Covers the critical information you’ll need to know to score higher on your NCLEX-PN exam!
Caring for the Client with Disorders of the Cardiovascular System
Download the sample pages (includes Chapter 13 and index)
Introduction ................................................................................................... xxi
Welcome to the NCLEX-PN® 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
About the Book .............................................................................................................. xxv
Contact the Authors ....................................................................................................... xxv
Self-Assessment .............................................................................................................. xxv
Companion Website ..................................................................................................... xxvi
Accessing the Pearson Test Prep Software and Questions ........................................xxvii
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
Suggested Reading and Resources ................................................................................. 40
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 ................................................................................................................. 47
Acute Respiratory Failure ............................................................................................... 48
Acute Respiratory Distress Syndrome .................................................................. 48
Pulmonary Embolus .............................................................................................. 48
Emerging Infections ....................................................................................................... 50
Severe Acute Respiratory Syndrome ..................................................................... 50
Legionnaire’s Disease ............................................................................................ 51
Diagnostic Tests for Review ........................................................................................... 52
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 ............................................................................................................... 64
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 Resuscitative (Emergent) Phase .................................................................. 106
The Acute (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 Stem Cell Transplantation (SCT) ..................... 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 ................................................................................... 173
Clostridium Difficile ..................................................................................................... 174
Food-Borne Illnesses .................................................................................................... 175
Diagnostic Tests for Review ......................................................................................... 176
Pharmacology for Review ............................................................................................. 176
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 .................................................................................................... 191
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-Barré ............................................................................................................... 261
Treating Clients with Guillian-Barré ................................................................. 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 Disorders .......................................................................................................... 270
Generalized Anxiety Disorder ............................................................................. 271
Panic Disorder ..................................................................................................... 271
Specific Phobia ..................................................................................................... 271
Obsessive-Compulsive Disorder ......................................................................... 272
Trauma-Related Disorders ........................................................................................... 272
Posttraumatic Stress Disorder ............................................................................. 273
Dissociative Disorders .................................................................................................. 273
Dissociative Identity Disorder ............................................................................. 274
Somatic Disorder ................................................................................................. 274
Personality Disorders .................................................................................................... 274
Paranoid Personality Disorder ............................................................................ 275
Schizoid Personality Disorder ............................................................................. 275
Schizotypal Personality Disorder ........................................................................ 275
Histrionic Personality Disorder .......................................................................... 276
Narcissistic Personality Disorder ........................................................................ 276
Antisocial Personality Disorder ........................................................................... 276
Borderline Personality Disorder ......................................................................... 277
Avoidant Personality Disorder ............................................................................ 277
Dependent Personality Disorder ........................................................................ 277
Obsessive-Compulsive Personality Disorder ...................................................... 277
Managing Clients with Personality Disorders .................................................... 278
Psychotic Disorders ...................................................................................................... 278
Schizophrenia ....................................................................................................... 278
Bipolar Disorders ................................................................................................. 281
Substance Abuse ............................................................................................................ 283
Alcoholism ............................................................................................................ 283
Other Commonly Abused Substances ................................................................ 286
Disorders of Childhood and Adolescence .................................................................... 288
Disruptive, Control, and Conduct Disorders ..................................................... 288
Neurodevelopmental Disorders .......................................................................... 289
Eating Disorders .................................................................................................. 290
Diagnostic Tests for Review ......................................................................................... 291
Pharmacology Categories for Review .......................................................................... 291
Exam Prep Questions ................................................................................................... 292
Answer Rationales ......................................................................................................... 294
Suggested Reading and Resources ............................................................................... 295
Chapter 16 Caring for the Maternal/Infant Client ..................................................... 297
Signs of Pregnancy ........................................................................................................ 298
Presumptive Signs ................................................................................................ 298
Probable Signs ..................................................................................................... 298
Positive Signs ....................................................................................................... 299
Prenatal Care ................................................................................................................. 299
Prenatal Diet and Weight Maintenance ............................................................. 299
Alpha-Fetoprotein Screening .............................................................................. 299
Other Prenatal Diagnostic Tests ........................................................................ 300
Assessing Fetal Heart Tones ............................................................................... 301
Ultrasonography .................................................................................................. 301
