Introduction . . . . . 1
Welcome to the NCLEX-RN (R) Exam Cram . . . 1
Taking the Computerized Adaptive Test . . . 2
The Cost of the Exam . . . . 2
How to Prepare for the Exam . . . 2
How to Use This Book. . . . 3
About the Book . . . . 4
Contact the Authors . . . . 5
Self-Assessment . . . . 5
Testing Your Exam Readiness . . . 6
Chapter 1: Preparing for the National Council Exam for Registered Nurses . . 7
Preparing for the Exam . . . . 8
The CAT Exam . . . . 8
Testing Strategies. . . . 9
Read the Question Carefully . . . 10
Look for Keywords . . . . 10
Watch for Specific Details . . . 10
Eliminate Options That Are Clearly Wrong or Incorrect . . 11
Look for Similar Options . . . 11
Look for Opposite Answers . . . 12
Remember Legalities . . . . 12
Remember Infection Control . . . 12
Exam Prep Questions . . . . 13
Answer Rationales . . . . 15
Chapter 2: Pharmacology . . . . . 17
Three Areas of Pharmacology . . . 18
How Nurses Work with Pharmacology . . . 19
Time-released Drugs . . . . 20
Administering Medications . . . . 21
The Seven Rights of Administering Medication. . 21
Understanding and Identifying the Various Drugs. . 22
Angiotensin-Converting Enzyme Inhibitors . . 22
Beta Adrenergic Blockers . . . 23
Anti-Infectives (Aminoglycosides). . . 25
Benzodiazepines (Anticonvulsants/Antianxiety) . . 26
Phenothiazines (Antipsychotic/Antiemetic). . 28
Glucocorticoids . . . . 29
Antivirals. . . . 31
Cholesterol-Lowering Agents . . . 32
Angiotensin Receptor Blockers . . . 33
Histamine 2 Antagonists. . . 34
Proton Pump Inhibitors . . . 36
Anticoagulants . . . . 37
More Drug Identification Helpers . . . 38
Herbals . . . . . 38
Drug Schedules . . . . 39
Pregnancy Categories for Drugs. . . 40
Exam Prep Questions . . . . 41
Answer Rationales . . . . 43
Chapter 3: Caring for the Client with Disorders of the Respiratory System . . 45
Chronic Obstructive Pulmonary Disease. . . 46
Chronic Bronchitis . . . . 46
Emphysema . . . . 46
Asthma . . . . 47
Acute Respiratory Infections . . . 47
Pneumonia . . . . 48
Pleurisy . . . . 49
Tuberculosis . . . . 50
Influenza . . . . 50
Acute Respiratory Failure. . . . 51
Acute Respiratory Distress Syndrome . . . 51
Pulmonary Embolus . . . . 52
Emerging Infections . . . . 53
Severe Acute Respiratory Syndrome. . . 53
Legionnaire's Disease . . . . 54
Diagnostic Tests for Review. . . . 55
Pharmacology Categories for Review. . . 55
Exam Prep Questions . . . . 57
Answer Rationales . . . . 59
Suggested Readings and Resources. . . 60
Chapter 4: Caring for the Client with Disorders of the Genitourinary System . . 61
Acute Glomerulonephritis . . . . 62
Chronic Glomerulonephritis . . . 63
End Stage Renal Disease . . . . 64
Peritoneal Dialysis. . . . 64
Hemodialysis . . . . 64
Renal Transplantation. . . . 65
Nephrotic Syndrome . . . . 65
Urinary Calculi . . . . 66
Urinary Tract Infections. . . . 67
Genitourinary Disorders . . . . 67
Prostatitis . . . . 67
Benign Prostatic Hyperplasia . . . 68
Bladder Cancer . . . . 69
Diagnostic Tests for Review. . . . 70
Pharmacology Categories for Review. . . 70
Exam Prep Questions . . . . 72
Answer Rationales . . . . 74
Suggested Reading and Resources . . . 75
Chapter 5: Caring for the Client with Disorders of the Hematopoietic System . . 77
Anemia . . . . . 78
Pernicious Anemia. . . . 78
Aplastic Anemia . . . . 79
Sickle Cell Anemia . . . . 80
Iron Deficiency Anemia . . . 80
Cooley's Anemia (Thalassemia Major) . . . 81
Hemophilia. . . . 81
Polycythemia Vera. . . . 82
Diagnostic Tests for Review. . . . 83
Pharmacology for Review . . . . 83
Exam Prep Questions . . . . 84
Answer Rationales . . . . 86
