NCLEX RN LPN Success for Nurses

🩺 NCLEX RN NGN QUESTION A nurse is caring for a client admitted with heart failure. The client has: • BP: 92/58 mmHg • HR: 118/min • RR: 30/min • SpO₂: 86% on room air • New bilateral crackles • Increasing confusion The following questions are related to this case study.!

SATA — Increased Intracranial Pressure Which findings are concerning for increased intracranial pressure? A. Decreasing level of consciousness B. Projectile vomiting C. Widening pulse pressure D. Bradycardia E. Hypotension with tachycardia F. Unequal pupils

. Prioritization The nurse receives report on four clients. Which client should be assessed first? A. Client with pneumonia whose temperature is 38.2°C (100.8°F) B. Client with heart failure who gained 2 lb overnight C. Client with COPD who is newly confused and has an SpO₂ of 84% D. Client with diabetes whose glucose is 210 mg/dL #NCLEX #NCLEXSuccess #NCLEXPrep #NCLEXReview #NCLEXlpn

Cloze — Heparin A client receiving an IV heparin infusion has a markedly elevated aPTT and develops bleeding from the gums. The nurse should first ____, because the client is at risk for ____.? Like share comment! #LPN #NursingStudents #FutureNurses #NCLEXReview #NCLEXPrep #NCLEXSuccess #NCLEX

Answers: A, B, C, E Rationale: Severe hyperkalemia with ECG changes is an emergency. IV calcium stabilizes the cardiac membrane but does not remove potassium. Insulin shifts potassium intracellularly, with dextrose used to prevent hypoglycemia. Potassium-binding therapy helps remove potassium from the body. Continuous ECG monitoring is essential. Potassium supplementation and high-potassium foods would worsen the condition.

Answer: Condition: Ischemic stroke Actions: • Prepare for thrombolytic therapy • Maintain airway and oxygenation Monitor: • Neurological status • Blood pressure Rationale: Sudden focal neurological deficits with no hemorrhage on CT are consistent with an acute ischemic stroke. Because symptoms began within the appropriate treatment window, the client should be evaluated for thrombolytic therapy. Airway and oxygenation must be maintained. Frequent neurological assessments detect deterioration, while BP monitoring is essential because uncontrolled hypertension can worsen cerebral injury and affect eligibility for thrombolysis. #NCLEX #NCLEXSuccess #NCLEXPrep #NCLEXReview #FutureNurses #NursingStudents #LPN

SATA: Hyperkalemia A client with acute kidney injury has a potassium level of 6.8 mEq/L and peaked T waves on the ECG. Which interventions should the nurse anticipate? Select all that apply. A. IV calcium gluconate B. Regular insulin with IV dextrose C. Sodium zirconium cyclosilicate or another potassium-binding therapy as prescribed D. IV potassium chloride E. Continuous cardiac monitoring F. Encourage foods high in potassium #NursingSchool #LPN #RN #NursingStudents #FutureNurses #NCLEXReview #NCLEXPrep #NCLEXSuccess #NCLEX

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Question 2: Bow-Tie Acute Stroke A 68-year-old client suddenly develops right-sided weakness, facial drooping, and difficulty speaking. Symptoms began 45 minutes ago. CT of the head shows no evidence of hemorrhage. Select the most likely condition, two appropriate actions, and two parameters to monitor. Condition • Ischemic stroke • Hemorrhagic stroke • Hypoglycemia • Seizure Actions • Prepare for thrombolytic therapy • Maintain airway and oxygenation • Administer aspirin immediately before thrombolysis • Give oral fluids • Lower BP rapidly to normal Monitor • Neurological status • Blood pressure • Bowel sounds • Urine ketones

NGN Case Study — DKA A 22-year-old client with type 1 diabetes presents with nausea, vomiting, abdominal pain, and increasing thirst. Assessment: HR 118/min, RR 28/min and deep, BP 94/58 mm Hg. The client has dry mucous membranes and a fruity odor to the breath. Laboratory results: • Glucose: 486 mg/dL • pH: 7.18 • HCO₃⁻: 11 mEq/L • Potassium: 5.6 mEq/L • Sodium: 130 mEq/L The following questions are related to the case study above.!

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Mark K lectures. https://drive.google.com/drive/folders/1GZaVcOs0Yi_6t4-glCco5vdHhV2gnGwS

2. Safety & Infection Control Standard Precautions: Applied to ALL clients. Hand hygiene, gloves when touching blood/fluids. Contact Precautions: (Gown + Gloves) Conditions: C. difficile, MRSA, VRE, Scabies, RSV. Rule: C. diff requires handwashing with soap and water (alcohol hand sanitizer does NOT kill spores). Droplet Precautions: (Surgical Mask + Eye Protection/Face Shield within 3-6 ft) Conditions: Influenza, Pertussis, Bacterial Meningitis, Mumps, Rubella. Rule: Client wears a surgical mask during transport. Airborne Precautions: (N95 Respirator or PAPR, Negative Pressure Room) Conditions: Tuberculosis (TB), Measles (Rubeola), Varicella (Chickenpox), Disseminated Herpes Zoster. Rule: Door must remain closed at all times.

1. Fundamentals & Prioritization ABCs vs. MASLOW vs. SAFETY: Airway/Breathing/Circulation: Always prioritized first unless the patient is in Cardiac Arrest (then CAB—Compressions, Airway, Breathing). Acute over Chronic: A client with acute confusion takes priority over a client with chronic dementia exhibiting baseline confusion. Unstable over Stable: Unexpected symptoms take priority over expected disease progression (e.g., angina post-MI vs. typical baseline angina). Actual over Risk: An actual impaired gas exchange takes priority over a risk for skin breakdown. Triage (Mass Casualty/Disaster): Red (Immediate): Life-threatening injuries, but high chance of survival if treated immediately (e.g., tension pneumothorax, open fracture with distal pulse present, hemorrhage). Yellow (Delayed): Serious injuries, treatment can be delayed 30–120 minutes (e.g., stable abdominal trauma, large bone fracture with distal pulses). Green (Minimal/Walking Wounded): Minor injuries; can delay treatment hours/days. Black (Expectant): Deceased or injuries so severe survival is unlikely (e.g., 90\% 3rd-degree burns, penetrating head injury with fixed/dilated pupils).