Introduction ...................................................................................................xxi
Welcome to the NCLEX-PN (R) 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
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
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 .................................................................................................................46
Acute Respiratory Failure................................................................................................47
Acute Respiratory Distress Syndrome ...................................................................47
Pulmonary Embolus ...............................................................................................48
Emerging Infections ........................................................................................................50
Severe Acute Respiratory Syndrome .....................................................................50
Legionnaire's Disease .............................................................................................51
Diagnostic Tests for Review............................................................................................51
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 ................................................................................................................63
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 Emergent Phase............................................................................................106
The 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 Peripheral Stem Cell Transplantation (PSCT)...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 ....................................................................................174
Clostridium Difficile......................................................................................................175
Food-Borne Illnesses .....................................................................................................175
Diagnostic Tests for Review..........................................................................................176
Pharmacology for Review..............................................................................................177
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 .....................................................................................................192
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-Barre ................................................................................................................261
Treating Clients with Guillian-Barre...................................................................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-Related Disorders ............................................................................................270
Generalized Anxiety Disorder..............................................................................270
Post-traumatic Stress Disorder ............................................................................271
Dissociative Identity Disorder .............................................................................271
Somatoform Disorder...........................................................................................272
Panic Disorder ......................................................................................................272
Phobic Disorders ..................................................................................................273
Obsessive-Compulsive Disorder ..........................................................................273
Personality Disorders ....................................................................................................274
Cluster A...............................................................................................................274
Cluster B...............................................................................................................275
Cluster C...............................................................................................................276
Managing Clients with Personality Disorders ....................................................277
Psychotic Disorders .......................................................................................................277
Schizophrenia .......................................................................................................277
Bipolar Disorders..................................................................................................280
Substance Abuse.............................................................................................................282
Alcoholism ............................................................................................................282
Other Commonly Abused Substances .................................................................285
Disorders of Childhood and Adolescence.....................................................................287
Conduct Disorder.................................................................................................287
Oppositional Defiant Disorder ............................................................................287
Attention Deficit Hyperactive Disorder..............................................................288
Autistic Disorder...................................................................................................288
Eating Disorders...................................................................................................289
Diagnostic Tests for Review..........................................................................................289
Pharmacology Categories for Review...........................................................................290
Exam Prep Questions ....................................................................................................291
Answer Rationales.................................................................................................293
Suggested Reading and Resources ................................................................................294
Chapter 16 Caring for the Maternal/Infant Client......................................................295
Signs of Pregnancy ........................................................................................................296
Presumptive Signs ................................................................................................296
Probable Signs ......................................................................................................296
Positive Signs ........................................................................................................297
Prenatal Care .................................................................................................................297
Prenatal Diet and Weight Maintenance ..............................................................297
Alpha-Fetoprotein Screening...............................................................................297
Other Prenatal Diagnostic Tests ..........................................................................298
Assessing Fetal Heart Tones.................................................................................299
Ultrasonography ...................................................................................................299
Signs of Complications of Pregnancy ...........................................................................299
Types of Abortions.........................................................................................................300
Complications Affecting Pregnancy..............................................................................301
Diabetes in Pregnancy..........................................................................................301
Preeclampsia .........................................................................................................302
Disseminated Intravascular Coagulation .............................................................303
Cord Prolapse .......................................................................................................303
Abruptio Placenta .................................................................................................303
Placenta Previa......................................................................................................303
Maternal Infections........................................................................................................304
Preterm Labor ...............................................................................................................306
Intrapartal Care..............................................................................................................307
Stages of Labor .....................................................................................................307
Phases of Labor ....................................................................................................308
Important Terms You Should Know....................................................................308
Prelabor Testing.............................................................................................................309
Fetal Monitoring............................................................................................................310
Pharmacologic Management of Labor .........................................................................312
Postpartum Care............................................................................................................313
Terms Associated with the Normal Newborn ..............................................................313
Rh Incompatibility.........................................................................................................314
Contraception ................................................................................................................315
Diagnostic Tests for Review..........................................................................................316
Pharmacology Categories for Review...........................................................................317
Exam Prep Questions ....................................................................................................318
Answer Rationales.................................................................................................320
Suggested Reading and Resources ................................................................................321
Chapter 17 Caring for the Pediatric Client .............................................................323
Growth and Development.............................................................................................324
Infant (28 Days to 1 Year) ....................................................................................324
Toddler (1-3 Years)...............................................................................................326
Preschooler (3-5 Years) ........................................................................................327
School Age (6-12 Years) .......................................................................................328
Adolescence (12-18 Years)....................................................................................329
Congenital Anomalies....................................................................................................329
Anomalies of the Gastrointestinal System...........................................................330
Anomalies of the Musculoskeltal System.............................................................334
Anomalies of the Cardiovascular System.............................................................336
Inborn Errors of Metabolism...............................................................................339
Respiratory Disorders....................................................................................................340
Acute Otitis Media ...............................................................................................341
Tonsillitis...............................................................................................................342
Laryngotracheobronchitis ....................................................................................343
Acute Epiglottitis..................................................................................................343
Bronchiolitis..........................................................................................................344
Cystic Fibrosis (Mucoviscidosis) ..........................................................................345
Gastrointestinal Disorders.............................................................................................345
Gastroenteritis ......................................................................................................346
Pyloric Stenosis.....................................................................................................346
Intussusception .....................................................................................................346
Celiac (Gluten-Induced Enteropathy, Celiac Sprue) ..........................................347
Cardiovascular Disorders ..............................................................................................347
Rheumatic Fever...................................................................................................347
Kawasaki's Disease (Mucocutaneous Lymph Node Syndrome) .........................348
Musculoskeletal Disorders.............................................................................................350
Scoliosis.................................................................................................................350
Legg-Calve-Perthes Disease (Coxa Plana) ..........................................................351
Muscular Dystrophies...........................................................................................351
Childhood Cancer .........................................................................................................352
Wilms Tumor (Nephroblastoma) ........................................................................352
Leukemia...............................................................................................................352
Osteogenic Sarcoma (Osteosarcoma) ..................................................................352
Ingestion of Hazardous Substances...............................................................................353
Salicylate Overdose...............................................................................................353
Acetaminophen (Tylenol) Overdose ....................................................................353
Lead (Plumbism) ..................................................................................................353
Iron Poisoning ......................................................................................................354
Diagnostic Tests for Review..........................................................................................354
Pharmacology Categories for Review...........................................................................355
Exam Prep Questions ....................................................................................................356
Answer Rationales.................................................................................................358
Suggested Reading and Resources ................................................................................359
Practice Exam 1 .............................................................................................361
Answers to Practice Exam 1 ...............................................................................405
Practice Exam 2 .............................................................................................427
Answers to Practice Exam 2 ...............................................................................469
Appendix A Things You Forgot............................................................................491
Appendix B Need to Know More? ........................................................................499
Appendix C Calculations...................................................................................507
Glossary ......................................................................................................511
TOC, 9780789753151, 5/1/2014
