NCLEX Pharma

1. Muscarinic Agonists

A. Bethanecol (URECHOLINE) – increase GI motility

B. Carbachol (ISOPTO, MIOSTAT, CARBACHOL) – various types of glaucoma

C. Methacholine (PROVOCHOLINE) – test hyperactivity of airways

D. Pilocarpine – used for glaucoma

2. Anticholinesterases

A. Pysostigmine (ANTILIRIUM) – treat glaucoma, crosses BBB, reverse anticholinergic toxicity.

B. Neostigmine (PROSTIGMIN) – synthetic form of Pysostigmine

(Anticholinesterases) – used for Myasthenia gravis, glaucoma, and to increase tone in bladder

Symptoms of Anticholinesterase toxicity:

1. Miosis
2. Rhinitis
3. Bradycardia
4. GI spasms
5. brochoconstriction
6. involuntary voiding of urine

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

US demand for Filipino nurses declining - educator

Some 40 percent of Filipino nurses in the United States have undesirable work habits, which could likely be the cause for the slump in the demand for Pinoy nurses, an educator said Friday.

An article in Sun-Star Cebu quoted Henry Seno, president of the American Dream Review Institute Inc. (Amdream) as saying that the decline in the demand for Filipino nurses abroad is caused more by a change in work attitude of the latest batch of nursing professionals rather than the June 2006 nursing board exam cheating controversy.

Amdream's website said it is an affiliate of a Los Angeles-based company with operations in the Philippines that serves as a springboard for Asian operations. It was conceptualized for the purpose of assisting nurses to pass the different US immigration requirements. The Philippines is a haven for medical professionals. However, the dilemma is, only a handful passes the test required for migration to the US.

“Nurses in the Philippines now are no longer of the same quality as the nurses five to 10 years back," Seno said.

He said 40 percent of Filipino nurses in the United States, despite receiving an average salary of $8,000 to $10,000 a month, “do not show up for work (and) literally do not report to the hospitals, especially those with immigrant status (while) those who report act as if they are not there because they’re busy doing other things."

Seno also hits the growing number of nursing schools in the country, churning out nursing graduates who are lacking in hands-on experience and a good grasp of educational background.

“There are more nursing schools now and so many nursing graduates. These schools have become mere diploma mills," Seno said.

This negative scenario, he said, has caused hospitals and clinics in the United States to recruit more nurses from India, Korea and China compared to those they hire from Philippines as these institutions have become apprehensive in their choice of nursing imports.

Seno also blames local recruitment agencies for taking advantage of the need for nurses in the US by “duping" hospitals and health institutions to hire Pinoy nurses who are not qualified for nursing jobs.

- Luis Gorgonio, GMANews.TV

RECRUITERS LURE JOBSEEKERS W/ STUDENT VISA TO UK:

POEA has warned against a new ploy that illegal recruiters use in the Internet to decieve job applicants to the United Kingdom (UK).

The POEA said unscrupulous recruiters entice job applicants to work as CAREGIVER in the EUROPEAN country USING STUDENT VISA.

The MODUS OPERANDI works this way: THE RECRUITER SENDS AN EMAIL TO THE TARGET VICTICS, INVITING THEM TO A MAKATI OFFICE SUPPOSEDLY FOR A ONE-ON-ONE INTERVIEW.

The applicants are then asked to pay US625.00 processing or consultancy fee upon "PASSING THE INTERVIEW"

They claim that the "TUITION" costs 2,750 pounds, payable in options of 750 pounds after passing the interview and the balance to be deducted in UK, or pay the whole amount and be guaranteed 2-year multiple entry STUDENT VISA.

The POEA said such recruitment activity is illegal and is inviting victims of this recruitment scheme to file formal complaints with the Legal Assistance Division.

SO...PLEASE BE AWARE... PALAGI PO NATING SINASABI DITO SA FORUM... KUNG DI PO KAYO SIGURADO..ALWAYS ASK POEA...
AGAIN.. DI PO BASTA-BASTA NAKAKAPASOK SA MAY LUGAR NA TO...

-poea source

Mnemonics 01

MI management: MONA
Morphine
O2
Nitroglycerine
Aspirin

HYPOGLYCEMIA: TIRED
T Tired
I Irritability
R Restless
E Excessive hunger
D Diaphoresis-Depression

HEART MURMURS: SPASM
S Stenosis
P Partial obstruction
A Aneurysms
S Septal defect
M Mitral regurgitation

Hyperthyroidism (s/s)
THYROIDISM
Tremor
Heart rate up
Yawning (fatigueability)
Restlessness
Oligomenorrhea & amenorrhea
Intolerance to heat
Diarrhea
Irritability
Sweating
Muscle wasting & weight loss

Miotic: Little word=Little pupil
Mydriatic: Big word=Big pupil

Anticholingergics Side Effects:
Can't see
Can't pee
Can't spit
Can't sh*t

5W's of common causes of post-op fever

Wind (think pneumonia, splinting, incentive spirometer exercises not done, DB+ coughing not done)
Water (dehydration...)
Wound (infection, dehiscence...)
Walking (PE...)
Wonder drug (approriate antibiotic...)

Cranial Nerves

Oh Olfactory Some
Oh Optic Say
Oh Oculomotor Marry
To Trochlear Money
Touch Trigeminal But
And Abducens My
Feel Facial Brother
Virgin Vestibulocochlear Says
Girl's Glossopharangeal Big
Violins Vagus Breasts
Ah Accessory Mean
Heaven Hypoglossal More

For the third column, S stands for sensory, M for motor, and B is both. Also, you have one nose, so Olfactory is CNI, two eyes, so optic is CNII. To remember which order the As come in, ABducens comes before ACcessory alphabetically.

Acute Pancreatitis: I GET SMASHED

I - idiopathic
G - gallstone
E - EtOH
T - trauma
S - steroids
M - mumps (paramyxovirus) and other viruses (EBV, CMV)
A - autoimmune
S - scorpion sting / snake bite
H - hypercalcemia, hyperlipidemia and hypothermia
E - ERCP
D - drugs, duodenal ulcers

To apply a telemetry monitor:
White over right (top right shoulder)
Black beside the white (Over lt shoulder)
Checkers (red below the black)
Christmas (Green beside the red)
Then ofcourse, the brown will be in the middle!

The HYPERKALEMIA "Machine" - Causes of Increased Serum K+
M - Medications - ACE inhibitors, NSAIDS
A - Acidosis - Metabolic and respiratory
C - Cellular destruction - Burns, traumatic injury
H - Hypoaldosteronism, hemolysis
I - Intake - Excesssive
N - Nephrons, renal failure
E - Excretion - Impaired


Signs and Symptoms of Increased Serum K+: MURDER
M - Muscle weakness
U - Urine, oliguria, anuria
R- Respiratory distress
D - Decreased cardiac contractility
E - ECG changes
R - Reflexes, hyperreflexia, or areflexia (flaccid)

HYPERNATREMIA
"You Are Fried"

F - Fever (low grade), flushed skin
R - Restless (irritable)
I - Increased fluid retention and increased BP
E - Edema (peripheral and pitting)
D - Decreased urinary output, dry mouth


"CATS" of "HYPOCALCEMIA"

C - Convulsions
A- Arrhythmias
T - Tetany
S - Spasms and stridor