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. LDH: 100190 U/L . CPK: 21232 U/L . Uric acid: 3.57.5 mg/dL . Triglyceride: <150 mg/dL . Total cholesterol: 130200 mg/dL . Bilirubin: < 1.0 mg/dL . Protein: 6.28.1 g/dL . Albumin: 3.45.0 g/dL . Digoxin: 0.52.0 ng/ml . Lithium: 0.81.5 mEq/L . Dilantin: 1020 mcg/dL . Theophylline: 1020 mcg/dL . Heart rate: 80100 . Respiratory rate: 1220 . lood pressure: 110120 (systolic); 6090 B (diastolic) . Temperature: 98.6 +/1 . FHR: 120160 BPM. . Variability: 610 BPM. . ariable decelerationsAre noted as V V-shaped on the monitoring strip. Variable decelerations can occur anytime during monitoring of the fetus. They are caused by cord compression. The intervention is to change the mothers position; if pitocin is infusing, stop the infusion; apply oxygen; and increase the rate of IV fluids. Contact the doctor if the problem persists. . ate decelerationsOccur after the peak L of the contraction and mirror the contraction in length and intensity. These are caused by uteroplacental insuffiency. The intervention is to change the mothers position; if pitocin is infusing, stop the infusion; apply oxygen;, and increase the rate of IV fluids. Contact the doctor if the problem persists.

The NCLEX-RN Cram Sheet

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This cram sheet contains the distilled, key facts about the licensure exam. Review this information just before you enter the testing center, paying special attention to those areas where you feel you need the most review. You can transfer any of these facts from your head onto a blank sheet provided by the testing center. We also recommend reading the glossary as a last-minute cram tool before entering the testing center. Good luck.

17. Therapeutic drug levels

18. Vital signs (adult)

General TesT InformaTIon

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5. Watch for specific detailsAvoid vague answers. Look for adjectives and adverbs.

11. Make an educated guessIf you are unsure after carefully reading the question and all the Minimum 75/maximum 265The maximum time answers, choose C or the answer with the most allotted for the test is 6 hours. Dont get frustrated information. if you need to take the entire number of items 12. Dont hurry, you are not penalized for running or take the entire allotted time. Get up and move out of time. If you run out of time the computer around and take breaks if you need a time-out. calculates the last 60 items for consistency above Take deep breaths and imagine yourself or below the pass-point. studying in your favorite locationTake a small 13. Serum electrolytesIt is important for you to item with you that you have had with you during remember these normal lab values because they your study time. might be included in questions throughout the test. Read the question and all answers carefully . Sodium: 135145 mEq/L Dont jump to conclusions or make wild guesses. Look for keywordsAvoid answers that include . Potassium: 3.55.5 mEq/L always, never, all, every, only, must, no, except, . Calcium: 8.510.9 mg/L or none. . Chloride: 95105 m Eq/L . Magnesium: 1.52.5 mEq/L . Phosphorus: 2.54.5 mg/dL . RBC: 4.55.0 million . WBC: 5,00010,000 . Plt.: 200,000400,000 . Hgb: 1216 gms women; 1418 gms men ABG values . HCO3: 2426 mEq/L . CO2: 3545 mEq/L . PaO2: 80%100% . SaO2: > 95% Chemistry values . Glucose: 70110 mg/dL

22. TORCHS syndrome in the neonateThis is a combination of diseases. These include toxoplasmosis, rubella (German measles), cytomegalovirus, herpes, and syphyllis. Pregnant nurses should not be assigned to care for the client with toxoplasmosis or cytomegalovirus. 23. STOPThis is the treatment for maternal hypotension after an epidural anesthesia: 1. Stop pitocin if infusing. 2. Turn the client on the left side. 3. Administer oxygen. 4. If hypovolemia is present, push IV fluids. Anticoagulant therapy and monitoring . oumadin (sodium warfarin) PT: 1012 sec. C (control).

19. Maternity normals

. ontractions: normal frequency 25 minutes C apart; normal duration < 90 sec.; intensity < 100 mm/hg. . mniotic fluid: 5001200 ml (nitrozine A 24. urine-litmus paper green/amniotic fluidlitmus paper blue). . pgar scoring: A = appearance, P = pulses, A G = grimace, A = activity, R = reflexes (Done at 1 and 5 minutes with a score of 0 for absent, 1 for decreased, and 2 for strongly positive.)

7. Look for information given within the question and the answersFor example, the phrase client with diabetic ketoacidosis should bring to mind the range of 7.357.45 or normal pH. 15. 8. Look for the same or similar wording in the question and the answers. 9. Watch for grammatical inconsistencies Subjects and verbs should agree, meaning singular subject, singular verb or plural subject, plural verb. If the question is an incomplete sentence, the 16. correct answer should complete the question in a grammatically correct manner. 10. Dont read into questionsReading into the question can create errors in judgment. If the question asks for an immediate response or priori- tization of action, choose the answer that is critical to the life and safety of the client.

