RN Comprehensive Predictor Study Guide (2024–2025) Complete Exam Questions with Answers | Exams Health sciences | Docsity (2025)

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RN Comprehensive Predictor Study

Guide

Testing for TB ---CORRECT ANSWER--- A Mantoux skin test is the most accurate and valuable screening tool available for TB. A positive result means only that the client has been exposed to TB; it does not meant that the client has active TB. Testing for TB continue ---CORRECT ANSWER--- A sputum culture for acid fast bacillus (AFB) is used to confirm the diagnosis of pulmonary TB after a screening test and chest x-ray come back positive. Teaching instructions for the use of a cane: ---CORRECT ANSWER--(1) The cane is moved forward about 12 inches. (2) Then, the weak leg is moved even with the cane. (3) Finally, the strong leg is brought forward and ahead of the cane and weak leg.

• Cane is held on stronger side.
• The gripper of the cane should be level with the trochanter of the femur. Meningococcal vaccine ---CORRECT ANSWER--- Recommended that this vaccine be given to children who are 11 through 12 years of age and then given a booster dose at age 16. When should the single dose of Herpes zoster vaccine be given? ---CORRECT ANSWER--- To adults 60 years or older whether or not they report a previous episode of herpes zoster. Rotavirus should be given at what age? ---CORRECT ANSWER--- During the child's first year of life. Alendronate (Fosamax) ---CORRECT ANSWER--- This medication is used to prevent and treat postmenopausal osteoporosis and Paget's Disease.
• Alendronate-taken in morning on an empty stomach.
• The patient must be instructed to wait at least 30 minutes after taking Alendronate before eating, drinking, or taking other medications.

What to expect with a patient having a chest tube? ---CORRECT ANSWER--- Continuous gentle bubbling in the suction control chamber.

• Crepitus (with a pneumothorax, this will persist for several hours depending)
• Oscillations-tidaling in the water seal chamber upon respiration are expected. What is a potential complication of a thyroidectomy? ---CORRECT ANSWER--- Hypocalcemia: numbness and tingling in the hands, soles of the feet and around the lips. What is Chvostek's sign? And how is it done? ---CORRECT ANSWER--Tap on the pt's face at a point just anterior to the ear and just below the zygomatic bone. A positive response would be twitching of the ipsilateral (same side only) facial muscles, suggestive of neuromuscular excitability caused by hypocalcemia. Brudzinski's sign ---CORRECT ANSWER--- Is an indication of meningeal irritation, which may be positive in patient's with meningitis.
• To perform this, the client needs to be supine. The nurse: - places one hand behind patient's head.
• places the other hand on the client's chest. Kernig's sign ---CORRECT ANSWER--- Is an indication of meningeal irritation. The maneuver is usually performed with the client supine with hips and knees in flexion. Extension of the knees is attempted and the inability to extend the clients knee beyond 135 degrees w/out causing pain constitutes a positive test. Babinski sign ---CORRECT ANSWER--- This is used to test for brain damage or upper motor neuron damage. It is considered positive if the toes flare up upon stroking the plantar aspect of the foot. Cataract surgery discharge instructions ---CORRECT ANSWER--- Do not lift anything heavier than 10lbs for at least one week
• Sleep on your back or unaffected side to lessen the pressure.
• Need to report any pain, decrease in vision or increase in discharge in the eye. Cataract continue ---CORRECT ANSWER--- It is normal to feel itching and mild discomfort after surgery, but the pt should be instructed not to rub or place pressure on the eye. Exposure or possible exposure to anthrax ---CORRECT ANSWER--- Administer an antibiotic prophylaxis to all pt's newly exposed Those exposed to anthrax do not require decontamination and are not considered contagious Botulism treatment ---CORRECT ANSWER--- Give an antitoxin

RAST testing ---CORRECT ANSWER--- Involves measuring the quantity of IgE present in the serum after exposure to specific antigens that are selected based on the pts symptom hx. An elevated IgE indicates a positive response to RAST testing and is seen in pts who have a hx of allergic manifestations, anaphylaxis and asthma. If clear drainage is coming out of a patient and you suspect that it could be CSF, first action is to? ---CORRECT ANSWER--- First, test it for glucose

