Introduction . . . . . . . . . . 1
Organization . . . . . . . . 2
Instructional Features . . . . . . . . 2
Extensive Practice Test Options. . . . . . . 3
Final Review . . . . . . . . . 3
Other Valuable Tools . . . . . . . 4
About the NCLEX Exam . . . . . . . 4
Advice for Preparing for the Exam . . . . . . 6
Advice for Test Day . . . . . . . 6
Hints for Using This Book . . . . . . . 7
Contact the Author . . . . . . . . 8
Study and Exam Preparation Tips . . . . . . . 9
Study Tips . . . . . . . . . 9
Exam Prep Tips . . . . . . . . 10
Read the Question Carefully . . . . . . 11
Look for Keywords . . . . . . . 11
Watch for Specific Details . . . . . . . 11
Eliminate Options That Are Clearly Wrong or Incorrect . . . 11
Look for Similar Options . . . . . . . 12
Look for Opposite Answers . . . . . . 13
Part I: Exam Preparation
Chapter 1: Pharmacology . . . . . . . . . 15
Three Areas of Pharmacology . . . . . . . 15
How Nurses Work with Pharmacology . . . . . . 16
Time-released Drugs. . . . . . . . 17
Administering Medications. . . . . . . 18
The Seven Rights of Administering Medication . . . . 18
Understanding and Identifying the Various Drugs . . . . . 19
Angiotensin-Converting Enzyme Inhibitors . . . . . 19
Beta Adrenergic Blockers . . . . . . . 20
Anti-Infectives (Aminoglycosides) . . . . . . 21
Benzodiazepines (Anticonvulsants/Antianxiety). . . . 23
Phenothiazines (Antipsychotic/Antiemetic) . . . . . 24
Glucocorticoids . . . . . . . . 25
Antivirals . . . . . . . . 27
Cholesterol-Lowering Agents . . . . . . 28
Angiotensin Receptor Blockers . . . . . . 29
Histamine 2 Antagonists . . . . . . . 30
Proton Pump Inhibitors . . . . . . . 31
Anticoagulants . . . . . . . . 32
More Drug Identification Helpers . . . . . . 33
Herbals . . . . . . . . . 34
Drug Schedules . . . . . . . . 35
Pregnancy Categories for Drugs . . . . . . . 35
Key Concepts . . . . . . . . . 36
Key Terms . . . . . . . . 36
Apply Your Knowledge . . . . . . . . 37
Answer Rationales . . . . . . . 39
Chapter 2: Fluid and Electrolyte and Acid/Base Balance . . . . . . 41
Total Body Water Calculation . . . . . . . 41
Management of the Client with Imbalances in Fluid and Electrolytes . . . 43
Types of Intravenous Fluids . . . . . . 43
How the Body Regulates Electrolytes. . . . . 44
How the Body Regulates pH . . . . . . 52
Key Concepts . . . . . . . . . 60
Key Terms . . . . . . . . 60
Diagnostic Tests . . . . . . . . 60
Pharmacological Agents Used in the Treatment of Clients with Alterations in Fluids and Electrolytes . . . . . . . 60
Apply Your Knowledge . . . . . . . . 61
Exam Questions . . . . . . . . 62
Answers to Exam Questions . . . . . . 64
Suggested Reading and Resources. . . . . . 65
Chapter 3: Care of the Client with Cardiovascular Disorders . . . . . . 67
Hypertension . . . . . . . . . 68
Diagnosing the Client with Hypertension . . . . . 69
Managing the Client with Hypertension . . . . . 69
Coronary Artery Disease. . . . . . . 71
Atherosclerosis and Arteriosclerosis . . . . . . 71
Conduction System of the Heart. . . . . . . 72
Heart Block. . . . . . . . 73
Cardiac Monitoring . . . . . . . . 74
Reading an Electrocardiogram. . . . . . 76
Cardiac Dysrhythmias . . . . . . . . 76
Ventricular Tachycardia. . . . . . . 78
Ventricular Fibrillation . . . . . . . 79
Internal Pacemaker/Internal Cardiac Defibrillators . . . . 79
Cardiopulmonary Resuscitation . . . . . . 80
Angina Pectoris . . . . . . . . 81
Myocardial Infarction . . . . . . . . 82
Diagnosis of Myocardial Infarction . . . . . . 82
Management of a Client with Myocardial Infarction . . . . 83
Aneurysms. . . . . . . . . 89
Inflammatory Diseases of the Heart . . . . . . 90
Infective Endocarditis . . . . . . . 90
Pericarditis . . . . . . . . 91
Peripheral Vascular Disease . . . . . . 91
Varicose Veins/Thrombophlebitis . . . . . . 92
Raynaud’s Phenomenon . . . . . . . 93
Buerger’s Disease . . . . . . . . 93
Key Concepts . . . . . . . . . 94
Key Terms. . . . . . . . . 94
Diagnostics . . . . . . . . . 95
Pharmacological Agents Used in the Treatment of Clients with Cardiovascular Disorders. . . . . . . . 96
Apply Your Knowledge . . . . . . . 101
Exam Questions . . . . . . . . 101
Answers to Exam Questions . . . . . . 103
Suggested Reading and Resources. . . . . . 104
Chapter 4: Care of the Client with Endocrine Disorders . . . . . . 105