6. Eliminate answers that are clearly wrong or incorrectEliminating any incorrect answer increases the probability of selecting the correct answer by 25%.

14. Hematology values

. ntidote: The antidote for Coumadin is A vitamin K. . eparin/Lovenox/Dalteparin PTT: 3045 sec. H (control). . ntidote: The antidote for Heparin is A protamine sulfate. . herapeutic level: It is important to maintain T a bleeding time that is slightly prolonged so that clotting will not occur; therefore, the bleeding time with medication should be 1 1/22 times the control. The control is the premedication bleeding time. * . ead = 9% H . rms = 18% (9% each) A . ack = 18% B . egs = 36% (18% each) L . enitalia = 1% G

. VA: The umbilical cord has two arteries and A one vein. (Arteries carry deoxygenated blood. The vein carries oxygenated blood.) 20. FAB 9Folic acid = B9. Hint: B stands for brain (decreases the incidence of neural tube defects); the client should begin taking B9 three months prior to becoming pregnant. 21. Abnormalities in the laboring obstetric client Decelerations are abnormal findings on the fetal monitoring strip. Decelerations are classified as . arly decelerationsBegin prior to the E peak of the contraction and end by the end of the contraction. They are caused by head compression. There is no need for intervention if the variability is within normal range (that is, there is a rapid return to the baseline fetal heart rate) and the fetal heart rate is within normal range.

25. Rule of nines for calculating TBSA for burns

. Specific gravity: 1.0101.030 . BUN: 722 mg/dL . erum creatinine: 0.61.35 mg/dL S (< 2 in older adults) * nformation included in laboratory test may vary I slightly according to methods used

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CulTural and relIGIous ConsIderaTIons In HealTH Care

. H down, CO2 down, and HCO3 down = p metabolic acidosis client with a life-threatening illness or injury first. For disaster triage, choose to triage first those clients who can be saved with the least use of resources. . ngiotensin receptor blocker drugs: A Valsartan (Diovan), candesartan (Altacand), losartan (Cozaar), telmisartan (Micardis) . istamine 2 antagonist drugs: Cimetidine H (Tagamet), famotidine (Pepcid), nizatidine (Axid), rantidine (Zantac) . roton pump inhibitors: Esomeprazole P (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (AciPhex) . nticoagulant drugs: Heparin sodium A (Hepalean), enoxaparin sodium (Lovenox), dalteparin sodium (Fragmin) . Schedule IResearch use only (example LSD) . Schedule IIRequires a written prescription (example Ritalin) . chedule IIIRequires a new prescripS tion after six months or five refills (example codeine) . Schedule IVRequires a new prescription after six months (example Darvon) . chedule VDispensed as any other S prescription or without prescription if state law allows (example antitussives) Medication classifications commonly used in a medical/surgical setting . AntacidsReduce hydrochloric acid in the stomach . ntianemicsIncrease red blood cell A production . AnticholenergicsDecrease oral secretions

. H up, CO2 down, and HCO3 down = p 26. Arab American cultural attributesFemales respiratory alkalosis avoid eye contact with males; touch is accepted . H up, CO2 up, and HCO3 up = metabolic p if done by same-sex healthcare providers; most alkalosis decisions are made by males; Muslims (Sunni), refuse organ donation; most Arabs do not eat pork; 33. Addisons versus CushingsAddisons and they avoid icy drinks when sick or hot/cold drinks Cushings are diseases of the endocrine system together; colostrum is considered harmful to the involving either overproduction or inadequate newborn. production of cortisol: 27. Asian American cultural attributesThey avoid . reatment for the client with Addisons: T direct eye contact; feet are considered dirty (the feet increase sodium intake; medications include should be touched last during assessment); males cortisone preparations. make most of the decisions; they usually refuse . reatment for the client with Cushings: T organ donation; they generally do not prefer cold restrict sodium; observe for signs of infection. drinks, believe in the hot-cold theory of illness. 34. Treatment for spider bites/bleedingRICE (rest, 28. Native American cultural attributesThey ice, compression, and elevate extremity) sustain eye contact; blood and organ donation is generally refused; they might refuse circumcision; 35. may prefer care from the tribal shaman rather than using western medicine. 36. 29. Mexican American cultural attributesThey might avoid direct eye contact with authorities; they might refuse organ donation; most are very emotional during bereavement; believe in the hot-cold theory of illness. 30. Religions beliefs . ehovahs WitnessNo blood products J should be used . HinduNo beef or items containing gelatin . ewishSpecial dietary restrictions, use of J kosher foods Treatment for sickle cell crisesHHOP (heat, hydration, oxygen, pain medications) Five Ps of fractures and compartment syndromeThese are symptoms of fractures and compartment syndrome: . ain P . allor P . ulselessness P . aresthesia P . olar (cold) P

leGal Issues In nursInG

Review common legal terms: tort, negligence, malpractice, slander, assault, battery.