• Second, notify doctor What is a complication that you should frequently assess if a patient is suspected of having diabetes insipidus? ---CORRECT ANSWER--- Hypotension A pt who has diabetes insipidus will continue to excrete urine even though there is no intake. Hypovolemia, with resulting hypotension is possible. Active TB treatment duration? ---CORRECT ANSWER--A 6-9 month regimen consisting of two meds is frequently used. Active TB is usually treated with the simultaneous administration of a combo of meds to which the organisms are susceptible. Such therapy is continued until the disease is controlled. Chlorpromazine (Thorazine) ---CORRECT ANSWER--Chlorpromazine is used to treat psychotic disorders such as:
• schizophrenia
• manic-depression
• severe behavioral problems in children ages 1 through 12 Chlorpromazine is also used to treat:
• nausea and vomiting
• anxiety before surgery
• chronic hiccups
• acute intermittent porphyria
• symptoms of tetanus Chlorpromazine continue. ---CORRECT ANSWER--- This medication can cause photo- phobic skin reactions and damage to the retina of the eye if exposed to direct sunlight. Patients taking this should be reminded to wear protective clothing, apply sunscreen and wear sunglasses when they are outside. Ileal conduit continue ---CORRECT ANSWER--The bag should be emptied approx. every 2 hours to prevent leakage, skin irritation and infection. Ileal conduit ---CORRECT ANSWER--- It is used to divert urine outside of the body when the urinary bladder has been removed. The conduit cannot store urine the way

the bladder did; therefore, urine will be flowing continuously and an appliance must be worn as a collection device. Manifestations of tardive dyskinesia ---CORRECT ANSWER--- Tongue thrusting and lip smacking

• Facial grimacing and eye blinking
• Repetitive involuntary movements Ulcerative Colitis ---CORRECT ANSWER--- Is a chronic, episodic, inflammatory disease of the large intestines and rectum characterized by bloody diarrhea.
• Maintaining fluids and electrolyte balance is one of the most important nursing goals. To assess for cyanosis in a patient with dark skin where is the most appropriate areas to assess for this? ---CORRECT ANSWER--- Examine body areas with the least melanin, such as the underarm, soles of the feet, conjunctiva and mucous membranes. Post operative tx of arthroscopy ---CORRECT ANSWER--- This is used to visualize, diagnose and treat problems inside a joint. Applying ice to the affected area in the immediate postop period reduces pain and swelling. Pt may be allowed to walk as tolerated, but joint used should be minimizes for the first few days to reduces pain and swelling. Patient with Gout ---CORRECT ANSWER--- Gout is a painful and potentially disabling form of arthritis that is caused by an excess of uric acid in the body.
• Pt should remain well hydrated (this will minimize uric acid stones)
• Should avoid foods high in purines Gout continue ---CORRECT ANSWER--- Should limit alcohol consumption (too much alcohol can inhibit excretion of uric acid, leading to its build up and causes an onset of gout.
• Pt's should not take aspirin and/or salicylates (this can interfere with uric acid excretion and may precipitate an acute onset. Colostrum ---CORRECT ANSWER--Colostrum is secreted from the mother's breasts during postpartum days 1 to 3. It contains the IgA immunoglobulin that provides passive immunity to the newborn. Breastfeeding schedule ---CORRECT ANSWER--- Newborns should be breastfed every 2 to 3 hr. Parents should awaken the newborn to feed at least every 3 hr during the day and at least every 4 hr during the night until the newborn is feeding well and gaining weight adequately. Breastfeeding should occur 8 to 12 times within a 24-hr window. Then, a feed-on-demand schedule may be followed. Breastfeeding continue ---CORRECT ANSWER--- Tell the mother how to tell if her newborn is receiving adequate feeding (gaining weight, voiding 6 to 8 diapers a day, and contentedness between feedings).

