NCLEX-RN Exam Prep

Wilda Rinehart received an associate’s degree in nursing from Northeast Mississippi Community 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 28 years, she and her associates have worked with nursing graduates and schools of nursing to help graduates 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 coauthored materials used in seminars presented by Rinehart and Associates Nursing Review. As the president of Rinehart and Associates, she serves as the coordinator of a company dedicated to improving the quality of health through nursing education.   Dr. Diann Sloan received an associate’s 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 coauthored 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’s 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. Ms. Hurd is a certified nurse educator. She currently serves as a nurse educator consultant and an independent contractor and 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; 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 itemwriting for nursing faculty. Her primary professional goal is to prepare the student and graduate for excellence in the delivery of healthcare.  

 Introduction  1



Organization  2



Instructional Features 2



Extensive Practice Test Options 3



Final Review 3



  Other Valuable Tools 3



About the NCLEX Exam 4



  Advice for Preparing for the Exam 6



  Advice for Test Day



  Hints for Using This Book 7



Contact the Author 7



Study and Exam Preparation Tips 9



Study Tips 9



Exam Prep Tips 10



  Read the Question Carefully 10



  Look for Keywords 11



  Watch for Specific Details 11



  Eliminate Options That Are Clearly Wrong or Incorrect 11



Look for Similar Options 11



  Look for Opposite Answers 12



 



Part I: Exam Preparation



Chapter 1: Pharmacology 15



Three Areas of Pharmacology 15



How Nurses Work with Pharmacology 16



Time-released Drugs 17



Administering Medications 18



  The Seven Rights of Administering Medication 18



Understanding and Identifying the Various Drugs 19



  Angiotensin-Converting Enzyme Inhibitors 19



  Beta Adrenergic Blockers 20



  Anti-Infectives (Aminoglycosides) 21



  Benzodiazepines (Anticonvulsants/Antianxiety) 23



  Phenothiazines (Antipsychotic/Antiemetic) 24



  Glucocorticoids 25



  Antivirals 27



  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



Key Concepts 36



  Key Terms 36



Apply Your Knowledge 37



  Answer Rationales 39



 



Chapter 2: Fluid and Electrolyte and Acid/Base Balance  41



Total Body Water Calculation 41



Management of the Client with Imbalances in Fluid and Electrolytes 43



  Types of Intravenous Fluids 43



  How the Body Regulates Electrolytes 44



  How the Body Regulates pH 52



Key Concepts 60



  Key Terms 60



  Diagnostic Tests 60



  Pharmacological Agents Used in the Treatment of Clients with Alterations in Fluids and Electrolytes 60



Apply Your Knowledge 61



  Exam Questions 62



  Answers to Exam Questions 64



Suggested Reading and Resources 65



 



Chapter 3: Care of the Client with Cardiovascular Disorders 67



Hypertension 68



  Diagnosing the Client with Hypertension 69



  Managing the Client with Hypertension 69



Coronary Artery Disease 71



  Atherosclerosis and Arteriosclerosis 71



Conduction System of the Heart 72



  Heart Block 73



Cardiac Monitoring 74



  Reading an Electrocardiogram 75



Cardiac Dysrhythmias 76



  Ventricular Tachycardia 77



  Ventricular Fibrillation 78



  Internal Pacemaker/Internal Cardiac Defibrillators 79



  Cardiopulmonary Resuscitation 80



Angina Pectoris 80



Myocardial Infarction 81



  Diagnosis of Myocardial Infarction 82



  Management of a Client with Myocardial Infarction 82



Aneurysms 89



Inflammatory Diseases of the Heart 90



  Infective Endocarditis 90



  Pericarditis 90



  Peripheral Vascular Disease 91



Varicose Veins/Thrombophlebitis 92



Raynaud’s Phenomenon 92



Buerger’s Disease 92



Key Concepts 94



Key Terms 94



 Diagnostics 95



  Pharmacological Agents Used in the Treatment of Clients with Cardiovascular Disorders 96



Apply Your Knowledge 101



  Exam Questions 101



     Answers to Exam Questions 103



Suggested Reading and Resources 104



 