Pituitary Gland. . . . . . . . 106
Hypopituitarism . . . . . . . . 106
Hyperpituitarism . . . . . . . 106
Disorders of the Posterior Pituitary Gland . . . . . 107
Thyroid Disorders . . . . . . . . 108
Hypothyroidism . . . . . . . . 108
Hyperthyroidism . . . . . . . 110
Parathyroid Disorders . . . . . . . . 112
Hypoparathyroidism . . . . . . . 112
Hyperparathyroidism. . . . . . . 113
Diabetes Mellitus . . . . . . . . 114
Hyperglycemia . . . . . . . . 116
Hypoglycemia. . . . . . . . 117
Managing Hyperglycemia and Hypoglycemia. . . . 117
Adrenal Gland . . . . . . . . 118
Adrenal Gland Disorders . . . . . . . 119
Key Concepts . . . . . . . . 123
Key Terms . . . . . . . . 123
Diagnostics . . . . . . . . 124
Pharmacological Agents Used to Treat Clients with Endocrine Disorders. 124
Apply Your Knowledge . . . . . . . 128
Exam Questions . . . . . . . . 128
Answers to Exam Questions . . . . . . 130
Suggested Reading and Resources. . . . . . 131
Chapter 5: Care of the Client with Respiratory Disorders. . . . . . 133
Noninfectious Disorders of the Lower Respiratory Tract . . . . 133
Chronic Bronchitis. . . . . . . 133
Emphysema. . . . . . . . 134
Asthma. . . . . . . . . 135
Pleurisy . . . . . . . . 137
Pulmonary Hypertension . . . . . . . 138
Interstitial Pulmonary Disease . . . . . . 139
Sarcoidosis. . . . . . . . 139
Pulmonary Fibrosis . . . . . . . 140
Occupational Pulmonary Disease . . . . . . 140
Infectious Disorders of the Lower Respiratory Tract. . . . 142
Pneumonia . . . . . . . . 142
Tuberculosis . . . . . . . . 145
Influenza . . . . . . . . 147
Life-Threatening Pulmonary Disorders. . . . . . 148
Acute Respiratory Distress Syndrome. . . . . 148
Pulmonary Embolus . . . . . . . 152
Pneumothorax . . . . . . . . 154
Hemothorax . . . . . . . . 155
Emerging Infections . . . . . . . . 158
SARS . . . . . . . . . 158
Legionnaires’ Disease . . . . . . . 159
Key Concepts . . . . . . . . 161
Key Terms . . . . . . . . 161
Diagnostic Tests . . . . . . . . 161
Pharmacological Agents Used in the Care of the Client with Disorders of the Respiratory System . . . . . . . 162
Apply Your Knowledge . . . . . . . 165
Exam Questions . . . . . . . . 166
Answers to Exam Questions . . . . . . 168
Suggested Reading and Resources. . . . . . 169
Chapter 6: Care of the Client with Genitourinary Disorders . . . . . . 171
Renal Disorders . . . . . . . . 172
Acute Glomerulonephritis . . . . . . 172
Chronic Glomerulonephritis . . . . . . 173
Goodpasture’s Syndrome . . . . . . . 174
Nephrotic Syndrome . . . . . . . 175
Polycystic Kidney Disease . . . . . . 176
Hydronephrosis/Hydroureteronephrosis . . . . . 177
Pyelonephritis. . . . . . . . 178
Acute and Chronic Renal Failure . . . . . . 179
Chronic Renal Failure . . . . . . . 180
Peritoneal Dialysis . . . . . . . 181
Hemodialysis. . . . . . . . 182
Continuous Renal Replacement Therapy. . . . . 183
Renal Transplantation . . . . . . . 184
Urinary Disorders . . . . . . . . 185
Cystitis. . . . . . . . . 185
Urinary Incontinence . . . . . . . 187
Urolithiasis . . . . . . . . 188
Genitourinary Disorders. . . . . . . 189
Prostatitis . . . . . . . . 190
Benign Prostatic Hypertrophy . . . . . . 190
Erectile Dysfunction . . . . . . . 191
Epididymitis . . . . . . . . 193
Priapism. . . . . . . . 193
Key Concepts . . . . . . . . 195
Key Terms . . . . . . . . 195
Diagnostics . . . . . . . . 195
Pharmacologic Agents for the Client with Genitourinary Disorders. . 196
Apply Your Knowledge . . . . . . . 200
Exam Questions . . . . . . . . 200
Answers to Exam Questions . . . . . . 202
Suggested Reading and Resources. . . . . . 203
Chapter 7: Care of the Client with Integumentary Disorders . . . . . . 205
Common Infections of the Integumentary System . . . . . 205
Viral Infections . . . . . . . . 205
Fungal Infections . . . . . . . 207
Bacterial Infections . . . . . . . 208
Psoriasis. . . . . . . . . 208
Pressure Ulcers. . . . . . . . 209
Burns . . . . . . . . . 212
Burn Classifications . . . . . . . 213
Burn Measurement with TBSA . . . . . . 214
Nursing Care for Burn Victims . . . . . . 215
Key Concepts . . . . . . . . 223
Key Terms . . . . . . . . 223
Diagnostic Tests . . . . . . . . 223
Pharmacological Agents Used in the Care of the Client with Integumentary Disorders. . . . . . . . 224
