NCLEX-PN Exam Cram / Edition 4

by Wilda Rinehart, Diann Sloan, Clara Hurd

Overview

• Covers exactly what you need to know to score higher on your NCLEX-PN® exam
• 400 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
• 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-PN exam!

• Discover how the NCLEX-PN 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 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
  

Product Details

ISBN-13:	9780789753151
Publisher:	Pearson IT Certification
Publication date:	06/05/2014
Series:	Exam Cram Series
Pages:	650
Product dimensions:	7.00(w) x 9.10(h) x 1.50(d)

About the Author

Wilda Rinehart Gardner received an Associate Degree in Nursing from Northeast MississippiCommunity 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 26 years, she and her associates have worked with nursing graduates and schools of nursing to assist graduates to 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 co-authored materials used in seminars presented by Rinehart and Associates Nursing Review.

Dr. Diann Sloan received an Associate 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 co-authored 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 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. She currently serves as a nurse educator consultant and an independent contractor. Ms. Hurd 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, Tennessee; 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 item-writing for nursing faculty. Her primary professional goal is to prepare the student and graduate for excellence in the delivery of healthcare.

Read an Excerpt

Praise for NCLEX-PN Exam CramPraise for NCLEX-PN Exam Cram

"The book offers a quick 'cram' approach to the NCLEX that is user friendly and not time intensive. The overall approach is learner-centered and the content is well paced."

—Catherine Dearman, RN, PhD

IntroductionWelcome to the NCLEX-PN^® Exam Cram

This book will help you prepare to take and pass the Licensure Exam for Practical Nurses. This Introduction discusses the NCLEX^® exam in general and how the Exam Cram can help you prepare for the test. It doesn't matter whether this is the first time you're going to take the exam or if you have taken it previously; this book gives you the necessary information and techniques to obtain licensure.

Exam Cram books help you understand and appreciate the subjects and materials you need to pass. The books are aimed at test preparation and review. They do not teach you everything you need to know about the subject of nursing. Instead they present materials you are likely to encounter on the exam.

Using a simple approach, we help you understand the need-to-know information. First, you learn content as it applies to medical-surgical nursing, psychiatric-mental health nursing, obstetric nursing, and pediatric nursing, with an emphasis on pharmacology, skills, and management of these disorders. In a well-organized format, you learn the pathophysiology of the most common problems affecting clients, the treatment of these disorders, and the nursing care required.

The NCLEX-PN^® consists of questions from the cognitive levels of knowledge, comprehension,application, and analysis. The majority of questions are written at the application and analysis levels. Questions incorporate the five stages of the nursing process (assessment, diagnosis, planning, implementation, and evaluation) and the four categories of client needs. Client needs are divided into subcategories that define the content within each of the four major categories. These categories and subcategories are

• A. Safe, effective care environment:

• Coordinated care: 12%–18%

• Safety and infection control: 8%–14%

• B. Health promotion and maintenance: 7%–13%

• C. Psychosocial integrity: 8%–14%

• D. Physiological integrity:

• Basic care and comfort: 11%–17%

• Pharmacological and parenteral therapy: 9%–15%

• Reduction of risk: 10%–16%

• Physiological adaptation: 11%–17%

Taking the Computerized Adaptive Test

Computer Adaptive Testing offers the candidate several advantages. The graduate can schedule the exam at a time that is convenient for him. The Pearson VUE testing group is responsible for administering the exam. Because you might not be familiar with the Pearson VUE testing centers, we recommend that you arrive at least 30 minutes early to acclimate yourself to the surroundings and learn what you need to do while testing at the center. If you are late, you will not be allowed to test. Bring two forms of identification with you, one of which must be a picture ID. Be sure that your form of identification matches your application. You will be photographed and fingerprinted upon entering the testing site, so don't let this increase your stress. The allotted time is 5 hours. The candidate can receive results within approximately 7 days (in some states even sooner). Remember that the exam is written at approximately the 10th-grade reading level so keep a good dictionary handy during your studies.The Cost of the Exam

