A Funny facts

These are some of the funny facts about the world

1. Antarctica is the only continent without reptiles or snakes.
2. An eagle can kill a young deer and fly away with it.
3. In the Caribbean there are oysters that can climb trees.
4. Intelligent people have more zinc and copper in their hair.
5. The world's youngest parents were 8 and 9 and lived in China in 1910.
6. When George Lucas was mixing the American Graffiti soundtrack, he numbered the reels of film starting with an R and numbered the dialog starting with a D. Sound designer Walter Murch asked George for Reel 2, Dialog 2 by saying "R2D2". George liked the way that sounded so much he integrated that into another project he was working on.
7. The youngest pope was 11 years old.
8. Mark Twain didn't graduate from elementary school.
9. Proportional to their weight, men are stronger than horses.
10. Pilgrims ate popcorn at the first Thanksgiving dinner.
11. They have square watermelons in Japan - they stack better.
12. Iceland consumes more Coca-Cola per capita than any other nation.
13. Heinz Catsup leaving the bottle travels at 25 miles per year.
14. It is possible to lead a cow upstairs but not downstairs.
15. Armadillos can be housebroken.
16. The first Fords had engines made by Dodge.
17. A mole can dig a tunnel 300 feet long in just one night.
18. Peanuts are one of the ingredients in dynamite.
19. Ancient Egyptians slept on pillows made of stone.
20. A hippo can open its mouth wide enough to fit a 4 foot tall child inside.
21. A quarter has 119 grooves on its edge, a dime has one less groove.
22. A hummingbird weighs less than a penny.
23. Until 1796, there was a state in the United States called Franklin. Today it is known as Tennessee.
24. The flashing warning light on the cylindrical Capitol Records tower spells out HOLLYWOOD in Morse code.
25. Every time you lick a stamp, you're consuming 1/10 of a calorie.
26. The average person has over 1,460 dreams a year.
27. One in every 4 Americans has appeared on television.
28. The average American will eat about 11.9 pounds of cereal per year.
29. Over 1,000 birds a year die from smashing into windows.
30. The State of Florida is bigger than England.
31. Ants stretch when they wake up in the morning.
32. It's against the law to have a pet dog in Iceland.
33. Thomas Edison, light bulb inventor, was afraid of the dark.
34. During your lifetime, you'll eat about 60,000 pounds of food. That's the weight of about 6 elephants.
35. Some ribbon worms will eat themselves if they can't find any food.
36. Dolphins sleep with one eye open.
37. The world's oldest piece of chewing gum is 9000 years old.
38. In space, astronauts cannot cry, because there is no gravity, so the tears can't flow.
39. About 3000 years ago, most Egyptians died by the time they were 30.
40. More people use blue toothbrushes than red ones.
41. A sneeze travels out your mouth at over 100 m.p.h.
42. Your ribs move about 5 million times a year, every time you breathe.
43. In the White House, there are 13,092 knives, forks and spoons.
44. Slugs have 4 noses.
45. Recycling one glass jar saves enough energy to watch TV for 3 hours.
46. Lightning strikes about 6,000 times per minute on this planet.
47. Owls are the only birds who can see the color blue.
48. The average American drinks about 600 sodas a year.
49. It's against the law to slam your car door in Switzerland.
50. There wasn't a single pony in the Pony Express, just horses.
51. Honeybees have hair on their eyes.
52. A jellyfish is 95 percent water.
53. In Bangladesh, kids as young as 15 can be jailed for cheating on their finals.
54. A company in Taiwan makes dinnerware out of wheat, so you can eat your plate.
55. The elephant is the only mammal that can't jump.
56. The penguin is the only bird who can swim, but not fly.
57. The most common name in the world is Mohammed.
58. Q is the only letter in the alphabet that does not appear in the name of any of the United States.
59. America once issued a 5-cent bill.
60. You'll eat about 35,000 cookies in your lifetime.
61. Babe Ruth wore a cabbage leaf under his cap to keep him cool. He changed it every 2 innings.
62. Fortune cookies were actually invented in America, in 1918, by Charles Jung.
63. A giraffe can clean its ears with its 21-inch tongue.
64. Chewing gum while peeling onions will keep you from crying.
65. The pitches that Babe Ruth hit for his last-ever homerun and that Joe DiMaggio hit for his first-ever homerun where thrown by the same man.
66. Bats always turn left when exiting a cave.
67. The praying mantis is the only insect that can turn its head.
68. In Tokyo, they sell toupees for dogs.
69. There are over 52.6 million dogs in the U.S.
70. Dogs and cats consume almost $7 billion worth of pet food a year.
71. Baby robins eat 14 feet of earthworms every day.
72. The Pentagon has twice as many restrooms as necessary. When it was built, segregation was still in place in Virginia, so separate restrooms for blacks and whites were required by law.
73. In England, in the 1880's, "Pants" was considered a dirty word.
74. Most dust particles in your house are made from dead skin.
75. In 2003, there were 86 days of below-freezing weather in Hell, Michigan.