Addison's Disease Treatment: ---CORRECT ANSWER--- High protein, high carb diet

• Weigh daily
• Injectable IV fast acting steroid may be ordered or indicated for a patients experiencing an Addisonian crisis until the pt is no longer at risk for dehydration, hypotension and shock. SSRIs ---CORRECT ANSWER--- Citalopram (Celexa) an example of an SSRI
• Used to treat depression
• Can take 3-4 weeks before patients starts to experience signs of improvement and in some cases up to 8 weeks. Agoraphobia ---CORRECT ANSWER--- Fear of being in places in which help may not be available Pernicious anemia ---CORRECT ANSWER--- Caused by a lack of intrinsic factor, a substance needed to absorb Vit B12 from the GI tract.
• Often has a red beefy looking tongue
• Vit B12 is needed for the formation of RBCs. Iron deficiency Anemia ---CORRECT ANSWER--- Condition in which RBCs contain decreased hemoglobin Aplastic Anemia ---CORRECT ANSWER--- Caused by a failure of the bone marrow to produce sufficient number of RBC's. Hemolytic Anemia ---CORRECT ANSWER--- Erythrocyte destruction
• May be medication induced or caused by sickle cell disease, transfusion reaction, or kidney disease.
• Hematuria or hemoglobin present in the urine may indicate hemolytic anemia Benadryl can also be given to treat what? ---CORRECT ANSWER--- They also have an anticholinergic effect that can help control tremors in the early stages of Parkinson's. Haloperidol (Haldol) adverse effect? ---CORRECT ANSWER--Neuroleptic malignant syndrome:
• Manifestations of NMS are sudden onset of rigidity, tremors, stupor, incontinence, elevated serum enzymes, hyperkalemia, renal failure, elevated temp, hypertension, & tachycardia.

Isometrics ---CORRECT ANSWER--- Is a form of exercise involving static (no movement) contractions of a muscle w/out any movement of the joint. Isometrics may help to prevent muscle atrophy in pts who are on complete bedrest. EX: Instruct the pt to hold a muscle tight for approx. 5 seconds then relax Clozapine can cause? ---CORRECT ANSWER--- Agranulocytosis, therefore WBC count of < 3000 is contraindicated. Orlistat (Xenical) ---CORRECT ANSWER--- Is prescribed to morbidly obese pts to lose weight. It prevents absorption of some of the fat in the pts diet.

• The med should be taken 3 times/day within 1 hour of a meal
• Its a lipase inhibitor, not an appetite suppressor. Placenta previa ---CORRECT ANSWER--- Relaxed uterus
• Painless, vaginal bleeding
• Fundal height > expected gestation age Pre-Eclampsia ---CORRECT ANSWER--- Hyperactive deep-tendon reflexes 4+
• Hypertension Methycenedioxymethamphetamine (MDMA) ---CORRECT ANSWER--- Also referred to as Molly or Ecstasy
• Should expect diaphoresis
• Also might experience increased tactile sensitivity, lowered inhibition, chills, muscle cramping, teeth clenching & mild hallucinations. Mechanical restraints ---CORRECT ANSWER--- Patient needs to be assessed every 15 - 30 minutes and document findings, check for a new prescription every 4 hrs for clients >18 years, every 2 hrs for children 9-17 & every 1 hr for children younger than 9 years. Pulse paradoxus ---CORRECT ANSWER--- A finding in which systolic BP is 10 mmHg or greater on expiration than inspiration. Pt also may present with JVD, bradycardia & hypotension. A symptom of cardiac tamponade Estradiol ---CORRECT ANSWER--- Estradiol is used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation.
• Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body.

Flaxseed ---CORRECT ANSWER--- Migraine prophylaxis

• Can lead to GI symptoms such as bloating, abd pain and flatulence Lithium expected side effects ---CORRECT ANSWER--- Headache
• Polyuria
• Hyperglycemia Signs of lithium toxicity ---CORRECT ANSWER--- Confusion
• Coarse hand tremors
• ECG changes
• Sedation Macular Degeneration ---CORRECT ANSWER--Decrease in central vision Cataracts ---CORRECT ANSWER--Double Vision Detached retina ---CORRECT ANSWER--Floating dark spots Misoprostol ---CORRECT ANSWER--- Reduces gastric acid secretions so that ulcers can heal
• Avoid taking magnesium containing antacids as this will increase the risk of diarrhea. (Misoprostol tends to cause diarrhea)
• This can induce uterine contractions, so women of childbearing age must r/o pregnancy. Oxygen toxicity signs ---CORRECT ANSWER--- Bradypnea
• Crackels Early signs of Hypoxemia ---CORRECT ANSWER--- Restless
• Tachycardia Want lots of Vit A ---CORRECT ANSWER--- 1 medium raw carrot PACE ---CORRECT ANSWER--- program that provides adult daycare services along with in home assessments and supportive services Chlorpromazine ---CORRECT ANSWER--- Schizophrenia medication
• Monitor for neuroleptic syndrome! Symptoms include high fever, dysrhymias, decreased LOC and labile BP.
• Headaches, constipation & vomiting are common side effects of this medication. Hemoptysis ---CORRECT ANSWER--- Coughing up blood
• If the amount is greater than 275 mL/24 hours this indicates a risk for hemorrhage and needs to be reported.

