Monday, May 28, 2007

Sympathy for Quandara Ingram & Family

Please remember Quandara Ingram and her family to the passing of her beloved younger brother. He passed away May 26th.

In behalf of the Entralink family, I am extending our sincerest love, prayers, and support in this very difficult time.

Sympathy for Dr. Morris & Family

In behalf of the Entralink family, I am extending my heartfelt sadness, love, and prayers to Dr. Morris & her family to the passing of her beloved husband Frank.

Please remember Dr. Morris in your prayers as she recovers from this very difficult times. We love you Dr. Morris.

Friday, May 25, 2007

TRUE or FALSE

Urine and mucous shreds are the expected drainage from an ileal conduit.

TRUE.

When treating a child for the ingestion of a poisonous substance, the nurse should not induce vomiting if the child is having a seizure.

TRUE. Induced voiting should also be avoided when the child is comatose or in severe shock.

Clients with COPD should receive oxygen at high flow rates to prevent inhibition of hypoxic respiratory drive.

FALSE. For COPD clients, oxygen should be administered at low flow rates, typically 1-3 L/minute.

For abdominal surgery, clients are placed in Fowler’s position.

FALSE. Clients should be placed in Trendelenburg’s position.

Clients on Streptokinase should be monitored for signs of excessive bleeding, especially at injection sites.

TRUE.

When caring for a client with a peripherally inserted central catheter (PICC line), the nurse should avoid needle sticks near or above the PICC.

TRUE. Also, nurses should avoid taking BP from the PICC arm.

Thursday, May 24, 2007

Oliver Roque, NCLEX-RN Passer

I am so happy to announce that Oliver Roque just recently passed the NCLEX-RN exam. He is a new addition to the successful NCLEX-RN passers.

Erlinda Samaniego, NCLEX-RN Passer

Congratulations to Ms. Erlinda Samaniego, RN, BSN. Pumasa Kayo!

May Ann Co, NCLEX-RN Passer

Congratulations to Ms. Mary Ann Co, RN, BSN. Pumasa Kayo!

Thursday, May 17, 2007

More Questions Keep Your Minds Moving!

TRUE OR FALSE. An asthma client, is producing thick, white secretions. The attending nurse should increase her fluid intake to keep the secretions moist and easier to expectorate.

TRUE.

Reduction of Risk Potential

A client is in recovery following a renal transplant. Which of the following lab results would indicate that the transplant was successful?

A. Calcium, 6.5 mg/dL
B. Bilirubin, 0.7 mg/dL
C. Glucose, 85 mg/dL
D. Creatinine, 1.0 mg/dL

Answer D. Transplant rejection is associated with: fever, decreased urine output, decreasing creatinine clearance, increasing serum creatinine, elevated bun levels, weight gain, and increased blood pressure. Normal serum creatinine is 0.2-1.0 mg/dL. A, B & C do not indicate transplant success or rejection.

TRUE OR FALSE. When assessing a client with chronic arterial insufficiency, the nurse should expect to find increased capillary refill in the lower extremities.

FALSE. Reduced capillary refill and reduced arterial blood flow are signs of arterial insufficiency.

Psychosocial Adaptation

A 38 year old woman is admitted to the psychiatric ward after striking her 8 year old nephew with a frying pan. She is hyperactive and in handcuffs. Which of the following behaviors would indicate the client needs continued restraints?

A. She shouts nasty remarks to the staff.
B. She makes obscene gestures
C. She pushes a UAP out of her way
D. She tears up her chart.

Answer: C. If a client poses a threat of harm to themselves or others, they may be restrained. Usually, nurses first try to talk the client down, or may use a chemical restraint – such as antipsychotic meds. Shouting or making obscene gestures do not warrant restraint, while tearing up their chart means the client needs to be monitored closely (perhaps even given meds to control severe anxiety).

Monday, May 14, 2007

Graduation Party

Nurses who attended the 8-day April-May Intensive Review are shown waiting for the informal graduation ceremony and dinner to commence. The event was held at the office (399 2/F Enzo Building along Buendia Avenue in Makati) and doubled as an inauguration ceremony.

More Review Pictures

Ann is stressing a point while Ines Calma, wife of professional basketball star Hector Calma, is shown intently absorbing the lecture.

