Fingerprinting Done

I went to National Bureau of Investigation (NBI) this afternoon and did the fingerprinting for free. Thank You Lord first requirement done for my application.  Next is the application form and hoping tomorrow will be able to send the papers to my hubby. Please Lord help me how, where to start and be focused on my studies. Thank you Lord for today and for our safety.

CES Report Available - Thank You Lord

This is what I got from my mail this morning.


Dear -----,

Thank you for selecting CGFNS International for your credentials evaluation and verification needs. We are pleased to inform you that your application process is complete and that your CES Report has been issued to TEXAS BOARD OF NURSE EXAMINERS. Congratulations!

A copy of the report is located in your online account, please go to https://www.cgfns.org/cerpassweb/login.jsp. Click on the Order Status link under Applicant Options, select your order and click the View CES Applicant Report button. It will be available for one year.

We appreciate the opportunity to assist you in achieving your professional goals and hope your experience with us has been a positive one.

Please do not reply to this message, it is not monitored.

Best regards,

Erica N Fuller
Credentials Evaluation Service
CGFNS International
3600 Market Street
Philadelphia, PA 19104-2651 USA


Thank you so much Lord for I passed the credentials evaluation. They issued already a report to BON Texas and my next step is to start my application. I'm really happy Lord for it did not take long, only less than 3 months, despite the regular mail I used and the error  I made. Thank you Lord so much.

NCLEX Exam Practice Question 2

NCLEX Exam Practice Question of the Week - 04/06/11

Elsevier NCLEX Exam Review

Question: A client gives birth to a full-term newborn with an 8/9 Apgar score. List the initial nursing care in order of their priority.

1. Place in heated crib

2. Perform physical assessment

3. Apply identification band to mother and infant

4. Instill antibiotic prophylaxis and administer vitamin K

Click “Read More” for the answer.

Answer: 1, 3, 2, 4

Rationale: The newborn’s thermoregulation mechanism is immature and an exogenous heat source is needed. Once the Apgar score has confirmed a healthy newborn and the infant is warm, the next step is to identify both mother and infant using bands with the same numbers. The newborn is now ready to be protected from contracting ophthalmia neonatorum and Chlamydia with an antibiotic, and hemorrhagic disease of the newborn with vitamin K.

Clinical Area: Childbearing and Women’s Health Nursing

Client Need: Health Promotion and Maintenance

Cognitive Level: Analysis

Nursing Process: Planning

NCLEX Exam Practice Question of the Week - 04/13/11

Elsevier NCLEX Exam Review

Question: A lecithin-sphingomyelin (L/S) ratio is ordered for a primigravida client at 35 weeks’ gestation. What is the goal of this test?

1. To determine fetal lung maturity.
2. To evaluate the level of maternal-fetal estriol production
3. To check the position of the fetal head
4. To test the intrauterine fetal-placental circulation

Click “Read More” for the answer.

Answer: 1

Rationale: An L/S ration (converts 2:1 at approximately 34 to 35 weeks’ gestation) determines the relationship of two components of the fetal lung (lecithin and sphingomyelin) known as surfactant. Adequate surfactant must be present at birth for the alveoli to maintain expansion. 

NCLEX Exam Practice Question of the Week - 04/20/11

Elsevier NCLEX Exam Review

Question: A nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which of the following findings?

1. Inflammation
2. Serous drainage
3. Pain at a pin site
4. Purulent drainage

Click “Read More” for the answer.

Answer: 2

Rationale: A small amount of serous oozing is expected at pin insertion sites. Signs of infection such as inflammation, purulent drainage, and pain at the pin site are not expected findings and should be reported to the physician.

Test-Taking Strategy: Use the process of elimination. Note the strategic words least concerned. Options 1 and 4 seem to indicate an infectious problem and are eliminated first. From the remaining options, note that the complaint of pain is at “a pin site.” Also, because serous drainage is an expected finding, select option 2. Review expected findings in the client with skeletal traction if you had difficulty with this question.