Suggested Reading and Resources . . . 87
Chapter 6: Caring for the Client with Disorders of Fluid and Electrolyte Balance and Acid/Base Balance. . . . 89
Basic Knowledge of Fluid and Electrolyte Balance . . 90
Regulation of pH and Its Effect on Fluid and Electrolytes. . 91
How the Body Regulates pH . . . 91
Metabolic Acidosis . . . . 91
Causes of Metabolic Acidosis. . . 91
Symptoms of Metabolic Acidosis . . . 92
Care of the Client with Metabolic Acidosis. . 92
Respiratory Acidosis . . . . 93
Causes of Respiratory Acidosis . . . 93
Symptoms of Respiratory Acidosis . . . 94
Caring for the Client with Respiratory Acidosis. . 94
Metabolic Alkalosis . . . . 95
Causes of Metabolic Alkalosis . . . 95
Symptoms of Metabolic Alkalosis . . . 95
Caring for the Client with Metabolic Alkalosis. . 96
Respiratory Alkalosis. . . . 96
Symptoms of Respiratory Alkalosis. . . 96
Care of the Client with Respiratory Alkalosis . . 97
Normal Electrolyte Values. . . . 97
Changes Associated with Aging. . . 98
Exam Prep Questions . . . . 100
Answer Rationales . . . . 102
Suggested Reading and Resources . . . 103
Chapter 7: Caring for the Client with Burns. . . . 105
Burn Classifications. . . . 106
Burn Measurement with TBSA. . . 108
Nursing Care for Burn Victims. . . 109
The Emergent Phase . . . 110
The Intermediate Phase . . . 113
Dressings for Burns. . . . 114
The Rehabilitative Phase . . . 115
Diagnostic Tests for Review. . . 116
Pharmacology Categories for Review. . . 116
Exam Prep Questions . . . . 117
Answer Rationales . . . . 119
Suggested Reading and Resources . . . 120
Chapter 8: Caring for the Client with Sensorineural Disorders . . . 121
Disorders of the Eyes . . . . 122
Intraocular Disorders . . . 122
Retinal Disorders. . . . 125
Refractive Errors . . . . 127
Traumatic Injuries . . . . 128
Visual Tests for Review. . . . 129
Pharmacology Categories for Review. . . 129
Ear Disorders. . . . 129
Otitis Externa. . . . 130
Otitis Media . . . . 130
Meniere's Disease . . . . 130
Otosclerosis . . . . 131
Presbycusis . . . . 131
Ear Trauma. . . . 132
Assisting Clients with Hearing Loss. . . 132
Diagnostic Tests for Review. . . 132
Pharmacology Categories for Review. . . 133
Exam Prep Questions . . . . 134
Answer Rationales . . . . 136
Suggested Reading and Resources . . . 137
Chapter 9: Caring for the Client with Cancer. . . . 139
Cancer. . . . . 140
American Cancer Society's Seven Warning Signs of Cancer . 140
The Four Major Categories of Cancer . . . 140
Risk Factors for Specific Cancers . . . 141
Cancer Prevention. . . . 143
Patient Teaching . . . . 143
Management of the Client with Cancer. . . 143
Radiation. . . . 144
Chemotherapy . . . . 145
Bone Marrow and Peripheral Stem Cell Transplantation (PSCT) . 147
Types of Transplants . . . . 148
Nursing Care After Transplantation. . . 148
Hodgkin's Lymphoma . . . . 149
Diagnosis of Hodgkin's Lymphoma . . . 150
Prognosis of Hodgkin's Lymphoma . . . 150
Treatment of Hodgkin's Lymphoma. . . 150
Diagnostic Tests for Review. . . 151
Pharmacology for Review . . . . 152
Exam Prep Questions . . . . 154
Answer Rationales . . . . 156
Suggested Reading and Resources . . . 157
Chapter 10: Caring for the Client with Disorders of the Gastrointestinal System . . 159
Ulcers . . . . . 160
Types of Ulcers . . . . 160
Treatment of Ulcers . . . . 161
Inflammatory Bowel Disorders . . . 163
Crohn's Disease (Regional Enteritis) . . . 163
Ulcerative Colitis. . . . 164
Diverticulitis. . . . 165
Diagnosis of Diverticulitis . . . 165
Treatment of Diverticulitis. . . 166
Gastroesophageal Reflux Disease (GERD) . . . 166
Diseases Associated with the Liver . . . 167
Hepatitis . . . . 167
