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Score Higher on the NCLEX-PN (R) Exam!We provide you with the proven study tools and expert insight that will help you score higher on your examwww.pearsonITcertification.comThe CD-ROM-based practice exam includes an interactive test engine for a realistic exam experience with 645 questions.Study Tips like the advice and instruction that a personal tutor might provide Notes, Tips, and Cautions provide you with hints and strategies that will help you reduce your mistakes on the exam Comprehensive discussion of all subject areas covered on the NCLEX-PN (R) Exam Practice Questions that include detailed explanations of correct and incorrect answers-so you can learn the material from your success and mistakes COMPREHENSIVE! Succeed with comprehensive learning and practice testsMaster the NCLEX-PN (R) exam materials in all tested subject areas Prepare with four comprehensive practice tests Analyze your test readiness and areas for further study with topic-focused chapter tests CD-ROM-based practice exam includes an interactive test engine for a meaningful exam experience with approximately 645 questions Learn important test-taking strategies to maximize your score and diminish your anxiety Pearson IT Certification Practice Test minimum system requirements:Windows XP (SP3), Windows Vista (SP2), Windows 7, or Windows 8 Professional; Microsoft .NET Framework 4.0 Client; Pentium class 1GHz processor (or equivalent); 512 MB RAM; 650 MB hard disk space plus 50 MB for each downloaded practice exam ; access to the Internet to register and download xam databasesNCLEX-RN (R) and NCLEX-PN (R) are registered trademarks of the National Council of State Boards of Nursing, Inc. (NCSBN), which does not sponsor or endorse this product.
Contents
Introduction . . . . . . . . . . . . . . . . . . . 1Organization . . . . . . . . . . . . . . . . . 2Instructional Features . . . . . . . . . . . . . . . 3Extensive Practice Test Options. . . . . . . . . . . . . 3Final Review . . . . . . . . . . . . . . . . . 4Other Valuable Tools . . . . . . . . . . . . . . 4About the NCLEX Exam . . . . . . . . . . . . . . 4Advice for Preparing for the Exam . . . . . . . . . . . 6Advice for Test Day . . . . . . . . . . . . . . 6Hints for Using This Book . . . . . . . . . . . . . 7Contact the Author . . . . . . . . . . . . . . . . 8Study and Exam Preparation Tips . . . . . . . . . . . . . . 9Study Tips . . . . . . . . . . . . . . . . . . 9Exam Prep Tips . . . . . . . . . . . . . . . . 10Read the Question Carefully . . . . . . . . . . . . 11Look for Keywords . . . . . . . . . . . . . . 11Watch for Specific Details . . . . . . . . . . . . . 11Eliminate Options That Are Clearly Wrong or Incorrect . . . . . . 11Look for Similar Options . . . . . . . . . . . . . 11Look for Opposite Answers . . . . . . . . . . . . 12Part I: Exam PreparationChapter 1: Pharmacology . . . . . . . . . . . . . . . . . . 15Three Areas of Pharmacology . . . . . . . . . . . . . 15How Nurses Work with Pharmacology . . . . . . . . . . . 16Time-released Drugs. . . . . . . . . . . . . . . 17Administering Medications. . . . . . . . . . . . . . 18The Seven Rights of Administering Medication . . . . . . . . 18Understanding and Identifying the Various Drugs . . . . . . . . . 19Angiotensin-Converting Enzyme Inhibitors . . . . . . . . . 19Beta Adrenergic Blockers . . . . . . . . . . . . . 20Anti-Infectives (Aminoglycosides) . . . . . . . . . . . 21Benzodiazepines (Anticonvulsants/Antianxiety). . . . . . . . 23Phenothiazines (Antipsychotic/Antiemetic) . . . . . . . . . 24Glucocorticoids . . . . . . . . . . . . . . . 25Antivirals . . . . . . . . . . . . . . . . 27Cholesterol-Lowering Agents . . . . . . . . . . . . 28Angiotensin Receptor Blockers . . . . . . . . . . . . 29Histamine 2 Antagonists . . . . . . . . . . . . . 30Proton Pump Inhibitors . . . . . . . . . . . . . 31Anticoagulants . . . . . . . . . . . . . . . 32More Drug Identification Helpers . . . . . . . . . . . 33Herbals . . . . . . . . . . . . . . . . . . 34Drug Schedules . . . . . . . . . . . . . . . . 35Pregnancy Categories for Drugs . . . . . . . . . . . . . 35Key Concepts . . . . . . . . . . . . . . . . . 36Key Terms . . . . . . . . . . . . . . . . 36Apply Your Knowledge . . . . . . . . . . . . . . . 37Answer Rationales . . . . . . . . . . . . . . 39Chapter 2: Fluid and Electrolyte and Acid/Base Balance . . . . . . . . . . . . 41Total Body Water Calculation . . . . . . . . . . . . . 41Management of the Client with Imbalances in Fluid and Electrolytes . . . . . 43Types of Intravenous Fluids . . . . . . . . . . . . 