HERBAL MEDS

Chamomile

Uses: Chamomile is often used in the form of a tea as a sedative.

Reactions: Allergic reactions can occur, particularly in persons allergic to ragweed. Reported reactions include abdominal cramps, tongue thickness, tightness in the throat, swelling of the lips, throat and eyes, itching all over the body, hives, and blockage of the breathing passages. Close monitoring is recommended for patients who are taking medications to prevent blood clotting (anticoagulants) such as warfarin.

Echinacea

Uses: Largely because white blood cells in the laboratory can be stimulated to eat particles, Echinacea has been touted to be able to boost the body's ability to fight off infection.
Reactions: The most common side effect is an unpleasant taste. Echinacea can cause liver toxicity. It should be avoided in combination with other medications that can affect the liver (such as ketaconazole, leflunomide (Arava), methotrexate (Rheumatrex), isoniazide (Nizoral).

St. John's Wort

Uses: St. John's Wort is popularly used as an herbal treatment for depression, anxiety, and sleep disorders. It is technically known as Hypericum perforatum. C

NCLEX sample q's 103

1. A nurse is reviewing a patient’s medication during shift change. Which of the following medication would be contraindicated if the patient were pregnant? Note: More than one answer may be correct.

A: Coumadin

B: Finasteride

C: Celebrex

D: Catapress

E: Habitrol

F: Clofazimine

2. A nurse is reviewing a patient’s PMH. The history indicates photosensitive reactions to medications. Which of the following drugs has not been associated with photosensitive reactions? Note: More than one answer may be correct.

A: Cipro

B: Sulfonamide

C: Noroxin

D: Bactrim

E: Accutane

F: Nitrodur

3. A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following patient’s medication does not cause urine discoloration?

A: Sulfasalazine

B: Levodopa

C: Phenolphthalein

D: Aspirin

4. You are responsible for reviewing the nursing unit’s refrigerator. If you found the following drug in the refrigerator it should be removed from the refrigerator’s contents?

A: Corgard

B: Humulin (injection)

C: Urokinase

D: Epogen (injection)

5. A 34 year old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?

A: IgA

B: IgD

C: IgE

D: IgG

6. A second year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most important action that nursing student should take?

A: Immediately see a social worker

B: Start prophylactic AZT treatment

C: Start prophylactic Pentamide treatment

D: Seek counseling

7. A thirty five year old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect?

A: Atherosclerosis

B: Diabetic nephropathy

C: Autonomic neuropathy

D: Somatic neuropathy

8. You are taking the history of a 14 year old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect?

A: Multiple sclerosis

B: Anorexia nervosa

C: Bulimia

D: Systemic sclerosis

9. A 24 year old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Which of the following would you most likely suspect?

A: Diverticulosis

B: Hypercalcaemia

C: Hypocalcaemia

D: Irritable bowel syndrome

10. Rho gam is most often used to treat____ mothers that have a ____ infant.

A: RH positive, RH positive

B: RH positive, RH negative

C: RH negative, RH positive

D: RH negative, RH negative

Answer Key

1. (A) and (B) are both contraindicated with pregnancy.

2. (F) All of the others have can cause photosensitivity reactions.

3. (D) All of the others can cause urine discoloration.

4. (A) Corgard could be removed from the refigerator.

5. (D) IgG is the only immunoglobulin that can cross the placental barrier.

6. (B) AZT treatment is the most critical innervention.

7. (C) Autonomic neuropathy can cause inability to urinate.

8. (B) All of the clinical signs and systems point to a condition of anorexia nervosa.

9. (B) Hypercalcaemia can cause polyuria, severe abdominal pain, and confusion.

10. (C) Rho gam prevents the production of anti-RH antibodies in the mother that has a Rh positive fetus.

