I have a question?????
Has everyone gotten their final course grade in Nur 3????? I know what I got but when I go to check under academic history,it says IP. Tell I'm not the only one.

Is there any one at LMH, taking 4 first and then 5 willing to switch to SJGH 5 first, please email me at djeremic@sbcglobal.net
Denise

Aloha all! Hope everyone is enjoying their time off (or working during it, like many of us :( )...but anyhoo....please dont forget about next Monday...Jan 9th from 10 to 12 please come in uniform to show support during the welcome tea...thanks guys!!! See you soon ;)

Cira
Please give me a call regarding CPR class. I lost your #.
Mine is 477-6250.

Hi all,

Does anyone know if Richard has posted our Pharm (N3) grade yet? If yes, Where??? I know what I've got for the final exam but I want to see the overall grade for the class.



Vanessa

OK....one last attempt....Is there anyone willing to trade if they have Nurs 4 Prieto second half to LMH Nurs 4 first half. Please email me at djeremic@sbcglobal.net.
Denise Jeremic

Yoo Hoo all...

I hope you all enjoy your winter break coming up in 24 hours! Congrats to all for finishing up our first semester!

Please remember the welcoming tea on Monday Jan 9th, it begins at 10 am...but of course you all would like to come around 830 or 9 to help set up.

Thank you so much Miranda for volunteering to do the sign in table. Kathryn R...could you please sit with Miranda at the table that morning? I cant find your phone number, I will talk to u tonight at class...please let me know.

Thank you guys so much for all your support..wishing you holiday happiness, health and peace...always!!!

Christine :)

Just a reminder.....
Don't forget to bring your evaluations for nurs. 2 tomorrow. Boy...did the semester fly or what??
Happy holidays guys!!!!!!!!

Happy Holidays to All!
Congratulations on the completion of your 1st semester !
!!!!!!!!!!!!!!!!! WOO-HOO!!!!!!!!!!!!!!!!!!!
Debbie and I are organizing a bunch of study and organizational helps for you when you go into N4 and N5. We will be working on this over the break. Email us if you have any questions. Click on our names on your members list to get the email addresses.

Attention Attention...

Hello everbody...it is time for me to call on you all's assistance for the tea. I know that everyone is busy preparing for finals, as am I...but we have a commitment to our next class to provide a welcome reception, so I need your help please!! :)

I need at least 2 people to commit to the sign in table. I need at the least one person from each clinical group to be there the day of the tea..MONDAY JAN 9TH at 830 am to help greet all the incoming students who will be joining your past clinical instructors.

I have speakers in line already, if you have something you think is important to speak on, please send me an email and let me know.

The food is going to be taken care of by Chuck's brother in law, who is a teacher here at the culinary school as well as a private chef and party planner.

I have 6 donated raffle prizes already. Lindsay is making bags for each student. And Mike is putting on the slide show and setting up the DVD for us.

As long as we can feed everyone, provide a nice production...I am happy. But...If any of you feel that we can add something else, please please email me and let me know, or call me at home k? Thanks so much!

I am going to plan on seeing many of you at the day of the tea to help set up and greet in uniform please! :)

Your grateful friend in need, i mean in deed...

Christine Moles ;)
209-547-0460
email: rnstudychris@aol.com

Oh and PS...good luck on your finals! Merry Christmas to all!!!!

Mike...
You're email isn't working again...I tried to send you an email yesterday and I just got it back today. Please contact me through email so I can send you an email back!

Thanks sir!
-Lisa
lisajanaes@yahoo.com

St. Joseph's TW group! Yee-haw!

I will have y'all a copy for Thursday...Thanks for a great semester!

-Lisa

Free Lab Jacket
See Julie Lang.
Maybe it could be offered to the new semester if no one is interested.

Anyone that is going to SJGH Nursing 5 C. Smith and Nursing 4 Prieto interested in switching to Lodi Memorial for Nursing 4 with M. Black and Nursing 5 the second half, please let me know. My group would like to stick together and one of us did not get the same as the others. Consider this begging :)
Denise

Huge medical download site for your PDA
This has to be the biggest medical download site that I have ever seen!!!!!!
http://pdacortex.pdaorder.com/welcome.xml
This site has 104 pages with 10 medical downloads on each page. I have cut and pasted the links to the free download pages with brief descriptions of what you can find there. Many pages have multiple free downloads. These downloads will be very helpful in our clinicals and theory classes. These are not those annoying free trial downloads that you probably already regret ever downloading.
The list is too long for me to post here.
If you would like for me to send it to you, send me an email and I will forward it to you.
bboss947@sbcglobal.net

Cheaper Textbooks
I went to a textbook search engine called cheapesttextbooks.com which made a search from among these booksellers:
A1books, Abebooks, Alibris, Amazon, Barnes & Noble, Booksamillion, Buy.com, Chapters.Indigo.ca, Christianbook, eBay, eCampus, Half.com, Overstock.com, Phatcampus, Powells and TextbookX
It turned out that eCampus had the cheapest prices on our new textbooks. They were $10.00 cheaper than the college bookstore and also includes free shipping with minimum order.
Does anyone know of a place that has even better prices? I have never bought my books online before and so am looking into it.

Dear students.

Hello there all..thank you so kindly for all your donations!! Thus far we have collected a total of.....$170.00!!! Very nice!!!

Many of you have expressed concern about wanting to help me. IF you could get anything for raffle prizes that would be so kind of you...also each and everyone of you are totally needed on the day of the tea...Monday Jan 9th. If you could come at 8 am...that would be awesome! You could help set up and greet students. One stipulation....PLEASE PLEASE come in uniform, that is a MUST according to the college, so please help me keep my promise of this. Thanks :)

ALSO...if anyone has pictures from the semester you would like to have put onto the slide show...please provide the CD to Mike in our class...THANKS!!! :)

Dear students.

Hello there all..thank you so kindly for all your donations!! Thus far we have collected a total of.....$170.00!!! Very nice!!!

Many of you have expressed concern about wanting to help me. IF you could get anything for raffle prizes that would be so kind of you...also each and everyone of you are totally needed on the day of the tea...Monday Jan 9th. If you could come at 8 am...that would be awesome! You could help set up and greet students. One stipulation....PLEASE PLEASE come in uniform, that is a MUST according to the college, so please help me keep my promise of this. Thanks :)

ALSO...if anyone has pictures from the semester you would like to have put onto the slide show...please provide the CD to Mike in our class...THANKS!!! :)

"The challenges will be to your intellect and your heart, but your opportunities to make a difference are unlimited. You will never be bored. Keep in mind and also remember that nothing is rewarding that doesn't have some difficulty and challenge to it."-K Sanford RN, President of American Organization of Nurses

SNA meeting-ya'll come now.

Our next SNA meeting will be on
 December 5th @ 1300
in Locke 313
 Let's get in the holiday spirit together
 and celebrate the end of the semester
by bringing a treat to share.

Happy Thanksgiving Everybody! We're almost done with our first semester! Wahoo!! It's hard to believe! I'm thankful #1-to be in the program, but #2- to be associated with some really great people. Hang in there guys.... we can do it!

AMSA Knowledge Bowl

AMSA Knowledge Bowl
When: Friday, December 9th, 2005
Time: 1600 (4 p.m.)
Where: Danner Hall
What: A competition against other clubs on campus in multiple academic and fun categories for points and a prize. Teams are 5 people with 2 alternates.
Cost: $5
Club: Student Nurses Association (that is what you belong to even if you never attend meetings)
Who: Mandy Parker 495-7807 or aparker892@students.deltacollege.edu
Deadline for registration is November 23rd, 2005
Anyone that wants to participate can contact me for the details. I am working that day and will not be able to do this. Is anyone interested?

Hello there everyone!

I gotta say...we are so awesome...we have actually put needles into our friends arms..and they are still our friends!!!!

I wanted to say thank you to each of you that have offered help with the tea, given money as donations and keep putting up with my begging!!! :)

And lastly.....

Happy Thanksgiving to all of you!! Think of all the things you are thankful for..I dont know about you all, but I feel that I have made 79 wonderful friends, and have almost one whole semester of nursing school done! Take a few minutes to count your blessings,give thanks and relax with your famalies!

Blessings,

Christine

Mike,

Hello there...please call me at home, I tried to email you but...something must be wrong with the email that I have (or the operator is the issue haha). I want to talk with you about the tea....

Thanks kindly!!

Christine
547-0460

Anyone registered for Nurs 5 63875 willing to switch to 99116, please let christina know.

Posts of interest for you 2nd semester.
http://deltarnstudents.blogspot.com/2005/11/calling-all-student-mentors.html
http://deltarnstudents.blogspot.com/2005/11/futurenurses2007.html
post comments and questions here so that we can help you.

This is probably a shot in the dark but anyone who may have SJGH starting in March, with C Smith for N5, but mostly N4 and would be willing to trade,... please let me know? Michelle and I live in Tracy and I have that clinical but we couldn't get her in and we would really like to drive together :) Thanks muchly!