LegalitiesThe RN and the physician institute seclusion protection. 40. Examples of types of drugs . ngiotensin-converting agents: Benazepril A (Lotensin), lisinopril (Zestril), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), moexipril (Univas), quinapril (Acupril), ramipril (Altace) . eta adrenergic blockers: Acebutolol B (Monitan, Rhotral, Sectral), atenolol (Tenormin, Apo-Atenol, Nova-Atenol), esmolol (Brevibloc), metaprolol (Alupent, Metaproterenol), propanolol (Inderal) * he generic name is listed first with the trade T name in parentheses.

41. Drug schedules

37. Hip fracturesHip fractures commonly hemorrhage, whereas femur fractures are at risk for fat emboli.

31. Therapeutic diets

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TIps for assIGnInG sTaff duTIes . out dietLow purine; omit poultry (cold G chicken) medication for acute episodes: 39. Management and delegation Colchicine; maintenance medication: Zyloprim . elegate sterile skills such as dressing changD . eart healthy dietLow fat (less than H es to the RN or LPN. Where nonskilled care is 30% of calories should be from fat) required, you can delegate the stable client to the nursing assistant. Choose the most critical 32. Acid/base balance client to assign to the RN, such as the client . OME (respiratory opposite/metabolic equal) R who has recently returned from chest surgery. is a quick way of remembering that in respiClients who are being discharged should have ratory acid/base disorders the pH is opposite final assessments done by the RN. to the other components. For example, in . he PN, like the RN, can monitor clients with T respiratory acidosis, the pH is below normal IV therapy, insert urinary catheters and feedand the CO2 is elevated, as is the HCO3 ing tubes, apply restraints, discontinue IVs, (respiratory opposite). In metabolic disorders, drains, and sutures. the components of the lab values are the . or room assignments, do not coassign the F same. An example of this is metabolic acipost-operative client with clients who have dosis. In metabolic acidosis, the pH is below vomiting, diarrhea, open wounds, or chest normal and the CO2 is decreased, as is the tube drainage. Remember the A, B, Cs (airHCO3. This is true in a compensated situation. way, breathing, circulation) when answering . H down, CO2 up, and HCO3 up = respiratory p questions choices that ask who would you acidosis see first. For hospital triage, care for the

38. Profile of gallbladder diseaseFair, fat, forty, five pregnancies, flatulent (actually gallbladder . enal dietHigh calorie, high carbohydrate, R disease can occur in all ages and both sexes). low protein, low potassium, low sodium, and fluid restricted to intake = output + 500 ml

. nti-infective drugs: Gentamicin A (Garamycin, Alcomicin, Genoptic), kanamycin (Kantrex), neomycin (Mycifradin), 42. streptomycin (Streptomycin), tobramycin (Tobrex, Nebcin), amikacin (Amikin) . enzodiazepine drugs: Clonazepam B (Klonopin), diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan), flurazepam (Dalmane) . henothiazine drugs: Chlopromazine P (Thorazine), prochlorperazine (Compazine), trifluoperazine (Stelazine), promethazine (Phenergan), hydroxyzine (Vistaril), fluphenazine (Prolixin)

. nticoagulantsPrevent clot formation A . AnticonvulsantsUsed for management of seizures/bipolar disorder . ntidiarrhealsDecrease gastric motility A and reduce water in bowel . AntihistaminesBlock the release of histamine . ntihypertensivesLower blood pressure A and increase blood flow . nti-infectivesUsed for the treatment of A infections . BronchodilatorsDilate large air passages in asthma/lung disease . iureticsDecrease water/sodium from the D Loop of Henle . axativesPromote the passage of stool L . MioticsConstrict the pupils . ydriaticsDilate the pupils M . arcotics/analgesicsRelieve moderate to N severe pain

. lucocorticoid drugs: Prednisolone (DeltaG Cortef, Prednisol, Prednisolone), prednisone (Apo-Prednisone, Deltasone, Meticorten, Orasone, Panasol-S), betamethasone (Celestone, Selestoject, Betnesol), dexamethasone (Decadron, Deronil, Dexon, Mymethasone, Dalalone), cortisone (Cortone), hydrocortisone (Cortef, Hydrocortone Phosphate, Cortifoam), methylprednisolone (Solu-cortef, Depo-Medrol, Depopred, Medrol, Rep-Pred), triamcinolone (Amcort, Aristocort, Atolone, Kenalog, Triamolone)

. ntivirals: Acyclovir (Zovirax), ritonavir A (Norvir), saquinavir (Invirase, Fortovase), indinavir (Crixivan), abacavir (Ziagen), cidofo- vir (Vistide), ganciclovir (Cytovene, Vitrasert) . holesterol-lowering drugs: Atorvastatin C (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocar), rosuvastatin (Crestor)