NCLEX Exam Practice Question of the Week - 04/27/11

Elsevier NCLEX Exam Review

Question: A nurse is assessing the family dynamics of a suspected abusive family. What behavior is expected? Select all that apply.

1. Child cringes when approached
2. Child has unexplained healed injuries
3. Parents are overly affectionate toward the child
4. Child lies still while surveying the environment
5. Parents give detailed accounts of the child’s injuries

Click “Read More” for the answer.

Answer: 1, 2, 4

Rationale: The child cringes when approached because past experiences with adults have inflicted pain rather than comfort. Evidence of past injuries may exist but the parents do not discuss them because this would be an admission of child abuse. Abused children are always on the alert for potential future abuse. Lying motionless prevents bringing attention to them; also, in the past resisting abuse often precipitated more abuse. Abusive parents are unable to provide any emotional support. Because abusing parents try to hide the fact of abuse, explanations about injuries usually are fabricated, inconsistent, and vague. 

NCLEX Exam Practice Question of the Week - 05/04/11

Elsevier NCLEX Exam Review

Question: What is the priority nursing action for the client who is complaining of nausea in the recovery room after gastric resection?

1. Evaluate the nasogastric tube for patency.
2. Call the physician for the antiemetic order.
3. Place client in semi-Fowler’s position so that he will not aspirate.
4. Medicate the client with a narcotic analgesic.

Click “Read More” for the answer.

Answer: 1

Rationale: Evaluate the nasogastric tube patency; it is important to prevent nausea and vomiting. The next action would be to put the client in semi-Fowler’s position. It is very important to assess the client and take nursing measures to determine the source of the nausea and to decrease the nausea before calling the doctor.

NCLEX Exam Practice Question of the Week - 05/11/11

Elsevier NCLEX Exam Review

Question: The nurse is providing an educational session to new employees, and the topic is abuse of the older client. The nurse helps the employees identify that which client is most typical of a victim of abuse?

1. A 75-year-old man with moderate hypertension.
2. A 68-year-old man with newly diagnosed cataracts
3. A 90-year-old woman with advanced Parkinson’s disease
4. A 70-year-old woman with early diagnosed Lyme disease

Click “Read More” for the answer.

Answer: 3

Rationale: Elder abuse includes physical, sexual, or psychological abuse, misuse of property, and violation of rights. The typical abuse victim is a woman of advanced age with few social contacts and at least one physical or mental impairment that limits her ability to perform activities of daily living. In addition, the client usually lives alone or with the abuser and depends on the abuser for care. 

NCLEX Exam Practice Question of the Week - 05/18/11

Elsevier NCLEX Exam Review

Question: When talking with a client who has been receiving paroxetine (Paxil), the nurse identifies that more clarification is needed when the client states:

1. “I will be a little drowsy in the mornings.”
2. “I’m expecting to feel somewhat better but I may need other therapy.”
3. “I’ve been on the medication for 8 days now and I don’t feel any better.”
4. “I know I will probably have to take this medication for several months.”

Click “Read More” for the answer.

Answer: 3

Rationale: This is too short a period of time to expect a therapeutic response to an antidepressant; clients usually begin to feel a lightening of depression in approximately 14 to 20 days, with the full antidepressant effects being felt between 3 and 4 weeks. Drowsiness, fatigue, and insomnia are common side effects. Medication alone may not be effective; some form of psychotherapy often is needed. Clients usually remain on these medications for several months. 

NCLEX Exam Practice Question of the Week - 05/25/11

Elsevier NCLEX Exam Review

Question: When a client is taking theophylline (Theo-Dur), which is the highest priority for the nurse to include in the plan of care?

1. Restrict the client’s fluid intake.

2. Instruct the client to report lethargy and fatigue.

3. Assess the client for hypertension and polyuria.

4. Monitor the client for therapeutic plasma levels of the drug.

Click “Read More” for the answer.