Hi Guys!!! Sounds like we are all almost done with registering and I am dying to know who is in my clinical groups!!! I signed up for Nursing 4 with Prieto (61013) and Nursing 5 with TBA :) (63875) Let me know who you are. Can you believe we are almost done with our fist semester? YEAH!!!

Thank you so much...each of you who donated to the tea fund! I will send around the envelope next Thursday for those that are still interested in donating. There will be another meeting on Thursday Dec 1st at 12 pm. If anyone has gotten any raffle donations, please let me know in an email.

Some of you have shared interest to me regarding your will to help. I would greatly appreciate those of you willing, to call around town and see what you can get donated. We need decorations, supermarkets to donate gift cards to help us with food..things like that..so if you all dont mind begging...haha

Thanks again all of you!! You guys are a terrific support, we have a very nice class here (the best in my opinion ;)

See you all soon

Christine

NursingCenter - Professional Development - CE Article guys....Shelba wrote this for the nursing center...I bet some of this would probably be on the test...;) There is a test at the end of the article too.

Dear Future nurses,

Thanks to everyone for making last night's test taking session a success. To continue to increase your critical thinking skills, I have scheduled a session for Monday November 21, 2005 5:00pm to 6:00pm in the South Forum, "Learning How To Make a Pathophysiological map for Appendicitis".

For those who could not be there the slides are posted under Docushare - Nursing 101 Success folder. There are questions with the correct responses.

Also refer to my previous post about the Meds Publishing programs. Focus on the Skill building program and the nurse logic program. We will be purchasing these program for your use in the future for the computer lab but have free access until December 1. So if your grade are not what you ant them to be I highly recommend you look at the programs before it to late.

Remember, it not the question but the concept. Know the concept and you can answer the question.

Good luck and see you next week.

Caralee

READ THIS IF YOU ARE IN NEED FOR UNITS TO MEET FINANCIAL AID REQUIREMENTS FOR 12 UNITS NEXT SEMESTER...

Hello everyone. Today I met with the director of the work experience program. I was pleading er, um I mean discussing with him about how the nursing students were in need of 3 units to cover the rest of the 9 units that we have in nursing school. Many of us have already taken our pre req's thus leaving us scrambling for internet courses, etc to meet the financial aid required units of 12 for full aid...so after showing him our schedule and explaining to him about our clinical time, we were able to decide that indeed the 14-18 hours of clinical is considered "non paid" we had to discuss about the fact whether or not it would qualify as "volunteer" time. I told him that it was non paid but was surely not "volunteer", it is a requirement of the RN program. After careful consideration he decided that we as nursing students would be eligible for work experience some people being eligible for up to 4 units...however...of course there are requirments with hours and such...I will speak to yall at the lecture on Thursday if you are interested. I hope this will help some of you... I know it is a HUGE help to me.

See you all soon!
Blessings,

Christine

HEAR YE HEAR YE

HEAR YE! HEAR YE!
THE NEXT MEETING OF THE
STUDENT NURSE’S ASSOCIATION
WILL be ON
November 21, 2005
At
1330 hrs (130 Pm)
In
Locke 118

  Please join us for conversation and pizza

Learning through the NCLEX
Is anyone interested in having a regular time to meet and learn more about your current theory subject, and focus in on prioritization and rationale through NCLEX style questions? Everyone has a unique way of looking at, learning and thinking about new material. It helps everyone involved piece together the whole picture. I would like to set up (a) regular meeting time(s) on Monday, Tuesday or Wednesday afternoons. It does not have to be in the tutor center or even on campus. Let me know if you are interested. This is a valuable way to learn and will really help you when you go into N4.

Might I make a suggestion?
If you are having a hard time with taking the tests and are not happy with your scores, I reccommend that you take N5 first. Mrs. Ippolito majors on helping you to decipher the NCLEX questions and you will have more confidence with the tests in N4. You can also use this time to focus in and study ahead on a pet subject or body system (or past subjects) that is (are) intimidating to you. Set a goal to do at least 5-10 NCLEX questions everyday pertaining to your current subjects. If you disclipline yourself, you will be ready for the big one after graduation without having to enroll in any extra costly review courses.

If you like to hit the ground running but get tired halfway through the semester (or your family does), I suggest that you take N4 first. Also, if you have a hard time motivating yourself into a more intensive study mode halfway through, you should take N4 first.

Hello my friends..

I know that some of you desired to come to the meeting today but were unable to make it..of course I understand. If you are interested, there are lots of things to do, and I would LOVE to have you help us!! :)

I am in desperate need of at least one person from each clinical group to agree to be at the tea on Jan 9th to greet the new students, pretty please ;)

We need people to call and get donations for the raffle prizes and donations for our food table as well.

Also, as a reminder...I will be collecting monetary donations from ya'll next Thursday, again I appreciate all of your support!

Please email me with suggestions, comments or anything else you may need information on at: rnstudychris@aol.com or at home, 209-547-0460.

c ya all later! ;)
blessings,

Christine

All you future nurses you...guys as I spoke about on Thursday, there will be a donation box on top of the desk in lecture this Thursday as well as next Thursday. I would greatly appreciate it if you would each put in $5.00 a piece. Shelba said you all would want to know where the money goes...well Delta Student Nurse Association gave us $50.00 and we have 80-100 people to feed and provide a warm welcome to. If we used $5.00 x 80 students we would have $400.00 which would equal out to about $4.00 per student this is for food, drinks, paper plates, decorations, and 2 carnations for each new student...so you all can see how fast that money can go. I know that we are all poor, and I hate to beg you all, but I can assure you that your money will be well spent and much appreciated. So..thanks in advance. Any questions, please call me, or come on Thursday at 12 in the skills lab...k guys byyyyeeee! ;)

Foods and Electrolytes
1. Dairy Products, Dark Green Leafy Vegetables, Canned Salmon are rich in which electrolyte?
2. Dried Fruit, Legumes, Green Leafy Vegetables, Dairy Products, Meat, Fish are rich in which electrolyte?
3. Meat, Fish, Poultry, Milk Products, Legumes are rich in which electrolyte?
4. Bacon Ham, Processed Cheese, Processed Food, Table Salt are rich in which electrolyte?
5. Avocado, Baked Potato, Spinach, Meat, Dates, Raisins, Banana, Milk, Orange Juice are rich in which electrolyte?

A Sodium (Na+)
B Magnesium (Mg+)
C Potassium (K+)
D Calcium (Ca+)
E Chloride (Cl-)

Nursing Blog
This blog has lots of practice tests and more. Check it out.
http://www.geocities.com/webstation_4nurses/index.html
I found the above blog link, on the following blog, so check this one out too. Whatever you find helpful, post it for the rest of us! There is too much information and helps for one person to sort through, but as a team, we can help each other.
http://mediblogopathy.blogspot.com/

Skills Lab Question...

For those of you that had skills lab last week...Monday labs didn't cause of the BRN and Wound thing...can you tell me what you did!

Also, does anyone have Julie Kay's correct cell phone number...apparently I have the wrong one! Thanks a TON!

-Lisa

A New Tool

Hey everyone, I found a new program that may help people post on the blog easier. It is a utility for your Word program that allows you to type into Word and post directly to the blog. I am using it now. The link, if you want to download and install it is:  http://buzz.blogger.com/bloggerforword.html

Test taking statagies will be held November 14, 2005 5pm - 6pm. sorry for the mixup and inconvience.

Caralee

New Tutoring Hours
I will be able to be at the tutor center on Mondays, Tuesdays and Wednesdays from 14oo-1700 if anyone is interested. Let me know. I will try to always have NCLEX questions with me to practice with.
I am sorry that I missed some of you over the last 3 days. I have been working 12 hour shifts at LMH. Great experience!

Guess who??? :)

Does anyone have any hookups to free stuff for a raffle I would like to do at the welcoming tea? A wine basket, movie theatre tickets etc...hey...Will...you would be a good guy to get people to give us free stuff!!! Send me an email if you are interested in wondering around and seeing what you can find ;)

PS...you guys are gonna love the invitations Dan made...so so cute!!

K...ta ta for now

Dear future nurses,

Since no room is available between 9 and 10 am on Monday for Test Taking Statagies, How about changing the time to between 5 and 6 pm prior to Pharm. Let me know what you think.
Caralee

Top Ten Reasons (and more) Why I Want Star Trek’s© Medical Beds In My Unit!
#10. The patient never has to be helped into or out of bed, nor even undressed.
#9. The patient doesn’t have or need any I.V. lines, tubes, or monitor cables.
#8. The patient doesn’t need a footstool, to be pulled up in bed, or even have a siderail.
#7. The patient never needs to be fed, and never needs to be bathed.
#6. The patient never has an excessive number of visitors.
#5. The patient never vomits, urinates, defecates, or expectorates.
#4. The patient will get up cured at the end of 46 minutes, unless killed off in the first five minutes of the show to entice you into watching the remainder of the program. He will not need a wheelchair for discharge.
#3. The patient rarely needs translator services arranged.
#2. The patient never contradicts or denies to the doctor what I just reported the patient had said or done.
#1 The patient does not have a callbell, does not call out “NURSE, !!!!”, or demand that his unreasonable request be done because he was a physician in his old country.

