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NCLEX-RN Exam Cram, 4th Edition

By Wilda Rinehart, Diann Sloan, Clara Hurd

Published by Pearson IT Certification

Published Date: Aug 13, 2013

Description

This is the eBook version of the print title. The eBook edition does not provide access to the test engine and practice test that accompanies the print book.

 

“The book offers a quick ‘cram’ approach to the NCLEX that is very user-friendly and not time-intensive. The overall approach is very learner-centered and the content is well-paced.”—Catherine Dearman, R.N., Ph.D.

 

  • Covers exactly what you need to know to score higher on your NCLEX-RN® exam
  • 545 sample test questions help you gain confidence and decide when you’re ready to take the actual exam
  • Includes the popular Cram Sheet tearcard to help you remember key concepts and do extra last-minute studying
  • Exam Alerts identify important information found on the exam
  • Simplifies key medication aide concepts and techniques for easy learning

 

 

Covers the critical information you’ll need to know to score higher on your NCLEX-RN exam!

 

  • Discover how the NCLEX-RN exam works, and how best to prepare for it
  • Understand essential disease processes, treatments, and diagnostic studies
  • Care for clients with respiratory, genitourinary, hematopoietic, gastrointestinal, musculoskeletal, endocrine, cardiovascular, neurological, and many other disorders
  • Serve maternal, infant, and pediatric clients
  • Provide compassionate and effective emergency and psychiatric care
  • Consider cultural, religious, and legal concerns associated with client care
  • Review all stages of the nursing process: assessment, diagnosis, planning, implementation, and evaluation
  • Address client needs for a safe, effective-care environment; health promotion and maintenance; and psychosocial and physiological integrity

 

 