NCLEX Practice Test 101

1. A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use?

1. Body temperature of 99°F or less

2. Toes moved in active range of motion

3. Sensation reported when soles of feet are touched

4. Capillary refill of <>

2. A 30-year-old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for this client?

1. Side-lying with knees flexed

2. Knee-chest

3. High Fowler's with knees flexed

4. Semi-Fowler's with legs extended on the bed

3. A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this client?

1. Taking hourly blood pressures with mechanical cuff

2. Encouraging fluid intake of at least 200mL per hour

3. Position in high Fowler's with knee gatch raised

4. Administering Tylenol as ordered

4. Which of the following foods would the nurse encourage the client in sickle cell crisis to eat?

1. Peaches

2. Cottage cheese

3. Popsicle

4. Lima beans

5. A newly admitted client has sickle cell crisis. The nurse is planning care based on assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 92. Which of the following interventions would be implemented first? Assume that there are orders for each intervention.

1. Adjust the room temperature

2. Give a bolus of IV fluids

3. Start O₂

4. Administer meperidine (Demerol) 75mg IV push

6. The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?

1. Roast beef, gelatin salad, green beans, and peach pie

2. Chicken salad sandwich, coleslaw, French fries, ice cream

3. Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie

4. Pork chop, creamed potatoes, corn, and coconut cake

7. Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and hypoxemia. Which of the following activities would the nurse recommend?

1. A family vacation in the Rocky Mountains

2. Chaperoning the local boys club on a snow-skiing trip

3. Traveling by airplane for business trips

4. A bus trip to the Museum of Natural History

8. The nurse is conducting an admission assessment of a client with vitamin B12 deficiency. Which of the following would the nurse include in the physical assessment?

1. Palpate the spleen

2. Take the blood pressure

3. Examine the feet for petechiae

4. Examine the tongue

9. An African American female comes to the outpatient clinic. The physician suspects vitamin B12 deficiency anemia. Because jaundice is often a clinical manifestation of this type of anemia, what body part would be the best indicator?

1. Conjunctiva of the eye

2. Soles of the feet

3. Roof of the mouth

4. Shins

10. The nurse is conducting a physical assessment on a client with anemia. Which of the following clinical manifestations would be most indicative of the anemia?

1. BP 146/88

2. Respirations 28 shallow

3. Weight gain of 10 pounds in 6 months

4. Pink complexion

11. The nurse is teaching the client with polycythemia vera about prevention of complications of the disease. Which of the following statements by the client indicates a need for further teaching?

1. "I will drink 500mL of fluid or less each day."

2. "I will wear support hose when I am up."

3. "I will use an electric razor for shaving."

4. "I will eat foods low in iron."

12. A 33-year-old male is being evaluated for possible acute leukemia. Which of the following would the nurse inquire about as a part of the assessment?

1. The client collects stamps as a hobby.

2. The client recently lost his job as a postal worker.

3. The client had radiation for treatment of Hodgkin's disease as a teenager.

4. The client's brother had leukemia as a child.

13. An African American client is admitted with acute leukemia. The nurse is assessing for signs and symptoms of bleeding. Where is the best site for examining for the presence of petechiae?

1. The abdomen

2. The thorax

3. The earlobes

4. The soles of the feet

14. A client with acute leukemia is admitted to the oncology unit. Which of the following would be most important for the nurse to inquire?

1. "Have you noticed a change in sleeping habits recently?"

2. "Have you had a respiratory infection in the last 6 months?"

3. "Have you lost weight recently?"

4. "Have you noticed changes in your alertness?"

15. Which of the following would be the priority nursing diagnosis for the adult client with acute leukemia?

1. Oral mucous membrane, altered related to chemotherapy

2. Risk for injury related to thrombocytopenia

3. Fatigue related to the disease process

4. Interrupted family processes related to life-threatening illness of a family member

16. A 21-year-old male with Hodgkin's lymphoma is a senior at the local university. He is engaged to be married and is to begin a new job upon graduation. Which of the following diagnoses would be a priority for this client?

1. Sexual dysfunction related to radiation therapy

2. Anticipatory grieving related to terminal illness

3. Tissue integrity related to prolonged bed rest

4. Fatigue related to chemotherapy

17. A client has autoimmune thrombocytopenic purpura. To determine the client's response to treatment, the nurse would monitor:

1. Platelet count

2. White blood cell count

3. Potassium levels

4. Partial prothrombin time (PTT)

18. The home health nurse is visiting a client with autoimmune thrombocytopenic purpura (ATP). The client's platelet count currently is 80, It will be most important to teach the client and family about:

1. Bleeding precautions

2. Prevention of falls

3. Oxygen therapy

4. Conservation of energy

19. A client with a pituitary tumor has had a transphenoidal hyposphectomy. Which of the following interventions would be appropriate for this client?