43How the Body Regulates Electrolytes. . . . . . . . . . 44How the Body Regulates pH . . . . . . . . . . . . 52Key Concepts . . . . . . . . . . . . . . . . . 60Key Terms . . . . . . . . . . . . . . . . 60Diagnostic Tests . . . . . . . . . . . . . . . 60Pharmacological Agents Used in the Treatment of Clients with Alterations in Fluids and Electrolytes. . . . . . . . . . 60Apply Your Knowledge . . . . . . . . . . . . . . . 61Exam Questions . . . . . . . . . . . . . . . 62Answers to Exam Questions . . . . . . . . . . . . 64Suggested Reading and Resources. . . . . . . . . . . . 65Chapter 3: Care of the Client with Cardiovascular Disorders . . . . . . . . . . . 67Hypertension . . . . . . . . . . . . . . . . . 68Diagnosing the Client with Hypertension . . . . . . . . . 69Managing the Client with Hypertension . . . . . . . . . . 69Coronary Artery Disease. . . . . . . . . . . . . . 71Atherosclerosis and Arteriosclerosis . . . . . . . . . . . 72Conduction System of the Heart. . . . . . . . . . . . . 72Heart Block. . . . . . . . . . . . . . . . 73Cardiac Monitoring . . . . . . . . . . . . . . . 74Reading an Electrocardiogram. . . . . . . . . . . . 75Cardiac Dysrhythmias . . . . . . . . . . . . . . . 76Ventricular Tachycardia. . . . . . . . . . . . . 77Ventricular Fibrillation . . . . . . . . . . . . . 78Internal Pacemaker/Internal Cardiac Defibrillators . . . . . . . 79Cardiopulmonary Resuscitation . . . . . . . . . . . . 80Angina Pectoris . . . . . . . . . . . . . . . . 80Myocardial Infarction . . . . . . . . . . . . . . . 81Diagnosis of Myocardial Infarction . . . . . . . . . . . 82Management of a Client with Myocardial Infarction . . . . . . . 82Aneurysms. . . . . . . . . . . . . . . . . 89Inflammatory Diseases of the Heart . . . . . . . . . . . . 90Infective Endocarditis . . . . . . . . . . . . . . 90Pericarditis . . . . . . . . . . . . . . . . 90Peripheral Vascular Disease . . . . . . . . . . . . 91Varicose Veins/Thrombophlebitis . . . . . . . . . . . . 92Raynaud's Phenomenon . . . . . . . . . . . . . . 92Buerger's Disease . . . . . . . . . . . . . . . . 92Key Concepts . . . . . . . . . . . . . . . . . 94Key Terms. . . . . . . . . . . . . . . . . 94Diagnostics . . . . . . . . . . . . . . . . . 95Pharmacological Agents Used in the Treatment of Clients with Cardiovascular Disorders . . . . . . . . . . . . . 96Apply Your Knowledge . . . . . . . . . . . . . . 101Exam Questions . . . . . . . . . . . . . . . 101Answers to Exam Questions . . . . . . . . . . . . 103Suggested Reading and Resources. . . . . . . . . . . . 104Chapter 4: Care of the Client with Endocrine Disorders . . . . . . . . . . . . 105Pituitary Gland. . . . . . . . . . . . . . . . 106Hypopituitarism . . . . . . . . . . . . . . . 106Hyperpituitarism . . . . . . . . . . . . . . 106Disorders of the Posterior Pituitary Gland . . . . . . . . . 107Thyroid Disorders . . . . . . . . . . . . . . . 108Hypothyroidism . . . . . . . . . . . . . . . 108Hyperthyroidism . . . . . . . . . . . . . . 110Parathyroid Disorders . . . . . . . . . . . . . . . 112Hypoparathyroidism . . . . . . . . . . . . . . 112Hyperparathyroidism. . . . . . . . . . . . . . 113Diabetes Mellitus . . . . . . . . . . . . . . . . 114Hyperglycemia . . . . . . . . . . . . . . . 116Hypoglycemia. . . . . . . . . . . . . . . 117Managing Hyperglycemia and Hypoglycemia. . . . . . . . 117Adrenal Gland . . . . . . . . . . . . . . . . 118Adrenal Gland Disorders . . . . . . . . . . . . . 119Key Concepts . . . . . . . . . . . . . . . . 123Key Terms . . . . . . . . . . . . . . . . 123Diagnostics . . . . . . . . . . . . . . . . 124Pharmacological Agents Used to Treat Clients with Endocrine Disorders . . . . . . . . . . . . . 124Apply Your Knowledge . . . . . . . . . . . . . . 128Exam Questions . . . . . . . . . . . . . . . 128Answers to Exam Questions . . . . . . . . . . . . 130Suggested Reading and Resources. . . . . . . . . . . . 132Chapter 5: Care of the Client with Respiratory Disorders. . . . . . . . . . . 133Noninfectious Disorders of the Lower Respiratory Tract . . . . . . . 133Chronic Bronchitis. . . . . . . . . . . . . . 133Emphysema. . . . . . . . . . . . . . . . 134Asthma. . . . . . . . . . . . . . . . . 135Pleurisy (Pleuritis) . . . . . . . . . . . . . . 137Pulmonary Hypertension . . . . . . . . . . . . . 138Interstitial Pulmonary Disease . . . . . . . . . . . . 139Sarcoidosis. . . . . . . . . . . . . . . . 139Pulmonary Fibrosis . . . . . . . . . . . . . . 140Occupational Pulmonary Disease . . . . . . . . . . . 140Infectious Disorders of the Lower Respiratory Tract. . . . . . . . 142Pneumonia . . . . . . . . . . . . . . . . 