Practise Questions

1. TRUE or FALSE. A hemorrhagic stroke is commonly due to thrombosis or embolism.

FALSE. This type of stroke is due to the rupture of cerebral vessel.

2. A nurse knows that a client with encephalitis would display all of the following except:

A. Sudden fever
B. Severe headache
C. Photophobia
D. Decreased body tempurature.

Answer: D. The body temperature of this patient would increase.

3. A common characteristic of Vitamin B12 and Vitamin B6 is that they are:

A. Soluble in water or alcohol
B. Soluble in water
C. Easily destroyed by oxidation
D. Soluble in fat

Answer: A.

Pediatrics: Administering Medications

With otic installations for children under 3 years of age, the nurse should:

A. Pull the pinna gently down and back.
B. Pull the pinna gently up and back.
C. Pull the pinna gently down and forward.
D. Pull the pinna gently up and forward.

Answer: A. After administering ear drops, the child should remain with their head to the side with the affected ear up (to maximize contact with the external canal and reach the eardrum).

True or False

Usually 1ml is the maxiumum volume that should be administered in a single site to infants and children. TRUE.

After administering eye drops, the nurse should:

A. Encourage the child to leave their eyes open.
B. Encourage the child to keep their eyes closed briefly.
C. Encourage the child to look in all directions with eyes closed.
D. Both B & C

Answer: D. When the child closes their eyes briefly and looks in all directions, it maximizes the contact and distribution of the medication.

True or False

Since children's skin is more permeable, there is an increased risk for medication absorption and resultant systemic effects. TRUE.

Special Diets

A client with gastroesophageal reflux disease (GERD) should:

A. Decrease protein.
B. Increase protein and avoid alcohol.
C. Decrease protein and restrict spicy foods.
D. Increase protein and increase fatty foods.

Answer: B. Clients with GERD should avoid strong stimulants of acid secretion (such as alcohol), increase protein and avoid foods that reduce LES competence (such as fatty foods, tomato-based foods and onions).

The diet for a client with cystine stones should be low in:

A. Purine
B. Phosphorus
C. Calcium
D. Protein

Answer: D.

A client with hyperthyroidism should have a diet which is:

A. High in protein and vitamin C
B. High in purine and vitamin B
C. High in protein and vitamin B
D. High and protein and vitamin D

Answer: C. Clients with hyperthyroidism should have a high calorie diet, which is high in protein and vitamin B.

Happy New Year!

I want to wish all of you a happy new year. I pray that this will be a successful year for all of our Entralink students. May this year bring you new focus, a fresh perspective, and the confidence to pass the NCLEX. My thoughts and prayers are with you all.

Ann

Hypertrophic Cardiomyopathy

A disease in which the heart muscle has thickened, making it harder to pump blood. Hypertrophic cardiomyopathy is often asymmetrical, meaning one part of the heart is thicker than the other parts. It is usually inherited genetically.

Causes
It is believed to be caused by defects with the genes that control heart muscle growth.

Symptoms
Symptoms can include: chest pain, light-headedness, dizziness, sudden fainting, abnormal heart rhythms, and shortness of breath, especially following activity. In some cases, clients do not experience symptoms and may not even realize they have the condition. The first symptom of hypertrophic cardiomyopathy among many young patients is sudden death, caused by arrhythmias.

Tests
Tests used to diagnose heart muscle thickness, problems with blood flow, or leaky heart valves may include: ECG, echocardiography with Doppler ultrasound, chest x-ray and cardiac catherization.

Treatment
Treatment can include beta blockers, implanted pacemakers or surgery.

TRUE or FALSE
In people over age 60, hypertrophic cardiomyopathy is often associated with mild hypertension . TRUE

Hypertrophic cardiomyopathy is a major cause of death in young athletes who seem completely healthy but die during heavy exercise.

Sample Questions

A client is diagnosed with Nephrotic Syndrome. The nurse knows that the diet for this client would include a:

A. Decrease in both potassium and sodium
B. Decrease in protein and increase in potassium
C. Decrease in sodium and increase in protein
D. Decrease in protein and increase in sodium

Answer: C .

A nurse is caring for a client who has recently been diagnosed with COPD and fibromyalgia. Which of the following tasks could the nurse delegate to the nursing assistant?