Hope these information are useful

EBOOKS

Sometimes it really sucks when we look for the book we want to read and can't find it in the book store or if the book is far behind our pocket. Well what to do then, anyhow we have to get a book and don't want to spend penny for it. Best idea would be to download the books online. But they do sometimes cost money to do so. In any of those circumstances a tiny chance to find out book online and getting them able to download would be like hell lot of help to us.

I had a same problem and a I by chance found out a site which allows us to find lots of book stuffs and gives us free download. The name of the site is www.scribd.com. Check this site and you will enjoy it. If you have any other sites except from these, do write to me.



Hoping you be enjoying this site.

FACEBOOK HELP

Have you got a call from your friend about your facebook account or have you doubt that some of your friends are using your facebook account without your notification. Well if you are thinking like that there is no need to worry about these matter any more. Your problem has been solved by the facebook. Facebook provides a option which gives you a notification about your usage of facebook account either to you by email or by sms to your mobile.




This will surely take your worries away from you about your facebook usage by other people. Just what you have to do is go to the Account option choose account setting and then account security choose change and then choose on option. Bingo you go and you will get notification in your mail.

Visit Nepal 2011

Nepal is a democratic country in south Asia. It’s a landlocked country with the borders with India and China. Northern side has Mt. Everest and is bordered with People’s Republic of China while as to the remaining side Nepal has open border with Republic of India. Nepal has area of 147,181 sq. kilometer and is the 93rd largest country by land mass. It has population of 30 million and is 41st most populous country. Kathmandu is the capital city of Nepal. Nepal was kingdom with Shah Dynasty ruling the country since 1768. With the people’s revolution along with Communist party of Nepal (Maoist) Federal democratic republic is recently established in 28th of May 2008.

Visit Nepal 2011 was organized to increase the number of visitor in Nepal which would support in the economical growth of the country and to reestablish the image of Nepal to the world. Nepal was going through lots of domestic problem for the long period of time, so the peaceful and beautiful image of Nepal was deemed. Visit Nepal 2011 was organized to reestablish the image of Nepal that it had before the domestic problem. It gives people the opportunity to explore the uniqueness of Nepal and feel the different world which one can find within Nepal. Last visit Nepal was organized in 1998. Tourism is the source of economy in the Nepal followed by the agriculture, which is the primary source.

Nepal is rich is flora and fauna. Around 6500 varieties of flower along with bushes and trees are found in Nepal, which includes lots of flora which are rare and endangered in world. Among these floral, 245 types of plants are only found in Nepal. 845 kinds of birds have been reported in Nepal which covers overall 10% of the birds recorded so far. Among the world’s top ten highest mountains, 8 of them lies in Nepal which include the highest peak of world Mt. Everest. Tilicho is the lake in the highest altitude of the world. Nepal is the birth place of Gautama Buddha, the proprietor of Buddhism. Along with that, Nepal is only country in the world with living goddess, Kumari. These are all the things which people can see and explore and feel the difference. During the visit Nepal year 2011, one can explore the Nepal as if being local people and lots of opportunities will be there to explore the real Nepal’s heritage, culture, religion, natural beauty, be a part of Nepal in an affordable price. Nepal is reported to have 123 different languages spoken by different ethnic groups of Nepal.

Lots of packages are being offered by lots of travel agencies at the low price. IF you love trekking, Everest base camp trekking is offered, where you will be able to trek up to the base camp of the Mount Everest. This trekking package is of 16 days and cost around 765 dollars. In these 16 days you will be able to explore the Himalayas of Nepal along with the Mount Everest followed by the other Himalayas. You will be able to explore the Sherpa’s culture and life in brief and will be able to explore about the animals like leopard, musk dear, mountain Thar and birds like long tail bird etc. The best time to trek would be March to mid may and September to mid November.

