NCLEX-RN EXAM REVIEW REVISION 2024

When selecting an NCLEX answer or determining the order of priority what should you remember or use and what is the exception? - ANSWERSUse the ABC rule: Airway breathing, and circulation. The exception to the rule is with actual CPR, use C-A-B for CPR. Also remember safety first and acute before chronic. If the pt. is not in distress then you assess. If the pt is in distress then you should do something. If the pt has diaphorisis you should always do something. How should you address questions related to Maslow's Hierarchy of Needs - ANSWERSAddress physiological needs first, followed by safety and security needs, love and belonging needs, self esteem needs and finally self actualization needs. *When a physiological need is not addressed in the question, look for the option that addresses safety. If a question is related to the nursing process, read the question to determine the step of the nursing process. What are the steps in the nursing process and what kind of question might be related to that step. - ANSWERSAssessment question address the gathering and verification of data. Analysis questions require the nurse to: interpret data, collect additional information, identify and communicate nursing diagnoses and determine the health team's ability to meet the pts needs. Planning questions ask about determining, prioritizing, and modifying outcomes of care. Implementation questions reflect the management and organization of care and the assignment and delegation of tasks. Be prepared for questions on client teaching. Evaluation questions focus on comparing the actual outcomes of care with the expected outcomes and on communicating and documenting findings. What are the normal ranges for H&H? What are the nursing implications - ANSWERSHemoglobin - Male 14-18 Female 12-16 Newborn 14-24 High altitude living increases value, slight decrease during pregnancy. Drug therapy can alter values. Hematocrit - Male 42-52 Female 37-47 Newborn 44-64 Prolonged stasis from vasoconstriction secondary to the tourniquet can alter values. Abnormalities in RBC size may alter Hct values What are the normal ranges for WBC? What can increase values? What can decrease values? How long does the postpartum period of pregnancy affect normal ranges? What range is normal during the postpartum period? - ANSWERSBoth genders Newborn Anesthetics, stress, exercise, and convulsions can increased values. Drug therapy can decrease values. 24-28 hr postpartum: a count as high as 25000 is normal What are the normal ranges for RBC? What can increase levels What happens to levels during pregnancy? - ANSWERSMales: 4.7-6.1 million Female: 4.2-5.4 million Exercise and high altitudes can cause an increase levels pregnancy usually lower values drug therapy can alter values Never draw a specimen from an arm with an infusing IV. What are the normal ranges for PLATELETS? What may increase values? What may decrease values? What drugs decrease values? - ANSWERSBoth Genders: Living at high altitudes, exercising strenuously or taking oral contraceptives may increase values decreased values may be caused by hemorrhage, DIC, reduced production of platelets, infections, use of prosthetic heart valves, and drugs. Drugs that decrease platelets: acetaminophen, aspirin, chemotherapy, H2 blockers, INH, Levaquin, streptomycin, sulfonamides, thiazide diuretics. What are the normal ranges for K+? What should you keep in mind when getting a specimen? - ANSWERS3.5-5 is normal range for potassium Exercise of the forearm with tourniquet in place may cause an increased level. Hemolysis of specimen can result in a falsely elevated value What are the normal ranges for Na+? What should you consider when collecting a specimen? - ANSWERS136-145 is a normal sodium range Do Not collect from an arm with an infusing IV solution What are the normal ranges for Ca+? What type of drug can increase calcium levels? What are two tests with positive results that are associated with hypocalcemia? How do you preform the two tests? - ANSWERS9-10.5 for adults. slightly lower in the elder Use of thiazide diuretics can cause increased levels of calcium Positive Chvostek and Trousseau tests are associated with hypocalcemia. • Chvostek sign: contraction of ipsilateral facial muscles when the facial nerve is tapped just in front of the ear. • Trousseau sign: carpopedal spasm elicited by inflating a sphygmomanometer above systolic BP for 3 minutes. What are the normal ranges for Mg+? What may high magnesium levels indicate? What may low magnesium levels indicate? - ANSWERS1.7-2.2 A high magnesium level may indicate: Addison disease Chronic renal failure, Dehydration, Diabetic acidosis Oliguria A low magnesium level may indicate: Alcoholism Chronic diarrhea, Delirium tremens, Hemodialysis Hepatic (liver) cirrhosis, Hyperaldosteronism Hypoparathyroidism, Pancreatitis, Too much insulin Toxemia of pregnancy, Ulcerative colitis What are the normal ranges for Cl- - ANSWERS98-106 is the normal range for chloride What are the normal ranges for ALP (alkaline phosphatase)? - ANSWERS30-120 slightly increased in the elderly What are the normal ranges for BUN? What does BUN stand for? What is the ratio of BUN-creatinine? What does it indicate? - ANSWERS10-20 blood urea nitrogen BUN-creatinine ratio of 20:1 indicates adequate kidney functioning What are the normal ranges for Creatinine? What is the ratio of BUN-creatinine? What does it indicate? - ANSWERSMale 0.6-1.2 Female 0.5-1.1 BUN-creatinine ratio of 20:1 indicates adequate kidney functioning What is the relationship of Ca+ and PO4? What is the relationship of Ca+ and pH? - ANSWERScalcium and phosphorus have an inverse relationship: when calcium levels increase, phosphorus levels decrease, and vice versa. pH also affects the level of ionized calcium: As pH rises and blood becomes more alkalotic, calcium binds more easily with protein, causing the level of ionized calcium to drop. Conversely, when pH falls, causing acidosis, less calcium binds with protein, which raises the ionized calcium level What are the normal ranges for ABGs? (pH, pCO2, HCO3) - ANSWERSpH (AC) 7.35-7.45 (AL)