The candidate wanting to take the licensure exam must fill out two applications, one to the National Council and one to the state in which she wants to be licensed. A separate fee must accompany each application. The fee required by the National Council is $200. State licensing fees vary from state to state. The candidate should contact the state where she wishes to become licensed for a list of fees for that specific state. Licensure applications can be obtained on the National Council's website at http://www.ncsbn.org. Several states are members of the multistate licensure compact. This means that, if you are issued a multistate license, you pay only one fee. This information can also be obtained by visiting the National Council's website. A list of phone numbers and websites is included on this book's CD, in Appendix C, "Alphabetical Listing of Nursing Boards in the United States and Protectorates."How to Prepare for the Exam

Judicious use of this book, either alone or with a review seminar, such as that provided by Rinehart and Associates, will help you to achieve your goal of becoming a practical nurse. As you review for the NCLEX® Exam, we suggest that you find a location where you can concentrate on the material each day. A minimum of 2 hours per day for at least 2 weeks is suggested. We have provided you with exam alerts, tips, notes, and sample questions, both multiple-choice and alternative items. These questions will acquaint you with the type of questions you will see during the exam. We have also formulated a mock exam, with those difficult management and delegation questions, which you can score to determine your readiness to test. Pay particular attention to the Exam Alerts and the Cram Sheet. Using these will help you gain and retain knowledge and help reduce your stress as you prepare to test.How to Use This Book

Each topical Exam Cram chapter follows a regular structure and includes cues about important or useful information. Here's the structure of a typical chapter:

• Opening hotlists—Each chapter begins with a list of terms and concepts you must learn and understand before you can know the subject matter. The hotlists are followed by an introductory section to set the stage for the rest of the chapter.

• Topical coverage—After the opening hotlists, each chapter covers a series of topics related to the chapter's subject title.

Even though the book is structured to the exam, these flagged items are often particularly important:

• Exam Alert—Exam alerts normally stress concepts, terms, or activities that are related to one or more test questions. Anything found in exam alert format is worthy of greater attention on your part. This is what an exam alert looks like:

  ***

  Caution - Exam alerts are provided as a heads up that the content mentioned here might appear on the NCLEX-PN^® exam.

  ***

• Notes—Throughout each chapter additional information is provided that, although not directly related to the exam itself, is still useful and will aid your preparation. A sample note is shown here:

  ***

  Note - This is how notes are formatted. Notes direct your attention to important pieces of information that relate to nursing and nursing certification.

  ***

• Tips—A tip might tell you another way of accomplishing something in a more efficient or time-saving manner. An example of a tip is shown here:

  ***

  Tip - This is how tips are formatted. Keep your eyes open for these, and you'll learn some interesting nursing tips!

  ***

• Exam Prep Questions—Although we talk about test questions and topics throughout the book, the section at the end of each chapter presents a series of mock test questions and explanations of both correct and incorrect answers.

• Practice Exams—This book offers two exams written in the NCLEX^® format. These have been provided to help you evaluate your readiness to test. Answers and rationale to these questions have also been provided. We suggest that you score the exam by subtracting the missed items from the total and dividing the total answered correctly by the total number of questions. This will give you the percentage of answers correctly. We suggest that you achieve a score of at least 77% before you schedule your exam.

• Glossary—At the end of the book is a glossary that defines critical nursing terms we cover in this book.

• The CD—The CD includes a testing engine with many practice questions that you should use repeatedly to practice your test-taking skills and measure your level of learning. You should be able to correctly answer more than 77% of the questions on the practice tests before trying the real exam. The CD also contains Appendix A, "Things You Forgot"; Appendix B, "Need to Know More?"; and Appendix C, "Alphabetical Listing of Nursing Boards in the United States and Protectorates."

• Cram Sheet—At the beginning of the book is a tear card we call the Cram Sheet. This is a helpful tool that gives you distilled, compressed facts and is a great tool for last-minute study and review.

About the Book

The topics in this book have been structured using the systems approach to nursing. We believe that a simple approach to learning the disease process, treatments, and diagnostic studies is best. We review material related to diseases of each body system; the related nursing skills; and the diagnostic tests, nutrition, and pharmacology associated with each. We also consider cultural and religious aspects as they relate to the care of clients with specific illnesses.