Smile! I found this on the nursing studio blog.
http://www.nursingstudio.net/

Need a little humor?
Check out
You might be an ER nurse if......
http://deltarnstudents.blogspot.com/2005/11/you-might-be-er-nurse-if.html

Oooopsie daisy....Thanks Chuck for pointing out that I forgot to tell y'all where to go for the meeting...and since I already told him where to go (haha) you guys can meet with me in Locke 229...C ya later! :)

My friends....

Please join me on Thursday, November 10th at 12 pm to help plan the welcome reception. There are alot of ideas floating around, and I have information to share. I know that some of you will be going away for your much deserved winter break, but I would still love to hear your imput!

We have invitations that need to be folded and little things that can be done at home to help us prepare if you are not one of the speak in public types :).

Also...a HUGE HUGE favour I need from each of you...I would like to prepare some sort of food for the new people coming in...is 5 dollars a piece feasable for each of you?

Thank you all so much!

Let us create a nice welcome for those coming in

-Christine :)

More for you future nurses,

Several people have requested a "Test Taking Statagies class", on how to read nursing test questions. I will be having a one class on Monday, November 7, 2005 9:00 - 10:00 am in L228. See you there.
Caralee

Dear SJDC Future Nurses,

We are in the process of evaluating new software for the computer lab and would like to get your input.

The online preview of Learning System, Nurse Logic, Dosage & Calculations, Pharmacology and Skill Building from Meds publishing has been set up. You have free access until December 1, 2005. Please follow the instructions on the attached student login document and use the following class activation code to access the exams.


7566fly680house669


You’ll first want to go to http://online.medspub.com/medsonline/sec-support.html and click “Check My Computer Settings.” That will walk you through six easy steps to make sure your computer is ready for Meds. Steps 2 and 3 even have places to click for FREE Internet Explorer and FlashPlayer upgrades if needed. Those two things are a must in order to run Meds online.

After you have reviewed the program, please send your comments to cbromme@deltacollege.edu

Identify was it easy to access and use?
Did it help you in your studies?

I look forward to your input.
Caralee

End of life care summary and free NCLEX questions...scroll down to the end of the article and click "take the test"End-of-Life Care - continuing education course for nurses, physical therapists, occupational therapists, paramedics, EMTs and...


:)

Does anybody know what's up with the "Question of the Week" on learningext.com ? It's been on the same question since 10/17 .... ?

Would you like your name/initials on your Delta Nursing jacket, sweatshirt, poloshirt?? I dont have a cost right now, but I need 25 items to place the order. If you sign up, and then if the price is not what you want to pay, then you can remove your name.... I just need an estimate of the #'s. Please send me an email : RDeYoung585@students.deltacollege.edu

I will post on the BLOG when I get the price :)

I was thinking white lettering, script style -- don't know if we have other options so if there is something different you would like, let me know & I'll find out

Does anyone have shelbas email?????
I have her hours that she is available and her phone number but not her email.
If someone could post that, it would be great.

Mike,

Hi there..please email me. I need to ask your help with a possible slide show presentation for the welcome reception...and your group's cultural thing was so good...please email me at rnstudychris@aol.com thanks so much!! :)

Everyone...there is a new shirt available from the SNA with the Delta ADN logo...Polo shirts! How fun! ;)Now available for $20.00 a piece in grey and navy blue.....guys I know you will like these, I suggested we get them..so y'all should buy one, so I dont look bad haha..Let me know if anyone wants one! :)

N2 Cancer drug considerations
Lilley: Pharmacology and the Nursing Process, 4th Edition
Multiple Choice Review Questions Chapter 46
1.
The term nadir refers to:
A. The average number of days it takes the bone marrow to recover from a dose of chemotherapy
B. The average number of days it takes for the chemotherapy to have its peak effect on the bone marrow
C. The patient's tolerance to the chemotherapy's bone marrow suppressant effect
D. The maximum dose for a chemotherapy agent in reference to bone marrow suppression

2.
General adverse effects of chemotherapy include which of the following? (choose all that apply)
A. Leukocytosis
B. Thrombocytopenia
C. Alopecia
D. Urinary retention

3.
Prednisone added to a chemotherapeutic regimen contributes to all of the following except:
A. Fluid retention and risk of infection
B. Increase in blood sugar
C. Sense of well-being and euphoria
D. Decrease in bleeding tendency

4.
Combinations of chemotherapeutic agents are frequently used for all of the following purposes except:
A. Preventing drug resistance
B. Providing a synergistic action
C. Decreasing cost of treatment
D. Decreasing the severity of adverse effects

5.
When a patient is receiving cyclophosphamide (Cytoxan), he or she should be advised to drink plenty of water/fluids to:
A. Prevent renal failure
B. Prevent hemorrhagic cystitis
C. Prevent liver dysfunction
D. Increase the red blood cell count

6.
The nurse would anticipate administering which of the following medications to patients receiving high-dose methotrexate?
A. bleomycin
B. cisplatin
C. leucovorin
D. dactinomycin

7.
Nausea and vomiting are frequent adverse effects associated with antineoplastic therapy. Patients who are experiencing this unpleasant effect should be advised:
A. To avoid eating any food during chemotherapy
B. That there is nothing that can be done for this effect and it will pass with time
C. To try to maintain hydration and nutrition, which are very important during treatment
D. To use antacids to relieve the irritation to the stomach, which should stop the nausea

8.
When teaching a patient receiving paclitaxel (Taxol), the nurse needs to prepare the patient for which of the following?
A. Weight gain
B. Vertigo
C. Arthralgias
D. Hypertension

9.
When assessing a patient for adverse effects related to cisplatin (Platinol), the nurse will monitor for which of the following? (choose all that apply)
A. Nephrotoxicity
B. Peripheral neuropathy
C. Hepatoxicity
D. Severe nausea/vomiting

10.
A major dose-limiting side effect of doxorubicin (Adriamycin) is:
A. Hemorrhagic cystitis
B. Cardiomyopathy
C. Hepatoxicity
D. Nephrotoxicity

11.
Which of the following laboratory results would cause the nurse to question administration of cyclophosphamide (Cytoxan)?
A. White blood cell count of 8000
B. Platelet count of 450,000
C. Hemoglobin of 15
D. Thrombocyte count of 8000

12.
The nurse would suspect which type of cancer in a patient receiving tamoxifen?
A. Lung cancer
B. Renal cancer
C. Breast cancer
D. Colon cancer

Hello everyone!!

Just a reminder for those that are interested...this Thursday at 10 am is the dimensional analysis review with Fern, then at 11 is the NCLEX review question session with Bonnie.

There are many sweatshirts available for those interested...they are 30 for pullovers and 35 for zip-up.

One more thing...I need speakers for the tea so far I have...

Christine Moles welcome and introduction

Mike speaking about PDA'S

Fazia will pass on the blog torch

Robyn will help with graduation letter

and Dan is making the invitations

Chuck will speak on the importance of sitting at the end of the row and speed reading (haha)


ANY ideas on speakers, handouts etc...Send em to my email rnstudychris@aol.com or talk to me on the break Thursday...later nurses to be

Congratulations Sarah Coots on the delivery of your first grandbaby!!!!!

Christine, If you haven't received any other offers, I would be happy to help you with invitations. I wasn't able to go to the reception so I missed out! Please email me at rdeyoung585@delta..... and we can exchange phone #'s or something if you want. Thanks for taking this on!

Complimentary and alternative medicine.
http://nccam.nih.gov/health/

Just thought I should say this...

To those that have decided that nursing is not the path for you...

We wish you all the best with your future endeavors. We offer our encouragement and honor your decsions to go on another path aside this one of nursing. Many of you had to make the very difficult decision to go another way, some feeling very sad for those of us remaining. Don't be sad for us, for this is the choice we have made. Let each of us rejoice in the bravery of one straying from the pack to lead another. You all will do tremendous things, we are proud of you, wish you all the happiness and health in the world.



(Ps..thanks Julie K...for opening my eyes, and being able to share with others :)

Check out this link to a former student, now RN
http://www.nursingstudio.net/
Her website is full of NCLEX RN questions and links to everything of interest to nursing students.

Hi everybody....A few things for you all..

1. Thank you Julie Kay. We are going to be able to use Locke 231 on Fridays as a quiet study room. The key word for this room is.....QUIET. So, if you are interested in coming in here...please be interested in being quiet haha. Thank you.

2. Beginning next Thursday, the 27th of October Bonnie has graciously offered her services to us as a tutor. She will be providing NCLEX questions that are relating to what we are learning about in N2. I have a request in with Julie Kay to be able to use the empty room on Locke 3 (I dont know the number, it is the one with the desks and supplies in it, the same place where Fern does her Monday meetings with us).

3. BONNIE...please send me an email with your email so that I dont have to keep asking you little things on this blog haha. Thank you...my email is rnstudychris@aol.com

Hi All,
I was just wondering what time the make up Math test is and where?
Thanks,
Tami

End-of-Life Care
http://www.criticalcareceu.com/courses/103/index_ccare.html
1.
More than 2.4 million people die each year in the United States. Of those:
a. Ninety percent die at home.
b. Less that 25% die at home.
c. Twenty percent die in hospitals.
d. Most die suddenly in an accident.