NCLEX addition question

1. A client has an arteriovenous (AV) fistula in place in the right upper extremity for hemodialysis treatments. When planning care for this client, which of the following measure should the nurse implement to promote client safety?
a. Take blood pressures only on the right arm to ensure accuracy.
b. Use the fistula for all venipunctures and intravenous infusions.
c. Ensure that small clamps are attached to the AV fistula dressing.
d. Assess the fistula for the presence of a bruit and thrill every 4 hours.
2. A client is due in hydrotherapy for a burn dressing change. To ensure that the procedure is the most tolerable for the client, the nurse takes which of the following actions?
a. Ensure that the client has a robe and slippers
b. Administers an analgesic 20 minutes before therapy
c. Sends dressing supplies with the client to hydrotherapy
d. Administers the intravenous abtibiotic 30 minutes before therapy
3. The nurse is caring for a client with heart failure who has a magnesium level of 1.4 mg/dL. The nurse should:
a. Monitor the client for irregular heart rhythms.
b. Teach the client to avoid food high in magnesium.
c. Encourage the intake of antacids with phosphates.
d. Provide a diet of ground beef, eggs, and chicken breast.
4. A nurse is preparing to care for a client following parathyroidectomy. The nurse plans care anticipating which postoperative order?
a. Maintain the endotracheal tube for 36 hours.
b. Take a rectal temperature only until discharge.
c. Ensure that intravenous calcium preparations are available.
d. Place the client in a flat position with the head and neck immobilized.
5. A client with a wound infection and osteomyelitis is to receive hyperbaric oxygen therapy. During the therapy, the nurse implements which priority intervention?
a. Maintains an intravenous access
b. Ensures that oxygen is being delivered.
c. Administers sedation to prevent claustrophobia.
d. Provides emotional support to the client’s family.
6. The nurse is caring for a client with a herniated lumbar intervertebral disk. The nurse plans to place the client in which position to minimize the pain?
a. Flat with a knees raised
b. High fowler’s position with the foot of the bed flat
c. Semi-fowler’s position with the foot of the bed flat.
d. Semi-Fowler’s position with the knees slightly raised.
7. A mother arrives at the emergency department with her child, stating that she just found the child sitting on the floor next to an empty bottle of aspirin. On assessment, the nurse notes that the child is drowsy but conscious. The nurse anticipates that the physician will prescribe which of the following?
a. Ipecac syrup
b. Activated charcoal
c. Magnesium citrate
d. Magnesium sulfate
8. A client with myasthenia gravis is admitted to the hospital, and the nursing history reveals that the client is taking pyridostigmine (Mestinon). The nurse assesses the client for side effects of the medication and asks the client about the presence of
a. Mouth ulcers
b. Muscles cramps
c. Feeling of depression
d. Unexplained weight gain.
9. A client with a fractured right ankle has a short leg cast applied in the emergency department. During discharge teaching, the nurse provides which information to the client to prevent complications?
a. Trim the rough edges of the cast after it is dry.
b. Weight-bearing on the right leg is allowed once the cast feels dry.
c. Expect burning and tingling sensations under the cast for 3 to 4 days.
d. Keep the right ankle elevated above the heart level with pillows for 24 hours.
10. An older adult female client with a fractured left tibia has a long leg cast and is using crutches to ambulate. In caring for the client, the nurse assesses for which sign or symptom that indicates a complication associated with crutch walking?
a. Left leg discomfort
b. Weak biceps brachii
c. Triceps muscle spasms
d. Forearm muscle weakness
11. A client with myasthenia gravis is experiencing prolonged periods of weakness, and the physician orders an endophonium (Tensilon) test. A test dose is administered and the client becomes weaker. The nurse interprets that this test result as:
a. Normal
b. Positive
c. Myasthenic crisis
d. Cholinergic crisis
12. The nurse notes an isolated premature ventricular contraction (PVC) on the cardiac monitor. The appropriate nursing action is to:
a. Prepare for defibrillation.
b. Continue to monitor the rhythm.
c. Notify the physician immediately.
d. Prepare to administer lidocaine hydrochloride (Xylocaine)
13. The nurse is caring for a client admitted to a hospital with the diagnosis of active tuberculosis. The nurse determines that the diagnosis was confirmed by a:
a) Tine Test
b) Chest X-ray
c) Mantoux text
d) Sputum culture
14. A clinic nurse prepares to assess the fundal height on a client who is in the second trimester of pregnancy. When measuring the fundal height, the nurse will most likely expect the measure to:
a) Correlate with gestational age
b) Be less that gestational age
c) Be greater than gestational age.
d) Have no correlation to gestational age.
15. A pregnant client tells a nurse that she felt wetness on her peri-pad and found some clear fluid. The nurse immediately inspects the perineum and notes the presence of the umbilical cord. The nurse’s initial action is to:
a) Notify the physician.
b) Monitor the fetal heart rate.
c) Transfer the client to the delivery room.
d) Place the client in the Trendelenburg position
16. A nurse admits a newborn infant to the nursery. On assessment of the infant, the nurse palpates the anterior fontanel and notes that it feels soft. The nurse determines that this finding indicates:
a. Dehydration
b. A normal finding
c. Increased intracranial pressure
d. Decreased intracranial pressure
17. A client with acquired immunodeficiency syndrome (AIDS) is admitted to the hospital for chills, fever, nonreproductive dough, and pleuritic chest pain. A diagnosis of Pneumocystic Jiroveci pneumonia is made and the client is started on intravenous (IV) pentamidine (Pentam-300). Which of the following should the nurse plan to carry out to safely administer the medication?
a) Infuse over 1 hour and allow the client to ambulate.
b) Infuse over 1 hour with the client in a supine position.
c) Administer over 30 minutes with the client in a reclining position.
d) Administer an IV push over 15 minutes with the client in a supine position.
18. The nurse is caring for a client who has been transferred to the surgical unit after having a pelvic exenteration. During the postoperative period, the client complains of pain the calf area. What action should the nurse take?
a) Ask the client to walk and observe the gait.
b) Lightly massage the calf area to relieve the pain.
c) Check the calf area for temperature, color, and size.
d) Administer prn morphine as prescribed for postoperative pain.
19. A prenatal client with a history of rheumatic heart disease is experiencing unusual episodes of a nonproductive couth on minimal exertion. The nurse interprets that this assessment finding may be an early manifestation of which potential complication?
a) Chronic hypertension
b) Eisenmenger’s syndrome
c) Right-sided heart failure
d) Cardiac decompensation
20. A nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris who is receiving sotalol (Betapace) 80 mg orally daily. Which assessment finding indicates that the client is experiencing a side effect of a medication?
a) Dry mouth
b) Palpitations
c) Diaphoresis
d) Difficulty swallowing
Ans:
1. D 2. B 3. A 4. C 5. B 6. D 7. B 8. B 9. D 10. D
11. D 12. B 13. D 14. A 15. D 16. B 17. B 18. C 19. D 20. B