Cirrhosis . . . . 172
Pancreatitis . . . . 174
Cholecystitis/Cholelithiasis . . . 176
Symptoms of Cholecystitis and Cholelithiasis. . 176
Diagnosis of Cholecystitis/Cholethiasis . . . 177
Treatment of Cholecystitis. . . 177
Treatment of Cholethiasis . . . 177
Clostridium Difficile. . . . 178
Food-Borne Illnesses . . . . 179
Diagnostic Tests for Review. . . 180
Pharmacology for Review . . . . 180
Exam Prep Questions . . . . 182
Answer Rationales . . . . 184
Suggested Reading and Resources . . . 185
Chapter 11: Caring for the Client with Disorders of the Musculoskeletal System . . 187
Fractures. . . . 188
Treating Fractures . . . . 188
Compartment Syndrome . . . 191
Osteomyelitis . . . . 192
Osteoporosis. . . . 193
Treatment of Osteoporosis. . . 194
Gout . . . . . 195
Treatment of the Client with Gout. . . 195
Rheumatoid Arthritis . . . . 195
Treatment of Rheumatoid Arthritis . . . 196
Musculoskeletal Surgical Procedures . . . 197
Fractured Hip and Hip Replacement . . . 197
Total Knee Replacement . . . 198
Amputations . . . . 199
Assistive Devices for Ambulation . . . 201
Crutches . . . . 201
Canes. . . . 202
Walkers . . . . 202
Diagnostic Tests for Review. . . 203
Pharmacology for Review . . . . 203
Exam Prep Questions . . . . 205
Answer Rationales . . . . 207
Suggested Reading and Resources . . . 208
Chapter 12: Caring for the Client with Disorders of the Endocrine System . . 209
The Endocrine System. . . . 210
Pituitary Disorders . . . . 210
Tumors of the Pituitary . . . 211
Thyroid Disorders . . . . 213
Hypothyroidism. . . . 213
Hyperthyroidism . . . . 214
Parathyroid Disorders. . . . 216
Hypoparathyroidism . . . . 216
Hyperparathyroidism . . . 217
Adrenal Gland Disorders . . . . 218
Adrenocortical Insufficiency (Addison's Disease) . . 218
Adrenocortical Hypersecretion (Cushing's Syndrome) or Cushing's Disease. . . 219
Diabetes Mellitus. . . . 219
Diagnostic Tests for Review. . . 223
Pharmacology Categories for Review. . . 223
Exam Prep Questions . . . . 224
Answer Rationales . . . . 226
Suggested Reading and Resources . . . 227
Chapter 13: Caring for the Client with Disorders of the Cardiovascular System . . 229
Hypertension . . . . 230
Medications Used to Treat Hypertension . . 231
Heart Block . . . . 231
Toxicity to Medications . . . 233
Malfunction of the Conduction System . . . 233
Myocardial Infarction . . . . 234
Diagnosis of Myocardial Infarction . . . 235
Management of Myocardial Infarction Clients . . 236
Inflammatory Diseases of the Heart. . . 239
Infective Endocarditis . . . 239
Pericarditis . . . . 239
Buerger's Disease. . . . 240
Thrombophlebitis . . . . 240
Raynaud's Syndrome. . . . 241
Aneurysms . . . . 241
Congestive Heart Failure . . . . 242
Diagnostic Tests for Review. . . 242
Pharmacology Categories for Review. . . 243
Exam Prep Questions . . . . 244
Answer Rationales . . . . 246
Suggested Reading and Resources . . . 247
Chapter 14: Caring for the Client with Disorders of the Neurological System . . 249
Seizures. . . . . 250
Types of Seizures . . . . 250
Treatment of Seizure Clients. . . 252
Status Epilepticus . . . . 253
Brain Injuries . . . . 253
Epidural Hematomas . . . 254
Subdural Hematoma . . . . 254
Treatment of Epidural and Subdural Hematomas . . 254
Increased Intracranial Pressure . . . 255
Treatment of ICP . . . . 257
Neurological Assessment . . . . 258
Cranial Nerve Assessment . . . 258
Glasgow Coma Scale. . . . 259
Intracranial Pressure Monitors . . . 260
Care of the Client with Intracranial Surgery (Craniotomy) . . 260
Cerebrovascular Accident/Stroke . . . 262
Spinal Cord Injury . . . . 263
Treatment of Spinal Cord Injuries . . . 263