2.
In the United States, end-of-life care programs:
a. Are widely used in most states.
b. Are used for far more than the 60 days considered necessary to gain maximum benefit.
c. Are available in the vast majority of hospitals.
d. Have few nurses or physicians certified in palliative care.

3.
All of the following statements about hospice care are true except:
a. Drugs for symptom control and pain relief are not covered by the Medicare hospice benefit program.
b. Most Americans do not know that hospice care can be provided in the home.
c. The Medicare hospice benefit guarantees comprehensive high-quality care at little or no cost.
d. To access the hospice benefit, the client’s doctor must certify that the client likely has six months or less of life remaining.

4.
Palliative care:
a. Seeks to hasten death once a person has been declared terminal.
b. Seeks to improve the quality of life of dying clients.
c. Should not be used in conjunction with other therapies that prolong life.
d. Is not applicable in the early stages of an illness.

5.
Which of the following statements about hospice care is true?
a. It is a specific place or facility.
b. It is only for people with cancer.
c. Anyone diagnosed with terminal illness is eligible.
d. It is only for older people.

6.
The principle of double effect states:
a. The healthcare provider has a duty to protect life and to provide the means to end life.
b. Hastening death is acceptable if it is an unintended consequence of relieving suffering.
c. A healthcare worker is not required to intervene if a client attempts to take his or her own life. d. A client can refuse medical treatments but cannot refuse artificial nutrition or hydration.

7.
Studies of death trends in American hospitals show:
a. More blacks than whites die as hospital inpatients.
b. In 2000, whites and blacks died in the hospital in equal proportions.
c. Access to pain medications is better for blacks than for whites.
d. Poor communication is not a factor when deciding on end-of-life care options.

8.
Federal law requires hospitals to inform clients that they have the right to complete an advance directive.
a. True
b. False

9.
All of the following statements about do-not-attempt-resuscitation (DNAR) orders are true except:
a. It was formerly known as do-not-resuscitate orders.
b. DNAR orders are found in over 90% of medical charts.
c. The DNAR order should be readily available in the event of an emergency.
d. Withholding CPR does not equate with letting someone die.

10.
All of the following statements about artificial nutrition and hydration (ANH) are true except:
a. Many older clients choose to end their lives by refusing food and liquids.
b. Forgoing ANH is the same as “killing” or “starving” the client.
c. Nasogastric tube feedings can lead to such complications as pain, aspiration pneumonia, and epistaxis.
d. People who choose not to have ANH do not suffer from hunger or thirst.

11.
Which of the following is an urgent indication of the need to discuss end-of-life care?
a. Discussion of the prognosis.
b. Discussing treatment with low probability of success.
c. Discussing hopes and fears.
d. Inquiries about hospice or palliative care.

12.
Discussing death explicitly helps the client express fears and concerns about the dying process and allows the clinician to address them directly.
a. True
b. False

13.
Which of the following statements about pain is true?
a. It should not be considered as a vital sign.
b. Most people in nursing homes with advanced cancer receive effective treatment for pain.
c. When pain is relieved symptoms such as depression, diminished appetite, and impaired sleep may disappear.
d. Its symptoms are generally effectively managed by clinicians.

14.
The Joint Committee on Accreditation of Healthcare Organizations (JCAHO) requires that hospitals and other healthcare facilities regularly assess, monitor and manage pain in all clients.
a. True
b. False

15.
Which of the following statements about pain is false?
a. Pain perception varies from person to person.
b. Older adults may have a higher pain threshold than younger people or children.
c. A person’s perception of pain may be affected by cultural considerations.
d. The client’s preferences should not define the goal of pain management.

16.
Drowsiness frequently occurs at the beginning of opioid therapy, not only from drug action on the brain but also because the client has been sleep-deprived due to unrelieved pain.
a. True
b. False

17.
Shortness of breath is common among dying clients. All of the following approaches are used to treat this symptom except:
a. Inhaled corticosteroids.
b. Supplemental oxygen.
c. Anti-anxiety medications.
d. Low doses of morphine.

18.
Methods such as massage, physical therapy, acupuncture, and psychotherapy can be effective in the treatment of pain.
a. True
b. False

19.
One of the most common fears expressed by a person with a terminal illness is:
a. Fear of starvation.
b. Fear of disfigurement.
c. Fear of pain.
d. Fear of dying in the presence of family members.

20.
Depression during end-of-life care may be due to all of the following factors except:
a. A weak support system.
b. Persistent negative thinking regarding the diagnosis.
c. The need to spend time alone.
d. Increased dysfunction related to the illness.

21.
Although depression is highly treatable in most people, it cannot be treated effectively during end-of-life.
a. True
b. False

22.
Bereavement is:
a. The period of time, approximately 6 months, before a loved one’s death.
b. Being deprived of someone through death and the feeling of desolation that follows.
c. The process by which an individual is able to move through the stages of grief and emerge from the grieving process.
d. An exaggeration of the normal process of grieving, often resulting from multiple losses.

23.
All of the following caregiver problems are common except:
a. Families may face severe economic consequences.
b. Physical exhaustion, economic worries, and disrupted routines may lead to anxiety and depression.
c. Care for the loved one often takes priority over the caregiver’s own healthcare needs.
d. Hospice benefits provide mental health services for the caregiver.

24.
Which statement about end-of-life and cancer is true?
a. Chemotherapy and radiation treatments are usually stopped several months before death.
b. Treatment of cancer clients near death becomes gradually less aggressive.
c. Hospice is often being used to manage the death rather than palliate the disease.
d. Cancer clients are usually admitted to hospice care several months before death.

25.
Clients with Alzheimer’s disease are eligible for hospice care and account for more 30% of the annual hospice census.
a. True
b. False

26.
In people with severe cognitive impairment, artificial nutrition and hydration:
a. Can be withheld if the client’s wishes have been made clear in an advance directive.
b. Is given via feeding tube to more than 18% of those with severe cognitive impairment.
c. Is sometimes given because the nursing home receives special reimbursement.
d. All of the above

27.
The availability of HAART for the treatment of HIV/AIDS has eliminated the need to provide end-of-life care to HIV positive clients.
a. True
b. False

28.
A person living with advanced AIDS may have unique issues related to the disease including:
a. Stigmatization because of HIV/AIDS.
b. Lack of traditional support systems.
c. Bereavement from multiple losses.
d. All of the above

29.
Which of the following statements about dying children is true?
a. The majority of children with cancer receive palliative care.
b. It is sometimes difficult to predict whether a life-threatening illness will end in cure or death.
c. Children do not fear death as much as adults.
d. Children are prone to addiction from pain medications.

30.
The dying child and family members need to talk with one another about death.
a. True
b. False

31.
The possibility of dying raises issues for both the child and the family. These include:
a. Fear of a painful death.
b. Fear of dying alone.
c. Fear of not being present when the child dies.
d. All of the above

32.
Signs of imminent death include all of the following except:
a. Drowsiness.
b. Extremities becoming cool to the touch.
c. Rattling or gurgling breath sounds.
d. Increased ease in controlling pain.

33.
Post-mortem care should include all of the following except:
a. Remove all equipment and soiled linen from the bedside.
b. Avoid facial discoloration by placing the body in a supine position with a pillow under the head and shoulders.
c. Avoid upsetting the family by allowing only a short viewing of the body.
d. Attach identification tags to the ankle and wrist.

34.
All of the following statements about autopsies are true except:
a. Nationally, only about 5% of deaths undergo autopsy.
b. Clinical diagnoses, whether obtained from death certificates or hospital discharge data, contain major inaccuracies compared with autopsy diagnoses.
c. The healthcare system as a whole can benefit enormously from autopsy data.
d. Autopsies disfigure the body.

35.
Questions about organ donation are best discussed with the client in the context of advance directives.
a. True
b. False

36.
Which of the following statements about bereavement is false?
a. A family’s bereavement begins when their loved one is diagnosed with terminal illness.
b. Grief can cause somatic distress, guilt, and hostile reactions.
c. Grief can cause overwhelming fatigue.
d. It is best not to form new relationships while grieving.

Next Thursday at 11 am there is going to be a group study with Bonnie. It will be sort of like an NCLEX related question/answer session. I have requested the use of Locke 230(where the meetings with Fern are). If y'all are interested in coming...please look onto the blog and I will find out where the actual room is going to be. I have also asked Kim Thompson if there is a classroom that can be used for people who like quiet study in lieu of the throng of teenage love affairs going on under the desks in the library. :) Hope everyone is doing well in clinicals...on to nursing two :) PS...Thank you Bonnie for all your support

Christine M.,
I talked to Kim Thompson about getting a classroom to have a study group, Thurs at 1100 as you mentioned to me today. She will get it done and I will leave it up to you to verify it with her and get the word out to anyone interested if that is ok with you.
Since you all have study sessions and lectures already, I would like to bring in a bunch of NCLEX questions concerning your present subject and show you how you can study smarter, increase your comprehension and raise your test scores all at the same time.
The way I will show you is an alternative way of learning. If you are doing great already with traditional learning, keep doing what you are doing, but if you feel as if you are struggling and are not getting good scores despite reading all of the required material, then I can show you another way to learn.
Let me know. Tell me where and when, and I will be there.