NCLEX, more questions

I hope the NCLEX question with rational helped my readers a lot. Hoping it helped i am posting some more question on NCLEX
21. When a client asks the nurse why the physician says he "thinks" he has tuberculosis, the nurse explains to him that diagnosis of tuberculosis can take several weeks to confirm. Which of the following statements supports this answer?
a. A positive reaction to a tuberculosis skin test indicates that the client has active tuberculosis, even if one negative sputum is obtained
b. A positive sputum culture takes at least 3 weeks, due to the slow reproduction of the bacillus
c. Because small lesions are hard to detect on chest x-rays, x-rays usually need to be repeated during several consecutive weeks
d. A client with a positive smear will have to have a positive culture to confirm the diagnosis

22. The nurse is counseling a client with the diagnosis of glaucoma. She explains that if left untreated, this condition leads to
a. Blindness
b. Myopia
c. Retrolental fibroplasia
d. Uveitis

23. A nursing assessment for initial signs of hypoglycemia will include
a. Pallor, blurred vision, weakness, behavioral changes
b. Frequent urination, flushed face, pleural friction rub
c. Abdominal pain, diminished deep tendon reflexes, double vision
d. Weakness, lassitude, irregular pulse, dilated pupils

24. The physician has ordered a 24-hour urine specimen. After explaining the procedure to the client, the nurse collects the first specimen. This specimen is then
a. Discarded, then the collection begins
b. Saved as part of the 24-hour collection
c. Tested, then discarded
d. Placed in a separate container and later added to the collection

25. Following an accident, a client is admitted with a head injury and concurrent cervical spine injury. The physician will use Crutchfield tongs. The purpose of these tongs is to
a. Hypoextend the vertebral column
b. Hyperextend the vertebral column
c. Decompress the spinal nerves
d. Allow the client to sit up and move without twisting his spine

26. The most appropriate nursing intervention for a client requiring a finger probe pulse oximeter is to
a. Apply the sensor probe over a finger and cover lightly with gauze to prevent skin breakdown
b. Set alarms on the oximeter to at least 100 percent
c. Identify if the client has had a recent diagnostic test using intravenous dye
d. Remove the sensor between oxygen saturation readings

27. A client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control the bleeding. The most important assessment is for the nurse to
a. Check that a hemostat is at the bedside
b. Monitor IV fluids for the shift
c. Regularly assess respiratory status
d. Check that the balloon is deflated on a regular basis

28. A 55-year-old client with sever epigastric pain due to acute pancreatitis has been admitted to the hospital. The client's activity at this time should be
a. Ambulation as desired
b. Bedrest in supine position
c. Up ad lib and right side-lying position in bed
d. Bedrest in Fowler's position

29. Of the following blood gas values, the one the nurse would expect to see in the client with acute renal failure is
a. pH 7.49, HCO3 24, PCO2 46
b. pH 7.49, HCO3 14, PCO2 30
c. pH 7.26, HCO3 24, PCO2 46
d. pH 7.26, HCO3 14, PCO2 30