Apply Your Knowledge . . . . . . . 226
Exam Questions . . . . . . . . 226
Answers to Exam Questions . . . . . . 228
Suggested Reading and Resources. . . . . . 229
Chapter 8: Care of the Client with Sensory Disorders. . . . . . 231
Disorders of the Eyes . . . . . . . . 231
Intraocular Disorders . . . . . . . 232
Uveitis . . . . . . . . . 236
Corneal Dystrophy and Corneal Transplantation . . . . 236
Retinal Disorders . . . . . . . 236
Refractive Errors . . . . . . . 239
Traumatic Injuries . . . . . . . 240
Ocular Melanoma . . . . . . . 240
Disorders of the Ears. . . . . . . . 242
Otitis Externa . . . . . . . . 243
Otitis Media . . . . . . . . 243
Mastoiditis. . . . . . . . 244
Ménière’s Disease. . . . . . . 244
Acoustic Neuroma . . . . . . . 245
Otosclerosis. . . . . . . . 245
Presbycusis . . . . . . . . 246
Ear Trauma . . . . . . . . 246
Assisting Clients with Hearing Loss . . . . . 247
Key Concepts . . . . . . . . 250
Key Terms . . . . . . . . 250
Diagnostic Tests . . . . . . . . 251
Pharmacological Agents Used in the Care of the Client with Disorders of the Eyes and Ears . . . . . . . . 251
Apply Your Knowledge . . . . . . . 253
Exam Questions . . . . . . . . 253
Answers to Exam Questions . . . . . . 255
Suggested Reading and Resources. . . . . . 256
Chapter 9: Care of the Client with Gastrointestinal Disorders . . . . . 257
Peptic Ulcer Disease . . . . . . . . 258
Types of Ulcers. . . . . . . . 259
Diagnosis of Ulcers . . . . . . . 259
Treatment of Ulcers. . . . . . . 260
Inflammatory Bowel Disorders . . . . . . . 263
Crohn’s Disease . . . . . . . . 263
Ulcerative Colitis . . . . . . . 263
Management of the Client with Inflammatory Bowel Disease . . . 264
Diverticular Disease. . . . . . . . 265
Management of the Client with Diverticulitis . . . . 265
Hemorrhoids . . . . . . . . 266
Appendicitis . . . . . . . . . 266
Peritonitis . . . . . . . . . 268
Intestinal Obstruction . . . . . . . . 269
Esophageal Disorders . . . . . . . . 270
GERD . . . . . . . . . 270
Hiatal Hernia . . . . . . . . 274
Diseases Associated with the Liver . . . . . . 275
Hepatitis . . . . . . . . 275
Cirrhosis . . . . . . . . 281
Acute Pancreatitis . . . . . . . . 285
Diagnosis of Pancreatitis. . . . . . . 286
Treatment of Pancreatitis . . . . . . . 286
Cholecystitis/Cholelithiasis . . . . . . . 287
Symptoms of Cholecystitis and Cholelithiasis . . . . 288
Diagnosis of Cholecystitis/Cholelithiasis . . . . . 288
Treatment of Cholecystitis . . . . . . 289
Treatment of Cholethiasis. . . . . . . 289
Clostridium Difficile . . . . . . . . 290
Food-Borne Illnesses. . . . . . . . 291
Key Concepts . . . . . . . . 294
Key Terms . . . . . . . . 294
Diagnostic Tests . . . . . . . . 295
Pharmacological Agents Used in the Care of the Client with Disorders of the Gastrointestinal System . . . . . . . 295
Apply Your Knowledge . . . . . . . 297
Exam Questions . . . . . . . . 298
Answers to Exam Questions . . . . . . 300
Suggested Reading and Resources. . . . . . 301
Chapter 10: Care of the Client with Hematological Disorders . . . . . . 303
Anemia. . . . . . . . . 303
Pernicious Anemia . . . . . . . 304
Aplastic Anemia . . . . . . . . 304
Sickle Cell Anemia. . . . . . . 305
Iron Deficiency Anemia . . . . . . . 309
Thalassemia . . . . . . . . . 311
Polycythemia Vera . . . . . . . . 312
Hemophilia . . . . . . . . . 313
Transfusion Therapy . . . . . . . . 315
Transfusion Reactions . . . . . . . 317
Key Concepts . . . . . . . . 319
Key Terms . . . . . . . . 319
Diagnostic Tests for Review . . . . . . 319
Pharmacological Agents Used in Hematological Disorders . . . 320
Apply Your Knowledge . . . . . . . 321
Exam Questions . . . . . . . . 321
Answers to Exam Questions . . . . . . 323
Suggested Reading and Resources. . . . . . 324
Chapter 11:Care of the Client with Disorders of the Neurological System. . . . 325
Neurological Assessment . . . . . . . 326
Cranial Nerve Assessment . . . . . . 326
Glasgow Coma Scale . . . . . . . 327
Intracranial Pressure Monitors. . . . . . 328
Brain Injuries . . . . . . . . 329
Epidural Hematomas. . . . . . . 332
Subdural Hematoma . . . . . . . 332
Intracerebral Hematomas . . . . . . . 332
Treatment of Hematomas . . . . . . . 332
Increased Intracranial Pressure . . . . . . 332
Brain Tumors . . . . . . . . 336
Treatment of Brain Tumors . . . . . . 337