142Tuberculosis . . . . . . . . . . . . . . . 145Influenza . . . . . . . . . . . . . . . . 147Life-Threatening Pulmonary Disorders. . . . . . . . . . . 148Acute Respiratory Distress Syndrome. . . . . . . . . . 148Pulmonary Embolus . . . . . . . . . . . . . . 149Pneumothorax . . . . . . . . . . . . . . . 151Hemothorax . . . . . . . . . . . . . . . 152Emerging Infections . . . . . . . . . . . . . . . 155SARS . . . . . . . . . . . . . . . . . 155Legionnaires' Disease . . . . . . . . . . . . . 156Key Concepts . . . . . . . . . . . . . . . . 158Key Terms . . . . . . . . . . . . . . . . 158Diagnostic Tests . . . . . . . . . . . . . . . 158Pharmacological Agents Used in the Care of the Client with Disorders of the Respiratory System . . . . . . . . . . 159Apply Your Knowledge . . . . . . . . . . . . . . 162Exam Questions . . . . . . . . . . . . . . . 163Answers to Exam Questions . . . . . . . . . . . . 165Suggested Reading and Resources. . . . . . . . . . . . 166Chapter 6: Care of the Client with Genitourinary Disorders . . . . . . . . . . . 167Renal Disorders . . . . . . . . . . . . . . . . 168Acute Glomerulonephritis . . . . . . . . . . . . 168Chronic Glomerulonephritis . . . . . . . . . . . . 169Goodpasture's Syndrome . . . . . . . . . . . . . 170Nephrotic Syndrome . . . . . . . . . . . . . . 171Polycystic Kidney Disease . . . . . . . . . . . . 172Hydronephrosis/Hydroureteronephrosis . . . . . . . . . 173Pyelonephritis. . . . . . . . . . . . . . . 174Acute and Chronic Renal Failure . . . . . . . . . . . . 175Chronic Renal Failure . . . . . . . . . . . . . 176Peritoneal Dialysis . . . . . . . . . . . . . . 177Hemodialysis. . . . . . . . . . . . . . . 178Continuous Renal Replacement Therapy. . . . . . . . . 179Renal Transplantation . . . . . . . . . . . . . 180Urinary Disorders . . . . . . . . . . . . . . . 181Cystitis. . . . . . . . . . . . . . . . . 181Urinary Incontinence . . . . . . . . . . . . . 183Urolithiasis . . . . . . . . . . . . . . . . 184Genitourinary Disorders. . . . . . . . . . . . . . 185Prostatitis . . . . . . . . . . . . . . . . 186Benign Prostatic Hypertrophy . . . . . . . . . . . . 186Erectile Dysfunction . . . . . . . . . . . . . . 187Epididymitis . . . . . . . . . . . . . . . 189Priapism. . . . . . . . . . . . . . . . 189Key Concepts . . . . . . . . . . . . . . . . 191Key Terms . . . . . . . . . . . . . . . . 191Diagnostics . . . . . . . . . . . . . . . . 191Pharmacologic Agents for the Client with Genitourinary Disorders. . . . 192Apply Your Knowledge . . . . . . . . . . . . . . 196Exam Questions . . . . . . . . . . . . . . . 196Answers to Exam Questions . . . . . . . . . . . . 198Suggested Reading and Resources. . . . . . . . . . . . 199Chapter 7: Care of the Client with Integumentary Disorders . . . . . . . . . . . 201Common Infections of the Integumentary System . . . . . . . . . 201Viral Infections . . . . . . . . . . . . . . . 201Fungal Infections . . . . . . . . . . . . . . 203Bacterial Infections . . . . . . . . . . . . . . 204Psoriasis. . . . . . . . . . . . . . . . . . 204Pressure Ulcers. . . . . . . . . . . . . . . . 205Burns . . . . . . . . . . . . . . . . . . 208Burn Classifications . . . . . . . . . . . . . . 209Burn Measurement with TBSA . . . . . . . . . . . 210Nursing Care for Burn Victims . . . . . . . . . . . 211Key Concepts . . . . . . . . . . . . . . . . 216Key Terms . . . . . . . . . . . . . . . . 216Diagnostic Tests . . . . . . . . . . . . . . . 216Pharmacological Agents Used in the Care of the Client with Integumentary Disorders . . . . . . . . . . . . 217Apply Your Knowledge . . . . . . . . . . . . . . 219Exam Questions . . . . . . . . . . . . . . . 219Answers to Exam Questions . . . . . . . . . . . . 221Suggested Reading and Resources. . . . . . . . . . . . 222Chapter 8: Care of the Client with Sensory Disorders. . . . . . . . . . . . 223Disorders of the Eyes . . . . . . . . . . . . . . . 223Intraocular Disorders . . . . . . . . . . . . . 224Uveitis . . . . . . . . . . . . . . . . . 227Corneal Dystrophy and Corneal Transplantation . . . . . . . . 228Retinal Disorders . . . . . . . . . . . . . . 228Refractory Errors . . . . . . . . . . . . . . 231Traumatic Injuries . . . . . . . . . . . . . . 232Ocular Melanoma . . . . . . . . . . . . . . 233Disorders of the Ears. . . . . . . . . . . . . . . 234Otitis Externa . . . . . . . . . . . . . . . 235Otitis Media . . . . . . . . . . . . . . . 236Mastoiditis. . . . . . . . . . . . . . . . 236Meniere's Disease. . . . . . . . . . . . . . 237Acoustic Neuroma . . . . . . . . . . . . . . 237Otosclerosis. . . . . . . . . . . . . . . . 238Presbycusis . . . . . . . . . . . . . . . . 