30. A client in acute renal failure receives an IV infusion of 10% dextrose in water with 20 units of regular insulin. The nurse understands that the rationale for this therapy is to
a. Correct the hyperglycemia that occurs with acute renal failure
b. Facilitate the intracellular movement of potassium
c. Provide calories to prevent tissue catabolism and azotemia
d. Force potassium into the cells to prevent arrhythmias

31. A client has had a cystectomy and ureteroileostomy (ileal conduit). The nurse observes this client for complications in the postoperative period. Which of the following symptoms indicates an unexpected outcome and requires priority care?
a. Edema of the stoma
b. Mucus in the drainage appliance
c. Redness of the stoma
d. Feces in the drainage appliance

32. A nursing care plan for a client with a suprapubic cystostomy would include
a. Placing a urinal bag around the tube insertion to collect the urine
b. Clamping the tube and allowing the client to void through the urinary meatus before removing the tube
c. Catheter irrigations every 4 hours to prevent formation of
urinary stones
d. Limiting fluid intake to 1500 mL per day

33. For a client who has ataxia, which of the following tests would be performed to assess the ability to ambulate?
a. Kernig's
b. Romberg's
c. Riley-Day's
d. Hoffmann's

34. A client admitted to a surgical unit for possible bleeding in the cerebrum
has vital signs taken every hour to monitor to neurological status. Which of the following neurological checks will give the nurse the best information about the extent of bleeding?
a. Pupillary checks
b. Spinal tap
c. Deep tendon reflexes
d. Evaluation of extrapyramidal motor system

35. Assessing for immediate postoperative complications, the nurse knows that a complication likely to occur following unresolved atelectasis is
a. Hemorrhage
b. Infection
c. Pneumonia
d. Pulmonary embolism

36. A young client is in the hospital with his left leg in Buck's traction. The
team leader asks the nurse to place a footplate on the affected side at the bottom of the bed. The purpose of this action is to
a. Anchor the traction
b. Prevent footdrop
c. Keep the client from sliding down in bed
d. Prevent pressure areas on the foot

21. Answer: b
Rationale: Answer b is correct because the culture takes 3 weeks to grow. Usually even very small lesions can be seen on x-rays due to the natural contrast of the air in the lungs; therefore, chest x-rays do not need to be repeated frequently (c). Clients may have positive smears but negative cultures if they have been on medication (d). A positive skin test indicates the person only has been infected with tuberculosis but may not necessarily have active disease (a).
22. Answer: a
Rationale: The increase in intraocular pressure causes atrophy of the retinal ganglion cells and the optic nerve, and leads eventually to blindness.
23. Answer: a
Rationale: Weakness, fainting, blurred vision, pallor and perspiration are all common symptoms when there is too much insulin or too little food - hypoglycemia. The signs and symptoms in answers (b) and (c) are indicative of hyperglycemia.
24. Answer: a
Rationale: The first specimen is discarded because it is considered "old urine" or urine that was in the bladder before the test began. After the first discarded specimen, urine is collected for 24 hours.
25. Answer: b
Rationale: The purpose of the tongs is to decompress the vertebral column through
hyperextending it. Both (a) and (c) are incorrect because they might cause further damage.
(d) is incorrect because the client cannot sit up with the tongs in place; only the head of the bed can be elevated.
26. Answer: c
Rationale: Clients may experience inaccurate readings if dye has been used for a diagnostic test. Dyes use colors that tint the blood which leads to inaccurate readings.
27. Answer: c
Rationale: The respiratory system can become occluded if the balloon slips and moves up the esophagus, putting pressure on the trachea. This would result in respiratory distress and should be assessed frequently. Scissors should be kept at the bedside to cut the tube if distress occurs. This is a safety intervention.
28. Answer: d
Rationale: The pain of pancreatitis is made worse by walking and supine positioning. The client is more comfortable sitting up and leaning forward.
29. Answer: d
Rationale: The client with acute renal failure would be expected to have metabolic acidosis (low HCO3) resulting in acid blood pH (acidemia) and respiratory alkalosis (lowered PCO2) as a compensating mechanism. Normal values are pH 7.35 to 7.45; HCO3 23 to 27 mEg; and PCO2 35 to 45 mmHg.
30. Answer: b
Rationale: Dextrose with insulin helps move potassium into cells and is immediate management therapy for hyperkalemia due to acute renal failure. An exchange resin may also be employed.
This type of infusion is often administered before cardiac surgery to stabilize irritable cells and prevent arrhythmias; in this case KC1 is also added to the infusion.
31. Answer: d
Rationale: The ileal conduit procedure incorporates implantation of the ureters into a portion of the ileum which has been resected from its anatomical position and now functions as a reservoir or conduit for urine. The proximal and distal ileal borders can be resumed. Feces should not be draining from the conduit. Edema and a red color of the stoma are expected outcomes in the immediate postoperative period, as is mucus from the stoma.
32. Answer: b
Rationale: Allowing the client to void naturally will be done prior to removal of the
catheter to ensure adequate emptying of the bladder. Irrigations are not recommended,
as they increase the chances of the client developing a urinary tract infection. Any time a client has an indwelling catheter in place, fluids should be encouraged (unless contraindicated) to prevent stone formation.
33. Answer: b
Rationale: Romberg's test is the ability to maintain an upright position without swaying when standing with feet close together and eyes closed. Kernig's sign, a reflex contraction, is pain in the hamstring muscle when attempting to extend the leg after flexing the thigh.
34. Answer: a
Rationale: Pupillary checks reflect function of the third cranial nerve, which stretches as it becomes displaced by blood, tumor, etc.
35. Answer: c
Rationale: Pneumonia is a major complication of unresolved atelectasis and must be treated along with vigorous treatment for atelectasis. Hemorrhage and infection are not related to this condition. Pulmonary embolism could result from deep vein thrombosis.
36. Answer: b
Rationale: The purpose of the footplate is to prevent footdrop while the client is immobilized in traction. This will not anchor the traction, keep the client from sliding down in bed, or prevent pressure areas.