Hi Guys!!! 2 things I wanted to address.

1) How did those of you do on that test today in skills lab? Can you say major brain fart????

2) Anyone know when Richard will be posting our final grades for N1?

Have a great week!
I have to honestly say I am so thankful to have made it this far!!!

Cher

Just curious, is anyone else having problems opening the math info file on docushare??? You know the one caralee posted on nursing 101.

Changing classes. Sorry that I was not able to get right back to some of you to answer questions this weekend, I felt so free after getting out of N4 that I signed up for 3, 12 hour shifts of nursing at LMH this weekend. Now I am ready to start mental health on Mon. The next 2 weeks, we have lecture on Mon 1230-1630. I can probably meet you before or after, let me know. My Tues-Wed clinicals do not start until Nov. 1st, so I am not sure if that means that I will be free all day on those days until it starts. I will let you know after my first day.
For the N2 class, the pharm book is really helpful for the pain, I have posted a bunch of stuff and links on our blog to help you too.
I am looking at a Davis pocket Nutrition guide called Nutri Notes, that I bought from the college bookstore, right now. Unfortunately these little books cost as much as a big textbook.I wish that I had this pocket book when I was in your class. It has all of the different kinds of diets and foods in it for all of the different medical conditions. It includes ethnic and culture foods, lists of foods that have all of those wanted or unwanted vitamins and minerals that Shelba loves to test you on. Check it out. I will also have it with me if you want to look at it.
Good luck, have fun, remember that common sense goes a long way. Take notes (hint, hint) Tape lectures. Check out practice tests from the nursing center online. Shelba writes for them, they are Lippencott. Their info is current and very helpful, you can also find a bunch of Nursing Made Incredibly Easy articles and tests there. I have the links posted in most of my practice tests in the test bank. Take tests right away after lecture to see what you need to focus in on the most with your studies.

When you do the skills lab and watch the cancer video, take kleenexes.

Skills Lab Drug Scenarios ???

For the drugs that we need to be familiar with, when it says "Normal dose and rate" do we need to know the norms for each therapeutic action of the drug?

For instance with Acetylsalicylic acid - it reduces fever and inflammation, and it's an analgesic...do we need to know the normal does for each of the three uses and for adult and child?

If anyone can shed some light here I would love it!

Thanks,
-Lisa

Newsletters Anyone?
These are some of the newsletters that are sent to me in my email. If you are interested, here are some links to check out their sites or sign up. You can find info for the current subjects that you are learning in N2 and beyond. They have lots of practice questions too. Good resourses.

Kaplan Nursing Newsletter
http://www.kaptest.com/repository/templates/Lev2InitDroplet.jhtml;jsessionid=ZHMFZUXW02YIDLA3AQJHBNVMDUCBG2HB?_lev2Parent=/www/KapTest/docs/repository/content/Nursing_Domestic&source=nurse_index

Heart Center Newsletter Online
http://heart.healthcentersonline.com/newsletter/heart/101105.html

Advance for Nurses newsletter and free magazine
http://nursing.advanceweb.com/newsletter.htm

Medscape Nurses
http://www.medscape.com/nurses-home

Nursing Center Newsletter
http://www.nursingcenter.com/home/index.asp

Nurse practitioner enews
http://www.nursingcenter.com//upload/static/403753/NP_Aug05.htm

Diabetes Health online newsletter
http://diabetes.healthcentersonline.com/newsletter/diabetes/081605.html

Cancer Health online newsletter
http://cancer.healthcentersonline.com/newsletter/cancer/071905.html

I have a question for the "PDA Users" of this group. I wasn't planning on getting a PDA for a while, but an opportunity came up to get a used one really cheap. It is a Palm 505. I could really use some help getting set up. Anyone with some simple directions of what and how to get started? And I really mean simple directions. I am not that pda literate. I would be glad to meet with you a few minutes before class on Thursday if that is easier. Thanks!
Tami C

Potassium Problem
A physician orders furosemide (Lasix) and spironolactone (Aldactone) for a patient. Prior to administering the medication, the nurse determines that the patient's potassium is 3.2 mEq/L. In addition to notifying the physician, the nurse should anticipate taking which of the following actions?
(1) Not administering the Lasix or Aldactone.
(2) Administering the Aldactone only.
(3) Administering the Lasix only.
(4) Administering the Lasix and Aldactone.

Hello Future Nurses,

For those of you taking the skills test on Monday, check out the Nursing 101 success folder on docushare for the important handouts. These handouts will assist you in the check- off process and what to study for on the math test. Let me know if you have any questions.

Caralee

A little fun link to start off your weekend...

Click on the link below...this took me FOREVER to find the difference between the two pics.

See how long it takes you!

Good luck...it's hard. Make sure your speakers are on...cause a song will start playing that might help you find the difference.

http://members.home.nl/saen/Special/Zoeken.swf

Calm Student-Nurse Jitters - Search Nursing Jobs & Careers at Monster.com

Congratulations on completion of N1!!!! Take a break watch a movie, do something unproductive. Feel better? Good!

We started N2 around the 22 of March 2005. We were a little slow posting at the beginning but we really picked up speed as we went along, until the grand finale of everyone pitching in with study guide helps at the end. If you want to see if there is anything in our blog that could help you, here is the link.
http://deltarnstudents.blogspot.com/
Start in the archives in March.

I will be having to change my tutor hours at the tutor center starting Monday because I am now in N5 which has a different schedule. Monday afternoons may still be ok. Tues and Wed late afternoons may be ok too.
We'll work it out. Call me if you want to make sure and schedule some extra study time. If you want to just talk through practice questions and rationale, I love that too!
(C) 329-1369
(H) 474-6339

Tips for NCLEX_RN
I found this at a student site in all nurses.comm.
http://allnurses.com/forums/showthread.php?t=100105
Tips for NCLEX_RN
Maslow's Hierarchy:
the main two to focus on are physiological needs and Safety & Security.
Physiological needs- food, water, oxygen, shelter, rest, sex, temperature, elimination
Safety & Security- Physical (what is threatening the pt.)
Psychological (knowledge and understanding,What to expect) look at your answer choices and eliminate all the psychological answer choices.
Physiological needs must be met first!Can you apply the ABC's (airway, breathing, circulation, cardiac). if an answer involves maintaining the airway, or breathing problems, it is the correct one. if the answer pertains to the cardiovascular system that would be correct. if the ABC's don't apply ask yourself what is the highest priority?this is your answer.
Ex:A pt is being treated for heart failure with diuretic therapy. which of the following best indicates to the nurse that the pts condition is improving?
1. pts weight has remained stable since admission.
2. pts systolic BP has decreased
3. there are fewer crackles heard when auscultating tthe pts lungs
4. pts urinary output is 1500cc's per day
The answer is #3(rationale: crackles are due to pulmonary edema and a decrease in crackles is a sign that pulmonary edema is decreasing.#1 pts weight should be decreasing,#2 is a distractor BP should decrease but may be due to other causes,#4 a distractor, pts urinary output is within normal limits
Look for hints in the wording of the question stem: most, first, best, initial essential, vital, immediate, highest, priority, indicate that you must establish priorities.
Further teaching is necessary: indicates the answer will contain incorrect info.
The phrase client understands the teaching indicates the answer will be correct information.
The phrase most accurate: indicates that more than one answer will sound good.
You may see expected words in an answer choice that is not correct.if you come across a question that you are unfamiliar with or you do not know what the question is asking you, read the answers to obtain clues, then try to reword the question using the clues.
Prioritization: who would the nurse see first? who should the nurse transfer from the unit during a disaster?the nurse would always see the patient who is least stable FIRST (condition may be life threatening, or moving pt may cause further harm), ABC's apply. the nurse would always transfer the patient who is most stable (condition is not life threatening and outcome is predictable).
PRIORITIZING USING ABC'S
Ex: The client with a diagnosis of cancer is receiving morphine sulfate 10 mg subcutaneously every 3-4 hours for pain. when preparing the plan of care for the client, the nurse includes which priority action?
1.monitor the clients temperature
2. monitor the urine output
3. encourage the client to cough and deep breath
4. encourage increased fluids
The correct answer is #3(rationale; use the abc's, morphine suppresses the respiratory reflex). PRIORITIZING USING MASLOW'S HIERARCHYEX:
The nurse is reviewing the plan of care for a pregnant client with a diagnosis of sickle cell anemia. which nursing diagnosis, if stated on the plan of care, would the nurse select as receiving the highest priority?
1. Anxiety
2. Ineffective individual coping
3. Altered Body Image
4. Fluid volume deficit
The correct answer is #4(rationale: the physiological needs come first!Options 1, 2 & 3 are eliminated because they are all phsychological and physiological needs are first! Always eliminate the psychological needs.
Nursing Process:Assessment & Implementation
The nurse should ALWAYS ASSESS first! then implementation. Implementation is done after assessment.
Ex: The nurse is teaching a client with diabetes mellitus about dietary measures to follow. The client expresses frustration in learning the dietary regimen. the nurse would initially:
1. Identify the cause of the frustration
2. continue with the dietary teaching
3. notify the physician
4. tell the client that the diet needs to be followed
the correct answer is #1 (rationale; The initial action is to identify the cause of the frustration,assessment is the first step,options 2,3 &4 are implementation steps of the nursing process.)