Answer: 4

Rationale: Theophylline (Theo-Dur) has a narrow therapeutic range (10-20 mcg/mL); therefore serum levels should be monitored and dosage adjusted accordingly to achieve efficacy and to prevent toxicity. A client taking theophylline (Theo-Dur) should maintain adequate fluid intake (1). The client should be instructed to report signs of toxicity, including nausea, vomiting, tremors, nervousness, and seizures. Lethargy and fatigue (2), or hypertension and polyuria (3) are not associated signs of theophylline toxicity.

NCLEX Exam Practice Question of the Week - 06/01/11

Elsevier NCLEX Exam Review

Question: A nurse is caring for a child after spinal fusion for scoliosis treatment. The child complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. Based on these findings, the nurse should take which action?

1. Notify the physician.

2. Administer an antiemetic.

3. Increase the intravenous fluids.

4. Place the child in a Sims’ position.

Click “Read More” for the answer.

Answer: 1

Rationale: Scoliosis is a three-dimensional spinal deformity that usually involves lateral curvature, spinal rotation resulting in rib asymmetry, and hypokyphosis of the thorax. A complication after surgical treatment of scoliosis is superior mesenteric artery syndrome. This disorder is caused by mechanical changes in the position of the child’s abdominal contents, resulting from lengthening of the child’s body. The disorder results in a syndrome of emesis and abdominal distention similar to that which occurs with intestinal obstruction or paralytic ileus. Postoperative vomiting in children with body casts or children who have undergone spinal fusion warrants attention because of the possibility of superior mesenteric artery syndrome. Options 2, 3, and 4 are incorrect.

NCLEX Exam Practice Question of the Week - 06/08/11

Elsevier NCLEX Exam Review

Question: A practitioner orders additional diagnostic studies to assess a client’s acid-base status. The laboratory value that indicates metabolic acidosis is:

1. Urine pH of 8.4
2. Gastric content pH of 6.0
3. Venous serum pH of 7.28
4. Arterial plasma pH of 7.40

Click “Read More” for the answer.

Answer: 3

Rationale: The expected range of venous pH is 7.31 to 7.41; any condition that decreases bicarbonate anion concentration in extracellular fluid results in metabolic acidosis. Options 1 and 2 are not accurate assessments for metabolic acidosis. Option 4 is within the expected range.

Source: http://elsevierstudentlife.tumblr.com/post/26073276010/nclex-exam-practice-question-of-the-week-06-08-11

CES - Ready for Review

Here is the latest update of my CES application. Thank you Lord, I got a message that they received already my License verification today. Praying everything will be okay with my papers and that I can process to the second step, this is only the first step yet but I'm getting there with God's guidance and help. Thank you Father.

Credentials Evaluation Service (CES) - CES Professional Report application [Order Status: READY FOR REVIEW]

Requirement	Status	Notes
PAYMENT IN FULL	PAID IN FULL [?]
APPLICATION	RECEIVED [?]
SIGNED ATTESTATION	RECEIVED [?]
SECONDARY SCHOOL DIPLOMA	REQUIREMENT WAIVED [?]
LICENSE VALIDATION FORM - PHILIPPINES	RECEIVED [?]
TRANSCRIPT VALIDATION FORM -	RECEIVED [?]
ISSUED REPORT	WAITING FOR APPROVAL [?]

NCLEX Practice Question

NCLEX Exam Practice Question of the Week - 03/02/11

Question: While a client’s wife is visiting she observes the client’s chest drainage system and begins to nervously question the nurse regarding the amount of bloody drainage in the system. What is the best response from the nurse?

1. “Your husband has been really sick; this must be a very difficult time. Let’s sit down and talk about it.”
2. “I have checked all of the equipment and it is working fine; you do not need to worry about it.”
3. “The system is draining collected fluid from around the lungs. The drainage is expected and does not mean that he is bleeding.”
4. “The chest tube is draining the secretions from his chest; it is important for him to deep-breathe frequently.”