Signs of Complications of Pregnancy .......................................................................... 301
Types of Abortions ....................................................................................................... 302
Complications Affecting Pregnancy ............................................................................. 303
Diabetes in Pregnancy ......................................................................................... 303
Preeclampsia ........................................................................................................ 304
Disseminated Intravascular Coagulation ............................................................ 305
Cord Prolapse ...................................................................................................... 305
Abruptio Placenta ................................................................................................ 305
Placenta Previa ..................................................................................................... 305
Maternal Infections ....................................................................................................... 306
Preterm Labor ............................................................................................................... 308
Intrapartal Care ............................................................................................................. 309
Stages of Labor .................................................................................................... 309
Phases of Labor .................................................................................................... 310
Important Terms You Should Know .................................................................. 310
Prelabor Testing ........................................................................................................... 311
Fetal Monitoring ........................................................................................................... 312
Pharmacologic Management of Labor ......................................................................... 314
Postpartum Care ........................................................................................................... 315
Terms Associated with the Normal Newborn ............................................................. 315
Rh Incompatibility ........................................................................................................ 316
Contraception ............................................................................................................... 317
Diagnostic Tests for Review ......................................................................................... 318
Pharmacology Categories for Review .......................................................................... 319
Exam Prep Questions ................................................................................................... 320
Answer Rationales ......................................................................................................... 322
Suggested Reading and Resources ............................................................................... 323
Chapter 17 Caring for the Pediatric Client ............................................................. 325
Growth and Development ............................................................................................ 326
Infant (28 Days to 1 Year) ................................................................................... 326
Toddler (1—3 Years) ............................................................................................. 328
NCLEX-PN Exam Cram, Fifth Edition
Preschooler (3—5 Years) ....................................................................................... 329
School Age (6—12 Years) ...................................................................................... 330
Adolescence (12—18 Years) .................................................................................. 331
Congenital Anomalies ................................................................................................... 331
Anomalies of the Gastrointestinal System .......................................................... 332
Anomalies of the Musculoskeltal System ............................................................ 336
Anomalies of the Cardiovascular System ............................................................ 338
Inborn Errors of Metabolism .............................................................................. 341
Respiratory Disorders ................................................................................................... 342
Acute Otitis Media ............................................................................................... 343
Tonsillitis ............................................................................................................. 344
Laryngotracheobronchitis ................................................................................... 345
Acute Epiglottitis ................................................................................................. 345
Bronchiolitis ......................................................................................................... 346
Cystic Fibrosis (Mucoviscidosis) ......................................................................... 347
Gastrointestinal Disorders ............................................................................................ 347
Gastroenteritis ..................................................................................................... 348
Pyloric Stenosis .................................................................................................... 348
Intussusception ..................................................................................................... 348
Celiac Disease (Gluten-Induced Enteropathy, Celiac Sprue) ............................ 349
Cardiovascular Disorders .............................................................................................. 349
Rheumatic Fever .................................................................................................. 349
Kawasaki Disease (Mucocutaneous Lymph Node Syndrome) .......................... 350
Musculoskeletal Disorders ............................................................................................ 352
Scoliosis ................................................................................................................ 352
Legg-Calve-Perthes Disease (Coxa Plana) ......................................................... 353
Muscular Dystrophies .......................................................................................... 353
Childhood Cancer ......................................................................................................... 354
Wilms Tumor (Nephroblastoma) ....................................................................... 354
Leukemia .............................................................................................................. 354
Osteogenic Sarcoma (Osteosarcoma) .................................................................. 354
Ingestion of Hazardous Substances .............................................................................. 355
Salicylate Overdose .............................................................................................. 355
Acetaminophen Overdose.................................................................................... 355
Lead Poisoning (Plumbism) ................................................................................ 355
Iron Poisoning ..................................................................................................... 356
Diagnostic Tests for Review ......................................................................................... 356
Pharmacology Categories for Review .......................................................................... 357
Exam Prep Questions ................................................................................................... 358
Answer Rationales ......................................................................................................... 360
Suggested Reading and Resources ............................................................................... 361
Practice Exam 1 ............................................................................................. 363
Answers to Practice Exam 1 .............................................................................. 407
Practice Exam 2 ............................................................................................. 429
Answers to Practice Exam 2 .............................................................................. 471
Appendix A Things You Forgot ........................................................................... 493
Appendix B Need to Know More?........................................................................ 501
Appendix C Calculations .................................................................................. 509
Glossary ...................................................................................................... 513