Chapter 4: Care of the Client with Endocrine Disorders 105



Pituitary Gland 106



  Hypopituitarism 106



  Hyperpituitarism 106



  Disorders of the Posterior Pituitary Gland 107



Thyroid Disorders 108



  Hypothyroidism 108



  Hyperthyroidism 110



Parathyroid Disorders 112



  Hypoparathyroidism 112



     Hyperparathyroidism 113



Diabetes Mellitus 114



  Hyperglycemia 116



  Hypoglycemia 117



  Managing Hyperglycemia and Hypoglycemia 117



Adrenal Gland 118



  Adrenal Gland Disorders 119



Key Concepts 123



  Key Terms 123



  Diagnostics 124



  Pharmacological Agents Used to Treat Clients with Endocrine Disorders 124



Apply Your Knowledge 128



  Exam Questions 128



  Answers to Exam Questions 130



Suggested Reading and Resources 131



 



Chapter 5: Care of the Client with Respiratory Disorders 133



Noninfectious Disorders of the Lower Respiratory Tract 133



  Chronic Bronchitis 133



  Emphysema 134



  Asthma 135



  Pleurisy 137



  Pulmonary Hypertension 138



  Interstitial Pulmonary Disease 139



  Sarcoidosis 139



  Pulmonary Fibrosis 140



  Occupational Pulmonary Disease 140



Infectious Disorders of the Lower Respiratory Tract 142



  Pneumonia 142



  Tuberculosis 145



  Influenza 147



Life-Threatening Pulmonary Disorders 148



  Acute Respiratory Distress Syndrome 148



  Pulmonary Embolus 152



  Pneumothorax 154



  Hemothorax 155



Emerging Infections 158



  SARS 158



  Legionnaires’ Disease 159



Key Concepts 161



  Key Terms 161



  Diagnostic Tests 161



  Pharmacological Agents Used in the Care of the Client with Disorders of the Respiratory System 162



Apply Your Knowledge 165



  Exam Questions 166



  Answers to Exam Questions 168



Suggested Reading and Resources 169



 



Chapter 6: Care of the Client with Genitourinary Disorders 171



Renal Disorders 172



  Acute Glomerulonephritis 172



  Chronic Glomerulonephritis 173



  Goodpasture’s Syndrome 174



 Nephrotic Syndrome 175



  Polycystic Kidney Disease 176



  Hydronephrosis/Hydroureteronephrosis 177



  Pyelonephritis 178



Acute and Chronic Renal Failure 179



  Chronic Renal Failure 180



  Peritoneal Dialysis 181



  Hemodialysis 182



  Continuous Renal Replacement Therapy 183



  Renal Transplantation 184



Urinary Disorders 185



  Cystitis 185



  Urinary Incontinence 187



  Urolithiasis 188



Genitourinary Disorders 189



  Prostatitis 190



  Benign Prostatic Hypertrophy 190



  Erectile Dysfunction 191



  Epididymitis 193



Priapism 193



Key Concepts 195



  Key Terms 195



  Diagnostics 195



  Pharmacologic Agents for the Client with Genitourinary Disorders 196



Apply Your Knowledge 200



  Exam Questions 200



  Answers to Exam Questions 202



Suggested Reading and Resources 203



 



Chapter 7: Care of the Client with Integumentary Disorders 205



Common Infections of the Integumentary System 205



  Viral Infections 205



  Fungal Infections 207



  Bacterial Infections 208



Psoriasis 208



Pressure Ulcers 209



Burns 212



  Burn Classifications 212



  Burn Measurement with TBSA 214



  Nursing Care for Burn Victims 215



Key Concepts 223



  Key Terms 223



  Diagnostic Tests 223



  Pharmacological Agents Used in the Care of the Client with Integumentary Disorders 224  



Apply Your Knowledge 226



     Exam Questions 226



  Answers to Exam Questions 228



Suggested Reading and Resources 229



 