Answer: 3.

Rationale: This is important information to explain to the client’s wife regarding the bloody drainage in the chest tube collection system. After the nurse has explained the reason for the drainage, it would be appropriate to sit down and talk with the wife (option 1). Options 2 and 4 do not answer the question or address the wife’s concern.

NCLEX Exam Practice Question of the Week - 03/09/11

Question: A nurse has conducted discharge teaching with a client diagnosed with tuberculosis. The client has been taking medication for 11⁄2 weeks. The nurse evaluates that the client has understood the information if the client makes which of the following statements?

1. “I need to continue drug therapy for 2 months.”
2. “I can’t shop at the mall for the next 6 months.”
3. “I can return to work if a sputum culture comes back negative.”
4. “I should not be contagious after 2 to 3 weeks of medication therapy.”

Click “Read More” for the answer.

Answer: 4

Rationale: The client is continued on medication therapy for 6 to 12 months, depending on the situation. The client generally is considered not to be contagious after 2 to 3 weeks of medication therapy. The client is instructed to wear a mask if there will be exposure to crowds until the medication is effective in preventing transmission. The client is allowed to return to work when the results of three sputum cultures are negative.

Test-Taking Strategy: Use the process of elimination. Knowing that the medication therapy lasts for at least 6 months helps you eliminate option 1 first. Knowing that three sputum cultures must be negative helps you to eliminate option 3 next. From the remaining options, recalling that the client is not contagious after 2 to 3 weeks of therapy will direct you to option 4. If you had difficulty with this question, review the infectious period of tuberculosis.

NCLEX Exam Practice Question of the Week - 03/16/11

Question: A client with Crohn’s disease is admitted to the hospital with a history of chronic, bloody diarrhea, weight loss, and signs of general malnutrition. The client has anemia, a low serum albumin level, and signs of negative nitrogen balance. The nurse concludes that the client’s health status is related to a major deficiency of:

1. Iron
2. Protein
3. Vitamin C
4. Linoleic acid

Click “Read More” for the answer.

Answer: 2

Rationale: Protein deficiency causes a low serum albumin level, which permits fluid shifts from the intravascular to the interstitial compartment, resulting in edema. Decreased protein also causes anemia; protein intake must be increased. Although a deficiency of iron will result in anemia, it will not cause the other adaptations. Vitamin C and linoleic acid are unrelated to these adaptations. 

NCLEX Exam Practice Question of the Week - 03/23/11

Question: The nurse notes that a client is quite suspicious during an assessment interview and believes that her family is under investigation by the CIA. What would be appropriate nursing interventions with this client?Select all that apply.

1. Use active listening skills to seek information from the client.
2. Encourage the client to describe the problem as she sees it.
3. Ask the client to tell you exactly what she thinks is happening.
4. Tell the client that she is delusional and you can help her.
5. Explain to the client that most people are not investigated by the CIA or FBI.
6. Reassure the client that you are not with the CIA.

Click “Read More” for the answer.

Answer: 1, 2, 3

Rationale: The client is demonstrating paranoid behavior, which necessitates a matter-of-fact approach that is nonjudgmental and accepting of the client’s statements and shows the nurse’s willingness to listen attentively to the issue. Options 4, 5, and 6 do not help the paranoid client gain trust to talk with the nurse.

NCLEX Exam Practice Question of the Week - 03/30/11

Question: The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instruction(s) should the nurse provide? Select all that apply.

1. Use sunscreen when participating in outdoor activities.

2. Wear a hat, opaque clothing, and sunglasses when in the sun.

3. Avoid sun exposure in the late afternoon and early evening hours.

4. Examine your body monthly for any lesions that may be suspicious.

5. Sunscreen should be applied every 8 hours.

Click “Read More” for the answer.