238Ear Trauma . . . . . . . . . . . . . . . . 239Assisting Clients with Hearing Loss . . . . . . . . . . 239Key Concepts . . . . . . . . . . . . . . . . 242Key Terms . . . . . . . . . . . . . . . . 242Diagnostic Tests . . . . . . . . . . . . . . . 243Pharmacological Agents Used in the Care of the Client with Disorders of the Eyes and Ears . . . . . . . . . . . 243Apply Your Knowledge . . . . . . . . . . . . . . 245Exam Questions . . . . . . . . . . . . . . . 245Answers to Exam Questions . . . . . . . . . . . . 247Suggested Reading and Resources. . . . . . . . . . . . 248Chapter 9: Care of the Client with Gastrointestinal Disorders . . . . . . . . . . 249Peptic Ulcer Disease . . . . . . . . . . . . . . . 250Types of Ulcers. . . . . . . . . . . . . . . 251Diagnosis of Ulcers . . . . . . . . . . . . . . 251Treatment of Ulcers. . . . . . . . . . . . . . 252Inflammatory Bowel Disorders . . . . . . . . . . . . . 255Crohn's Disease . . . . . . . . . . . . . . . 255Ulcerative Colitis . . . . . . . . . . . . . . 255Management of the Client with Inflammatory Bowel Disease . . . . . 256Diverticular Disease. . . . . . . . . . . . . . . 257Management of the Client with Diverticulitis . . . . . . . . 257Hemorrhoids . . . . . . . . . . . . . . . . 258Appendicitis . . . . . . . . . . . . . . . . . 258Peritonitis . . . . . . . . . . . . . . . . . 260Intestinal Obstruction . . . . . . . . . . . . . . . 261Esophageal Disorders . . . . . . . . . . . . . . . 262GERD . . . . . . . . . . . . . . . . . 262Hiatal Hernia . . . . . . . . . . . . . . . 266Diseases Associated with the Liver . . . . . . . . . . . . 267Hepatitis . . . . . . . . . . . . . . . . 267Cirrhosis . . . . . . . . . . . . . . . . 273Acute Pancreatitis . . . . . . . . . . . . . . . 277Diagnosis of Pancreatitis. . . . . . . . . . . . . 278Treatment of Pancreatitis . . . . . . . . . . . . . 278Cholecystitis/Cholelithiasis . . . . . . . . . . . . . 279Symptoms of Cholecystitis and Cholelithiasis . . . . . . . . 280Diagnosis of Cholecystitis/Cholelithiasis . . . . . . . . . 280Treatment of Cholecystitis . . . . . . . . . . . . 281Treatment of Cholethiasis. . . . . . . . . . . . . 281Clostridium Difficile . . . . . . . . . . . . . . . 282Food-Borne Illnesses. . . . . . . . . . . . . . . 283Key Concepts . . . . . . . . . . . . . . . . 286Key Terms . . . . . . . . . . . . . . . . 286Diagnostic Tests . . . . . . . . . . . . . . . 287Pharmacological Agents Used in the Care of the Client with Disorders of the Gastrointestinal System. . . . . . . . . 287Apply Your Knowledge . . . . . . . . . . . . . . 289Exam Questions . . . . . . . . . . . . . . . 290Answers to Exam Questions . . . . . . . . . . . . 292Suggested Reading and Resources. . . . . . . . . . . . 293Chapter 10: Care of the Client with Hematological Disorders . . . . . . . . . . . 295Anemia. . . . . . . . . . . . . . . . . . 295Pernicious Anemia . . . . . . . . . . . . . . 296Aplastic Anemia . . . . . . . . . . . . . . . 296Sickle Cell Anemia. . . . . . . . . . . . . . 297Iron Deficiency Anemia . . . . . . . . . . . . . 301Thalassemia . . . . . . . . . . . . . . . . . 303Polycythemia Vera . . . . . . . . . . . . . . . 304Hemophilia . . . . . . . . . . . . . . . . . 305Transfusion Reactions . . . . . . . . . . . . . . . 307Key Concepts . . . . . . . . . . . . . . . . 309Key Terms . . . . . . . . . . . . . . . . 309Diagnostic Tests for Review . . . . . . . . . . . . 309Pharmacological Agents Used in Hematological Disorders . . . . . 310Apply Your Knowledge . . . . . . . . . . . . . . 311Exam Questions . . . . . . . . . . . . . . . 311Answers to Exam Questions . . . . . . . . . . . . 313Suggested Reading and Resources. . . . . . . . . . . . 314Chapter 11; Care of the Client with Disorders of the Neurological System. . . . . . . . 315Neurological Assessment . . . . . . . . . . . . . . 316Cranial Nerve Assessment . . . . . . . . . . . . 316Glasgow Coma Scale . . . . . . . . . . . . . . 317Intracranial Pressure Monitors. . . . . . . . . . . . 318Brain Injuries . . . . . . . . . . . . . . . . 319Epidural Hematomas. . . . . . . . . . . . . . 322Subdural Hematoma . . . . . . . . . . . . . . 322Intracerebral Hematomas . . . . . . . . . . . . . 322Treatment of Hematomas . . . . . . . . . . . . . 322Increased Intracranial Pressure . . . . . . . . . . . 322Brain Tumors . . . . . . . . . . . . . . . . 326Treatment of Brain Tumors . . . . . . . . . . . . 327Care of the Client with Intracranial Surgery (Craniotomy) . . . . . . . 328Cerebrovascular Accident/Stroke . . . . . . . . . . . . 332Ischemic Stroke . . . . . . . . . . . . . . . 332Hemorrhagic Stroke . . . . . . . . . . . . . . 