Autonomic dysreflexia ---CORRECT ANSWER--- Potentially life threatening spinal cord injury @ T6 or higher

• Facial flushing, nasal congestion, severe headache. Autonomic dysreflexia Tx ---CORRECT ANSWER--- Elevate head of bed to 90 degrees
• loosen constrictive clothing
• assess for bladder distention and bowel impaction
• administer antihypertensive meds Obtaining temp or giving ear drops to a child ---CORRECT ANSWER--- Up & back True or False? Methadone can be taken while pregnant? ---CORRECT ANSWER--- True, it can be taken for opioid withdrawl Blood Transfusion Considerations ---CORRECT ANSWER--- Normal Saline ONLY!
• Only collect one unit of blood at a time.
• 20 gauge needle or larger.
• Initiate blood transfusion 30 minutes or less after obtaining blood. Warfarin ---CORRECT ANSWER--- Daily blood draws are needed for the 1st 5 days of starting this medication.
• Pt should not take calcium supplements
• Do not take acetaminophen for headaches (increases risk for bleeding) Permanent Trach Care Steps ---CORRECT ANSWER--1st: Remove inner cannula. 2nd: Remove soiled dressing. 3rd: Clean stoma. 4th: Change collar. Newborn Care ---CORRECT ANSWER--- dry newborn 1st unless suction mouth. If there is an AIRWAY it is most important, then dry! Safety Teachings for parents ---CORRECT ANSWER--- No more than 120 degrees for water heater
• Crib slates should be no more than 2.25 in apart
• Car seat should face the rear until 2 years of age
• Newborn car seat should be at 45 degree angle. Myasthenia gravis care (with attention to improving nutrition) ---CORRECT ANSWER--- Monitor weight each week
• Take your anticholinesterase medications 45-60 minutes before meals to prevent aspiration
• Cut food into small bites & eat slowly
• Choose snacks that are high in calorie

True Labor signs & symptoms ---CORRECT ANSWER--- The cervix transitions to the anterior position

• Contractions increase with ambulation
• Contractions in true labor should be felt in the lower abdomen and back
• Cervix shortens and thins Amitriptyline ---CORRECT ANSWER--- Tx of depression
• Monitor for reactions like dry mouth & constipation
• Pts should avoid overheating because of the lack of an ability to sweat while taking this med.
• Should take at night before bedtime. Ulcerative Colitis medications ---CORRECT ANSWER--- Glucocorticoids to decrease inflammation Ileostomy consideration ---CORRECT ANSWER--- Avoid enteric-coated medications Implementing an emergency preparedness plan, what do you need to do FIRST? --- CORRECT ANSWER--- FIRST you want to notify the incident commander to initiate the command hierarchy and maintain order Thrombocytopenia ---CORRECT ANSWER--- Low amount of platelets Neutropenia ---CORRECT ANSWER--- Low WBC's ( <4000)
• Initiate precaution for infection wear masks when going in patients room, limit visitors, no flowers & no fresh veggies or fruit Signs of Stevens-Johnson Syndrome ---CORRECT ANSWER--- A vesicular crusty rash (report)
• Sulfamethazazole can cause this as well as many others Indomethacin ---CORRECT ANSWER--- NSAID
• Adverse effects: Dizziness, vertigo, muscle weakness, n/v, anorexia that leads to weight loss OTC decongestants ---CORRECT ANSWER--- Can constrict blood vessels causing an increase in BP & HR
• Caution anyone that has hypertension or on cardiac meds Clonidine ---CORRECT ANSWER--Treats diaphoresis during alcohol withdrawl Chlordiazepoxide ---CORRECT ANSWER--- Prevents delirium tremens from alcohol withdrawal