Answer: 1, 2, 4

Rationale: The client should be instructed to avoid sun exposure between the hours of 10 AM and 4 PM. Sunscreen, a hat, opaque clothing, and sunglasses should be worn for outdoor activities. The client should be instructed to examine the body monthly for the appearance of any possible cancerous or any precancerous lesions. Sunscreen should be reapplied every 2 to 3 hours and after swimming or sweating; otherwise, the duration of protection is reduced.

Test-Taking Strategy: Use the process of elimination and note the strategic words a need for further instructions. These words indicate a negative event query and ask you to select an option that is an incorrect statement. Note the strategic word avoid in option 1 to help direct you to this option. Review client teaching points for the prevention of skin cancer if you had difficulty with this question.

Source: http://elsevierstudentlife.tumblr.com

Online Practice Test 52 - Last

Your Results for: "NCLEX® Review"

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Site Title: Kozier & Erb's Fundamentals of Nursing Book Title: Kozier & Erb's Fundamentals of Nursing Location on Site: Chapter 52 > NCLEX® Review Date/Time Submitted: August 2, 2012 at 6:34 AM (UTC/GMT)

Summary of Results 70% Correct of 10 Scored items: 7 Correct:  70% 3 Incorrect:  30% More information about scoring

1.		Which individual would least likely suffer from a disturbance in fluid volume, electrolyte, or acid-base balance? Your Answer: Clients who are confused Correct Answer: An elderly client suffering from a type I decubitus
		Objective: Identify factors affecting normal body fluid, electrolyte, and acid-base balance. Rationale: The proportion of body water decreases with aging. Tissue trauma, such as burns, causes fluids and electrolytes to be lost from the damaged cells, and the breakdown in the continuity of the tissue. In Type I Decubitus, the skin remains intact, and any shifting of fluids is due to the inflammatory process and internally maintained within the body. Vomiting and diarrhea can cause significant fluid loses. Age, sex, and body fat affect total body water. Infants have the delete spaces highest proportion of water; it accounts for 70-80% of their body weight. Decreased blood flow to the kidneys as caused by impaired cardiac function stimulates the renin-angiotensin-aldosterone system, causing sodium and water retention. Clients who are confused or unable to communicate are at risk for inadequate fluid intake. Age does not play a significant factor here. Nursing Process: Assessment Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
2.		An elderly patient was hydrated with lactated Ringer's solution in the emergency room for the last hour. During the most recent evaluation of the patient by the nurse, a finding of a rapid bounding pulse and shortness of breath were noted. Reporting this episode to the physician, the nurse suspects that the patient now shows signs of: Your Answer: Hypervolemia, and needs the fluids adjusted
		Objective: Evaluate the effect of nursing and collaborative interventions on the client's fluid, electrolyte, or acid-base balance. Rationale: Isotonic solutions has the same osmolality as body fluids. Isotonic solutions, such as Normal Saline and Ringer's Lactate, initially remain in the vascular compartment, expanding vascular volume. Isotonic imbalances occur when water and electrolytes are lost or gained in equal proportions, and serum osmolality remains constant. Nursing Process: Assessment Client Need: Physiological Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
3.		A client taking lasix (furosemide) for congestive heart failure is seeing the physician for a potassium value of 3.0. An order for oral potassium taken daily is written and discussed with the client. In addition, potassium-rich foods should be eaten. The nurse educator meets with this client and has the client identify all of the following foods as potassium-rich except:  Your Answer: White bread
		Objective: Teach clients measures to maintain fluid and electrolyte balance. Rationale: White bread is known to help meet fiber needs for the body. Potassium is found in many fruits, vegetables, meat, and fish. Nursing Process: Planning Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
4.		Edema that forms in clients with kidney disease is due to: Your Answer: Decreased capillary hydrostatic pressures pushing fluid into the interstitial tissues Correct Answer: Reduced plasma oncotic pressure, so that fluid is not drawn into the capillaries from interstitial tissues
		Objective: Discuss the risk factors for and the causes and effects of fluid, electrolyte, and acid-base imbalances. Rationale: The edema is due to low levels of plasma proteins that exist with this disease, altering the oncotic pressure that helps regulate fluid movement in the vascular space moving into interstitial area. Increased capillary hydrostatic pressure is the cause. Capillaries have increased permeability when edema formation is possible. Obstructed lymph flow impairs the movement of fluid from interstitial tissues back into the vascular compartment, resulting in edema. Nursing Process: Assessment Client Need: Physiological Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