Potential Complications with SCI Clients. . 264
Guillain-Barre . . . . 265
Treating Clients with Guillian-Barre . . . 266
Degenerative Neurological Disorders . . . 266
Diagnostic Tests for Review. . . 267
Pharmacology for Review . . . . 267
Exam Prep Questions . . . . 269
Answer Rationales . . . . 271
Suggested Reading and Resources . . . 272
Chapter 15: Caring for the Client with Psychiatric Disorders . . . 273
Anxiety-Related Disorders . . . . 274
Generalized Anxiety Disorder . . . 274
Post-traumatic Stress Disorder . . . 275
Dissociative Identity Disorder . . . 275
Somatoform Disorder. . . 276
Panic Disorder . . . . 276
Phobic Disorders . . . . 277
Obsessive-Compulsive Disorder . . . 277
Personality Disorders . . . . 278
Cluster A. . . . 278
Cluster B. . . . 279
Cluster C . . . . 280
Managing Clients with Personality Disorders. . 281
Psychotic Disorders . . . . 282
Schizophrenia. . . . 282
Bipolar Disorders . . . . 284
Substance Abuse . . . . 286
Alcoholism . . . . 286
Other Commonly Abused Substances . . . 288
Disorders of Childhood and Adolescence . . . 291
Conduct Disorder . . . . 291
Oppositional Defiant Disorder . . . 291
Attention Deficit Hyperactive Disorder. . . 291
Autistic Disorder . . . . 292
Eating Disorders . . . . 293
Diagnostic Tests for Review. . . 293
Pharmacology Categories for Review. . . 294
Exam Prep Questions . . . . 295
Answer Rationales . . . . 297
Suggested Reading and Resources . . . 298
Chapter 16: Caring for the Maternal/Infant Client. . . 299
Signs of Pregnancy . . . . 300
Presumptive Signs . . . . 300
Probable Signs . . . . 300
Positive Signs . . . . 301
Prenatal Care . . . . 301
Prenatal Diet and Weight Maintenance. . . 301
Alpha-Fetoprotein Screening. . . 301
Other Prenatal Diagnostic Tests . . . 302
Assessing Fetal Heart Tones . . . 303
Ultrasonography . . . . 303
Signs of Complications of Pregnancy. . . 303
Types of Abortions . . . . 304
Complications Affecting Pregnancy . . . 305
Diabetes in Pregnancy . . . 305
Preeclampsia. . . . 306
Disseminated Intravascular Coagulation . . 307
Cord Prolapse . . . . 307
Abruptio Placenta . . . . 307
Placenta Previa. . . . 307
Maternal Infections. . . . 308
Preterm Labor . . . . 310
Intrapartal Care . . . . 311
Stages of Labor . . . . 311
Phases of Labor . . . . 312
Important Terms You Should Know. . . 312
Prelabor Testing . . . . 313
Fetal Monitoring . . . . 314
Pharmacologic Management of Labor. . . 316
Postpartum Care . . . . 317
Terms Associated with the Normal Newborn. . . 317
Rh Incompatibility . . . . 318
Contraception . . . . 319
Diagnostic Tests for Review. . . 320
Pharmacology Categories for Review. . . 321
Exam Prep Questions . . . . 322
Answer Rationales . . . . 324
Suggested Reading and Resources . . . 325
Chapter 17: Caring for the Pediatric Client . . . . 327
Growth and Development . . . . 328
Infant (28 Days to 1 Year) . . . 328
Toddler (1-3 Years) . . . . 330
Preschooler (3-5 Years) . . . 331
School Age (6-12 Years) . . . 332
Adolescence (12-18 Years) . . . 333
Congenital Anomalies. . . . 334
Anomalies of the Gastrointestinal System . . 334
Anomalies of the Musculoskeletal System . . 338
Anomalies of the Cardiovascular System . . 340
Inborn Errors of Metabolism . . . 343
Respiratory Disorders. . . . 344
Acute Otitis Media . . . . 345
Tonsillitis . . . . 346
Laryngotracheobronchitis . . . 347
Acute Epiglottitis. . . . 347
Bronchiolitis . . . . 348
Cystic Fibrosis (Mucoviscidosis) . . . 349
Gastrointestinal Disorders . . . . 350
Gastroenteritis . . . . 350
Pyloric Stenosis . . . . 350
Intussusception . . . . 351
Celiac (Gluten-Induced Enteropathy, Celiac Sprue) . . 351