Aside from being a test preparation book, this book is also useful if you are brushing up on your nursing knowledge. It is an excellent quick reference for the licensed nurse.Contact the Authors

The authors of this text are interested in you and want you to pass on the first attempt. If, after reviewing with this text, you would like to contact the authors, you can do so at Rinehart and Associates, PO Box 124, Booneville, MS 38829 or by visiting our website at http://www.nclexreview.net. You can also contact us by phone at 662-728-4622.

© Copyright Pearson Education. All rights reserved.

Table of Contents

Introduction ................................................................................................... xxi
Welcome to the NCLEX-PN® Exam Cram .................................................................xxi
Taking the Computerized Adaptive Test .....................................................................xxii
The Cost of the Exam ...................................................................................................xxii
How to Prepare for the Exam ......................................................................................xxiii
How to Use This Book .................................................................................................xxiii
About the Book .............................................................................................................. xxv
Contact the Authors ....................................................................................................... xxv
Self-Assessment .............................................................................................................. xxv
Companion Website ..................................................................................................... xxvi
Accessing the Pearson Test Prep Software and Questions ........................................xxvii
Self-Assessment ............................................................................................... 1
Testing Your Exam Readiness .......................................................................................... 2
Chapter 1 Preparing for the National Council Exam for Licensed Practical Nurses................ 3
Preparing for the Exam .................................................................................................... 4
The Computer Adaptive Test ................................................................................. 4
Testing Strategies .................................................................................................... 5
Reading the Question Carefully .............................................................................. 6
Look for Keywords .................................................................................................. 6
Watch for Specific Details ...................................................................................... 6
Exam Prep Questions ....................................................................................................... 9
Answer Rationales ........................................................................................................... 11
Chapter 2 Simplifying Pharmacology .....................................................................13
Pharmacology .................................................................................................................. 14
Three Areas of Pharmacology ............................................................................... 14
How Nurses Work with Pharmacology ......................................................................... 15
Time-Released Drugs ............................................................................................ 16
Administering Medications ................................................................................... 17
Understanding and Identifying the Various Drugs ....................................................... 18
Angiotensin-Converting Enzyme Inhibitors ........................................................ 18
Beta Adrenergic Blockers ...................................................................................... 19
Anti-Infectives (Aminoglycosides) ......................................................................... 20
Benzodiazepines (Anticonvulsants/Antianxiety) ................................................... 22
Phenothiazines (Antipsychotic/Antiemetic) .......................................................... 24
Glucocorticoids ...................................................................................................... 25
Antivirals ................................................................................................................ 26
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
Exam Prep Questions ..................................................................................................... 36
Answer Rationales ........................................................................................................... 38
Suggested Reading and Resources ................................................................................. 40
Chapter 3 Caring for the Client with Disorders of the Respiratory System .........................41
Chronic Obstructive Pulmonary Disease ....................................................................... 42
Chronic Bronchitis ................................................................................................ 42
Emphysema ............................................................................................................ 42
Asthma .................................................................................................................... 43
Acute Respiratory Infections .......................................................................................... 44
Pneumonia ............................................................................................................. 44
Pleurisy ................................................................................................................... 45
Tuberculosis ........................................................................................................... 46
Influenza ................................................................................................................. 47
Acute Respiratory Failure ............................................................................................... 48
Acute Respiratory Distress Syndrome .................................................................. 48
Pulmonary Embolus .............................................................................................. 48
Emerging Infections ....................................................................................................... 50
Severe Acute Respiratory Syndrome ..................................................................... 50
Legionnaire’s Disease ............................................................................................ 51
Diagnostic Tests for Review ........................................................................................... 52
Pharmacology Categories for Review ............................................................................ 52
Exam Prep Questions ..................................................................................................... 53
Answer Rationales ........................................................................................................... 55
Suggested Reading and Resources ................................................................................. 56
Chapter 4 Caring for the Client with Disorders of the Renal and Genitourinary System .........57
Acute Glomerulonephritis .............................................................................................. 58
Chronic Glomerulonephritis .......................................................................................... 59
End Stage Renal Disease ................................................................................................ 60
Peritoneal Dialysis ................................................................................................. 60
Hemodialysis .......................................................................................................... 60