5.		A client suffering from a narcotic overdose is seen in the Emergency Department. The client is confused, with warm, flushed skin, headache, and weakness. Vital signs of noted are T 102.6, HR 128, R 24, and BP 130/86. A blood gas analysis sample was drawn on room air, and the results are as follows: pH 7.33, PaCO2 53, PaO2 72, HCO3 24. This client is at risk for:  Your Answer: Respiratory acidosis
		Objective: Identify examples of nursing diagnoses, outcomes, and interventions for clients with altered fluid, electrolyte, or acid-base balance. Rationale: Narcotic overdose causes more carbonic acid levels to rise because of hypoventilation and carbon dioxode retention. Nursing Process: Assessment and Evaluation Client Need: Physiological Integrity Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
6.		Measurements related to fluid balance of clients that a nurse can initiate without a physician's order include:  Your Answer: Daily weights, vital signs, and fluid intake and output
		Objective: Teach clients measures to maintain fluid and electrolyte balance. Rationale: Daily weights, checking vital signs, and monitoring fluid I&O all fall within the realm of nursing interventions. The remaining interventions either have the nurse perform a task requiring an MD order, such as giving diuretics or placing a Foley catheter, or have an action unrelated to this problem, such as the calorie count. Nursing Process: Implementation Client Need: Physiological Integrity Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
7.		The nurse has been invited to discuss "the importance of promoting a good fluid and electrolyte balance in children" for a group of parents at the local school parents club meeting. Of the following actions, which is not representative of this topic? Your Answer: Encouraging excessive amounts of foods or fluids high in salt or caffeine
		Objective: Teach clients measures to maintain fluid and electrolyte balance. Rationale: Salt causes the body to retain fluids due to an increase in the concentration of sodium and the release of ADH. Caffeine acts as a diuretic in individuals and may lead to loss of excess fluids in the body. The remaining identified measures are all appropriate. Nursing Process: Implementation Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
8.		The nurse is admitting a new client, 80 years old, with congestive heart failure into your home health agency. The following assessment findings have been determined after meeting the client: overweight but no gain since the client left the hospital two days ago; VS: T 99.0, HR 100, R 22, BP 130/86. Foods eaten include canned soup at each meal, ham, and cheese. When completing the care plan for this client, the nurse should include which of the following nursing diagnosis: Your Answer: Risk for Fluid Volume Imbalance
		Objective: Identify examples of nursing diagnoses, outcomes, and interventions for clients with altered fluid, electrolyte, or acid-base balance. Rationale: Sodium is found in high quantities in the foods noted that the client has consumed. When sodium levels increase in the body, water is retained, adding to the volume of fluid in circulation, making it harder for the body to move fluids through the circulation. Therefore, the excess fluid may in time impair gas exchange if levels eventually act on the lungs; fluid volume is increasing, not decreasing, in this situation, and this problem has no involvement with platelets. Nursing Process: Planning Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
9.		The results of an arterial blood gas are as follows: pH: 7.5, PaCO2: 50, PaO2: 88, HCO3: 28; Base excess: +5. Evaluate the acid-base imbalance. __________ Your Answer: Metabolic Alkalosis Correct Answer: Metabolic alkalosis with a respiratory compensation.
		Objective: Collect assessment data related to the client’s fluid, electrolyte, and acid-base balances. Rationale: Arterial blood gases are performed to evaluate the client’s acid-base balance and oxygenation. pH is the measure of relative acidity or alkalinity. PaCO2: is the partial pressure of carbon dioxide in arterial plasma. PaO2 is the pressure exerted by oxygen dissolved in the plasma, HCO3: is the measure of the metabolic component of acid-base balance. Base excess is a calculated value of bicarbonate levels. Nursing Process: Assessment and Implementation Client Need: Physiological Integrity Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
10.		Following surgery, the client requires a blood transfusion. The main reason the nurse wants to complete the unit transfusion within a four-hour period that blood: Your Answer: Hanging for a longer four hours creates an increased risk of sepsis
		Objective: Implement measures to correct imbalances of fluids and electrolytes or acids and bases such as enteral or parenteral replacements and blood transfusions. Rationale: Hanging for a longer four hours creates an increased risk of sepsis, which is why the nurse wants to complete the unit transfusion in less than four hours. The remaining items are not likely to happen. Nursing Process: Implementation Client Need: Physiological Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and process of elimination.