Acetazolamide ---CORRECT ANSWER--- This is a med used for open angle glaucoma

• Adverse effect of this med is tingling of fingers and hyperglycemia Donepezil ---CORRECT ANSWER--- Used for Alzheimer's
• Side Effects: Dyspepsia, diarrhea, dizziness
• Adverse effect: Dyspnea (NEED TO REPORT TO PROVIDER) Furosemide ---CORRECT ANSWER--- Puts pt at risk for hypokalemia, dizziness (can cause drop in BP which leads to the dizziness) & urinary frequency Decreased LOC signs ---CORRECT ANSWER--- Depressed deep tendon reflexes
• Decreased BP
• Lethargy Methotrexate ---CORRECT ANSWER--- Immuno suppressant can cause bone marrow suppression. monitor for fever or sore throat. Tetracycline ---CORRECT ANSWER--- Can cause GI upset, suggest to take with applesauce.
• Should advise pt to take med in the morning to prevent esophageal ulceration.
• Do not take with antacids, will alter absorption Flumazenil ---CORRECT ANSWER--- Used for Benzo reversal (antidote) Albuterol ---CORRECT ANSWER--- Used for acute asthma attacks Long-term tx of asthma ---CORRECT ANSWER--- Montelukast (Leukotine)
• Beclomethasone (corticoseteriod)
• Nedocromil (Mast-cell) Phenytoin (Dilantin) ---CORRECT ANSWER--- Medication for seizures (anticonvulsant)
• Should not take with calcium containing foods.
• Commonly causes gingival hyperplasia Phenytoin continue ---CORRECT ANSWER--- Nystagmus-a serious reaction and should be reported.
• Levels less than 10 mcg/mL are sub therapeutic and can result in seizure activity. Levels more than 20 mcg/mL can produce toxic effects. Enalapril ---CORRECT ANSWER--(ACE Inhibitor)
• Should monitor for hyperkalemia (due to potassium retention by the kidneys)

• Phenytoin
• Carbamazepine
• Valproic acid
• Iamotrigine
• Gabapentin For status epilepticus (Diazepam, Lorazepam) Rheumatoid arthritis meds ---CORRECT ANSWER--- Prednisone (Glucocorticoid)
• Adalimumab (DMARD) Alzheimer meds ---CORRECT ANSWER--- Memantine
• Donazepril Med to tx Mysathena gravis ---CORRECT ANSWER--- Neostigmine (its a anticholinesterase) Liver failure medication (to eliminate ammonia levels) ---CORRECT ANSWER--- Lactulose (causes diarrhea) Medication specifically for migraines ---CORRECT ANSWER--Sumatriptan Antifungals ---CORRECT ANSWER--- End in "zole"
• Also nystatin (used for mouth) Azithromycin ---CORRECT ANSWER--- Antibiotic: Macrolide
• No cross allergy with penicillins Medication for UTI's that causes urine and contacts to turn orange? ---CORRECT ANSWER--- Phenazopyridine Medications prescribed for UTI's: ---CORRECT ANSWER--- Sufamethoxazole- trimethoprim
• Ciprofloxacin
• Phenazopyridine Medications to fight bone marrow suppression (typically due to cancer treatment) --- CORRECT ANSWER--- Erthropoietin
• Filgrastim Growth factors Atorvastatin ---CORRECT ANSWER--- Watch for muscle pain (stop med & contact provider)
• Watch liver enzymes