Wow!!! Hey guys...we did it!!! Nursing one? CHECK

The days go by quick, dont they? Before we know it we will be graduating! Anyone interested in planning a graduation trip? How about a cruise for all of us? ....if we could just get the staff to pay for it...haha good luck to everyone, we should be very proud! :)

Hello futurenurses!
Goodluck on your final! Wear bright colors to stim your brain, watch out for caffeine and carbs, but make sure you eat.
Sorry about bogging you guys down with a lot of questions that you don't need right now. I am studying for my final too and did not have enough time to thin them down for you. Just ignore the ones you don't need. These are just examples to show you all of the different directions that you might have to think.

Here is on more that might interest you. Very short.
http://deltarnstudents.blogspot.com/2005/04/test-fluids-and-electrolytes.html

Disorders of Fluid Volume, Osmolality, and Electrolytes
Price: Pathophysiology, 6th Edition
Study Questions Chapter 21

1.
ECF volume imbalances are characterized by:
A.Isotonic body fluid losses or gains
B.Relatively greater losses or gains of Na+ than that of water
C.Relatively greater losses or gains of water than that of Na+
D.None of the above

2.
Na+ ions account for what percentage of the osmotically active particles in the ECF?
A.5%
B.15%
C.20%
D.90%

3.
Which of the following effects would result from a decrease of the serum Na+ concentration below the normal range?
A.Shift of water from the ICF to the ECF, causing cell shrinkage
B.Shift of water from the ECF to the ICF, causing cell swelling
C.Shift of water and Na+ from the ECF to the interstitial fluid (ISF), causing edema
D.None of the above

4.
The most common condition that causes a fluid volume deficit is:
A.GI losses (e.g., vomiting, diarrhea) combined with inadequate fluid intake
B.Third-space losses
C.Osmotic diuresis
D.Aldosterone deficiency

5.
Rapid administration of IV fluids can result in pulmonary edema because:
A.Tissue hydrostatic pressure in the lung parenchyma increases
B.Colloid osmotic pressure in the pulmonary vessels increases
C.Hydrostatic pressure in the pulmonary vessels increases
D.Lymphatic clearance in the interstitium increases

6.
You are caring for Mr. Brown, a 75-year-old patient with congestive heart failure who is receiving IV fluids. You notice that he is becoming increasingly restless and short of breath. His blood pressure and respiratory rate are increasing, and he has a moist-sounding cough. You also note that he has neck vein distention up to the jaw angle in the sitting position. You hear medium rales (crackles) throughout both posterior lung fields. Mr. Brown's symptoms are probably caused by:
A.Decreased venous return to the right ventricle
B.Circulatory overload and pulmonary edema
C.Liver congestion from fluid reflux from the heart
D.Increased tissue hydrostatic pressure in the alveoli
E.Decreased hydrostatic pressure in the pulmonary capillaries

7.
The best nursing intervention for Mr. Brown (see question #6) would be:
A.Elevating the foot of the bed to aid venous return
B.Slowing down the IV to a keep open rate and notifying the physician
C.Continuing to monitor the vital signs
D.Encouraging the patient to cough and breathe deeply to improve alveolar ventilation

8.
The first emergency action in the treatment of severe acute pulmonary edema is:
A.Positioning the patient in high Fowler's position with the legs lowered to reduce hydrostatic pressure in the chest
B.Placing the patient in a supine position to aid venous return to the heart
C.Increasing the IV rate to increase the effective circulating volume
D.Applying rotating tourniquets

9.
Serum osmolality changes represent total body water changes provided that:
A.No solute is lost from the body
B.Only electrolytes are lost from the body
C.Cell membranes are impermeable to water
D.The serum osmolality is corrected for the urea concentration

10.
What is the estimated serum osmolality in a patient with a serum Na+ concentration of 140 mEq/L and serum glucose of 100 mg/dl?
A.280 mOsm/kg
B.140 mOsm/kg
C.100 mOsm/kg
D.240 mOsm/kg

11.
The osmolality of urine in a person with normal renal function:
A.Is only lowered to 100 mOsm/kg in water diuresis
B.May be lowered to less than 30 mOsm/kg in water diuresis
C.Is raised only to 900 mOsm/kg in fluid volume deficit
D.Is iso-osmotic with the plasma in an isotonic fluid volume deficit
E.Is iso-osmotic with the plasma in water diuresis

12.
A 65-year-old man with a 40-year history of heavy cigarette smoking and a recent diagnosis of oat cell carcinoma of the lung is admitted to the hospital with a 2-week history of progressive lethargy and headaches. Physical assessment is within normal limits except for the lethargy, headaches, and diminished deep tendon reflexes. Serum laboratory values reveal the following: Na+, 105 mEq/L; Cl-, 72 mEq/L; K+, 4 mEq/L; HCO-3, 23 mEq/L; plasma osmolality, 222 mOsm/kg. Urine laboratory values include the following: urine Na+, 78 mEq/L; urine osmolality, 804 mOsm/kg; specific gravity, 1.029. The most likely cause of this patient's problem is:
A.Diabetes insipidus (ADH deficiency)
B.Isotonic ECF volume excess
C.SIADH (ectopic source)
D.Hyperaldosteronism
E.Compulsive water drinking (psychogenic polydipsia)

13.
The direct cause of the patient's neurologic symptoms in question #12 is:
A.Brain cell shrinkage
B.Increased levels of circulating ADH
C.Decreased serum Na+ concentration
D.Brain cell swelling and increased intracranial pressure

14.
Which of the following is the best treatment for the patient in question #12?
A.Water restriction alone
B.Isotonic saline alone
C.Hypotonic saline
D.Hypertonic saline and water restriction

15.
When hypertonic (3% to 5%) saline is injected IV, which of the following will occur?
A.Water will be drawn out of the cells to the ECF compartment
B.Water will shift from the ECF compartment to the ICF compartment
C.The Na+ pump will maintain equilibrium
D.Urine output will decrease

16.
Which of the following conditions associated with hyponatremia causes plasma hyperosmolality rather than hypoosmolality?
A.Acute renal failure
B.SIADH
C.Uncontrolled diabetes mellitus
D.Diuretic excess

17.
Some iatrogenic causes of hypernatremia include
A.High-protein enteral tube feedings with insufficient water intake
B.Insufficient fluid provided for confused older adults
C.Prolonged use of artificial ventilator
D.Therapeutic abortion with hypertonic saline entry into circulation
E.All of the above

18.
Hypokalemia is associated with all of the following conditions except:
A.Protracted vomiting or diarrhea
B.Cushing's syndrome
C.Administration of IV glucose and regular insulin to correct diabetic ketoacidosis (DKA)
D.Mineralocorticoid deficiency in Addison's disease
E.Metabolic acidosis

19.
Hypokalemia associated with protracted vomiting is caused by:
A.Loss of K+ in vomitus
B.Loss of K+ in the urine
C.Lowering of serum K+ because of a shift into the cells
D.All of the above

20.
The most frequent cause of hypokalemia is likely:
A.Licorice ingestion
B.Diuretic drugs
C.Mg++ depletion
D.Primary hyperaldosteronism

21.
Clinical manifestations of hypokalemia include all of the following except:
A.Fatigue and generalized muscle weakness
B.Serum K+ < 3.5 mEq/L
C. Tall, peaked T waves
D. Decreased bowel sounds
E. Paresthesias

22.
Which statement about hypokalemia is false?
A.Diuretics, digitalis, and hypokalemia are a particularly dangerous combination.
B.Hypokalemia can be diagnosed on the basis of clinical signs and symptoms alone.
C.The rate of K+ administration should not exceed 20 mEq/hr when it is added to an IV line to correct hypokalemia.
D.Ingestion of citrus fruits and juices should be encouraged in persons on long-term diuretic therapy.

23.
Hyperkalemia can be treated by all of the following procedures except:
A.IV calcium gluconate
B.IV glucose and insulin
C.IV sodium bicarbonate
D.Oral or rectal ion exchange resin (Kayexalate)
E.IV acidic solution

24.
Which of the following statements best describes normal Ca++ homeostasis?
A.The rate of Ca++ absorption from the gut is equal to the urinary excretion of Ca++.
B.The rate of Ca++ reabsorption from the bone is equal to the amount of serum calcitonin.
C.The rate of Ca++ reabsorption by the renal tubules is equal to the rate of HPO=4 reabsorption by the renal tubules.