334Seizures . . . . . . . . . . . . . . . . . . 337Types of Seizures . . . . . . . . . . . . . . 337Treatment of Seizure Clients . . . . . . . . . . . . 340Parkinson's Disease . . . . . . . . . . . . . . . 340Meningitis . . . . . . . . . . . . . . . . . 342Autoimmune Neurological Disorders. . . . . . . . . . . 344Multiple Sclerosis. . . . . . . . . . . . . . 344Myasthenia Gravis . . . . . . . . . . . . . . 345Guillain-Barre. . . . . . . . . . . . . . . 347Degenerative Neurological Disorders . . . . . . . . . . . 348Cranial Nerve Disorders. . . . . . . . . . . . . . 349Trigeminal Neuralgia . . . . . . . . . . . . . 349Bell's Palsy. . . . . . . . . . . . . . . . 349Spinal Cord Injuries . . . . . . . . . . . . . . . 350Treatment of Spinal Cord Injuries. . . . . . . . . . . 351Potential Complications with SCI Clients . . . . . . . . . 352Intervertebral Disk Disease . . . . . . . . . . . . . 353Key Concepts . . . . . . . . . . . . . . . . 356Key Terms . . . . . . . . . . . . . . . . 356Diagnostics . . . . . . . . . . . . . . . . 357Pharmacological Agents Used in the Care of Clients with Neurological Disorders. . . . . . . . . . . . . 358Apply Your Knowledge . . . . . . . . . . . . . . 363Exam Questions . . . . . . . . . . . . . . . 363Answers to Exam Questions . . . . . . . . . . . . 366Suggested Reading and Resources. . . . . . . . . . . . 367Chapter 12: Care of the Client with Immunological Disorders . . . . . . . . . . . 369Immunodeficiency Syndrome . . . . . . . . . . . . . 370Diagnoses . . . . . . . . . . . . . . . . . 371HIV Prevention . . . . . . . . . . . . . . . . 373Standard Precautions. . . . . . . . . . . . . . 373Airborne Transmission-Based Precautions (Second Tier of CDC Guidelines for Infection Control) . . . . . . . . . . . 374Droplet Transmission-Based Precautions (Second Tier of CDC Guidelines for Infection Control) . . . . . . . . . . . 374Contact Transmission-Based Precautions (Second Tier of CDC Guidelines for Infection Control) . . . . . . . . . . . 375Treatments After Occupational Exposure. . . . . . . . . 375Management of the Client with HIV . . . . . . . . . . . 375Key Concepts . . . . . . . . . . . . . . . . 379Key Terms . . . . . . . . . . . . . . . . 379Diagnostic Tests . . . . . . . . . . . . . . . 379Pharmacological Agents Used in the Care of the Client with Immunologic Disorders . . . . . . . . . . . . . 380Apply Your Knowledge . . . . . . . . . . . . . . 383Exam Questions . . . . . . . . . . . . . . . 384Answers to Exam Questions . . . . . . . . . . . . 386Suggested Reading and Resources. . . . . . . . . . . . 387Chapter 13: Care of the Client with Neoplastic Disorders . . . . . . . . . . . 389American Cancer Society's Seven Warning Signs of Cancer. . . . . . . 389The Four Major Categories of Cancer. . . . . . . . . . . 390Risk Factors for Specific Cancers . . . . . . . . . . . . 390Cancer Prevention . . . . . . . . . . . . . . . 392Major Types of Cancer . . . . . . . . . . . . . . 393Colorectal Cancer . . . . . . . . . . . . . . 393Lung Cancer. . . . . . . . . . . . . . . 397Prostate Cancer . . . . . . . . . . . . . . . 399Breast Cancer . . . . . . . . . . . . . . . 401Other Major Cancers. . . . . . . . . . . . . . 406General Interventions for Clients with Cancer . . . . . . . . . 411Radiation . . . . . . . . . . . . . . . . 411Chemotherapy . . . . . . . . . . . . . . . 413Total Parenteral Nutrition . . . . . . . . . . . . 414Neoplastic-Associated Disorders and Emergencies . . . . . . . . 416Bone Marrow and Peripheral Stem Cell Transplantation . . . . . . . 417Types of Transplants . . . . . . . . . . . . . . 417Nursing Care After Transplantation . . . . . . . . . . 418Key Concepts . . . . . . . . . . . . . . . . 420Key Terms . . . . . . . . . . . . . . . . 420Diagnostic Tests . . . . . . . . . . . . . . . 421Pharmacologic Agents Used in the Care of the Client with Specific Neoplastic Disorders. . . . . . . . . . . . . 422Apply Your Knowledge . . . . . . . . . . . . . . 429Exam Questions . . . . . . . . . . . . . . . 429Answers to Exam Questions . . . . . . . . . . . . 432Suggested Reading and Resources. . . . . . . . . . . . 434Chapter 14: Care of the Client with Musculoskeletal and Connective Tissue Disorders . . . . . 435Fractures . . . . . . . . . . . . . . . . . 436Major Fracture Sites . . . . . . . . . . . . . . 438General Treatment for Fractures. . . . . . . . . . . 438Common Complications Associated with Fractures . . . . . . . 442Osteoporosis . . . . . . . . . . . . . . . . . 445Osteoarthritis . . . . . . . . . . . . . . . . 446Diagnosis of Osteoarthritis. . . . . . . . . . . . 