Renal Transplantation ........................................................................................... 61
Nephrotic Syndrome ...................................................................................................... 61
Urinary Calculi................................................................................................................ 62
Urinary Tract Infections................................................................................................. 63
Genitourinary Disorders ................................................................................................. 63
Prostatitis ............................................................................................................... 64
Benign Prostatic Hyperplasia ......................................................................................... 64
Bladder Cancer ................................................................................................................ 66
Diagnostic Tests for Review ........................................................................................... 67
Pharmacology Categories for Review ............................................................................ 67
Exam Prep Questions ..................................................................................................... 68
Answer Rationales ........................................................................................................... 70
Suggested Reading and Resources ................................................................................. 71
Chapter 5 Caring for the Client with Disorders of the Hematopoietic System .....................73
Anemia ............................................................................................................................. 74
Pernicious Anemia ................................................................................................. 74
Aplastic Anemia ..................................................................................................... 75
Sickle Cell Anemia ................................................................................................. 76
Iron Deficiency Anemia ......................................................................................... 77
Cooley’s Anemia (Thalassemia Major) ................................................................. 77
Hemophilia ...................................................................................................................... 77
Polycythemia Vera .......................................................................................................... 78
Diagnostic Tests for Review ........................................................................................... 79
Pharmacology for Review ............................................................................................... 79
Exam Prep Questions ..................................................................................................... 80
Answer Rationales ........................................................................................................... 82
Suggested Reading and Resources ................................................................................. 83
Chapter 6 Caring for the Client with Disorders of Fluid and Electrolyte Balance and Acid/Base Balance ..............................................................................85
Basic Knowledge of Fluid and Electrolyte Balance ....................................................... 86
Regulation of pH and Its Effect on Fluid and Electrolytes .......................................... 87
How the Body Regulates pH ................................................................................ 87
Metabolic Acidosis .......................................................................................................... 87
Causes of Metabolic Acidosis ................................................................................ 87
Symptoms of Metabolic Acidosis .......................................................................... 88
Care of the Client with Metabolic Acidosis ......................................................... 88
Respiratory Acidosis ........................................................................................................ 89
Causes of Respiratory Acidosis .............................................................................. 89
Symptoms of Respiratory Acidosis ........................................................................ 90
Caring for the Client with Respiratory Acidosis .................................................. 90
Metabolic Alkalosis ......................................................................................................... 91
Causes of Metabolic Alkalosis ............................................................................... 91
Symptoms of Metabolic Alkalosis ......................................................................... 91
Caring for the Client with Metabolic Alkalosis .................................................... 92
Respiratory Alkalosis ....................................................................................................... 92
Symptoms of Respiratory Alkalosis ....................................................................... 92
Care of the Client with Respiratory Alkalosis ...................................................... 93
Normal Electrolyte Values ............................................................................................. 93
Changes Associated with Aging ...................................................................................... 94
Exam Prep Questions ..................................................................................................... 96
Answer Rationales ........................................................................................................... 98
Suggested Reading and Resources ................................................................................. 99
Chapter 7 Caring for the Client with Burns ............................................................ 101
Burn Classifications ....................................................................................................... 102
Burn Measurement with TBSA ........................................................................... 104
Nursing Care for Burn Victims .................................................................................... 105
The Resuscitative (Emergent) Phase .................................................................. 106
The Acute (Intermediate) Phase ......................................................................... 110
Dressings for Burns ............................................................................................. 111
The Rehabilitative Phase ..................................................................................... 112
Diagnostic Tests for Review ......................................................................................... 112
Pharmacology Categories for Review .......................................................................... 112
Exam Prep Questions ................................................................................................... 114
Answer Rationales ......................................................................................................... 116
Suggested Reading and Resources ............................................................................... 117
Chapter 8 Caring for the Client with Sensorineural Disorders...................................... 119
Disorders of the Eyes .................................................................................................... 120
Intraocular Disorders ........................................................................................... 120
Retinal Disorders ................................................................................................. 123
Refractive Errors .................................................................................................. 125
Traumatic Injuries ............................................................................................... 126
