmonary embolism – turn patient to left side and lower HOB. • Postural Drainage – Lung segment to be drained should be in the uppermost position to allow gravity to work. • Post Lumbar puncture – patient should lie flat in supine to prevent headache and leaking of CSF. • Continuous Bladder Irrigation (CBI) – catheter should be taped to thigh so legs should be kept straight. • After myringotomy – position on the side of affected ear after surgery (allows drainage of secretion). • Post cataract surgery – patient will sleep on unaffected side with a night shield for 1-4 weeks. • Detached retina – area of detachment should be in the dependent position. • Post thyroidectomy – low or semi-Fowlers, support head, neck and shoulders. • Thoracentesis – sitting on the side of the bed and leaning over the table (during procedure); affected side up (after procedure). • Spina Bifida – position infant on prone so that sac does not rupture. • Buck’s Traction – elevate foot of bed for counter-traction. • Post Total Hip Replacement – don’t sleep on operated side, don’t flex hip more than 45-60 degrees, don’t elevate HOB more than 45 degrees. Maintain hip abduction by separating thighs with pillows. • Prolapsed cord – knee-chest position or Trendelenburg. • Cleft-lip – position on back or in infant seat to prevent trauma to the suture line. While feeding, hold in upright position. • Cleft-palate – prone. • Hemorrhoidectomy – assist to lateral position. • Hiatal Hernia – upright position. • Preventing Dumping Syndrome – eat in reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low fiber diet, and small frequent meals). • Enema Administration – position patient in left-side lying (Sim’s position) with knees flexed. • Post supratentorial surgery (incision behind hairline) – elevate HOB 30-45 degrees. • Post infratentorial surgery (incision at nape of neck) – position patient flat and lateral on either side. • Increased ICP – high Fowler’s. • Laminectomy – back as straight as possible; log roll to move and sand bag on sides. • Spinal Cord Injury – immobilize on spine board, with head in neutral position. Immobilize head with padded Ccollar, maintain traction and alignment of head manually. Log roll client and do not allow client to twist or bend. • Liver Biopsy – right side lying with pillow or small towel under puncture site for at least 3 hours. • Paracentesis – flat on bed or sitting. • Intestinal Tubes – place patient on right side to facilitate passage into duodenum. • Nasogastric Tubes – elevate HOB 30 degrees to prevent aspiration. Maintain elevation for continuous feeding or 1hour after intermittent feedings. • Rectal Exam – knee-chest position, Sim’s, or dorsal recumbent. • During internal radiation – patient should be on bed rest while implant is in place. • Autonomic Dysreflexia – place client in sitting position (elevate HOB) first before any other implementation. • Shock – bed rest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified Trendelenburg). • Head Injury – elevate HOB 30 degrees to decrease intracranial pressure. • Peritoneal Dialysis when outflow is inadequate – turn patient side to side before checking for kinks in the tubing.