Table of Contents

Introduction . . . . . 1

    Welcome to the NCLEX-RN® Exam Cram . . . 1

    Taking the Computerized Adaptive Test . . . 2

    The Cost of the Exam . . . . 2

    How to Prepare for the Exam . . . 2

    How to Use This Book. . . . 3

    About the Book . . . . 4

    Contact the Authors . . . . 5

    Self-Assessment . . . . 5

    Testing Your Exam Readiness . . . 6

Chapter 1: Preparing for the National Council Exam for Registered Nurses . . 7

    Preparing for the Exam . . . . 8

        The CAT Exam . . . . 8

    Testing Strategies. . . . 9

        Read the Question Carefully . . . 10

        Look for Keywords . . . . 10

        Watch for Specific Details . . . 10

        Eliminate Options That Are Clearly Wrong or Incorrect . . 11

        Look for Similar Options . . . 11

        Look for Opposite Answers . . . 12

        Remember Legalities . . . . 12

        Remember Infection Control . . . 12

    Exam Prep Questions . . . . 13

        Answer Rationales . . . . 15

Chapter 2: Pharmacology . . . . . 17

    Three Areas of Pharmacology . . . 18

    How Nurses Work with Pharmacology . . . 19

    Time-released Drugs . . . . 20

    Administering Medications . . . . 21

        The Seven Rights of Administering Medication. . 21

    Understanding and Identifying the Various Drugs. . 22

        Angiotensin-Converting Enzyme Inhibitors . . 22

        Beta Adrenergic Blockers . . . 23

        Anti-Infectives (Aminoglycosides). . . 25

        Benzodiazepines (Anticonvulsants/Antianxiety) . . 26

        Phenothiazines (Antipsychotic/Antiemetic). . 28

        Glucocorticoids . . . . 29

        Antivirals. . . . 31

        Cholesterol-Lowering Agents . . . 32

        Angiotensin Receptor Blockers . . . 33

        Histamine 2 Antagonists. . . 34

        Proton Pump Inhibitors . . . 36

        Anticoagulants . . . . 37

        More Drug Identification Helpers . . . 38

    Herbals . . . . . 38

    Drug Schedules . . . . 39

    Pregnancy Categories for Drugs. . . 40

    Exam Prep Questions . . . . 41

        Answer Rationales . . . . 43

Chapter 3: Caring for the Client with Disorders of the Respiratory System . . 45

    Chronic Obstructive Pulmonary Disease. . . 46

        Chronic Bronchitis . . . . 46

        Emphysema . . . . 46

        Asthma . . . . 47

    Acute Respiratory Infections . . . 47

        Pneumonia . . . . 48

        Pleurisy . . . . 49

        Tuberculosis . . . . 50

        Influenza . . . . 50

    Acute Respiratory Failure. . . . 51

        Acute Respiratory Distress Syndrome . . . 51

        Pulmonary Embolus . . . . 52

    Emerging Infections . . . . 53

        Severe Acute Respiratory Syndrome. . . 53

        Legionnaire’s Disease . . . . 54

    Diagnostic Tests for Review. . . . 55

    Pharmacology Categories for Review. . . 55

    Exam Prep Questions . . . . 57

        Answer Rationales . . . . 59

    Suggested Readings and Resources. . . 60

Chapter 4: Caring for the Client with Disorders of the Genitourinary System . . 61

    Acute Glomerulonephritis . . . . 62

    Chronic Glomerulonephritis . . . 63

    End Stage Renal Disease . . . . 64

        Peritoneal Dialysis. . . . 64

        Hemodialysis . . . . 64

        Renal Transplantation. . . . 65

    Nephrotic Syndrome . . . . 65

    Urinary Calculi . . . . 66

    Urinary Tract Infections. . . . 67

    Genitourinary Disorders . . . . 67

        Prostatitis . . . . 67

    Benign Prostatic Hyperplasia . . . 68

    Bladder Cancer . . . . 69

    Diagnostic Tests for Review. . . . 70

    Pharmacology Categories for Review. . . 70

    Exam Prep Questions . . . . 72

        Answer Rationales . . . . 74

    Suggested Reading and Resources . . . 75

Chapter 5: Caring for the Client with Disorders of the Hematopoietic System . . 77

    Anemia . . . . . 78

        Pernicious Anemia. . . . 78

        Aplastic Anemia . . . . 79

        Sickle Cell Anemia . . . . 80

        Iron Deficiency Anemia . . . 80

        Cooley’s Anemia (Thalassemia Major) . . . 81

    Hemophilia. . . . 81

    Polycythemia Vera. . . . 82

    Diagnostic Tests for Review. . . . 83

    Pharmacology for Review . . . . 83

    Exam Prep Questions . . . . 84

        Answer Rationales . . . . 86

    Suggested Reading and Resources . . . 87

Chapter 6: Caring for the Client with Disorders of Fluid and Electrolyte Balance and Acid/Base Balance. . . . 89