Care of the Client with Intracranial Surgery (Craniotomy) . . . . 338
Cerebrovascular Accident/Stroke . . . . . . 342
Ischemic Stroke . . . . . . . . 342
Hemorrhagic Stroke . . . . . . . 344
Seizures . . . . . . . . . 347
Types of Seizures . . . . . . . 347
Treatment of Seizure Clients . . . . . . 350
Parkinson’s Disease . . . . . . . . 350
Meningitis . . . . . . . . . 352
Autoimmune Neurological Disorders. . . . . . 354
Multiple Sclerosis. . . . . . . 354
Myasthenia Gravis . . . . . . . 355
Guillain-Barré. . . . . . . . 357
Degenerative Neurological Disorders . . . . . . 358
Cranial Nerve Disorders. . . . . . . 359
Trigeminal Neuralgia . . . . . . . 359
Bell’s Palsy. . . . . . . . 359
Spinal Cord Injuries . . . . . . . . 360
Treatment of Spinal Cord Injuries. . . . . . 361
Potential Complications with SCI Clients . . . . . 362
Intervertebral Disk Disease . . . . . . . 363
Key Concepts . . . . . . . . 366
Key Terms . . . . . . . . 366
Diagnostics . . . . . . . . 367
Pharmacological Agents Used in the Care of Clients with Neurological Disorders. . . . . . . . 368
Apply Your Knowledge . . . . . . . 373
Exam Questions . . . . . . . . 373
Answers to Exam Questions . . . . . . 376
Suggested Reading and Resources. . . . . . 377
Chapter 12: Care of the Client with Immunologic Disorders . . . . . . 379
Immunodeficiency Syndrome . . . . . . . 380
Diagnoses . . . . . . . . . 381
HIV Prevention . . . . . . . . 383
Standard Precautions. . . . . . . 383
Airborne Transmission–Based Precautions (Second Tier of CDC Guidelines for Infection Control) . . . . . . . 384
Droplet Transmission–Based Precautions (Second Tier of CDC Guidelines for Infection Control) . . . . . . . 384
Contact Transmission–Based Precautions (Second Tier of CDC Guidelines for Infection Control) . . . . . . . 385
Treatments After Occupational Exposure. . . . . 385
Management of the Client with HIV . . . . . . 385
Key Concepts . . . . . . . . 389
Key Terms . . . . . . . . 389
Diagnostic Tests . . . . . . . . 389
Pharmacological Agents Used in the Care of the Client with Immunologic Disorders. . . . . . . . 390
Apply Your Knowledge . . . . . . . 393
Exam Questions . . . . . . . . 394
Answers to Exam Questions . . . . . . 396
Suggested Reading and Resources. . . . . . 397
Chapter 13: Care of the Client with Neoplastic Disorders . . . . . . 399
American Cancer Society’s Seven Warning Signs of Cancer. . . . 399
The Four Major Categories of Cancer. . . . . . 400
Risk Factors for Specific Cancers . . . . . . 400
Cancer Prevention . . . . . . . . 402
Major Types of Cancer . . . . . . . 403
Colorectal Cancer . . . . . . . 403
Lung Cancer. . . . . . . . 407
Prostate Cancer . . . . . . . . 409
Breast Cancer . . . . . . . . 411
Other Major Cancers. . . . . . . 416
General Interventions for Clients with Cancer . . . . . 421
Radiation . . . . . . . . 421
Chemotherapy . . . . . . . . 423
Total Parenteral Nutrition . . . . . . 424
Neoplastic-Associated Disorders and Emergencies . . . . 426
Bone Marrow and Peripheral Stem Cell Transplantation . . . . 427
Types of Transplants . . . . . . . 428
Nursing Care After Transplantation . . . . . 428
Key Concepts . . . . . . . . 431
Key Terms . . . . . . . . 431
Diagnostic Tests . . . . . . . . 432
Pharmacologic Agents Used in the Care of the Client with Specific Neoplastic Disorders. . . . . . . . 433
Apply Your Knowledge . . . . . . . 440
Exam Questions . . . . . . . . 440
Answers to Exam Questions . . . . . . 443
Suggested Reading and Resources. . . . . . 445
Chapter 14: Care of the Client with Musculoskeletal and Connective Tissue Disorders . . . 447
Fractures . . . . . . . . . 448
Major Fracture Sites . . . . . . . 450
General Treatment for Fractures. . . . . . 450
Common Complications Associated with Fractures . . . . 454
Osteoporosis . . . . . . . . . 457
Osteoarthritis . . . . . . . . 458
Diagnosis of Osteoarthritis. . . . . . 459
Treatment of the Client with Osteoarthritis . . . . . 459
Fibromyalgia. . . . . . . . . 460
Ankylosing Spondylitis . . . . . . . 460
Gout. . . . . . . . . 461
Rheumatoid Arthritis. . . . . . . . 462
Lupus Erythematosus . . . . . . . . 464
Musculoskeletal Surgical Procedures . . . . . . 466
Fractured Hip and Hip Replacement . . . . . 466
Total Knee Replacement. . . . . . . 467
Amputations . . . . . . . . 468