Visual Tests for Review ................................................................................................ 127
Pharmacology Categories for Review .......................................................................... 127
Ear Disorders ................................................................................................................ 127
Otitis Externa ....................................................................................................... 128
Otitis Media ......................................................................................................... 128
Meniere’s Disease ................................................................................................ 128
Otosclerosis .......................................................................................................... 129
Presbycusis ........................................................................................................... 129
Ear Trauma .......................................................................................................... 130
Assisting Clients with Hearing Loss ............................................................................ 130
Diagnostic Tests for Review ......................................................................................... 130
Pharmacology Categories for Review .......................................................................... 131
Exam Prep Questions ................................................................................................... 132
Answer Rationales ......................................................................................................... 134
Suggested Reading and Resources ............................................................................... 135
Chapter 9 Caring for the Client with Cancer ........................................................... 137
Cancer ........................................................................................................................... 138
American Cancer Society’s Seven Warning Signs of Cancer ............................ 138
The Four Major Categories of Cancer ............................................................... 138
Risk Factors for Specific Cancers ........................................................................ 139
Cancer Prevention ............................................................................................... 140
Patient Teaching .................................................................................................. 141
Management of the Client with Cancer ...................................................................... 141
Radiation .............................................................................................................. 142
Chemotherapy ..................................................................................................... 143
Bone Marrow Transplantation and Stem Cell Transplantation (SCT) ..................... 145
Types of Transplants ........................................................................................... 145
Nursing Care After Transplantation .................................................................. 146
Hodgkin’s Lymphoma .................................................................................................. 147
Diagnosis of Hodgkin’s Lymphoma ................................................................... 147
Prognosis of Hodgkin’s Lymphoma ................................................................... 148
Treatment of Hodgkin’s Lymphoma .................................................................. 148
Diagnostic Tests for Review ......................................................................................... 148
Pharmacology for Review ............................................................................................. 149
Exam Prep Questions ................................................................................................... 151
Answer Rationales ......................................................................................................... 153
Suggested Reading and Resources ............................................................................... 154
Chapter 10 Caring for the Client with Disorders of the Gastrointestinal System ................ 155
Ulcers ............................................................................................................................. 156
Types of Ulcers .................................................................................................... 156
Treatment of Ulcers ............................................................................................ 157
Inflammatory Bowel Disorders .................................................................................... 159
Crohn’s Disease (Regional Enteritis) .................................................................. 159
Ulcerative Colitis ................................................................................................. 160
Diverticulitis .................................................................................................................. 161
Diagnosis of Diverticulitis ................................................................................... 161
Treatment of Diverticulitis ................................................................................. 161
Gastroesophageal Reflux Disease (GERD) .................................................................. 162
Diseases Associated with the Liver ............................................................................... 163
Hepatitis ............................................................................................................... 163
Cirrhosis ............................................................................................................... 168
Pancreatitis ........................................................................................................... 170
Cholecystitis/Cholelithiasis .......................................................................................... 172
Symptoms of Cholecystitis and Cholelithiasis .................................................... 172
Diagnosis of Cholecystitis/Cholethiasis .............................................................. 173
Treatment of Cholecystitis .................................................................................. 173
Treatment of Cholethiasis ................................................................................... 173
Clostridium Difficile ..................................................................................................... 174
Food-Borne Illnesses .................................................................................................... 175
Diagnostic Tests for Review ......................................................................................... 176
Pharmacology for Review ............................................................................................. 176
Exam Prep Questions ................................................................................................... 178
Answer Rationales ......................................................................................................... 180
Suggested Reading and Resources ............................................................................... 181
Chapter 11 Caring for the Client with Disorders of the Musculoskeletal System................ 183
Fractures ........................................................................................................................ 184
Treating Fractures ............................................................................................... 184
Compartment Syndrome ..................................................................................... 187
Osteomyelitis ....................................................................................................... 188
Osteoporosis .................................................................................................................. 189
Treatment of Osteoporosis ................................................................................. 190
