What You Need to Know:

  1. How to Document a Healing Wound:
    • When documenting a healing wound, it’s important to note the wound’s size, depth, color, and the presence of any exudate or necrotic tissue. Additionally, the type of wound (e.g., surgical, pressure ulcer) and the stage of healing should be recorded. Document any interventions used, such as dressings or debridement, and monitor the wound for signs of infection or improvement.
  2. Conditions That Can Have the Nursing Diagnosis “Impaired Mobility Related to Neurological Changes” [Select All That Apply]:
    • Stroke (CVA)
    • Multiple sclerosis
    • Parkinson’s disease
    • Spinal cord injury
    • Amyotrophic lateral sclerosis (ALS)
  3. Foods That Will Cause Gas for Someone with a Colostomy [Select All That Apply]:
    • Broccoli
    • Beans
    • Cabbage
    • Onions
    • Carbonated beverages
  4. Conditions That Will Cause Poor Pain Relief [Select All That Apply]:
    • Opioid tolerance
    • Inadequate dosing
    • Psychological factors (e.g., anxiety, depression)
    • Poor medication adherence
    • Incorrect administration of pain medication
  5. Wound Healing Stages – Focus on Stage 1:
    • Stage 1: Non-blanchable erythema of intact skin. Skin may be painful, firm, soft, warmer, or cooler compared to adjacent tissue.
  6. Characteristics of Someone Who Is Diaphoretic, Receiving Parenteral Nutrition, and Confused [Select All That Apply]:
    • Sweating (diaphoresis)
    • Altered mental status
    • Electrolyte imbalances
    • Hyperglycemia
    • Fluid overload
  7. Medication Calculation:
    • A doctor prescribed Amoxil 600 mg PO every 12 hours. How many ml would be given per dose?
      • To calculate, you need to know the concentration of the Amoxil suspension (e.g., 400 mg/5 mL). Then, use the formula:
        • Dose (mg) / Concentration (mg/mL) = Volume (mL)
        • Example: 600 mg / 400 mg/5 mL = 7.5 mL per dose.
  8. How to Convert Kilograms to Pounds (Patient Weight):
    • Use the conversion factor: 1 kg = 2.2 lbs.
    • Example: If a patient weighs 70 kg, multiply 70 by 2.2 to get 154 lbs.
  9. Log Rolling a Patient:
    • Log rolling is a technique used to turn a patient while maintaining the alignment of the spine. This method is often used for patients with spinal injuries or those who have had spinal surgery. It requires at least three caregivers: one at the patient’s head, one at the torso, and one at the legs. The patient is rolled in a coordinated motion to avoid twisting the spine.
  10. Buccal Route of Medication Administration:
    • Medications administered buccally are placed between the cheek and gums where they dissolve and are absorbed directly into the bloodstream. This method avoids the first-pass metabolism by the liver.
  11. Infectious Process – Focus on the Convalescent Stage:
    • The convalescent stage is the period during which the patient’s symptoms begin to subside and the body starts to return to normal. During this stage, the patient may still be contagious, depending on the infection.
  12. Personal Protective Equipment (PPE):
    • PPE includes gloves, gowns, masks, and eye protection, and is used to protect healthcare workers from exposure to infectious agents. The type of PPE required depends on the mode of transmission of the infection (e.g., contact, droplet, airborne).
  13. How to Instill Ear Drops:
    • To instill ear drops, have the patient lie on their side with the affected ear facing up. For adults, pull the ear auricle up and back; for children under three, pull the auricle down and back. Administer the prescribed number of drops into the ear canal and have the patient remain in position for a few minutes to allow the medication to penetrate.
  14. Best Intervention When a Patient Aspirates After a Nurse Stops a Feeding:
    • If a patient aspirates, immediately stop the feeding, assess the patient’s airway, breathing, and circulation, and suction if necessary. Notify the healthcare provider and monitor the patient closely for signs of respiratory distress.
  15. Pulses and Respirations – Action by NAP That Indicates Need for Further Education:
    • If a NAP is observed counting respirations for only 15 seconds and multiplying by four, this indicates a need for further education. Respirations should be counted for a full 60 seconds, especially if the patient has an irregular breathing pattern.
  16. Medication Errors – Best Statement Made by the Nurse to Prevent Errors:
    • “Always double-check the medication label against the patient’s MAR before administering, and if in doubt, consult a pharmacist or another nurse.”
    • Responsibility for administering medications safely lies with the nurse, who must ensure that the correct medication is given to the correct patient, in the correct dose, by the correct route, at the correct time.
  17. Review Side Effects, Synergistic, and Idiosyncratic Reactions:
    • Side Effects: Unintended effects that occur at therapeutic doses.
    • Synergistic Effect: When two drugs work together to create a more potent effect than either drug alone.
    • Idiosyncratic Reaction: An unusual or unexpected reaction to a drug that is specific to an individual.
  18. How a Patient Is Supposed to Use Their Crutches:
    • Ensure that the patient uses their crutches properly by bearing weight on their hands and arms, not on the underarm pads, to avoid nerve damage. Teach the different gaits based on the patient’s weight-bearing status and balance capabilities.
  19. Diseases That Fall Under Different Precautions:
    • Contact Precautions: MRSA, VRE, C. difficile
    • Droplet Precautions: Influenza, Pertussis, Mumps
    • Airborne Precautions: Tuberculosis, Measles, Varicella
  20. REE (Resting Energy Expenditure):
    • Resting Energy Expenditure refers to the amount of calories required by the body to maintain vital functions while at rest. Conditions such as hyperthyroidism can increase REE, while hypothyroidism can decrease it.
  21. Hyperglycemia, Hypoglycemia, Hypercapnia – When a Patient Is Confused:
    • Hyperglycemia: High blood sugar can cause confusion, along with other symptoms such as increased thirst and urination.
    • Hypoglycemia: Low blood sugar can lead to confusion, shakiness, and even loss of consciousness if not treated promptly.
    • Hypercapnia: Elevated levels of CO2 in the blood can result in confusion, lethargy, and if severe, respiratory acidosis.