Key Concepts . . . . . . . . 474
Key Terms . . . . . . . . 474
Diagnostics . . . . . . . . 474
Pharmacologic Agents Used in Musculoskeletal and Connective Tissue Disorders. . . . . . . . 475
Apply Your Knowledge . . . . . . . 479
Exam Questions . . . . . . . . 479
Answers to Exam Questions . . . . . . 481
Suggested Reading and Resources. . . . . . 482
Chapter 15: Care of the Childbearing Client and the Neonatal Client . . . . . 483
Prenatal Care . . . . . . . . 483
Signs of Pregnancy. . . . . . . 483
Prenatal Diet and Weight Maintenance . . . . . 484
Measuring Fetal Heart Tones. . . . . . 486
Measuring Fundal Height. . . . . . . 486
Prelabor Testing . . . . . . . . 486
Intrapartal Care . . . . . . . . 488
Stages of Labor. . . . . . . . 489
Important Terms You Should Know . . . . . 489
Complications Associated with Pregnancy. . . . . 490
Cardiac Disease During Pregnancy. . . . . . 490
Diabetes in Pregnancy. . . . . . . 493
Preeclampsia . . . . . . . . 494
Ectopic Pregnancy . . . . . . . 495
Hydatidiform Mole . . . . . . . 495
Incompetent Cervix . . . . . . . 496
Types of Abortions. . . . . . . 496
Placenta Previa . . . . . . . . 497
Abruptio Placenta. . . . . . . 497
Complications Associated with Labor and Delivery . . . . 498
Fetal Malpresentation . . . . . . . 499
Post-term Labor and Birth . . . . . . 499
Precipitate Delivery . . . . . . . 500
Cord Prolapse. . . . . . . . 500
Cesarean Birth . . . . . . . . 500
Assisted Birth . . . . . . . . 501
Fetal Monitoring . . . . . . . 501
Pharmacologic Management of Labor . . . . . . 503
Postpartum Care . . . . . . . . 504
Newborn Care . . . . . . . . 505
Terms Associated with the Normal Newborn . . . . 506
Rh Incompatibility . . . . . . . 507
Women’s Health Issues . . . . . . . 508
Pelvic Inflammatory Disease . . . . . . 508
Menopause . . . . . . . . 508
Maternal Infections . . . . . . . 508
Methods of Contraception . . . . . . 511
Key Concepts . . . . . . . . 514
Key Terms . . . . . . . . 514
Diagnostic Tests . . . . . . . . 515
Pharmacological Agents Used in the Care of the Obstetric Client . . 516
Apply Your Knowledge . . . . . . . 517
Exam Questions . . . . . . . . 518
Answers to Exam Questions . . . . . . 520
Suggested Reading and Resources. . . . . . 521
Chapter 16: Care of the Pediatric Client . . . . . . . . 523
Growth and Development . . . . . . . 523
Infant (28 Days to 1 Year). . . . . . . 523
Toddler (1–3 Years) . . . . . . . 524
Preschooler (3–5 Years) . . . . . . . 525
School Age (6–12 Years) . . . . . . . 527
Adolescence (12–18 Years) . . . . . . 527
Caring for the Child with Respiratory Disorders . . . . . 528
Upper Airway Infections. . . . . . . 529
Lower Airway Infections. . . . . . . 533
Long-Term Respiratory Disorders . . . . . . 535
Cystic Fibrosis (Mucoviscidosis) . . . . . . 536
Caring for the Child with Gastrointestinal Disorders . . . . 537
Disorders of Motility. . . . . . . 538
Structural Defects . . . . . . . 540
Obstructive Disorders . . . . . . . 542
Inflammatory and Parasitic Disorders. . . . . 544
Malabsorptive/Metabolic Syndromes . . . . . 545
Ingestion of Hazardous Substances . . . . . . 547
Caring for the Child with Cardiovascular Disorders . . . . 549
Congenital Heart Defects. . . . . . . 550
Acquired Heart Disease. . . . . . . 557
Caring for the Child with Genitourinary Disorders. . . . 560
Obstructive Uropathy . . . . . . . 561
External Defects (Hypospadias, Epispadias, Exstrophy of the Bladder). . 561
Epispadias/Exstrophy of the Bladder . . . . . 562
Caring for the Child with Neoplastic Disorders. . . . . 563
Leukemia. . . . . . . . 563
Wilms’ Tumor (Nephroblastoma) . . . . . . 563
Retinoblastoma. . . . . . . . 564
Neuroblastoma . . . . . . . . 564
Osteosarcoma and Ewing’s Sarcoma . . . . . 564
Rhabdomyosarcoma. . . . . . . 565
Surviving Childhood Cancer . . . . . . 565
Caring for the Child with Cerebral Disorders . . . . . 566
Intracranial Infections (Encephalitis and Bacterial Meningitis) . . . 566
Reye’s Syndrome . . . . . . . 567
Caring for the Child with Integumentary Disorders . . . . 568
Eczema (Atopic Dermatitis) . . . . . . 568
Scabies . . . . . . . . . 569
Pediculosis Capitis (Head Lice) . . . . . . 569
Lyme Disease . . . . . . . . 570
Rocky Mountain Spotted Fever . . . . . . 570
Caring for the Child with Communicable Disease. . . . . 571
