Mark Klimek Blue Book (ALL) NCLEX Study Guide

If the pH and the BiCarb are both in the same direction 

then it is? 

Metabolic 

If the pH is up it is? 

Alkalosis 

If the pH is down it is? 

Acidosis 

As the pH goes so goes my patient except for? 

Potassium 

If the pH is UP my patient will show signs and symptoms 

of...? 

Increase... like tachycardia,diarrhea and borborygmi 

If the pH is down my patient will show signs and symtoms 

of? 

Decrease... like decreased output, bradycardia and 

constipation 

If my pH is up my potassium (K+) is ? 

Down 

If my pH is down my potassium (K+) is? 

Up 

If my patient is overventilating I should choose? 

Respiratory Alkalosis 

If my patient is underventilating I should choose? 

Respiratory Acidosis 

If my patient has prolonged gastric vomiting or suction I 

choose? 

Metabolic Alkalosis 

If it is not lung or prolonged vomiting or suctioning I 

choose? 

Metabolic Acidosis 

High pressure alarms are triggered when? 

They cannot push air in 

High pressure alarms are caused by what three types of 

obstructions? 

Kinking, Water in dependant loops and mucus in the airway. 

If kinking in the tube is present you? 

Unkink 

If water is present in the dependant loops you? 

Open system and empty water. 

If mucus is present you? 

Turn them, cough and have them deeo breath first. If 

ineffective you then suction. 

Low pressure alarms are triggered when? 

It is too easy to push air in. 

Low pressure alarms are normally caused by? 

Disconnection 

If the tubing is disconnected you? 

Reconnect 

If O2 sensor line is disconnected you? 

Reconnect 

In a vented client respiratory alkalosis means the vent 

setting may be too? 

High 

In a vented client respiratory acidosis means the vent may 

be too? 

Low 

What do you do if the patients disconnected tube is on the 

floor? 

Bag them, (call for help) get new tube and then reconnect. 

What do you do if the patients disconnected tube is on the 

chest? 

Reconnect ... if its above the waist its ok. 

What is the biggest problem in abuse? 

Denial 

applicable to all forms of abuse

To treat denial you need to? 

Confront 

How do you confront? 

Point out the difference between what they say and what 

they do. 

What is the one circumstance that you as a nurse would 

support denial? 

Loss and Grief 

What is dependency? 

When the abuser gets a significant other to make decisions 

for them or do thing for them. 

the abuser is dependent

What is codependency? 

When the significant other gets positive self esteem from 

doing things or making decisions for an abuser. 

To treat dependency/codependency you? 

Set limits and enforce them. You also need to work or the self 

estreem of the codependent. 

What is manipulation? 

When the abuser gets the significant other fo do things for 

them that is not in the best interest of the significant other. 

This can be dangerous and harmful to the significant other. 

How do you treat manipulation? 

Set limits and enforce. 

Why is manipulation easier to treat then 

dependency/codependency? 

Because no one likes being manipulated. 

What is Wernickes (Korsakoffs) Syndrome? 

Psychosis induced by vitamin B1 (Thiamine) deficiency. 

Vitamin B1 helps breakdown? 

Alcohol 

Primary symptom of Wernickes? 

Amnesia with confabulation (making up stories). 

Is Wernickes preventable? 

Yes 

Is Wernickes arrestable? 

Yes 

Is Wernickes reversible? 

No 

What is aversion therapy? 

When you try and make the patient hate something. 

Antabuse onset and duration is? 

2 weeks 

Teach a patient taking Antabuse to avoid what? 

Alochol 

On top of alcohol a patient taking Antabuse should also 

avoid what other 7 things? 

Elixirs, Vanilla Extract, Aftershave/Perfumes, Alcohol based

hand sanitizer, Insect repellant, Mouthwash and Vinagerette. 

What are the five uppers? 

Caffeine, Cocaine, Methamphetamines, PCP/LSD and ADHD 

Meds 

Downers are? 

Everything other then the five uppers. 

S/S of upper use? 

Everything goes up...Tachycardia, increased BP etc. 

S/S of downer use? 

Everything goes down...Bradycardia, decreased BP etc. 

Overdose of a downer causes everything to go? 

Down 

Overdose of an upper causes everything to go? 

Up 

Withdrawal of an upper causes everything to go? 

Down 

Withdrawal of a downer causes everything to go? 

Up 

At birth if the mother was addicted to a substance always 

assume the newborn is in? 

Intoxication 

If 24 hours after birth assume the baby is in? 

Withdrawal 

Every alcoholic goes through what withing 24 hours after 

cessation? 

Withdrawal syndrome 

After 72 hours of alochol withdrawal a small minority may 

get? 

Delirium Tremens 

Can Delirium Tremens kill you? 

Yes 

Can Alcohol Withdrawal Syndrome kill you? 

No 

Are patients with Alcohol Withdrawal Syndrome a danger to

themselves or others? 

No 

Are patients with Delirium Tremens a danger to themselves 

or others? 

Yes 

N/I for Delirium Tremens? 

Private room near nurses station, NPO/Clear liquids, 

Restricted bed rest, restraints, tranquilizer, multivitamin (B1 

vit.) and antihypertensive. 

N/I for Alcohol Withdrawal Syndrome? 

Semi-private room anywhere, regular diet, up and ad-lib, no 

restraint, tranquilizer, multivitamin (B1) and 

antihypertensive. 

A two point restraint is? 

One arm and the opposite leg. 

N/I for restraints? 

Check Q15min. and rotate sites Q2H 

All aminoglycosides end in? 

"mycin" Vancomycin 

If it has "thro" in it you? 

Throw it out...Zithromycin 

Toxic effects of aminoglycosides? 

Ototoxicity, nephrotoxicity and cranial nerve 8 

(vestibulocochlear nerve) which senses sound.