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coming back on PPP

It has been long time since i was joined up with PPP. So now i have to reactivate my account again by coping this test "Against a monster proceeds an intentional unfortunate. " so to claim my website.

NCLEX, what do you say about it?

National Council Licensure Examination (NCLEX) is an exam that a fellow nurse has to pass in order to get licensed to legally practice as a nurse in the United States. A prospective nurse must pass either a NCELX-RN (to become registered nurse) or NCLEX-PN (to practice as a practical nurse) after completion of nursing school. According to the data from the NCLEX statics, a candidate studied in the US has good passing percentage of 87.50% while as student from other countries have very low passing rate of 38.26%. Student apart from US educated have a great problem dealing NCLEX exam. My blog with some samples questions with rational answers might help those students who wish to appear in NCLEX exam. I will be submitting around 20 questions with rational answers in each of blog. Hope my effort will help international students.

1. After the lungs, the kidneys work to maintain body pH. The best explanation of how the kidneys accomplish regulation of pH is that they

a. Secrete hydrogen ions and sodium.
b. Secrete ammonia.
c. Exchange hydrogen and sodium in the kidney tubules.
d. Decrease sodium ions, hold on to hydrogen ions, and then secrete sodium bicarbonate.



2.. A female client has orders for an oral cholecystogram. Prior to the test, the nursing intervention would be to

a. Provide a high fat diet for dinner, then NPO
b. Explain that diarrhea may result from the dye tablets
c. Administer the dye tablets following a regular diet for dinner
d. Administer enemas until clear

3. The nurse explains to a client who has just received the diagnosis of Noninsulin-Dependent Diabetes Mellitus (NIDDM) that sulfonylureas, one group of oral hypoglycemic agents, act by

a. Stimulating the pancreas to produce or release insulin
b. Making the insulin that is produced more available for use
c. Lowering the blood sugar by facilitating the uptake and utilization of glucose
d. Altering both fat and protein metabolism


4. Myasthenic crisis and cholinergic crisis are the major complications of myasthenia gravis. Which of the following is essential nursing knowledge when caring for a client in crisis?

a. Weakness and paralysis of the muscles for swallowing and breathing occur in either crisis
b. Cholinergic drugs should be administered to prevent further complications associated with the crisis
c. The clinical condition of the client usually improves after several days of treatment
d. Loss of body function creates high levels of anxiety and fear


5. A 54-year-old client was put in Quinidine (a drug that decreases myocardial excitability) to prevent atrial fibrillation. He also has kidney disease. The nurse is aware that this drug, when given to a client with kidney disease, may

a. Cause cardiac arrest
b. Cause hypotension
c. Produce mild bradycardia
d. Be very toxic even in small doses


6. A client is about to be discharged on the drug bishydroxycoumarin (Dicumarol). Of the principles below, which one is the most important to teach the client before discharge?

a. He should be sure to take the medication before meals
b. He should shave with an electric razor
c. If he misses a dose, he should double the dose at the next scheduled time
d. It is the responsibility of the physician to do the teaching for this medication


7. A cyanotic client with an unknown diagnosis is admitted to the emergency room. In relation to oxygen, the first nursing action would be to

a. Wait until the client's lab work is done
b. Not administer oxygen unless ordered by the physician
c. Administer oxygen at 2 liters flow per minute
d. Administer oxygen at 10 liters flow per minute and check the client's nail beds