A. Transferring the client to the shower.
B. Educating the client on monitoring fatigue
C. Ambulating the client for the first time.
D. Taking the client's breath sounds

Answer: A. Nursing assistants should be competent on all transfers.

A 36 year-old client with a complaint of dizziness has an order for Morphine via. IV. Which of the following should the nurse should do first?

A. Recommend that the on-call physician assess the client.
B. Check the resuls of the client’s chest x-ray.
C. Perform a neurological screen on the client.
D. Retake vitals including blood pressure.

Answer: D. Dizziness can be a sign of hypotension, that may be a contraindication with Morphine.

TRUE or FALSE

With polycytemia vera, lab results show an increase in bone marrow iron and a decrease in hemoglobin, leukocytes and uric acid.

False. Polycytemia vera is an abnormal increase in circulating red blood cells. Lab data would show a decrease in bone marrow iron and an increase in hemoglobin, leukocytes, uric acid, hematocrit, RBC's and platelets.

FILL IN THE BLANKS

With Severe Acute Respiratory Syndrome, the main risk of infection is related to _____________ or ____________ transmission.

(droplet, airborne)

General anesthesia is administered to a client prior to surgery. Which of the following drugs, if taken by the client, could create a hazardous drug interaction:

A. Prozac
B. Coumadin
C. Aspirin
D. A, B or C could cause hazardous drug interactions.

Answer: D. With Prozac, liver and renal functions must be monitored. Coumadin could increase bleeding times which may result in excessive blood loss or hemorrhage. Aspirin could decrease platelet aggregation and may result in increased bleeding.

Samran Batara-NCLEX RN

Another Entralink die hard, Samran just recently passed the NCLEX-RN. He is now a license RN for the state of California. Sam utilized the proprietary critical questioning to his advantage. Congratulations Sam.

Atty Johnny Salazar-NCLEX RN

Entralink is happy to announce that Attorney is now a US NCLEX-RN. He has been diligent in his review. More power to you attorney. See you in the US, hopefully soon.

Genevieve Sepulveda-NCLEX RN

Congratulations to Genevieve Sepulveda for recently passing the NCLEX Exam. We are proud of you.

Important Announcement

Pls. inform your friends that Entralink is offering assistance to non-Entralink students in NCLEX application processing. Invite them to attend the seminars on Wednesdays and we will provide application packet for New Mexico or California. Pls. tell your friends to make reservation by email if they are coming for assistance.

Maureen Yu-NCLEX RN

This is another Entralink success story. Maureen Yu passed her NCLEX also in July. This is also a late posting. I must have overlooked the message.

Congratulations. Pls. keep in touch Maureen.

Rommel Abris- NCLEX-RN

Congratulations to Rommel Abris for passing NCLEX. He is now in Texas working as an RN. He passed NCLEX in July. Sorry for this late announcement.

NCLEX or CGFNS Passers Needed

Hi All,

Pls. be aware that I am accepting application for Memphis, TN. I need 10-20 nurses and the hospital is willing to hire nurses with no local experience. NC STAFFING will provide skills training to assist nurses in their transition to US nursing. This is an evidence of our commitment to helping Filipino nurses become NC Leapfrogs- "Strong. Energetic. And a leap above the others."

If you are interested, pls email me at aadams@ncstaffing.com. Pls. go to www.ncstaffing.com- Non-US nurses and check the requirements.

Regards

Psych Sample Questions

Jenny, a client with bipolar disorder, is losing weight. Which of the following nursing interventions should be a priority when planning care for this client?

A. Create rituals around eating.
B. Obtain an order for a sedative 2 hours before meals.
C. Ensure the eating place is free from stimulation.
D. Determine the calorie requirements for the client.

Answer: D. In this case, the priority in nursing care would be stabilizing the client's weight. In order to do this, the nurse needs to determine the client's calorie requirements. "A" would not improve the client's nutritional status or meet the goal of weight stabilization. "C" would benefit the client, but it does not take priority.


TRUE or FALSE. Pick's Disease can be managed through the use of hearing aids, speech therapy, and SSRIs. TRUE.