Online Practice Test 51

Your Results for: "NCLEX® Review"

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Site Title: Kozier & Erb's Fundamentals of Nursing Book Title: Kozier & Erb's Fundamentals of Nursing Location on Site: Chapter 51 > NCLEX® Review Date/Time Submitted: August 2, 2012 at 5:07 AM (UTC/GMT)

Summary of Results 70% Correct of 10 Scored items: 7 Correct:  70% 3 Incorrect:  30% More information about scoring

1.		A neighbor recently has been diagnosed with congestive heart failure, and seeks information on the cause of the disease. In a discussion with the neighbor, it is related that the functional mechanism for heart failure is: Your Answer: That the heart is not able to keep up with the body's needs for oxygen and nutrients to tissues, due to a variety of reasons
		Objective: Discuss the manifestations of cardiovascular disorders. Rationale: Heart failure may develop if the heart isn't able to keep up with the body's need for oxygen and nutrients to the tissues. Heart failure usually occurs because of myocardial infarction, chronic overwork of the heart, or cardiac muscle impairment. Smoking and being overweight are risk factors related to this problem. A normally functioning heart conduction system should not interfere with the heart's ability to pump unless the muscle that it is acting upon is damaged severely. Nursing Process: Implementation Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
2.		A middle-aged woman presents to a primary care provider's office with a complaint of aching legs and swelling every evening. Her occupation is waitress. She wears walking shoes at work, is 30 pounds over weight, and smokes half a pack of cigarettes a day. Which of the following interventions, restated to the nurse by the client, shows that there is still a misunderstanding in the concepts being presented?  Your Answer: Resting as much as possible with legs crossed
		Objective: Identify major risk factors for the development of coronary heart disease. Rationale: Activity is encouraged because leg exercises help promote circulation in the extremities and the return of venous blood to the heart. Crossing legs sets up the possibility of blocking blood flow and allowing stasis to form. It is discouraged. Smoking alters the size of the vessels constricting them, causing more work needed to pump fluid through them. Maintaining ideal weight does not add any extra workload to the heart or vessels. Antiembolic stockings provide varying degrees of leg compression to the vessels, assisting the venous return of blood to the heart. Nursing Process: Implementation Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
3.		When evaluating the size and shape of the heart and great vessels of a client with congestive heart failure, a number of assessment techniques can be performed. Which technique noted below would not be included in the assessment of this client?  Your Answer: Visual assessment for eye refraction
		Objective: Outline the structure and function of the cardiovascular system. Rationale: Although the eye is supplied by blood vessels, certainly these have an impact on the overall health. Visual assessment for eye refraction is not routinely performed for a client with congestive heart failure. Nursing Process: Assessment Client Need: Physiological Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
4.		Which person is most at risk for experiencing sudden cardiac event? Your Answer: A 50-year-old hypertensive, high-lipid profile male
		Objective: Identify major risk factors for the development of coronary heart disease Rationale: Research has identified hypertension and high lipid levels as relevant risk factors to cardiovascular disease, setting up the possibility of a sudden cardiac event. The infant's description seems normal. The 10-year-old may see consequences of the illness later in life. The elderly client is at risk and should be monitored over time, but with normal blood pressures, the risk is slightly diminished over the 50-year-old. Nursing Process: Assessment Client Need: Physiological Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