More Pictures


Nurses waiting for the review to resume after a short break.

Pictures from the May NCLEX-RN Intensive Review

One of the many pictures we took during the review held at the Asian Institute of Management (AIM).

Wednesday, May 09, 2007

More NCLEX Practice

TRUE or FALSE. The best explanation a nurse can give for wrapping a client’s stump after leg amputation is to decrease the swelling.

TRUE. Wrapping a stump helps reduce edema and shapes the residual limb in a firm cone-shaped form for the prosthesis

TRUE OR FALSE. A client who is taking monoamine oxidase inhibitor (MAOI) should be eating prunes.

FALSE. Prunes should be avoided as they can result in a sudden and severe increase in blood pressure caused by high levels of tyramine. If this blood pressure is not controlled immediately, intracranial hemorrhage and death may result. This client should be eating fresh vegetables.

REDUCTION OF RISK

Appropriate placement of a nasogastric tube is associated with which of the following assessment techniques?

A. Listening for bowel sounds
B. Palpating over the epigastric region
C. Aspirating drainage through the nasogastric tube
D. Inserting the open end of the nasogastric tube into water

Answer: C. The nurse should instill air into the tube with a syringe and listen to a stethoscope for the air passing into the stomach or aspirate gastric contents. The other options are not identified as measures for verifying tube placement.

COPING AND ADAPTATION

A nurse is asked to obtain the vital signs on a sleeping 4-month-old infant. Which of the following assessments would the nurse obtain first?

A. Apical pulse
B. Blood pressure
C. Axillary temperature
D. Respiratory rate

Answer: D. This is the least intrusive because the nurse does not need to touch the infant. The other assessments require touching and possibly disturbing the client. If an infant fusses or cries, the accuracy of the vital signs will decrease.

Friday, May 04, 2007

NCLEX PRACTICE QUESTIONS

BASIC CARE AND COMFORT

A male client has just had a cholecytectomy. Which of the following statements would indicate that the client understands the post-op dietary restrictions?

A. "I can eat whatever I can tolerate."
B. "I should avoid sodas and other carbonated drinks."
C. "I need to increase my intake of high-fiber foods."
D. "I need to limit my intake of citrus foods like oranges and grapefruit."

Answer: A. For several weeks following stone removal, the client should eat a low fat diet until fat digestion is normalized. After that period, a normal diet is usually tolerated & should be encouraged.

PHYSIOLOGICAL ADAPTATION

A female post laryngectomy client, is being prepared for discharge. Which of the following questions would indicate the client has an understanding of the discharge teachings?

A. "Should I eat a high protein, low fat diet?"
B. "How long should I keep the plug for the laryngectomy tube in a disinfectant?"
C. "Which humidifier would be best to use?"
D. "How long will I aspirate food?"

Answer: C. Since the nose normally humidifies air, a client who has had a laryngectomy will require supplemental humidification. There are no dietary restrictions, and laryngectomy tubes are not plugged. There is no risk for aspiration since there is no connection between the esophagus & respiratory tract.

PHARMACOLOGICAL AND PARENTERAL THERAPIES

A female client is taking TheoDur (theophylline) to manage her asthma. Which of the following symptoms, if displayed, should the client report to the nurse?

A. Orangey-red urine
B. Heart palpitations
C. Excessive thirst
D. Weight gain

Answer: B. Adverse effects of theophylline include headache, dizziness, N&V, nervousness, epigastric pain and heart palpitations. The other options are not adverse effects of the drug.

SAFETY AND INFECTION CONTROL

A 80 year old male patient, is experiencing bladder incontinence. He is also at high risk for falls. Which of the following nursing measures should be included in this client's care plan?

A. Sedate as needed
B. Toilet every 1-2 hours
C. Use a chest posey restraint
D. Monitor activities every 2 hours

Answer:B. Establishing a bladder routine would be important for this patient, usually set at 2 hour intervals throughout the day & every 4 hours at night. This client should be encouraged to urinate when the urge arises. Restraints should not be used as convenience devices for fall prevention. Sedatives should be limited because they decrease the urination sensation.

Tuesday, May 01, 2007

Leni De Ramos-RN, NCLEX Passer

I want to congratulate Leni De Ramos for recently passing NCLEX. I am proud of her success.