    Basic Knowledge of Fluid and Electrolyte Balance . . 90

    Regulation of pH and Its Effect on Fluid and Electrolytes. . 91

        How the Body Regulates pH . . . 91

    Metabolic Acidosis . . . . 91

        Causes of Metabolic Acidosis. . . 91

        Symptoms of Metabolic Acidosis . . . 92

        Care of the Client with Metabolic Acidosis. . 92

    Respiratory Acidosis . . . . 93

        Causes of Respiratory Acidosis . . . 93

        Symptoms of Respiratory Acidosis . . . 94

        Caring for the Client with Respiratory Acidosis. . 94

    Metabolic Alkalosis . . . . 95

        Causes of Metabolic Alkalosis . . . 95

        Symptoms of Metabolic Alkalosis . . . 95

        Caring for the Client with Metabolic Alkalosis. . 96

    Respiratory Alkalosis. . . . 96

        Symptoms of Respiratory Alkalosis. . . 96

        Care of the Client with Respiratory Alkalosis . . 97

    Normal Electrolyte Values. . . . 97

    Changes Associated with Aging. . . 98

    Exam Prep Questions . . . . 100

        Answer Rationales . . . . 102

    Suggested Reading and Resources . . . 103

Chapter 7: Caring for the Client with Burns. . . . 105

    Burn Classifications. . . . 106

        Burn Measurement with TBSA. . . 108

    Nursing Care for Burn Victims. . . 109

        The Emergent Phase . . . 110

        The Intermediate Phase . . . 113

        Dressings for Burns. . . . 114

        The Rehabilitative Phase . . . 115

    Diagnostic Tests for Review. . . 116

    Pharmacology Categories for Review. . . 116

    Exam Prep Questions . . . . 117

        Answer Rationales . . . . 119

    Suggested Reading and Resources . . . 120

Chapter 8: Caring for the Client with Sensorineural Disorders . . . 121

    Disorders of the Eyes . . . . 122

        Intraocular Disorders . . . 122

        Retinal Disorders. . . . 125

        Refractive Errors . . . . 127

        Traumatic Injuries . . . . 128

    Visual Tests for Review. . . . 129

    Pharmacology Categories for Review. . . 129

    Ear Disorders. . . . 129

        Otitis Externa. . . . 130

        Otitis Media . . . . 130

        Meniere’s Disease . . . . 130

        Otosclerosis . . . . 131

        Presbycusis . . . . 131

        Ear Trauma. . . . 132

    Assisting Clients with Hearing Loss. . . 132

    Diagnostic Tests for Review. . . 132

    Pharmacology Categories for Review. . . 133

    Exam Prep Questions . . . . 134

        Answer Rationales . . . . 136

    Suggested Reading and Resources . . . 137

Chapter 9: Caring for the Client with Cancer. . . . 139

    Cancer. . . . . 140

        American Cancer Society’s Seven Warning Signs of Cancer . 140

        The Four Major Categories of Cancer . . . 140

        Risk Factors for Specific Cancers . . . 141

        Cancer Prevention. . . . 143

        Patient Teaching . . . . 143

    Management of the Client with Cancer. . . 143

        Radiation. . . . 144

        Chemotherapy . . . . 145

    Bone Marrow and Peripheral Stem Cell Transplantation (PSCT) . 147

        Types of Transplants . . . . 148

        Nursing Care After Transplantation. . . 148

    Hodgkin’s Lymphoma . . . . 149

        Diagnosis of Hodgkin’s Lymphoma . . . 150

        Prognosis of Hodgkin’s Lymphoma . . . 150

        Treatment of Hodgkin’s Lymphoma. . . 150

    Diagnostic Tests for Review. . . 151

    Pharmacology for Review . . . . 152

    Exam Prep Questions . . . . 154

        Answer Rationales . . . . 156

    Suggested Reading and Resources . . . 157

Chapter 10: Caring for the Client with Disorders of the Gastrointestinal System . . 159

    Ulcers . . . . . 160

        Types of Ulcers . . . . 160

        Treatment of Ulcers . . . . 161

    Inflammatory Bowel Disorders . . . 163

        Crohn’s Disease (Regional Enteritis) . . . 163

        Ulcerative Colitis. . . . 164

    Diverticulitis. . . . 165

        Diagnosis of Diverticulitis . . . 165

        Treatment of Diverticulitis. . . 166

    Gastroesophageal Reflux Disease (GERD) . . . 166

    Diseases Associated with the Liver . . . 167

        Hepatitis . . . . 167

        Cirrhosis . . . . 172

        Pancreatitis . . . . 174

    Cholecystitis/Cholelithiasis . . . 176

        Symptoms of Cholecystitis and Cholelithiasis. . 176

        Diagnosis of Cholecystitis/Cholethiasis . . . 177

        Treatment of Cholecystitis. . . 177

        Treatment of Cholethiasis . . . 177

    Clostridium Difficile. . . . 178

    Food-Borne Illnesses . . . . 179

    Diagnostic Tests for Review. . . 180

    Pharmacology for Review . . . . 180

    Exam Prep Questions . . . . 182

        Answer Rationales . . . . 184

    Suggested Reading and Resources . . . 185

Chapter 11: Caring for the Client with Disorders of the Musculoskeletal System . . 187