1. Place the client in Trendelenburg position for postural drainage

2. Encourage coughing and deep breathing every 2 hours

3. Elevate the head of the bed 30°

4. Encourage the Valsalva maneuver for bowel movements

20. The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is:

1. Measure the urinary output

2. Check the vital signs

3. Encourage increased fluid intake

4. Weigh the client

21. A client with hemophilia has a nosebleed. Which nursing action is most appropriate to control the bleeding?

1. Place the client in a sitting position with the head hyperextended

2. Pack the nares tightly with gauze to apply pressure to the source of bleeding

3. Pinch the soft lower part of the nose for a minimum of 5 minutes

4. Apply ice packs to the forehead and back of the neck

22. A client has had a unilateral adrenalectomy to remove a tumor. To prevent complications, the most important measurement in the immediate post-operative period for the nurse to take is:

1. Blood pressure

2. Temperature

3. Output

4. Specific gravity

23. A client with Addison's disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids (Solu-Medrol). Which of the following interventions would the nurse implement?

1. Glucometer readings as ordered

2. Intake/output measurements

3. Sodium and potassium levels monitored

4. Daily weights

24. A client had a total thyroidectomy yesterday. The client is complaining of tingling around the mouth and in the fingers and toes. What would the nurses' next action be?

1. Obtain a crash cart

2. Check the calcium level

3. Assess the dressing for drainage

4. Assess the blood pressure for hypertension

25. A 32-year-old mother of three is brought to the clinic. Her pulse is 52, there is a weight gain of 30 pounds in 4 months, and the client is wearing two sweaters. The client is diagnosed with hypothyroidism. Which of the following nursing diagnoses is of highest priority?

1. Impaired physical mobility related to decreased endurance

2. Hypothermia r/t decreased metabolic rate

3. Disturbed thought processes r/t interstitial edema

4. Decreased cardiac output r/t bradycardia

NCLEX in MANILA UPDATES

NCSBN will begin NCLEX testing in Manila, the capital city of the Philippines, at the international Pearson Professional Center on Aug. 23, 2007. Scheduling for examination appointments will begin on July 13, 2007.

FOR IMMEDIATE RELEASE
CHICAGO - The National Council of State Boards of Nursing, Inc. (NCSBN) will begin NCLEX testing in Manila, the capital city of the Philippines, at the international Pearson Professional Center on Aug. 23, 2007. Scheduling for examination appointments will begin on July 13, 2007.
The Manila site was chosen in February by the NCSBN Board of Directors because of the deep commitment shown by the Philippine government to ensuring a secure test center. The placement of a test site in the Philippines will allow for greater customer service to nurses without compromising the goal of safeguarding the public health, safety and welfare of patients in the U.S.
Intended for the purposes of domestic nurse licensure in U.S. states and territories, all security policies and procedures currently used to administer the NCLEX examination domestically will be fully implemented at this new site. Administration of the NCLEX examination abroad does not contradict or circumvent any current board of nursing process or requirement. All international candidates are required to apply to the board of nursing in the state or territory where they wish to be licensed before registering for the NCLEX examination. The NCLEX examination fee for all candidates is $200. Candidates who elect to take the NCLEX at an international site pay an additional $150 when they schedule their examination. State and territorial NCLEX examination fees remain at their current levels and are not being used to subsidize the international testing initiative.
Offered abroad since January 2005, the current international sites for NCLEX examinations are in London, England; Hong Kong; Sydney, Australia; Toronto, Montreal, and Vancouver, Canada; Frankfurt, Germany; Mumbai, New Delhi, Hyderabad, Bangalore, and Chennai, India; Mexico City, Mexico; Taipei, Taiwan; and Chiyoda-ku and Yokohama, Japan.

Technical inquiries about the NCLEX examination may be directed to the NCLEX information line at:
1.866.293.9600 (domestic) or nclexinfo@ncsbn.org+1.312.525.3750 (international)NCSBN Web site http://www.ncsbn.org/Pearson VUE Web site http://www.pearsonvue.com/

https://www.ncsbn.org/1282.htm