447Treatment of the Client with Osteoarthritis . . . . . . . . . 447Fibromyalgia. . . . . . . . . . . . . . . . . 448Ankylosing Spondylitis . . . . . . . . . . . . . . 448Gout. . . . . . . . . . . . . . . . . . 449Rheumatoid Arthritis. . . . . . . . . . . . . . . 450Lupus Erythematosus . . . . . . . . . . . . . . . 452Musculoskeletal Surgical Procedures . . . . . . . . . . . 454Fractured Hip and Hip Replacement . . . . . . . . . . 454Total Knee Replacement. . . . . . . . . . . . . 455Amputations . . . . . . . . . . . . . . . 456Key Concepts . . . . . . . . . . . . . . . . 462Key Terms . . . . . . . . . . . . . . . . 462Diagnostics . . . . . . . . . . . . . . . . 462Pharmacologic Agents Used in Musculoskeletal and Connective Tissue Disorders . . . . . . . . . . . . . . 463Apply Your Knowledge . . . . . . . . . . . . . . 467Exam Questions . . . . . . . . . . . . . . . 467Answers to Exam Questions . . . . . . . . . . . . 469Suggested Reading and Resources. . . . . . . . . . . . 470Chapter 15: Care of the Childbearing Client and the Neonatal Client . . . . . . . . . 471Prenatal Care . . . . . . . . . . . . . . . . 471Signs of Pregnancy. . . . . . . . . . . . . . 471Prenatal Diet and Weight Maintenance . . . . . . . . . . 472Measuring Fetal Heart Tones. . . . . . . . . . . . 474Measuring Fundal Height. . . . . . . . . . . . . 474Prelabor Testing . . . . . . . . . . . . . . . 474Intrapartal Care . . . . . . . . . . . . . . . . 476Stages of Labor. . . . . . . . . . . . . . . 477Important Terms You Should Know . . . . . . . . . . 477Complications Associated with Pregnancy. . . . . . . . . . 478Cardiac Disease During Pregnancy. . . . . . . . . . . 478Diabetes in Pregnancy. . . . . . . . . . . . . 481Preeclampsia . . . . . . . . . . . . . . . 482Ectopic Pregnancy . . . . . . . . . . . . . . 483Hydatidiform Mole . . . . . . . . . . . . . . 483Incompetent Cervix . . . . . . . . . . . . . . 484Types of Abortions. . . . . . . . . . . . . . 484Placenta Previa . . . . . . . . . . . . . . . 485Abruptio Placenta. . . . . . . . . . . . . . 485Complications Associated with Labor and Delivery . . . . . . . . 486Fetal Malpresentation . . . . . . . . . . . . . 487Post-term Labor and Birth . . . . . . . . . . . . 487Precipitate Delivery . . . . . . . . . . . . . . 488Cord Prolapse. . . . . . . . . . . . . . . 488Cesarean Birth . . . . . . . . . . . . . . . 488Assisted Birth . . . . . . . . . . . . . . . 489Fetal Monitoring . . . . . . . . . . . . . . 489Pharmacologic Management of Labor . . . . . . . . . . . 491Postpartum Care . . . . . . . . . . . . . . . . 492Newborn Care . . . . . . . . . . . . . . . . 493Terms Associated with the Normal Newborn . . . . . . . . 494Rh Incompatibility . . . . . . . . . . . . . . 495Women's Health Issues . . . . . . . . . . . . . . 496Pelvic Inflammatory Disease . . . . . . . . . . . . 496Menopause . . . . . . . . . . . . . . . . 496Maternal Infections . . . . . . . . . . . . . . 496Methods of Contraception . . . . . . . . . . . . 499Key Concepts . . . . . . . . . . . . . . . . 502Key Terms . . . . . . . . . . . . . . . . 502Diagnostic Tests . . . . . . . . . . . . . . . 503Pharmacological Agents Used in the Care of the Obstetric Client . . . . 504Apply Your Knowledge . . . . . . . . . . . . . . 505Exam Questions . . . . . . . . . . . . . . . 506Answers to Exam Questions . . . . . . . . . . . . 508Suggested Reading and Resources. . . . . . . . . . . . 509Chapter 16: Care of the Pediatric Client . . . . . . . . . . . . . . . 511Growth and Development . . . . . . . . . . . . . . 511Infant (28 Days to 1 Year). . . . . . . . . . . . . 511Toddler (1-3 Years) . . . . . . . . . . . . . . 512Preschooler (3-5 Years) . . . . . . . . . . . . . 513School Age (6-12 Years) . . . . . . . . . . . . . 515Adolescence (12-18 Years) . . . . . . . . . . . . 515Caring for the Child with Respiratory Disorders . . . . . . . . . 516Upper Airway Infections. . . . . . . . . . . . . 517Lower Airway Infections. . . . . . . . . . . . . 521Long-Term Respiratory Disorders . . . . . . . . . . . 523Cystic Fibrosis (Mucoviscidosis) . . . . . . . . . . . 524Caring for the Child with Gastrointestinal Disorders . . . . . . . . 525Disorders of Motility. . . . . . . . . . . . . . 526Structural Defects . . . . . . . . . . . . . . 528Obstructive Disorders . . . . . . . . . . . . . 530Inflammatory and Parasitic Disorders. . . . . . . . . . 532Malabsorptive/Metabolic Syndromes . . . . . . . . . . 533Ingestion of Hazardous Substances . . . . . . . . . . . 535Caring for the Child with Cardiovascular Disorders . . . . . . . . 537Congenital Heart Defects. . . . . . . . . . . . . 