Caring for the Child with Musculoskeletal Disorders . . . . 573
Congenital Clubfoot . . . . . . . 573
Developmental Hip Dysplasia . . . . . . 573
Osteogenesis Imperfecta . . . . . . . 574
Legg-Calvé-Perthes Disease (Coxa Plana) . . . . . 575
Scoliosis . . . . . . . . 576
Juvenile Rheumatoid Arthritis (Juvenile Idiopathic Arthritis) . . . 576
Caring for the Child with Neuromuscular Disorders . . . . 577
Cerebral Palsy. . . . . . . . 577
Neural Tube Defects . . . . . . . 578
Spina Bifida. . . . . . . . 578
Muscular Dystrophies . . . . . . . 579
Caring for the Abused and Neglected Child . . . . . 580
Key Concepts . . . . . . . . 583
Key Terms . . . . . . . . 583
Diagnostics . . . . . . . . 584
Pharmacological Agents Used in the Care of Pediatric Clients . . . 584
Apply Your Knowledge . . . . . . . 584
Exam Questions . . . . . . . . 585
Answers to Exam Questions . . . . . . 587
Suggested Reading and Resources. . . . . . 588
Chapter 17: Care of the Client with Psychiatric Disorders . . . . . . 589
Anxiety-related Disorders. . . . . . . 589
Generalized Anxiety Disorder . . . . . . 590
Post-traumatic Stress Disorder . . . . . . 590
Dissociative Identity Disorder . . . . . . 591
Somatoform Disorder . . . . . . . 591
Panic Disorder . . . . . . . . 591
Phobic Disorders . . . . . . . 592
Obsessive-compulsive Disorder . . . . . . 592
Personality Disorders . . . . . . . . 593
Cluster A . . . . . . . . 593
Cluster B . . . . . . . . 594
Cluster C. . . . . . . . 595
Managing Clients with Personality Disorders . . . . 596
Psychotic Disorders. . . . . . . . 597
Schizophrenia . . . . . . . . 597
Bipolar Disorders . . . . . . . 599
Substance Abuse. . . . . . . . 602
Alcoholism . . . . . . . . 602
Chemical Dependence. . . . . . . 604
Psychological Disorders of Childhood and Adolescence . . . . 606
Autistic Disorder . . . . . . . 607
Conduct Disorder . . . . . . . 607
Oppositional Defiant Disorder . . . . . . 608
Attention Deficit Hyperactive Disorder . . . . . 608
Eating Disorders . . . . . . . 608
Key Concepts . . . . . . . . 611
Key Terms . . . . . . . . 611
Diagnostics . . . . . . . . 612
Pharmacological Agents Used in the Care of the Client with Psychiatric Disorders. . . . . . . . 612
Apply Your Knowledge . . . . . . . 617
Exam Questions . . . . . . . . 618
Answers to Exam Questions . . . . . . 620
Suggested Reading and Resources. . . . . . 621
Chapter 18: Emergency Care. . . . . . . . . 623
The ABCDs of Emergency Care. . . . . . 624
Airway . . . . . . . . . 624
Breathing. . . . . . . . 625
Circulation . . . . . . . . 625
Deficits . . . . . . . . 626
Obtaining Client Information . . . . . . 627
Trauma . . . . . . . . . 627
Head Injuries . . . . . . . . 627
Chest Injuries . . . . . . . . 628
Abdominal Injuries. . . . . . . 628
Documenting and Protecting Forensic Evidence . . . . 629
Poisoning . . . . . . . . . 630
Poisonous Stings and Bites . . . . . . . 631
Bioterrorism . . . . . . . . . 632
Chemical and Biological Agents . . . . . . 632
Nuclear Warfare. . . . . . . . 634
Triage Categories for Disaster Victims . . . . . 635
Key Concepts . . . . . . . . 637
Key Terms . . . . . . . . 637
Diagnostics . . . . . . . . 637
Pharmacological Agents Commonly Used in ER Treatment . . . 637
Apply Your Knowledge . . . . . . . 638
Exam Questions . . . . . . . . 638
Answers to Exam Questions . . . . . . 640
Suggested Reading and Resources. . . . . . 641
Chapter 19: Legal Issues in Nursing Practice . . . . . . . 643
Types of Laws. . . . . . . . 644
Statutory Laws/Regulatory Laws. . . . . . 644
Civil Laws . . . . . . . . 644
Criminal Laws . . . . . . . . 644
Common Law. . . . . . . . 644
Code of Ethical Behavior in Nursing Practice . . . . . 645
Legal Theories That Affect Nursing Practice . . . . . 646
Negligence . . . . . . . . 647
Malpractice . . . . . . . . 647
Witnessing Consent for Care. . . . . . 647
Tort . . . . . . . . . 647
Assault and Battery . . . . . . . 648
Fraud . . . . . . . . . 648
Managing Client Care. . . . . . . . 648
Key Terms. . . . . . . . . 652
Apply Your Knowledge . . . . . . . 652
Exam Questions . . . . . . . . 653
Answers to Exam Questions . . . . . . 655
Suggested Reading and Resources. . . . . . 656
Chapter 20: Cultural Practices Influencing Nursing Care . . . . . . 657
Cultural Assessment. . . . . . . . 657