Pick's Disease causes a slow shrinking of brain cells due to excess protein build-up. Clients initially exhibit personality and behavioral changes, and a decline in the ability to speak coherently. Clients can exhibit behaviors that can be dangerous to themselves and others. Occupational therapy, and behavior modification techniques that reward positive behaviors can also be used to manage this disorder.


Children that have been sexually abused should be encouraged to do which of the following:

A. Verbalize their feelings about the incident(s).
B. Draw a picture to show what happened.
C. Use dolls or toys to show what happened.
D. All of the above.

Answer: D. The child should be encouraged to verbalize their feelings to dispel the tension which has been built up by secrecy. The child should be encouraged to show what happened to them to help them recover from the traumatic ordeal.

Pediatrics Sample Questions

Which of the following signs of dehydration would a nurse expect to find during the admission assessment of an infant?

A. Sunken eyeballs and irritability.
B. Anuria and hypotension.
C. Fever and bradycardia.
D. Bulging anterior fontanel and dry mucous membranes.

Answer: A. This occurs because of fluid loss. Low blood pressure often results, followed by oliguria. Fever may be present with tachycardia. The mucous membranes may be dry, and the anterior fontanel sunken.

Which of the following children should the nurse recognize as the highest risk for fluid and electrolyte imbalance?

A. Benjamin, a preschooler with leukemia.
B. Mary, a toddler with lead poisoning.
C. David, an infant with acute gastroenteritis.
D. Jenny, a school-age child with multiple trauma.

Answer: C. This child has the greatest percentage of fluid per pound of body weight, and is at highest risk for F&E imbalance. None of the other children have conditions which make them at high risk for F&E imbalance.

TRUE or FALSE. A long term complication for a toddler who has recovered from meningitis is hydrocephalus. TRUE.

Congratulations to the NLE Passers

I would like to congratulate all Entralink students who just recently passed the National Licensure Exam (NLE). More power to you and wish you Godspeed on all your future endeavors.

Colostomy Appliance Care

When emptying a colostomy appliance, the nurse should not:

A. Check for leakage under the appliance every 2 to 4 hours
B. Remove the appliance each time it needs emptying
C. Put a few drops of deodorant in the appliance if not odor-proof
D. Unclamp the bottom of the bag

Answer: B. The appliance needs to be drained into a bedpan not removed.

When changing a colostomy appliance, the nurse should:

A. Attach the appliance in a way that the client is not involved in their own care
B. Make the opening large
C. Put skin prep solution onto the stoma
D. Wash the skin area with soap and water

Answer: D. The appliance should be easily accessible for the client so that they can be involved in their own care. A large opening increases the risk of leakage. Putting skin prep solution onto the stoma will cause irritation.

TRUE OR FALSE

A new surgical stoma will continue to shrink with the healing process, so the colostomy appliance must be measured to fit the stoma properly. TRUE.

Thank You Note

Hello Entralink students!

We had a very successful and productive Intensive Review. I would like to thank everyone for the warm welcome and the hospitality.

I am glad to be back home safely. I had a few snags on my trip back home. First, the flight from Japan to San Francisco was delayed for 2 hours due to maintenance problem. I missed my connecting flight from San Francisco to Little Rock and had to be rerouted to St. Paul, Minneapolis. En route to Little Rock, there was a heavy storm preventing us to land safely so the pilot circled around in Oklahoma for 1 hour to get a more stable landing. I finally made it home past 2AM on Wednesday instead of arriving at 8PM Tuesday night. I am thrilled to be back home.

This morning I can't wait to eat the special purple egg with bagoong. I want to thank those who sent me native delicacies and goodies.

Again thank you. Pls. keep in touch.

True or False

TRUE or FALSE. Following a craniotomy, a client's head should be elevated 45 degrees.

False. Following neurosurgery, an elevation of 30 degrees is the optimum position to reduce ICP, facilitate respiration and aid venous drainage from the brain. Placing the client's head at 45 degrees may increase hip flexion and may contribute to increased ICP.

TRUE or FALSE. The herb milk thistle is used to treat gallstones, liver cirrhosis and psoriasis.

True.

TRUE or FALSE. Otosclerosis is a disease of ear bone degeneration that most commonly develops in later adult life.

False. It most commonly develops during the teen or early adult years.