538Acquired Heart Disease. . . . . . . . . . . . . 545Caring for the Child with Genitourinary Disorders. . . . . . . . 548Obstructive Uropathy . . . . . . . . . . . . . 549External Defects (Hypospadias, Epispadias, Exstrophy of the Bladder). . . 549Hypospadias . . . . . . . . . . . . . . . 549Epispadias/Exstrophy of the Bladder . . . . . . . . . . 550Caring for the Child with Neoplastic Disorders. . . . . . . . . 551Leukemia. . . . . . . . . . . . . . . . 551Wilms' Tumor (Nephroblastoma) . . . . . . . . . . . 551Retinoblastoma. . . . . . . . . . . . . . . 552Neuroblastoma . . . . . . . . . . . . . . . 552Osteosarcoma and Ewing's Sarcoma . . . . . . . . . . 552Rhabdomyosarcoma. . . . . . . . . . . . . . 553Surviving Childhood Cancer . . . . . . . . . . . . 553Caring for the Child with Cerebral Disorders . . . . . . . . . 554Intracranial Infections (Encephalitis and Bacterial Meningitis) . . . . . 554Reye's Syndrome . . . . . . . . . . . . . . 555Caring for the Child with Integumentary Disorders . . . . . . . . 556Eczema (Atopic Dermatitis) . . . . . . . . . . . . 556Scabies . . . . . . . . . . . . . . . . . 557Pediculosis Capitis (Head Lice) . . . . . . . . . . . 557Lyme Disease . . . . . . . . . . . . . . . 558Rocky Mountain Spotted Fever . . . . . . . . . . . 558Caring for the Child with Communicable Disease. . . . . . . . . 559Caring for the Child with Musculoskeletal Disorders . . . . . . . . 561Congenital Clubfoot . . . . . . . . . . . . . . 561Developmental Hip Dysplasia . . . . . . . . . . . . 561Osteogenesis Imperfecta . . . . . . . . . . . . . 562Legg-Calve-Perthes Disease (Coxa Plana) . . . . . . . . . 563Scoliosis . . . . . . . . . . . . . . . . 564Juvenile Rheumatoid Arthritis (Juvenile Idiopathic Arthritis) . . . . . 564Caring for the Child with Neuromuscular Disorders . . . . . . . . 565Cerebral Palsy. . . . . . . . . . . . . . . 565Neural Tube Defects . . . . . . . . . . . . . . 566Spina Bifida. . . . . . . . . . . . . . . . 566Muscular Dystrophies . . . . . . . . . . . . . 567Caring for the Abused and Neglected Child . . . . . . . . . . 568Key Concepts . . . . . . . . . . . . . . . . 571Key Terms . . . . . . . . . . . . . . . . 571Diagnostics . . . . . . . . . . . . . . . . 572Pharmacological Agents Used in the Care of Pediatric Clients . . . . . 572Apply Your Knowledge . . . . . . . . . . . . . . 572Exam Questions . . . . . . . . . . . . . . . 573Answers to Exam Questions . . . . . . . . . . . . 575Suggested Reading and Resources. . . . . . . . . . . . 576Chapter 17: Care of the Client with Psychiatric Disorders . . . . . . . . . . . 577Anxiety-related Disorders. . . . . . . . . . . . . . 577Generalized Anxiety Disorder . . . . . . . . . . . . 578Post-traumatic Stress Disorder . . . . . . . . . . . 578Dissociative Identity Disorder . . . . . . . . . . . . 579Somatoform Disorder . . . . . . . . . . . . . 579Panic Disorder . . . . . . . . . . . . . . . 579Phobic Disorders . . . . . . . . . . . . . . 580Obsessive-Compulsive Disorder . . . . . . . . . . . 580Personality Disorders . . . . . . . . . . . . . . . 581Cluster A . . . . . . . . . . . . . . . . 581Cluster B . . . . . . . . . . . . . . . . 582Cluster C. . . . . . . . . . . . . . . . 583Managing Clients with Personality Disorders . . . . . . . . 584Psychotic Disorders. . . . . . . . . . . . . . . 585Schizophrenia . . . . . . . . . . . . . . . 585Bipolar Disorders . . . . . . . . . . . . . . 587Substance Abuse. . . . . . . . . . . . . . . . 590Alcoholism . . . . . . . . . . . . . . . . 590Chemical Dependence. . . . . . . . . . . . . 592Psychological Disorders of Childhood and Adolescence . . . . . . . 594Autistic Spectrum Disorder . . . . . . . . . . . . 595Conduct Disorder . . . . . . . . . . . . . . 595Oppositional Defiant Disorder . . . . . . . . . . . 596Attention Deficit Hyperactive Disorder . . . . . . . . . . 596Eating Disorders . . . . . . . . . . . . . . 596Key Concepts . . . . . . . . . . . . . . . . 599Key Terms . . . . . . . . . . . . . . . . 599Diagnostics . . . . . . . . . . . . . . . . 600Pharmacological Agents Used in the Care of the Client with Psychiatric Disorders . . . . . . . . . . . . . 600Apply Your Knowledge . . . . . . . . . . . . . . 605Exam Questions . . . . . . . . . . . . . . . 606Answers to Exam Questions . . . . . . . . . . . . 608Suggested Reading and Resources. . . . . . . . . . . . 609Chapter 18: Emergency Care. . . . . . . . . . . . . . . . . 611The ABCDs of Emergency Care. . . . . . . . . . . . 612Airway . . . . . . . . . . . . . . . . . 612Breathing. . . . . . . . . . . . . . . . 613Circulation . . . . . . . . . . . . . . . . 