8. A client with a diagnosis of gout will be taking colchicine and allopurinol bid to prevent recurrence. The most common early sign of colchicine toxicity that the nurse will assess for is

a. Blurred vision
b. Anorexia
c. Diarrhea
d. Fever

9. A client has chronic dermatitis involving the neck, face and antecubital creases. She has a strong family history of varied allergy disorders. This type of dermatitis is probably best described as

a. Contact dermatitis
b. Atopic dermatitis
c. Eczema
d. Dermatitis medicamentosa



10 . The physician has just completed a liver biopsy. Immediately following the procedure, the nurse will position the client

a. On his right side to promote hemostasis
b. In Fowler's position to facilitate ventilation
c. Supine to maintain blood pressure
d. In Sims' position to prevent aspiration

11 When a client has peptic ulcer disease, the nurse would expect a priority intervention to be

a. Assisting in inserting a Miller-Abbott tube
b. Assisting in inserting an arterial pressure line
c. Inserting a nasogastric tube
d. Inserting an IV


12. The nurse would expect to find an improvement in which of the blood values as a result of dialysis treatment?

a. High serum creatinine levels
b. Low hemoglobin
c. Hypocalcemia
d. Hypokalemia


13. A 24-year-old client is admitted to the hospital following an automobile accident. She was brought in unconscious with the following vital signs: BP 130/76, P 100, R 16, T 98F. The nurse observes bleeding from the client's nose. Which of the following interventions will assist in determining the presence of cerebrospinal fluid?

a. Obtain a culture of the specimen using sterile swabs and send to the laboratory
b. Allow the drainage to drip on a sterile gauze and observe for a halo or ring around the blood
c. Suction the nose gently with a bulb syringe and send specimen to the laboratory
d. Insert sterile packing into the nares and remove in 24 hours


14. A 24-year-old male is admitted with a possible head injury. His arterial blood gases show that his pH is less than 7.3, his PaCO2 is elevated above 60 mmHg, and his PaO2 is less than 45 mmHg. Evaluating this ABG panel, the nurse would conclude that

a. Edema has resulted from a low pH state
b. Acidosis has caused vasoconstriction of cerebral arterioles
c. Cerebral edema has resulted from a low oxygen state
d. Cerebral blood flow has decreased


15 In preparation for discharge of a client with arterial insufficiency and Raynaud's disease, client teaching instructions should include

a. Walking several times each day as a part of an exercise routine
b. Keeping the heat up so that the environment is warm
c. Wearing TED hose during the day
d. Using hydrotherapy for increasing oxygenation


16. A client is admitted following an automobile accident in which he sustained a contusion. The nurse knows that the significance of a contusion is

a. That it is reversible
b. Amnesia will occur
c. Loss of consciousness may be transient
d. Laceration of the brain may occur


17. A client with tuberculosis is given the drug pyrazinamide (Pyrazinamide). Which one of the following diagnostic tests would be inaccurate if the client is receiving the drug?

a. Liver function test
b. Gall bladder studies
c. Thyroid function studies
d. Blood glucose


18. Which one of the following conditions could lead to an inaccurate pulse oximetry reading if the sensor is attached to the client's ear?

a. Artificial nails
b. Vasodilation
c. Hypothermia
d. Movement of the head


19. While on a camping trip, a friend sustains a snake bite from a poisonous snake. The most effective initial intervention would be to

a. Place a restrictive band above the snake bite
b. Elevate the bite area above the level of the heart
c. Position the client in a supine position
d. Immobilize the limb


20. There is a physician's order to irrigate a client's bladder. Which one of the following nursing measures will ensure patency?

a. Use a solution of sterile water for the irrigation
b. Apply a small amount of pressure to push the mucus out of the catheter tip if the tube is not patent
c. Carefully insert about 100 mL of aqueous Zephiran into the bladder, allow it to remain for 10 hour, and then siphon it out
d. Irrigate with 20mL's of normal saline to establish patency

Answers
1. Answer: d

Rationale: By decreasing NA+ ions, holding onto hydrogen ions, and secreting sodium bicarbonate, the kidneys can regulate pH. Therefore, this is the most complete answer, and while this buffer system is the slowest, it can completely compensate for acid-base imbalance.
2. Answer: b

Rationale: Diarrhea is a very common response to the dye tablets. A dinner of tea and toast is usually given to the client. Each dye tablet is given at 5 minute intervals, usually with 1 glass of water following each tablet. The number of tablets prescribed will vary, because it is based on the weight of the client.
3. Answer: a

Rationale: Sulfonylurea drugs, Orinase for example, lowers the blood sugar by stimulating the beta cells of the pancreas to synthesize and release insulin.