Digoxin considerations ---CORRECT ANSWER--- Common side effect: Bradycardia

• Watch Potassium levels (if too low=toxicity)
• Check HR & hold if under 60 bpm Digoxin Toxicity manifestations ---CORRECT ANSWER--- Anorexia
• N/V
• Blurred vision
• Yellow haze
• Fatigue/weakness
• Normal Dig levels: 0.5-0. Reasons to hold BP meds ---CORRECT ANSWER--- HR <60 bpm
• Systolic BP < Ace Inhibitor adverse effects ---CORRECT ANSWER--- Watch for dry cough (discontinue and report)
• Hypotension
• Can cause hyperkalemia
• Common meds: Captopril, Enalapril (Ends in "pril") Beta- Blockers adverse effects ---CORRECT ANSWER--- Bradycardia
• hypotension
• No grapefruit
• Metroprolol can decrease cardiac output and needs to be cautioned with CHF.
• Propranolol can cause bronchoconstriction (so don't want to give to someone with asthmatics) Oprelevekin ---CORRECT ANSWER--- oprelevekin is used to tx low platelet counts caused by chemo therapy
• This med is a thrombopoletic growth factor and therefore a platelet count within the expected range would mean it is therapeutic Carbamazepine ---CORRECT ANSWER--- Used to treat bipolar and/or seizures
• Affects oral contraceptives Neostigmine ---CORRECT ANSWER--- Neostigmine is used to treat myasthenia gravis
• Adverse effects are nausea, bradycardia, and salvation at the mouth. Valproic Acid use and adverse affect ---CORRECT ANSWER--- Valproic acid treats:

Sucralfate continue ---CORRECT ANSWER--- Sucralfate is used to treat an active duodenal ulcer. Sucralfate can heal an active ulcer, but it will not prevent future ulcers from occurring. Fluoxetine ---CORRECT ANSWER--- SSRI used to Tx depression

• Suppresses platelet aggregation which increases risk for bleeding when used with NSAIDs & anticoagulants.
• Advise patients to use Acetaminophen instead of ibuprofen for headaches. Ferrous sulfate ---CORRECT ANSWER--- Iron
• Take on an empty stomach Metoclopramide ---CORRECT ANSWER--- Given for nausea
• Increases gastric motility and can cause sedation Ergotamine ---CORRECT ANSWER--- Taken on onset of a migraine
• It should be taken upon aura of headache
• Maximum of 3 tablets per 24 hours Allupurinol ---CORRECT ANSWER--- Inhibits production of uric acid
• Used to treat gout and/or kidney stones of that nature
• Watch for kidney toxicity
• Contraindicated with Warfarin & oral hypoglycemics (increases effects of meds) Aminoglycosides
• Gentamycin and
• Tobramycin ---CORRECT ANSWER--- Watch for nephro & Otto toxicity
• They also interfere with diuretics, skeletal muscle relaxants and anticoagulant meds. Amoxicillin ---CORRECT ANSWER--- Watch for renal insufficiency
• Decreases contraceptives and warfarin Delete ---CORRECT ANSWER-- Better perfusion: DAngle ---CORRECT ANSWER--Arteries Airborne Precaution ---CORRECT ANSWER--Think MTV M= Measles T= TB V= Varicella-Chicken pox/herpes Zoster-Shingles

Wear: N-95 Droplet Precautions ---CORRECT ANSWER--Think SPIDERMAN S = Sepsis, scarlet fever, streptococcal pharyngitis P = Parvovirus B19, pneumonia, pertussis I = Influenza D = Diptheria E = Epiglottitis R= Rubella M = Mumps, meningitis, mycoplasma or meningeal pneu. AN= Adenovirus (private room, mask) Droplet requires mask, gown, gloves, & goggles Contact Precaution ---CORRECT ANSWER--Think MRS.WEE M= Multidrug resistant organism R= Respiratory infection S= Skin infections W= Wound infection E= Enteric infection (C.diff) E= Eye infection (conjunctivitis) Gloves and gown Air/Pulmonary Embolism S/S and tx ---CORRECT ANSWER--S/S: Chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom, bloody sputum Tx: Heaprin, d-dimer lab, O Women in labor with un-reassuring FHR ---CORRECT ANSWER--- This would include late decels, decreased variability, fetal bradycardia.

• Turn patient on left side, give O2, stop Pitocin (if running) and increase fluids Tube feedings with decreased LOC ---CORRECT ANSWER--- Position patient on right side (this promotes emptying of the stomach) and head of bed elevated (to prevent aspiration) Myringotomy ---CORRECT ANSWER--- Myringotomy is a surgical procedure in which a tiny incision is created in the eardrum to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear.
• Patient should be positioned on affected ear after surgery (this allows drainage of secretions)