Gout ............................................................................................................................... 190
Treatment of the Client with Gout .................................................................... 191
Rheumatoid Arthritis .................................................................................................... 191
Treatment of Rheumatoid Arthritis .................................................................... 192
Musculoskeletal Surgical Procedures ........................................................................... 193
Fractured Hip and Hip Replacement ................................................................. 193
Total Knee Replacement ..................................................................................... 194
Amputations ......................................................................................................... 195
Assistive Devices for Ambulation ................................................................................. 196
Crutches ............................................................................................................... 197
Canes .................................................................................................................... 197
Walkers ................................................................................................................ 198
Diagnostic Tests for Review ......................................................................................... 198
Pharmacology for Review ............................................................................................. 199
Exam Prep Questions ................................................................................................... 201
Answer Rationales ......................................................................................................... 203
Suggested Reading and Resources ............................................................................... 204
Chapter 12 Caring for the Client with Disorders of the Endocrine System ....................... 205
The Endocrine System ................................................................................................. 206
Pituitary Disorders ........................................................................................................ 206
Tumors of the Pituitary ....................................................................................... 207
Thyroid Disorders ........................................................................................................ 209
Hypothyroidism ................................................................................................... 209
Hyperthyroidism .................................................................................................. 210
Parathyroid Disorders ................................................................................................... 212
Hypoparathyroidism ............................................................................................ 212
Hyperparathyroidism ........................................................................................... 213
Adrenal Gland Disorders .............................................................................................. 214
Adrenocortical Insufficiency (Addison’s Disease) ............................................... 214
Adrenocortical Hypersecretion (Cushing’s Syndrome) or Cushing’s Disease .............................................................................................. 215
Diabetes Mellitus .......................................................................................................... 215
Diagnostic Tests for Review ......................................................................................... 219
Pharmacology Categories for Review .......................................................................... 219
Exam Prep Questions ................................................................................................... 220
Answer Rationales ......................................................................................................... 222
Suggested Reading and Resources ............................................................................... 223
Chapter 13 Caring for the Client with Disorders of the Cardiovascular System ................. 225
Hypertension ................................................................................................................. 226
Medications Used to Treat Hypertension .......................................................... 227
Heart Block ................................................................................................................... 227
Toxicity to Medications ....................................................................................... 229
Malfunction of the Conduction System .............................................................. 229
Myocardial Infarction ................................................................................................... 230
Diagnosis of Myocardial Infarction .................................................................... 231
Management of Myocardial Infarction Clients .................................................. 232
Inflammatory Diseases of the Heart ............................................................................ 235
Infective Endocarditis .......................................................................................... 235
Pericarditis ........................................................................................................... 235
Buerger’s Disease .......................................................................................................... 236
Thrombophlebitis ......................................................................................................... 236
Raynaud’s Syndrome ..................................................................................................... 237
Aneurysms ..................................................................................................................... 237
Congestive Heart Failure.............................................................................................. 238
Diagnostic Tests for Review ............................................................................... 238
Pharmacology Categories for Review .......................................................................... 239
Exam Prep Questions ................................................................................................... 240
Answer Rationales ......................................................................................................... 242
Suggested Reading and Resources ............................................................................... 243
Chapter 14 Caring for the Client with Disorders of the Neurological System .................... 245
Seizures .......................................................................................................................... 246
Types of Seizures ................................................................................................. 246
Treatment of Seizure Clients .............................................................................. 248
Status Epilepticus .......................................................................................................... 249
Brain Injuries ................................................................................................................. 249
Epidural Hematomas ........................................................................................... 250
Subdural Hematoma ............................................................................................ 250
Treatment of Epidural and Subdural Hematomas ............................................. 250
Increased Intracranial Pressure..................................................................................... 251
Treatment of ICP ................................................................................................ 253
Neurological Assessment .............................................................................................. 253
Cranial Nerve Assessment ................................................................................... 254