25.
Body processes affected by the concentration of Ca++ ion include:
A.Contraction of cardiac and skeletal muscle
B.Permeability of the cell membrane to Na+ and K+
C.Release of neurotransmitters at synaptic junctions
D.Excitability of nerve tissue
E.All of the above

26.
All of the following statements concerning 1,25(OH)2D3 are true except:
A.It is the most metabolically active form of vitamin D.
B.It acts in concert with PTH to increase osteoclastic bone activity.
C.It increases the absorption of Ca++ and HPO=4 from the gut.
D.PTH stimulates its final hydroxylation in the liver.

27.
The major effect of calcitonin is to:
A.Stimulate hydroxylation of cholecalciferol in the liver
B.Inhibit PTH secretion by the parathyroid glands
C.Inhibit osteoclastic bone activity
D.Stimulate hydroxylation of 25-cholecalciferol in the kidney

28.
Direct effects of PTH secretion on target organs include all of the following except:
A.Increased osteoclastic bone resorption of Ca++ and HPO=4
B.Increased renal tubular Ca++ reabsorption
C.Increased renal tubular HPO=4 reabsorption
D.Increased serum Ca++

29.
Which of the following forms of Ca++ is physiologically active (i.e., plays a role in muscle contraction, nerve conduction, and blood coagulation)?
A.Ionized Ca++
B.Calcium bound to albumin
C.Calcium bound to globulin
D.Calcium complexed with HPO=4

30.
To accurately assess the total serum calcium concentration in the laboratory report, the examiner must correlate the measurement with:
A.Serum Na+ level
B.Serum Cl- level
C.Serum albumin level
D.Serum K+ level

31.
The most common cause of hypoparathyroidism and hypocalcemia is:
A.Idiopathic
B.End-organ resistance
C.Surgical removal of the parathyroids
D.Postradiation therapy

32.
A postoperative complication that results from sudden increased skeletal absorption of Ca++ and HPO=4 from the blood is called:
A.Hungry bone syndrome
B.Hypercalcemic crisis
C.Thyroid crisis
D.Acromegaly

33.
Signs and symptoms of hypocalcemia are more likely to be manifested under conditions of:
A.Metabolic acidosis
B.Metabolic alkalosis
C.ECF volume deficit
D.Hyperphosphatemia

34.
To check for Trousseau's sign (indicating latent tetany), a blood pressure cuff is applied to the arm and inflated above systolic pressure for 3 to 5 minutes. A positive response would be:
A.Paresthesias of the fingers
B.Bounding pulses in the wrist following removal of the cuff
C.Spasm of the wrist and finger muscles
D.Hyperemia of the hand

35.
Spasm of the facial muscles induced by tapping the facial nerve in front of the ear (indicating latent tetany) is known as:
A.Chvostek's sign
B.Temporomandibular sign
C.Homans' sign
D.Brudzinski's sign

36.
The most common cause of hypercalcemia is:
A.Malignancies
B.Primary hyperparathyroidism
C.Vitamin D intoxication
D.Adrenal insufficiency

37.
Factors important in the development of humoral hypercalcemia of malignancy include all of the following except:
A.Transforming growth factors such as TGF-alpha
B.Parathyroid hormone-related peptide (PTHrP)
C.Lymphotoxin
D.Osteoclast deactivating factors
E.Interleukin-1

38.
ECG changes characteristic of hypercalcemia are:
A.Shortened PR interval
B.Shortened QT interval
C.Prolonged QT interval
D.Sinus tachycardia

39.
The treatment of hypercalcemia requires adequate:
A.Vitamin D intake
B.Treatment with thiazide diuretics
C.Protein intake
D.Hydration with saline followed by giving loop diuretics

40.
Asymptomatic patients with malignancy-related hypercalcemia (< 12 mg/dl) who are receiving antineoplastic treatment may only require:
A. Increased oral fluid intake
B. Restriction of dietary calcium
C. Limitation of weight-bearing activities
D. Liberal use of sedatives to ensure a good night's rest

41.
Gallium nitrate, used in the treatment of malignancy-related hypercalcemia, exerts a hypocalcemic effect by:
A.Stimulating an antitumor response
B.Reducing renal Na+ excretion
C.Blocking PTH-induced bone resorption of calcium
D.Enhancing the action of prostaglandin-synthesis inhibitors

42.
The most common cause contributing to hypomagnesemia is:
A.Alcohol abuse
B.Vitamin D intoxication
C.Administration of cisplatin
D.Hyperparathyroidism

43.
The effect of hypomagnesemia on the neuromuscular system is:
A.Decreased excitability
B.Increased excitability
C.Significant paralysis
D.Release of ATP from cells

44.
The most common cause of hypermagnesemia is:
A.Ingestion of magnesium-containing drugs by a patient with renal insufficiency or failure
B.Diabetic ketoacidosis (DKA)
C.Adrenal insufficiency
D.Hemodialysis using untreated (hard) water

45.
Which of the following drugs should the nurse have available for emergency use when Mg++ is administered IV?
A.Digoxin
B.Lidocaine
C.Potassium chloride
D.Calcium gluconate

46.
A 35-year-old male alcoholic was brought to the hospital in a comatose state after being discovered in an alley behind a tavern. The patient's skull was fractured. An indwelling catheter inserted into his bladder revealed a urine output of 175 ml/hr. Serum laboratory tests revealed the following: Na+, 170 mEq/L; Cl-, 132 mEq/L; K+, 4.0 mEq/L; serum glucose, 80 mg/dl; plasma osmolality, 345 mOsm/kg. The urine osmolality was 100 mOsm/kg. After administration of the vasopressin test, the urine output decreased to 90 ml/hr, and the osmolality increased to 270 mOsm/kg. His vital signs included the following: blood pressure 120/84 mm Hg; oral temperature, 99.6° F; pulse, 90 beats/min; respirations, 20 breaths/min. The probable cause of this patient's problem is:
A.Central diabetes insipidus
B.Nephrogenic diabetes insipidus
C.Osmotic diuresis
D.SIADH

47.
Which of the following statements are correct regarding the treatment of the fluid and electrolyte imbalance of the patient in question #46? (More than one answer may be correct.)
A.The primary goal is to lower the serum Na+ gradually to avoid causing cerebral edema.
B.A hypotonic IV solution (D5W or D5-0.2% NaCl) should be given.
C.Water restriction is the treatment of choice to decrease polyuria.
D.Chronic treatment consists of administering exogenous ADH.

48.
Third-space fluid loss: (More than one answer may be correct.)
A.Is manifested by rapid decrease in body weight
B.Is the accumulation of fluid in a non-ECF or non-ICF compartment, which is not easily exchangeable with the ECF
C.May reduce the effective circulating blood volume
D.Represents a distributional loss of fluids from the ECF

49.
Which of the following test results indicate an isotonic fluid volume deficit caused by extrarenal losses? (More than one answer may be correct.)
A.Serum Na+ 140 mEq/L
B.Hematocrit 55%
C.Urine specific gravity 1.038 (or 1200 mOsm/kg)
D.Urine Na+ < name="Q_080B04F036664FB8B7071DAE8D222F6C">50.

50.
Somatic compensatory responses to the rapid loss of a large amount of body fluid (e.g., sequestration in intestinal obstruction, bleeding) include: (More than one answer may be correct.)
A.Sympathetic activation and peripheral vasoconstriction
B.Diminished renal perfusion
C.Stimulation of the ADH mechanism, causing thirst and increased renal water reabsorption
D.Activation of the renin-angiotensin-aldosterone mechanism, causing increased renal Na+ (and water) reabsorption
E.Increased heart rate and contractility to restore cardiac output

51.
Which of the following situations presents a danger of circulatory overload (hypervolemia)? (More than one answer may be correct.)
A.Administration of a hypertonic IV solution
B.Congestive heart failure
C.Acute renal failure
D.Pyrexia lasting 4 days

52.
SIADH may be associated with: (More than one answer may be correct.)
A.Massive edema
B.CNS lesions and injuries
C.Postoperative conditions: cardiac surgery
D.Administration of oxytocin for labor induction
E.Administration of oral hypoglycemic agents

53.
Some causes of hyperkalemia include: (More than one answer may be correct.)
A.Poor venipuncture technique
B.Acute and chronic renal failure
C.Ingestion of salt substitutes in a person with renal insufficiency
D.Aldosterone deficiency
E.Tissue damage (e.g., surgery, burns)

54.
ECG changes suggesting hyperkalemia include: (More than one answer may be correct.)
A.High, peaked T waves
B.Prolonged PR interval
C.Depressed ST segment
D.Prolonged QRS intervals

55.
Hyperkalemia that reaches critical levels (> 7 to 8 mEq/L) presents a distinct danger of: (More than one answer may be correct.)
A.Cardiac dysrhythmias
B.Cardiac arrest
C.Hypertensive crisis
D.Hypovolemic shock
E.Increased cardiac contractility

56.
Hypocalcemia may be treated by giving: (More than one answer may be correct.)
A.Calcitonin
B.Calcium gluconate
C.Vitamin D
D.Diphosphonates
E.Plicamycin (Mithracin)