5.		A client with chest pain and shortness of breath has arrived in the Emergency Department. The nurse is about to perform a physical assessment on this person. Data to be obtained in the nursing history of relevance to heart disease includes:  Your Answer: History including diabetes and smoking
		Objective: List signs of alterations in cardiovascular function. Rationale: Diabetes accelerates the development of cardiac disease, and smoking (nicotine) causes constriction of vessels, changing the diameter of the vessels through which blood is flowing. Broken bones, gum chewing, and multivitamins have no overall effect on this issue. Nursing Process: Assessment Client Need: Physiological Integrity Cognitive Level: Analysis Strategy: Physiologic needs come first then safety. Psychosocial needs are addressed after physiologic and safety.
6.		The cardinal signs of cardiac arrest include all of the following signs except: Your Answer: Dilated pupils Correct Answer: Gurgling sounds in the lungs
		Objective: Describe the critical nature of cardiopulmonary resuscitation. Rationale: Gurgling sounds in the lung represent the accumulation of fluid in the lungs, and are not a sign that the heart stops beating. The remaining signs noted are all recognized by the author and the American Heart Association as the cardinal signs of cardiac arrest. Nursing Process: Evaluation Client Need: Physiological Integrity Cognitive Level: Evaluation Strategy: ABCs: airway, breathing, circulation
7.		When assessing any client coming to see a primary care provider, a heart rate assessment is common practice. Of the client assessments performed, for which client would most concern the nurse? Your Answer: The 50-year-old hypertensive executive with a heart rate of 130
		Objective: Identify factors influencing cardiovascular function. Rationale: Pulse rates are normally highest and most variable in newborns, decreasing throughout infancy and early childhood, and reaching the adult rate of 55 to q100 beats about age 10. Nursing Process: Assessment Client Need: Physiological Integrity Cognitive Level: Application Strategy: Physiologic needs come first then safety. Psychosocial needs are addressed after physiologic and safety.
8.		The leading indicator and contributor of cardiac disease as the cause of death in North America is: Your Answer: Atherosclerosis
		Objective: Identify major risk factors for the development of coronary heart disease. Rationale: Atherosclerosis, the buildup of fatty plaque within the arteries, is the major contributor to cardiovascular disease, and the leading cause of death in North America. Aging and gender are considered to be risk factors that can lead to the development of cardiac diseases. Congenital heart defects usually show consequences in relation to heart muscle problems. Nursing Process: Assessment Client Need: Physiological Integrity Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
9.		Which practices promote a healthy heart? (Select all that apply.) Your Answer: Regular Exercise Correct Answer: Low carb/High fat diet
		Objective: Identify and describe nursing measures to promote circulation. Rationale: Exercise regularly, eliminate smoking, low fat diet, alcohol in moderation, reduce stress and manage anger, manage diabetes and hypertension. Nursing Process: Planning Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and health promotion activities.
10.		An individual who has had a cardiac arrest has how much time before the lack of oxygen causes brain damage? Your Answer: Eight to Ten Minutes Correct Answer: Less than Four minutes
		Objective: Describe the critical nature of cardiopulmonary resuscitation. Rationale: 4 to 6 minutes without oxygen can cause permanent brain damage. Nursing Process: Implementation Client Need: Physiological Integrity Cognitive Level: Application Strategy: Use nursing knowledge to answer question.