613Deficits . . . . . . . . . . . . . . . . 614Obtaining Client Information . . . . . . . . . . . . 614Trauma . . . . . . . . . . . . . . . . . . 615Head Injuries . . . . . . . . . . . . . . . 615Chest Injuries . . . . . . . . . . . . . . . 616Abdominal Injuries. . . . . . . . . . . . . . 616Documenting and Protecting Forensic Evidence . . . . . . . . 617Poisoning . . . . . . . . . . . . .. . . . 618Poisonous Stings and Bites . . . . . . . . . . . . . . 618Bioterrorism . . . . . . . . . . . . . . . . . 620Chemical and Biological Agents . . . . . . . . . . . 620Nuclear Warfare. . . . . . . . . . . . . . . 622Triage Categories for Disaster Victims . . . . . . . . . . 623Key Concepts . . . . . . . . . . . . . . . . 625Key Terms . . . . . . . . . . . . . . . . 625Diagnostics . . . . . . . . . . . . . . . . 625Pharmacological Agents Commonly Used in ER Treatment . . . . . 625Apply Your Knowledge . . . . . . . . . . . . . . 626Exam Questions . . . . . . . . . . . . . . . 626Answers to Exam Questions . . . . . . . . . . . . 628Suggested Reading and Resources. . . . . . . . . . . . 629Chapter 19: Legal Issues in Nursing Practice . . . . . . . . . . . . . . 631Types of Laws. . . . . . . . . . . . . . . . 632Statutory Laws/Regulatory Laws. . . . . . . . . . . 632Civil Laws . . . . . . . . . . . . . . . . 632Criminal Laws . . . . . . . . . . . . . . . 632Common Law. . . . . . . . . . . . . . . 632Code of Ethical Behavior in Nursing Practice . . . . . . . . . 633Legal Theories That Affect Nursing Practice . . . . . . . . . . 634Negligence . . . . . . . . . . . . . . . . 635Malpractice . . . . . . . . . . . . . . . . 635Witnessing Consent for Care. . . . . . . . . . . . 635Tort . . . . . . . . . . . . . . . . . 635Assault and Battery . . . . . . . . . . . . . . 636Fraud . . . . . . . . . . . . . . . . . 636Managing Client Care. . . . . . . . . . . . . . . 636Key Terms. . . . . . . . . . . . . . . . . 640Apply Your Knowledge . . . . . . . . . . . . . . 640Exam Questions . . . . . . . . . . . . . . . 641Answers to Exam Questions . . . . . . . . . . . . 643Suggested Reading and Resources. . . . . . . . . . . . 644Chapter 20: Cultural Practices Influencing Nursing Care . . . . . . . . . . . . 645Cultural Assessment. . . . . . . . . . . . . . . 645Understanding Client Beliefs . . . . . . . . . . . . 645Working with Clients Who Speak Different Languages . . . . . . 646Healthcare of Hispanics/Latinos . . . . . . . . . . . . 647Time Considerations . . . . . . . . . . . . . . 648Use of Nonverbal/Verbal Communication. . . . . . . . . 648Childbirth and Pain Response . . . . . . . . . . . . 649Healthcare of Native Americans and Alaskan Natives . . . . . . . . 649Time Considerations . . . . . . . . . . . . . . 649Use of Nonverbal/Verbal Communication. . . . . . . . . 650Childbirth and Pain Response . . . . . . . . . . . . 650Healthcare of Asian-Americans . . . . . . . . . . . . . 650Time Considerations . . . . . . . . . . . . . . 651Use of Nonverbal/Verbal Communication. . . . . . . . . 651Childbirth and Pain Response . . . . . . . . . . . . 652Healthcare of Arab-Americans. . . . . . . . . . . . . 652Time Considerations . . . . . . . . . . . . . . 653Use of Nonverbal/Verbal Communication. . . . . . . . . 653Childbirth and Pain Response . . . . . . . . . . . . 653Nursing Plan Dietary Considerations Across Cultures . . . . . . . . 653Religious Beliefs and Refusal of Care Considerations . . . . . . . . 655Key Terms. . . . . . . . . . . . . . . . . 657Apply Your Knowledge . . . . . . . . . . . . . . 657Exam Questions . . . . . . . . . . . . . . . 657Answers to Exam Questions . . . . . . . . . . . . 659Suggested Reading and Resources. . . . . . . . . . . . 660Part II: Final ReviewFast FactsThe NCLEX PN Exam Prep. . . . . . . . . . . . . . . 661Practice Exam I . . . . . . . . . . . . . . . . . 669Practice Exam II. . . . . . . . . . . . . . . . . 705Practice Exam III . . . . . . . . . . . . . . . . . 743Practice Exam IV: Management and Alternative Item Exam Questions. . . . . . . . . . 781Answers to Practice Exam I . . . . . . . . . . . . . . . 809Answers to Practice Exam II . . . . . . . . . . . . . . . 833Answers to Practice Exam III . . . . . . . . . . . . . . . 855Answers to Practice Exam IV: Management and Alternative Item Exam Questions. . . . . . . . . . 875Part III: AppendixesAppendix A: Things You Forgot . . . . . . . . . . . . . . . . . 889Appendix B; Need to Know More?. . . . . . . . . . . . . . . . 895Appendix C: Calculations . . . . . . . . . . . . . . . . . . 901Appendix D; Commonly-Prescribed Medications in the United States. . . . . . . . . 9059780789753137, TOC, 11/5/2014