Glasgow Coma Scale ........................................................................................... 255
Intracranial Pressure Monitors ............................................................................ 256
Care of the Client with Intracranial Surgery (Craniotomy) ....................................... 256
Cerebrovascular Accident/Stroke ................................................................................. 257
Spinal Cord Injury ........................................................................................................ 258
Treatment of Spinal Cord Injuries ..................................................................... 259
Potential Complications with SCI Clients ......................................................... 260
Guillain-Barré ............................................................................................................... 261
Treating Clients with Guillian-Barré ................................................................. 261
Degenerative Neurological Disorders .......................................................................... 261
Diagnostic Tests for Review ......................................................................................... 263
Pharmacology for Review ............................................................................................. 263
Exam Prep Questions ................................................................................................... 265
Answer Rationales ......................................................................................................... 267
Suggested Reading and Resources ............................................................................... 268
Chapter 15 Caring for the Client with Psychiatric Disorders ........................................ 269
Anxiety Disorders .......................................................................................................... 270
Generalized Anxiety Disorder ............................................................................. 271
Panic Disorder ..................................................................................................... 271
Specific Phobia ..................................................................................................... 271
Obsessive-Compulsive Disorder ......................................................................... 272
Trauma-Related Disorders ........................................................................................... 272
Posttraumatic Stress Disorder ............................................................................. 273
Dissociative Disorders .................................................................................................. 273
Dissociative Identity Disorder ............................................................................. 274
Somatic Disorder ................................................................................................. 274
Personality Disorders .................................................................................................... 274
Paranoid Personality Disorder ............................................................................ 275
Schizoid Personality Disorder ............................................................................. 275
Schizotypal Personality Disorder ........................................................................ 275
Histrionic Personality Disorder .......................................................................... 276
Narcissistic Personality Disorder ........................................................................ 276
Antisocial Personality Disorder ........................................................................... 276
Borderline Personality Disorder ......................................................................... 277
Avoidant Personality Disorder ............................................................................ 277
Dependent Personality Disorder ........................................................................ 277
Obsessive-Compulsive Personality Disorder ...................................................... 277
Managing Clients with Personality Disorders .................................................... 278
Psychotic Disorders ...................................................................................................... 278
Schizophrenia ....................................................................................................... 278
Bipolar Disorders ................................................................................................. 281
Substance Abuse ............................................................................................................ 283
Alcoholism ............................................................................................................ 283
Other Commonly Abused Substances ................................................................ 286
Disorders of Childhood and Adolescence .................................................................... 288
Disruptive, Control, and Conduct Disorders ..................................................... 288
Neurodevelopmental Disorders .......................................................................... 289
Eating Disorders .................................................................................................. 290
Diagnostic Tests for Review ......................................................................................... 291
Pharmacology Categories for Review .......................................................................... 291
Exam Prep Questions ................................................................................................... 292
Answer Rationales ......................................................................................................... 294
Suggested Reading and Resources ............................................................................... 295
Chapter 16 Caring for the Maternal/Infant Client ..................................................... 297
Signs of Pregnancy ........................................................................................................ 298
Presumptive Signs ................................................................................................ 298
Probable Signs ..................................................................................................... 298
Positive Signs ....................................................................................................... 299
Prenatal Care ................................................................................................................. 299
Prenatal Diet and Weight Maintenance ............................................................. 299
Alpha-Fetoprotein Screening .............................................................................. 299
Other Prenatal Diagnostic Tests ........................................................................ 300
Assessing Fetal Heart Tones ............................................................................... 301
Ultrasonography .................................................................................................. 301
Signs of Complications of Pregnancy .......................................................................... 301
Types of Abortions ....................................................................................................... 302
Complications Affecting Pregnancy ............................................................................. 303
Diabetes in Pregnancy ......................................................................................... 303
Preeclampsia ........................................................................................................ 304
Disseminated Intravascular Coagulation ............................................................ 305
Cord Prolapse ...................................................................................................... 305
Abruptio Placenta ................................................................................................ 305