    Fractures. . . . 188

        Treating Fractures . . . . 188

        Compartment Syndrome . . . 191

        Osteomyelitis . . . . 192

    Osteoporosis. . . . 193

        Treatment of Osteoporosis. . . 194

    Gout . . . . . 195

        Treatment of the Client with Gout. . . 195

    Rheumatoid Arthritis . . . . 195

        Treatment of Rheumatoid Arthritis . . . 196

    Musculoskeletal Surgical Procedures . . . 197

        Fractured Hip and Hip Replacement . . . 197

        Total Knee Replacement . . . 198

        Amputations . . . . 199

    Assistive Devices for Ambulation . . . 201

        Crutches . . . . 201

        Canes. . . . 202

        Walkers . . . . 202

    Diagnostic Tests for Review. . . 203

    Pharmacology for Review . . . . 203

    Exam Prep Questions . . . . 205

        Answer Rationales . . . . 207

    Suggested Reading and Resources . . . 208

Chapter 12: Caring for the Client with Disorders of the Endocrine System . . 209

    The Endocrine System. . . . 210

    Pituitary Disorders . . . . 210

        Tumors of the Pituitary . . . 211

    Thyroid Disorders . . . . 213

        Hypothyroidism. . . . 213

        Hyperthyroidism . . . . 214

    Parathyroid Disorders. . . . 216

        Hypoparathyroidism . . . . 216

        Hyperparathyroidism . . . 217

    Adrenal Gland Disorders . . . . 218

        Adrenocortical Insufficiency (Addison’s Disease) . . 218

        Adrenocortical Hypersecretion (Cushing’s Syndrome) or Cushing’s Disease. . . 219

    Diabetes Mellitus. . . . 219

    Diagnostic Tests for Review. . . 223

    Pharmacology Categories for Review. . . 223

    Exam Prep Questions . . . . 224

        Answer Rationales . . . . 226

    Suggested Reading and Resources . . . 227

Chapter 13: Caring for the Client with Disorders of the Cardiovascular System . . 229

    Hypertension . . . . 230

        Medications Used to Treat Hypertension . . 231

    Heart Block . . . . 231

        Toxicity to Medications . . . 233

        Malfunction of the Conduction System . . . 233

    Myocardial Infarction . . . . 234

        Diagnosis of Myocardial Infarction . . . 235

        Management of Myocardial Infarction Clients . . 236

    Inflammatory Diseases of the Heart. . . 239

        Infective Endocarditis . . . 239

        Pericarditis . . . . 239

    Buerger’s Disease. . . . 240

    Thrombophlebitis . . . . 240

    Raynaud’s Syndrome. . . . 241

    Aneurysms . . . . 241

    Congestive Heart Failure . . . . 242

        Diagnostic Tests for Review. . . 242

    Pharmacology Categories for Review. . . 243

    Exam Prep Questions . . . . 244

        Answer Rationales . . . . 246

    Suggested Reading and Resources . . . 247

Chapter 14: Caring for the Client with Disorders of the Neurological System . . 249