Understanding Client Beliefs . . . . . . 657
Working with Clients Who Speak Different Languages . . . 658
Healthcare of Hispanics/Latinos . . . . . . 659
Time Considerations . . . . . . . 660
Use of Nonverbal/Verbal Communication. . . . . 660
Childbirth and Pain Response . . . . . . 661
Healthcare of Native Americans and Alaskan Natives . . . . 661
Time Considerations . . . . . . . 661
Use of Nonverbal/Verbal Communication. . . . . 662
Childbirth and Pain Response . . . . . . 662
Healthcare of Asian-Americans . . . . . . . 662
Time Considerations . . . . . . . 663
Use of Nonverbal/Verbal Communication. . . . . 663
Childbirth and Pain Response . . . . . . 664
Healthcare of Arab-Americans. . . . . . . 664
Time Considerations . . . . . . . 665
Use of Nonverbal/Verbal Communication. . . . . 665
Childbirth and Pain Response . . . . . . 665
Nursing Plan Dietary Considerations Across Cultures . . . . 665
Religious Beliefs and Refusal of Care Considerations . . . . 667
Key Terms. . . . . . . . . 669
Apply Your Knowledge . . . . . . . 669
Exam Questions . . . . . . . . 669
Answers to Exam Questions . . . . . . 671
Suggested Reading and Resources. . . . . . 672
Part II: Final Review
Fast Facts The NCLEX RN Exam Prep . . . . . . . . 673
Practice Exam I . . . . . . . . . 681
Fluid and Electrolytes and Acid/Base Balance. . . . . 682
Care of the Client with Cardiovascular Disorders . . . . . 686
Care of the Client with Endocrine Disorders . . . . . 693
Care of the Client with Immunological Disorders . . . . . 700
Care of the Childbearing Client and the Neonatal Client . . . . 705
Practice Exam II. . . . . . . . . 717
Care of the Client with Respiratory Disorders . . . . . 718
Care of the Client with Genitourinary Disorders. . . . . 723
Care of the Client with Integumentary Disorders . . . . . 728
Care of the Client with Sensory Disorders . . . . . 731
Care of the Pediatric Client . . . . . . . 736
Care of the Client with Psychiatric Disorders. . . . . 744
Emergency Care. . . . . . . . 749
Practice Exam III . . . . . . . . . 753
Care of the Client with Musculoskeletal and Connective Tissue Disorders . . 754
Care of the Client with Gastrointestinal Disorders . . . . 760
Care of the Client with Neoplastic Disorders . . . . . 767
Care of the Client with Neurological Disorders. . . . . 777
Care of the Client with Hematological Disorders . . . . . 786
Practice Exam IV Management and Alternative Item Exam Questions. . . . . 791
Management Questions . . . . . . . 792
Alternative Items . . . . . . . . 808
Answers to Practice Exam I . . . . . . . . 819
Answers at a Glance to Practice Exam I . . . . . . 819
Answers with Explanations . . . . . . . 821
Fluid and Electrolytes and Acid/Base Balance . . . . 821
Care of the Client with Cardiovascular Disorders . . . . 823
Care of the Client with Endocrine Disorders . . . . 828
Care of the Client with Immunologic Disorders. . . . 832
Care of the Childbearing Client and the Neonatal Client. . . 835
Answers to Practice Exam II . . . . . . . . 843
Answers at a Glance to Practice Exam II . . . . . . 843
Answers with Explanations . . . . . . . 845
Care of the Client with Respiratory Disorders . . . . 845
Care of the Client with Genitourinary Disorders . . . . 848
Care of the Client with Integumentary Disorders . . . . 851
Care of the Client with Sensory Disorders . . . . . 853
Care of the Pediatric Client . . . . . . 855
Care of the Client with Psychiatric Disorders. . . . 859
Emergency Care. . . . . . . . 862
Answers to Practice Exam III . . . . . . . . 865
Answers at a Glance to Practice Exam III . . . . . 865
Answers with Explanations . . . . . . . 867
Care of the Client with Musculoskeletal and Connective Tissue Disorders . 867
Care of the Client with Gastrointestinal Disorders . . . . 870
Care of the Client with Neoplastic Disorders . . . . 873
Care of the Client with Neurological Disorders . . . . 878
Care of the Client with Hematological Disorders . . . . 883
Answers to Practice Exam IV: Management and Alternative Item Exam Questions. . . . . 885
Answers to Management Questions . . . . . . 885
Alternative Item Answers . . . . . . . 894
Part III: Appendixes
Appendix A: Things You Forgot . . . . . . . . . 899
Appendix B: Need to Know More?. . . . . . . . 905
Appendix C: Calculations . . . . . . . . . 911