Chapter 8: Care of the Client with Sensory Disorders 231



Disorders of the Eyes 231



  Intraocular Disorders 232



  Uveitis 235



  Retinal Disorders 236



  Refractive Errors 239



  Traumatic Injuries 240



  Ocular Melanoma 240



Disorders of the Ears 242



  Otitis Externa 243



  Otitis Media 243



  Mastoiditis 244



  Ménière’s Disease 244



  Acoustic Neuroma 245



  Otosclerosis 245



  Presbycusis 246



  Ear Trauma 246



  Assisting Clients with Hearing Loss 247



Key Concepts 250



  Key Terms 250



  Diagnostic Tests 251



  Pharmacological Agents Used in the Care of the Client with Disorders of the Eyes and Ears 251   



Apply Your Knowledge 253



  Exam Questions 253



  Answers to Exam Questions 255



Suggested Reading and Resources 256



Chapter 9: Care of the Client with Gastrointestinal Disorders 257



Peptic Ulcer Disease 258



  Types of Ulcers 259



  Diagnosis of Ulcers 259



  Treatment of Ulcers 260



Inflammatory Bowel Disorders 263



  Crohn’s Disease 263



  Ulcerative Colitis 263



  Management of the Client with Inflammatory Bowel Disease 264



Diverticular Disease 265



  Management of the Client with Diverticulitis 265



Hemorrhoids 266



Appendicitis 266



Peritonitis 268



Intestinal Obstruction 269



Esophageal Disorders 270



  GERD 270



  Hiatal Hernia 274



Diseases Associated with the Liver 275



  Hepatitis 275



  Cirrhosis 281



Acute Pancreatitis 285



  Diagnosis of Pancreatitis 286



  Treatment of Pancreatitis 286



Cholecystitis/Cholelithiasis 287



  Symptoms of Cholecystitis and Cholelithiasis 288



  Diagnosis of Cholecystitis/Cholelithiasis 288



  Treatment of Cholecystitis 289



  Treatment of Cholethiasis 289



Clostridium Difficile 290



Food-Borne Illnesses 291



Key Concepts 294



  Key Terms 294



  Diagnostic Tests 295



  Pharmacological Agents Used in the Care of the Client with Disorders of the Gastrointestinal System 295



Apply Your Knowledge 297



  Exam Questions 298



     Answers to Exam Questions 300



Suggested Reading and Resources 301



 



Chapter 10: Care of the Client with Hematological Disorders 303



Anemia 303



  Pernicious Anemia 304



  Aplastic Anemia 304



  Sickle Cell Anemia 305



  Iron Deficiency Anemia 309



Thalassemia 311



Polycythemia Vera 312



Hemophilia 313



Transfusion Therapy 315



  Transfusion Reactions 317



Key Concepts 319



  Key Terms 319



  Diagnostic Tests for Review 319



  Pharmacological Agents Used in Hematological Disorders 320



Apply Your Knowledge 321



  Exam Questions 321



  Answers to Exam Questions 323



Suggested Reading and Resources 324



 



Chapter 11: Care of the Client with Disorders of the Neurological System 325



Neurological Assessment 326



  Cranial Nerve Assessment 326



  Glasgow Coma Scale 327



  Intracranial Pressure Monitors 328



Brain Injuries 329



  Epidural Hematomas 332



  Subdural Hematoma 332



  Intracerebral Hematomas 332



  Treatment of Hematomas 332



  Increased Intracranial Pressure 332



Brain Tumors 336



  Treatment of Brain Tumors 337



Care of the Client with Intracranial Surgery (Craniotomy) 338



Cerebrovascular Accident/Stroke 342



  Ischemic Stroke 342



  Hemorrhagic Stroke 344



Seizures 347



  Types of Seizures 347



  Treatment of Seizure Clients 350



Parkinson’s Disease 350



Meningitis 352



Autoimmune Neurological Disorders 354



  Multiple Sclerosis 354



  Myasthenia Gravis 355



  Guillain-Barré 357



Degenerative Neurological Disorders 358



Cranial Nerve Disorders 359



  Trigeminal Neuralgia 359



  Bell’s Palsy 359



Spinal Cord Injuries 360



  Treatment of Spinal Cord Injuries 361



  Potential Complications with SCI Clients 362



Intervertebral Disk Disease 363



Diabetes Insipidus 365



Key Concepts 367



  Key Terms 367



  Diagnostics 368