    Seizures. . . . . 250

        Types of Seizures . . . . 250

        Treatment of Seizure Clients. . . 252

    Status Epilepticus . . . . 253

    Brain Injuries . . . . 253

        Epidural Hematomas . . . 254

        Subdural Hematoma . . . . 254

        Treatment of Epidural and Subdural Hematomas . . 254

    Increased Intracranial Pressure . . . 255

        Treatment of ICP . . . . 257

    Neurological Assessment . . . . 258

        Cranial Nerve Assessment . . . 258

        Glasgow Coma Scale. . . . 259

        Intracranial Pressure Monitors . . . 260

    Care of the Client with Intracranial Surgery (Craniotomy) . . 260

    Cerebrovascular Accident/Stroke . . . 262

    Spinal Cord Injury . . . . 263

        Treatment of Spinal Cord Injuries . . . 263

        Potential Complications with SCI Clients. . 264

    Guillain-Barré . . . . 265

        Treating Clients with Guillian-Barré . . . 266

    Degenerative Neurological Disorders . . . 266

    Diagnostic Tests for Review. . . 267

    Pharmacology for Review . . . . 267

    Exam Prep Questions . . . . 269

        Answer Rationales . . . . 271

    Suggested Reading and Resources . . . 272

Chapter 15: Caring for the Client with Psychiatric Disorders . . . 273

    Anxiety-Related Disorders . . . . 274

        Generalized Anxiety Disorder . . . 274

        Post-traumatic Stress Disorder . . . 275

        Dissociative Identity Disorder . . . 275

        Somatoform Disorder. . . 276

        Panic Disorder . . . . 276

        Phobic Disorders . . . . 277

        Obsessive-Compulsive Disorder . . . 277

    Personality Disorders . . . . 278

        Cluster A. . . . 278

        Cluster B. . . . 279

        Cluster C . . . . 280

        Managing Clients with Personality Disorders. . 281

    Psychotic Disorders . . . . 282

        Schizophrenia. . . . 282

        Bipolar Disorders . . . . 284

    Substance Abuse . . . . 286

        Alcoholism . . . . 286

        Other Commonly Abused Substances . . . 288

    Disorders of Childhood and Adolescence . . . 291

        Conduct Disorder . . . . 291

        Oppositional Defiant Disorder . . . 291

        Attention Deficit Hyperactive Disorder. . . 291

        Autistic Disorder . . . . 292

        Eating Disorders . . . . 293

    Diagnostic Tests for Review. . . 293

    Pharmacology Categories for Review. . . 294

    Exam Prep Questions . . . . 295

        Answer Rationales . . . . 297

    Suggested Reading and Resources . . . 298

Chapter 16: Caring for the Maternal/Infant Client. . . 299

    Signs of Pregnancy . . . . 300

        Presumptive Signs . . . . 300

        Probable Signs . . . . 300

        Positive Signs . . . . 301

    Prenatal Care . . . . 301

        Prenatal Diet and Weight Maintenance. . . 301

        Alpha-Fetoprotein Screening. . . 301

        Other Prenatal Diagnostic Tests . . . 302

        Assessing Fetal Heart Tones . . . 303

        Ultrasonography . . . . 303

    Signs of Complications of Pregnancy. . . 303

    Types of Abortions . . . . 304

    Complications Affecting Pregnancy . . . 305

        Diabetes in Pregnancy . . . 305

        Preeclampsia. . . . 306

        Disseminated Intravascular Coagulation . . 307

        Cord Prolapse . . . . 307

        Abruptio Placenta . . . . 307

        Placenta Previa. . . . 307

    Maternal Infections. . . . 308

    Preterm Labor . . . . 310

    Intrapartal Care . . . . 311

        Stages of Labor . . . . 311

        Phases of Labor . . . . 312

        Important Terms You Should Know. . . 312

    Prelabor Testing . . . . 313

    Fetal Monitoring . . . . 314

    Pharmacologic Management of Labor. . . 316

    Postpartum Care . . . . 317

    Terms Associated with the Normal Newborn. . . 317

    Rh Incompatibility . . . . 318

    Contraception . . . . 319

    Diagnostic Tests for Review. . . 320

    Pharmacology Categories for Review. . . 321

    Exam Prep Questions . . . . 322

        Answer Rationales . . . . 324

    Suggested Reading and Resources . . . 325

Chapter 17: Caring for the Pediatric Client . . . . 327

    Growth and Development . . . . 328

        Infant (28 Days to 1 Year) . . . 328

        Toddler (1–3 Years) . . . . 330

        Preschooler (3–5 Years) . . . 331

        School Age (6–12 Years) . . . 332

        Adolescence (12–18 Years) . . . 333

    Congenital Anomalies. . . . 334

        Anomalies of the Gastrointestinal System . . 334

        Anomalies of the Musculoskeletal System . . 338

        Anomalies of the Cardiovascular System . . 340

        Inborn Errors of Metabolism . . . 343

    Respiratory Disorders. . . . 344

        Acute Otitis Media . . . . 345