Cardiovascular Disorders . . . . 351
Rheumatic Fever . . . . 352
Kawasaki's Disease (Mucocutaneous Lymph Node Syndrome) . 353
Musculoskeletal Disorders . . . . 354
Scoliosis. . . . 354
Legg-Calve-Perthes Disease (Coxa Plana) . . 355
Muscular Dystrophies. . . 355
Childhood Cancer. . . . 356
Wilms Tumor (Nephroblastoma) . . . 356
Leukemia . . . . 356
Osteogenic Sarcoma (Osteosarcoma) . . . 357
Ingestion of Hazardous Substances . . . 357
Salicylate Overdose . . . . 357
Acetaminophen (Tylenol) Overdose . . . 357
Lead (Plumbism) . . . . 358
Iron Poisoning . . . . 358
Diagnostic Tests for Review. . . 359
Pharmacology Categories for Review. . . 359
Exam Prep Questions . . . . 360
Answer Rationales . . . . 362
Suggested Reading and Resources . . . 363
Chapter 18: Emergency Nursing. . . . 365
The ABCDs of Emergency Care . . . 366
Airway . . . . 367
Breathing . . . . 367
Circulation . . . . 368
Deficits . . . . 369
Obtaining Client Information . . . 369
Trauma . . . . . 370
Head Injuries . . . . 370
Chest Injuries. . . . 371
Abdominal Injuries . . . . 371
Documenting and Protecting Forensic Evidence . . 372
Poisoning . . . . 373
Poisonous Stings and Bites . . . 374
Bioterrorism. . . . 375
Chemical and Biological Agents . . . 375
Nuclear Warfare . . . . 378
Triage Categories for Disaster Victims . . . 379
Diagnostic Tests for Review. . . 379
Pharmacology Categories for Review. . . 380
Exam Prep Questions . . . . 381
Answer Rationales . . . . 383
Suggested Reading and Resources . . . 384
Chapter 19: Cultural Practices Influencing Nursing Care. . . 385
Cultural Assessment . . . . 386
Understanding Client Beliefs. . . 386
Working with Clients Who Speak Different Languages. . 387
Healthcare of Hispanics/Latinos. . . 388
Time Considerations. . . . 389
Use of Nonverbal/Verbal Communication . . 389
Childbirth and Pain Response . . . 390
Healthcare of Native Americans and Alaskan Natives. . 390
Time Considerations. . . . 391
Use of Nonverbal/Verbal Communication . . 391
Childbirth and Pain Response . . . 391
Healthcare of Asian-Americans . . . 391
Time Considerations. . . . 393
Use of Nonverbal/Verbal Communication . . 393
Childbirth and Pain Response . . . 393
Healthcare of Arab-Americans . . . 393
Time Considerations. . . . 394
Use of Nonverbal/Verbal Communication . . 394
Childbirth and Pain Response . . . 394
Nursing Plan Dietary Considerations Across Cultures . . 395
Religious Beliefs and Refusal of Care Considerations . . 396
Exam Prep Questions . . . . 400
Answer Rationales . . . . 402
Suggested Reading and Resources . . . 403
Chapter 20: Legal Issues in Nursing Practice . . . . 405
Types of Laws . . . . 406
Statutory Laws/Regulatory Laws . . . 407
Civil Laws. . . . 407
Criminal Laws . . . . 407
Common Law . . . . 407
Code of Ethical Behavior in Nursing Practice . . 409
Legal Theories That Affect Nursing Practice . . 410
Negligence . . . . 410
Malpractice. . . . 410
Witnessing Consent for Care . . . 411
Tort . . . . 411
Assault and Battery . . . . 411
Fraud . . . . 411
Managing Client Care . . . . 411
Exam Prep Questions . . . . 417
Answers to Exam Questions. . . 419
Suggested Reading and Resources . . . 420
Practice Exam I . . . . 421
Practice Exam II . . . . 475
Answers to Practice Exam I . . . . 529
Answers to Practice Exam II. . . . 559
Appendix A: Things You Forgot . . . . 589
Appendix B: Need to Know More? . . . . 597
Appendix C: Calculations. . . . . 605
Appendix D: Most-Prescribed Medications in the United States . . . 609
Appendix E: Alphabetical Listing of Nursing Boards in the United States and Protectorates . 613
TOC, 9780789751058, 7/18/2013