Placenta Previa ..................................................................................................... 305
Maternal Infections ....................................................................................................... 306
Preterm Labor ............................................................................................................... 308
Intrapartal Care ............................................................................................................. 309
Stages of Labor .................................................................................................... 309
Phases of Labor .................................................................................................... 310
Important Terms You Should Know .................................................................. 310
Prelabor Testing ........................................................................................................... 311
Fetal Monitoring ........................................................................................................... 312
Pharmacologic Management of Labor ......................................................................... 314
Postpartum Care ........................................................................................................... 315
Terms Associated with the Normal Newborn ............................................................. 315
Rh Incompatibility ........................................................................................................ 316
Contraception ............................................................................................................... 317
Diagnostic Tests for Review ......................................................................................... 318
Pharmacology Categories for Review .......................................................................... 319
Exam Prep Questions ................................................................................................... 320
Answer Rationales ......................................................................................................... 322
Suggested Reading and Resources ............................................................................... 323
Chapter 17 Caring for the Pediatric Client ............................................................. 325
Growth and Development ............................................................................................ 326
Infant (28 Days to 1 Year) ................................................................................... 326
Toddler (1—3 Years) ............................................................................................. 328
NCLEX-PN Exam Cram, Fifth Edition
Preschooler (3—5 Years) ....................................................................................... 329
School Age (6—12 Years) ...................................................................................... 330
Adolescence (12—18 Years) .................................................................................. 331
Congenital Anomalies ................................................................................................... 331
Anomalies of the Gastrointestinal System .......................................................... 332
Anomalies of the Musculoskeltal System ............................................................ 336
Anomalies of the Cardiovascular System ............................................................ 338
Inborn Errors of Metabolism .............................................................................. 341
Respiratory Disorders ................................................................................................... 342
Acute Otitis Media ............................................................................................... 343
Tonsillitis ............................................................................................................. 344
Laryngotracheobronchitis ................................................................................... 345
Acute Epiglottitis ................................................................................................. 345
Bronchiolitis ......................................................................................................... 346
Cystic Fibrosis (Mucoviscidosis) ......................................................................... 347
Gastrointestinal Disorders ............................................................................................ 347
Gastroenteritis ..................................................................................................... 348
Pyloric Stenosis .................................................................................................... 348
Intussusception ..................................................................................................... 348
Celiac Disease (Gluten-Induced Enteropathy, Celiac Sprue) ............................ 349
Cardiovascular Disorders .............................................................................................. 349
Rheumatic Fever .................................................................................................. 349
Kawasaki Disease (Mucocutaneous Lymph Node Syndrome) .......................... 350
Musculoskeletal Disorders ............................................................................................ 352
Scoliosis ................................................................................................................ 352
Legg-Calve-Perthes Disease (Coxa Plana) ......................................................... 353
Muscular Dystrophies .......................................................................................... 353
Childhood Cancer ......................................................................................................... 354
Wilms Tumor (Nephroblastoma) ....................................................................... 354
Leukemia .............................................................................................................. 354
Osteogenic Sarcoma (Osteosarcoma) .................................................................. 354
Ingestion of Hazardous Substances .............................................................................. 355
Salicylate Overdose .............................................................................................. 355
Acetaminophen Overdose.................................................................................... 355
Lead Poisoning (Plumbism) ................................................................................ 355
Iron Poisoning ..................................................................................................... 356
Diagnostic Tests for Review ......................................................................................... 356
Pharmacology Categories for Review .......................................................................... 357
Exam Prep Questions ................................................................................................... 358
Answer Rationales ......................................................................................................... 360
Suggested Reading and Resources ............................................................................... 361
Practice Exam 1 ............................................................................................. 363
Answers to Practice Exam 1 .............................................................................. 407
Practice Exam 2 ............................................................................................. 429
Answers to Practice Exam 2 .............................................................................. 471
Appendix A Things You Forgot ........................................................................... 493
Appendix B Need to Know More?........................................................................ 501
Appendix C Calculations .................................................................................. 509
Glossary ...................................................................................................... 513