57.
In primary hyperparathyroidism: (More than one answer may be correct.)
A.Serum levels of PTH are always greater than it is in patients with hypercalcemia caused by vitamin D3 intoxication
B.An adenoma of one or more of the parathyroid glands is often the cause of the PTH hypersecretion
C.A generalized loss of bone mineralization may be evident on x-ray examination

58.
Which of the following signs or symptoms would the nurse most likely observe when assessing for hypophosphatemia? (More than one answer may be correct.)
A.Irritability, apprehension
B.Paresthesias
C.Diarrhea
D.Hypertension

Acid-Base Disorders
Price: Pathophysiology, 6th Edition
Study Questions Chapter 22

1.
Acid-base balance in the human body is maintained by controlling the concentration of:
A.Blood
B.Hydrogen ions
C.Carbon dioxide
D.Oxygen

2.
An acid can best be explained as:
A.An anion
B.A cation
C.A chemical that is able to donate a H+ ion
D.A chemical that combines with a hydrogen ion to form an acid

3.
The normal pH of the blood serum indicates that the serum is:
A.Neutral
B.Slightly acid
C.Slightly alkaline
D.None of the above

4.
Normally the pH of human blood serum is:
A.7.38 to 7.42
B.7.31 to 7.42
C.7.35 to 7.48
D.7.35 to 7.55

5.
The normal [H+] of the blood is:
A.16 mEq/L
B.35 mEq/L
C.40 mEq/L
D.63 mEq/L

6.
The Henderson-Hasselbalch equation reveals that maintaining a normal pH requires that the ratio of base bicarbonate to carbonic acid must be:
A.20:1
B.1:20
C.2:20
D.30:2

7.
Three body systems act to maintain the blood pH near 7.4 and defend against large deviations. Choose the series below that lists these three systems in order, from the fastest acting to the slowest acting.
A.Kidneys, lungs, blood buffers
B.Blood buffers, lungs, kidneys
C.Blood buffers, kidneys, lungs
D.Lungs, blood buffers, kidneys

8.
The lowest limit of blood pH at which a person can live more than a few minutes is approximately:
A.6.0
B.6.8
C.7.2
D.7.3

9.
The first step in the assessment of the acid-base status is:
A.Review the clinical history for disease processes that might lead to an acid-base disturbance
B.Examine the PaCO2
C.Examine at the laboratory report of the base excess because it always leads to the right conclusion about acid-base disturbances
D.Calculate the anion gap

10.
The rapid or prolonged administration of normal saline may cause:
A.Metabolic alkalosis
B.Metabolic (Cl-) acidosis
C.Dehydration
D.Hypoventilation

11.
Diarrhea from a colostomy will cause metabolic acidosis. The primary reason that this acid-base imbalance occurs is a:
A.Primary HCO-3 deficit
B.Primary HCO-3 excess
C.Primary H2CO3 excess
D.Primary H2CO3 deficit

12.
The primary defect in respiratory acidosis is:
A.Primary HCO-3 deficit
B.Primary HCO-3 excess
C.Primary H2CO3 excess
D.Primary H2CO3 deficit

13.
A person who has a condition in which the production of endogenous organic acids (e.g., diabetic ketoacidosis) is increased above the normal level will develop:
A.Respiratory acidosis
B.Respiratory alkalosis
C.Metabolic alkalosis
D.Normal anion gap metabolic acidosis
E.High anion gap metabolic acidosis

14.
A not uncommon method of providing a feeling of euphoria, often expressed as "being high," is to deliberately hyperventilate. Hyperventilation causes an acid-base imbalance called:
A.Respiratory acidosis
B.Respiratory alkalosis
C.Metabolic acidosis
D.Metabolic alkalosis

15.
Indiscriminate administration of oxygen can be deadly for the patient with COPD (chronic bronchitis and emphysema). Which of the following sequences describes the progression of adverse effects? 1. Hypoventilation 2. Depression of the respiratory center 3. CO2 retention 4. CO2 narcosis (coma)
A.1 → 2 → 3 → 4
B.2 → 1 → 3 → 4
C.3 → 4 → 2 → 1
D.4 → 3 → 1 → 2

16.
To reduce the risk of metabolic alkalosis, nasogastric suction tubes should be irrigated with:
A.Tap water
B.Normal saline

17.
A 31-year-old man was admitted to the hospital in a coma with a diagnosis of brain tumor. A tracheostomy was performed on the day of admission and pressure-controlled mechanical ventilation given continuously. His temperature has ranged between 102° and 103.4° F. On the fifth day after admission, you note that he has carpopedal spasms of the hands when you check his blood pressure. Which of the following statements best explains this phenomenon?
A.The patient's elevated temperature has induced a neuromuscular irritability and a febrile convulsion is imminent.
B.Serum pH has decreased because of respiratory acidosis produced by hypoventilation. The decreased pH in turn caused irritability of the nervous system.
C.Serum pH has increased because of respiratory alkalosis produced by hyperventilation. The alkalosis directly stimulates the nervous system and also causes a decrease in ionized serum Ca++. Consequently, hyperirritability of the nervous system occurred.
D.Total serum calcium has decreased because of the patient's immobility and its consequent loss in the urine.

18.
The IV fluid of choice to treat a patient with metabolic alkalosis and a fluid volume deficit secondary to vomiting over several days is:
A.Lactated Ringer's solution (metabolized to HCO-3)
B.D5W
C.Normal saline
D.Normal saline with added KCl

19.
A 60-year-old widow has been in the hospital for several days for a complete medical checkup. She is worried that she may have cancer, although all tests have been negative. Her physician has diagnosed her case as an anxiety reaction following the death of her husband (from cancer). In the middle of the night, she calls the nurse into her room and complains of muscle cramps in her feet and a prickling sensation in her fingers and toes. The nurse notes that she sighs frequently. Her hands are cold and clammy to the touch and she has a slight tremor. The probable difficulty is:
A.Respiratory alkalosis
B.Respiratory acidosis
C.Metabolic acidosis
D.Metabolic alkalosis

20.
Intervention(s) that might help relieve the symptoms of the patient in question #19 include: (More than one answer may be correct.)
A.Offering her the antacid of her choice
B.Elevating the head of her bed to improve ventilation
C.Having her breathe into a paper bag
D.Offering her reassurance and allowing her to discuss her fears

21.
The clues to a mixed acid-base disturbance are: (More than one answer may be correct.)
A.Undercompensation or overcompensation of a primary acid-base disorder
B.Failure to balance the expected compensation formula
C.The change in the anion gap does not equal the change in the HCO-3
D.A large anion gap

22.
Which of the following are classified as blood buffers? (More than one answer may be correct.)
A.Bicarbonate-carbonic acid system
B.Hemoglobin
C.Phosphate
D.Protein

23.
Factors that contribute to the maintenance of metabolic alkalosis include: (More than one answer may be correct.)
A.K+ depletion
B.Na+ excess
C.Cl- depletion
D.Fluid volume deficit and secondary hyperaldosteronism

24.
Cl--responsive metabolic alkalosis is caused most often by vomiting or diuretics, and urine Cl- is less than 10 mEq/L.
True False

25.
HCO-3 and Cl- have a direct relationship: when HCO-3 increases Cl- also increase.
True False

26.
The basic cause of respiratory acidosis is hyperventilation.
True False

27.
Laboratory values alone are usually sufficient to recognize acid-base disturbances.
True False

28.
Kussmaul breathing in a patient with metabolic acidosis indicates that the lungs are attempting to compensate for the disturbance.
True False

29.
Match the cause(s) of acid-base disturbance with the type of primary acid-base disturbance.
1.High anion gap metabolic acidosis
2.Respiratory alkalosis
3.Chronic respiratory acidosis
4.Acute respiratory acidosis
5.Hyperchloremic metabolic acidosis
6.Metabolic alkalosis

1 2 3 4 5 6
A.Diarrhea

1 2 3 4 5 6
B.Renal failure; Uncontrolled diabetes; Starvation; Salicylate poisoning

1 2 3 4 5 6
C.Nasogastric suction or vomiting; Loop or thiazide diuretic; Secondary hyperaldosteronism

1 2 3 4 5 6
D.Laryngospasm

1 2 3 4 5 6
E.COPD

1 2 3 4 5 6
F.Emotional stress; Mechanical ventilation

30.
Match the likely cause(s) of mixed acid-base disturbance with the type of mixed acid-base disturbance.
1.Metabolic acidosis and respiratory alkalosis
2.Acute-on-chronic respiratory acidosis
3.Metabolic acidosis and respiratory acidosis
4.Metabolic alkalosis and respiratory acidosis
5.Metabolic alkalosis and respiratory alkalosis

1 2 3 4 5
A.Cardiopulmonary arrest

1 2 3 4 5
B.Hyperventilating chronic heart failure patient treated with diuretics; COPD patient placed on mechanical ventilator

1 2 3 4 5
C.Salicylate intoxication

1 2 3 4 5
D.COPD patient receiving nasogastric suction

1 2 3 4 5
E.COPD patient who develops pneumonia