4. Answer: a

Rationale: The client cannot handle his own secretions, and respiratory arrest may be
imminent. Atropine may be administered to prevent crisis. Anticholinergic drugs are administered to increase the levels of acetylcholine at the myoneural junction. Cholinergic drugs mimic the actions of the parasympathetic nervous system and would not be used.

5. Answer: a

Rationale: Kidney disease interferes with metabolism and excretion of Quinidine, resulting in higher drug concentrations in the body. Quinidine can depress myocardial excitability enough to cause cardiac arrest.

6. Answer: b

Rationale: Dicumarol is an anticoagulant drug and one of the dangers involved is bleeding. Using a safety razor can lead to bleeding through cuts. The drug should be given at the same time daily but not related to meals. Due to danger of bleeding, missed doses should not be made up.

7. Answer: c

Rationale: Administer oxygen at 2 liters per minute and no more, for if the client is emphysemic and receives too high a level of oxygen, he will develop CO2 narcosis and the respiratory system will cease to function

8. Answer: c

Rationale: Diarrhea is by far the most common early sign of colchicine toxicity. When given in the acute phase of gout, the dose of colchicine is usually 0.6 mg (PO) q hr (not to exceed 10 tablets) until pain is relieved or gastrointestinal symptoms ensue.


9. Answer: b

Rationale: Atopic dermatitis is chronic, pruritic and allergic in nature. Typically it has a longer course than contact dermatitis and is aggravated by commercial face or body lotions, emotional stress, and, in some instances, particular foods.
10. Answer: a

Rationale: Placing the client on his right side will allow pressure to be placed on the puncture site, thus promoting hemostasis and preventing hemorrhage. The other positions will not be effective in achieving these goals.

11. Answer: c

Rationale: An NG tube insertion is the most appropriate intervention because it will determine
the presence of active gastrointestinal bleeding. A Miller-Abbott tube is a weighted, mercury-filled ballooned tube used to resolve bowel obstructions. There is no evidence of shock or fluid overload in the client; therefore, an arterial line is not appropriate at this time and an IV is optional.

12. Answer: a

Rationale: High creatinine levels will be decreased. Anemia is a result of decreased production of erythropoietin by the kidney and is not affected by hemodialysis. Hyperkalemia and high base bicarbonate levels are present in renal failure clients.

13. Answer: b

Rationale: The halo or "bull's eye" sign seen when drainage from the nose or ear of a
head-injured client is collected on a sterile gauze is indicative of CSF in the drainage. The collection of a culture specimen using any type of swab or suction would be contraindicated because brain tissue may be inadvertently removed at the same time or other tissue damage may result.

14. Answer: c

Rationale: Hypoxic states may cause cerebral edema. Hypoxia also causes cerebral vasodilatation particularly in response to a decrease in the PaO2 below 60 mmHg.

15. Answer: b

Rationale: The client's instructions should include keeping the environment warm to prevent vasoconstriction. Wearing gloves, warm clothes, and socks will also be useful in preventing vasoconstriction, but TED hose would not be therapeutic. Walking will most likely increase pain.

16. Answer: d

Rationale: Laceration, a more severe consequence of closed head injury, occurs as the brain tissue moves across the uneven base of the skull in a contusion. Contusion causes cerebral dysfunction which results in bruising of the brain. A concussion causes transient loss of consciousness, retrograde amnesia, and is generally reversible.

17. Answer: a

Rationale: Liver function tests can be elevated in clients taking pyrazinamide. This drug is used when primary and secondary antitubercular drugs are not effective. Urate levels may be increased and there is a chemical interference with urine ketone levels if these tests are done while the client is on the drug.

18. Answer: c

Rationale: Hypothermia or fever may lead to an inaccurate reading. Artificial nails may distort a reading if a finger probe is used. Vasoconstriction can cause an inaccurate reading of oxygen saturation. Arterial saturations have a close correlation with the reading from the pulse oximeter as long as the arterial saturation is above 70 percent.
19. Answer: a

Rationale: A restrictive band 2 to 4 inches above the snake bite is most effective in
containing the venom and minimizing lymphatic and superficial venous return. Elevation of the limb or immobilization would not be effective interventions.

20. Answer: d

Rationale: Normal saline is the fluid of choice for irrigation. It is never advisable to force fluids into a tubing to check for patency. Sterile water and aqueous Zephiran will affect the pH of the bladder as well as cause irritation.

Back Again

Wow, it feel great to be back again to the blog. It's been a long time since i post a blog. Actually it was not being busy or not being unable to access the medium but there is something which hinders me from getting to this limit. Anyway, now seems those hinderance has been vanished or became opaque, anyway now the way is much more clear.

Anyway i feel more than happy to be back with blog.
Dear friends and my dearest reader, my appology not being able to be in touch with you for a such a long time, but now i hope i will be in touch with you constantly.

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