Appendix D: Most Commonly-Prescribed Medications in the United States . . . . 915
TOC, 9780789751065, 11/21/2013
Wilda Rinehart received an associate’s degree in nursing from Northeast Mississippi Community College in Booneville, Mississippi. After working as a staff nurse and charge nurse, she became a public health nurse and served in that capacity for a number of years. In 1975, she received her nurse practitioner certification in the area of obstetrics-gynecology from the University of Mississippi Medical Center in Jackson, Mississippi. In 1979, she completed her bachelor of science degree in nursing from Mississippi University for Women. In 1980, she completed her master of science degree in nursing from the same university and accepted a faculty position at Northeast Mississippi Community College, where she taught medical-surgical nursing and maternal-newborn nursing. In 1982, she founded Rinehart and Associates Nursing Consultants. For the past 28 years, she and her associates have worked with nursing graduates and schools of nursing to help graduates pass the National Council Licensure Exam for Nursing. She has also worked as a curriculum consultant with faculty to improve test construction. Ms. Rinehart has served as a convention speaker throughout the southeastern United States and as a reviewer of medical-surgical and obstetric texts. She has coauthored materials used in seminars presented by Rinehart and Associates Nursing Review. As the president of Rinehart and Associates, she serves as the coordinator of a company dedicated to improving the quality of health through nursing education.
Dr. Diann Sloan received an associate’s degree in nursing from Northeast Mississippi Community College, a bachelor of science degree in nursing from the University of Mississippi, and a master of science degree in nursing from Mississippi University for Women. In addition to her nursing degrees, she holds a master of science in counseling psychology from Georgia State University and a doctor of philosophy in counselor education, with minors in both psychology and educational psychology, from Mississippi State University. She has completed additional graduate studies in healthcare administration at Western New England College and the University of Mississippi. Dr. Sloan has taught pediatric nursing, psychiatric mental health nursing, and medical surgical nursing in both associate degree and baccalaureate nursing programs. As a member of Rinehart and Associates Nursing Review, Dr. Sloan has conducted test construction workshops for faculty and nursing review seminars for both registered and practical nurse graduates. She has coauthored materials used in the item-writing workshops for nursing faculty and Rinehart and Associates Nursing Review. She is a member of Sigma Theta Tau nursing honor society.
Clara Hurd received an associate’s degree in nursing from Northeast Mississippi Community College in Booneville, Mississippi (1975). Her experiences in nursing are clinically based, having served as a staff nurse in medical-surgical nursing. She has worked as an oncology, intensive care, orthopedic, neurological, and pediatric nurse. She received her bachelor of science degree in nursing from the University of North Alabama in Florence, Alabama, and her master of science degree in nursing from the Mississippi University for Women in Columbus, Mississippi. Ms. Hurd is a certified nurse educator. She currently serves as a nurse educator consultant and an independent contractor and has taught in both associate degree and baccalaureate degree nursing programs. She was a faculty member of Mississippi University for Women; Austin Peay State University in Clarksville, Tennessee; Tennessee State University in Nashville; and Northeast Mississippi Community College. Ms. Hurd joined Rinehart and Associates in 1993. She has worked with students in preparing for the National Council Licensure Exam and with faculty as a consultant in writing test items. Ms. Hurd has also been a presenter at nursing conventions on various topics, including itemwriting for nursing faculty. Her primary professional goal is to prepare the student and graduate for excellence in the delivery of healthcare.
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