        Tonsillitis . . . . 346

        Laryngotracheobronchitis . . . 347

        Acute Epiglottitis. . . . 347

        Bronchiolitis . . . . 348

        Cystic Fibrosis (Mucoviscidosis) . . . 349

    Gastrointestinal Disorders . . . . 350

        Gastroenteritis . . . . 350

        Pyloric Stenosis . . . . 350

        Intussusception . . . . 351

        Celiac (Gluten-Induced Enteropathy, Celiac Sprue) . . 351

    Cardiovascular Disorders . . . . 351

        Rheumatic Fever . . . . 352

        Kawasaki’s Disease (Mucocutaneous Lymph Node Syndrome) . 353

    Musculoskeletal Disorders . . . . 354

        Scoliosis. . . . 354

        Legg-Calve-Perthes Disease (Coxa Plana) . . 355

        Muscular Dystrophies. . . 355

    Childhood Cancer. . . . 356

        Wilms Tumor (Nephroblastoma) . . . 356

        Leukemia . . . . 356

        Osteogenic Sarcoma (Osteosarcoma) . . . 357

    Ingestion of Hazardous Substances . . . 357

        Salicylate Overdose . . . . 357

        Acetaminophen (Tylenol) Overdose . . . 357

        Lead (Plumbism) . . . . 358

        Iron Poisoning . . . . 358

    Diagnostic Tests for Review. . . 359

    Pharmacology Categories for Review. . . 359

    Exam Prep Questions . . . . 360

        Answer Rationales . . . . 362

    Suggested Reading and Resources . . . 363

Chapter 18: Emergency Nursing. . . . 365

    The ABCDs of Emergency Care . . . 366

        Airway . . . . 367

        Breathing . . . . 367

        Circulation . . . . 368

        Deficits . . . . 369

        Obtaining Client Information . . . 369

    Trauma . . . . . 370

        Head Injuries . . . . 370

        Chest Injuries. . . . 371

        Abdominal Injuries . . . . 371

        Documenting and Protecting Forensic Evidence . . 372

    Poisoning . . . . 373

    Poisonous Stings and Bites . . . 374

    Bioterrorism. . . . 375

        Chemical and Biological Agents . . . 375

        Nuclear Warfare . . . . 378

        Triage Categories for Disaster Victims . . . 379

    Diagnostic Tests for Review. . . 379

    Pharmacology Categories for Review. . . 380

    Exam Prep Questions . . . . 381

        Answer Rationales . . . . 383

    Suggested Reading and Resources . . . 384

Chapter 19: Cultural Practices Influencing Nursing Care. . . 385

    Cultural Assessment . . . . 386

        Understanding Client Beliefs. . . 386

        Working with Clients Who Speak Different Languages. . 387

    Healthcare of Hispanics/Latinos. . . 388

        Time Considerations. . . . 389

        Use of Nonverbal/Verbal Communication . . 389

        Childbirth and Pain Response . . . 390

    Healthcare of Native Americans and Alaskan Natives. . 390

        Time Considerations. . . . 391

        Use of Nonverbal/Verbal Communication . . 391

        Childbirth and Pain Response . . . 391

    Healthcare of Asian-Americans . . . 391

        Time Considerations. . . . 393

        Use of Nonverbal/Verbal Communication . . 393

        Childbirth and Pain Response . . . 393

    Healthcare of Arab-Americans . . . 393

        Time Considerations. . . . 394

        Use of Nonverbal/Verbal Communication . . 394

        Childbirth and Pain Response . . . 394

    Nursing Plan Dietary Considerations Across Cultures . . 395

    Religious Beliefs and Refusal of Care Considerations . . 396

    Exam Prep Questions . . . . 400

        Answer Rationales . . . . 402

    Suggested Reading and Resources . . . 403

Chapter 20: Legal Issues in Nursing Practice . . . . 405

    Types of Laws . . . . 406

        Statutory Laws/Regulatory Laws . . . 407

        Civil Laws. . . . 407

        Criminal Laws . . . . 407

        Common Law . . . . 407

    Code of Ethical Behavior in Nursing Practice . . 409

    Legal Theories That Affect Nursing Practice . . 410

        Negligence . . . . 410

        Malpractice. . . . 410

        Witnessing Consent for Care . . . 411

        Tort . . . . 411

        Assault and Battery . . . . 411

        Fraud . . . . 411

    Managing Client Care . . . . 411

    Exam Prep Questions . . . . 417

    Answers to Exam Questions. . . 419

        Suggested Reading and Resources . . . 420

Practice Exam I . . . . 421

Practice Exam II . . . . 475

Answers to Practice Exam I . . . . 529

Answers to Practice Exam II. . . . 559

Appendix A: Things You Forgot . . . . 589

Appendix B: Need to Know More? . . . . 597

Appendix C: Calculations. . . . . 605

Appendix D: Most-Prescribed Medications in the United States . . . 609

Appendix E: Alphabetical Listing of Nursing Boards in the United States and Protectorates . 613

TOC, 9780789751058, 7/18/2013

 

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