“Desire is the key to motivation, but it is determination and commitment to an unrelenting pursuit of your goal – a commitment to excellence – that will enable you to attain the success you seek.”

-Mario Andretti

Friday, March 28, 2008

Upcoming SF Davis NCLEX Review

Hey everybody! Congratulations on your hard work and dedication which has brought you this far!  You are almost there, can you see the light?

I just want to talk about the Davis NCLEX review course in SF.  There were 45 from my class that went. We went after graduation and never had the opportunity that you have to participate in their program in our 3rd semester. This is a great presentation that is put on, and the advantage of going early is that you will get to use and put into practice, everything that you will learn there, throughout your last semester and beyond. If you wait until after you graduate to attend, you will lose out on the opportunity of  using new test taking strategies, study methods, memory tricks and critical thinking skills that you will learn there. You will also gain access to a huge test bank which encompasses every subject enabling you to find and identify incorrect thought processes and possible test taking weaknesses. You will then be able to correct them before it is too late and time to take THE BIG ONE!
The SF review is a great way to reinforce and cement in your mind, all of the hard work from your past and present learning experiences from Peds, Psych and med surg,  before you start to forget, as you will by the time you get through the 4th semester. 
The 4th semester is very stressful in a busy sort of way which makes it very hard to review and retain your  N4, N5, N6 and N7 knowledge. These subjects will be presented by multiple Nurse speakers who will review subject matter while teaching you how to think and choose the correct answers. They are very entertaining and memorable in the interactive way that they present, plus they will give you nursing rationale which other NCLEX test courses do not. You will get to practice every kind of possible test question type that might be thrown your way. Showing you how to break them down, eliminate the incorrect choices and when all else fails show you how to make the best choice when you do not have a clue what the answer might possibly be. 
A big plus in favor of taking this course,  is the fact that it is only half of the cost of many of the other popular NCLEX courses.
For us, it was a blast! We had loads of fun bunking in together and it was a welcome break from all of our schooling.
If you decide this is for you, you need to contact Heidi ASAP because your special priced extended deadline ends April 4th!
No matter what you all decide, I wish you the best! I can't wait to see all of you out on the floors.  

Wednesday, March 26, 2008

New NCLEX Review Deadline


I contacted Davis NCLEX review and convinced them to give us an extension on submitting our registration forms and money due to the holiday on Monday. So for those of you interested in attending the review, you have until noon on April 4th to submit your registration forms/money to Judy Lee in the nursing office or myself. Please email me if you have any questions (hjamyers@yahoo.com)


Hello everyone,
I am cordinating the paperwork for the "highly recommended" Davis Nclex review being held at San Francisco State University on June 3, 4, 5, & 6, 2008. Unfortunately, I just received their information (sorry for the late notice) and there is an impending deadline of MARCH 31ST to submit registration forms and money. We must have at least 10 people to sign up by March 31st in order to secure a rate of $200 per person otherwise the rate will increase to $250 per person. I have spoken with some 4th semester students who attended this review (about 40 from their class attended) and they really enjoyed the review. They found it helpful in identifying their strengths and weaknesses as this review not only covers testing taking strategies but nursing content.
Davis Nclex review is also offering an online follow up review in January 2009 for those who attend the June 2008 review. They couldn't give me a set price but I was told it would be no more than $100. The review would be offered online for 30 days so students would not have to go back to San Francisco. It think this is a great idea considering most of us will be getting ready to sit for boards in January and this will be a good refresher.

You can go to their website at http://nclex.reviewfornurses.com
for the registration forms and more information regarding their services. Registration forms and payment can be submitted to me or to Judy Lee in the nursing office no later than March 31st at 11am. Please feel free to email me with any questions at hjamyers@yahoo.com.

Here is some general info regarding DAVIS NCLEX REVIEW:

Live NCLEX® Review

A 4-day Classroom NCLEX-RN® Review Course - featuring guest lecturers and author(s) of DAVIS'S NCLEX-RN® SUCCESS, 2e book and ATI NurseNotes Series. PASS THE FIRST TIME (or get free individual help from a nurse educator)

Successful! - 98% passing rate.
Fast! - Get what you need in 4 days.
Complete! - Covers all frequently tested areas.


It's FUN --- strategy sessions, with special focus on test-tips for Medical-Surgical, Pediatrics and Psychiatric questions.



June 3, 4, 5 & 6, 2008
8AM - 9AM Daily check-in
9AM - 5:30PM Lecture

Creative Arts Building
San Francisco State University

Thursday, March 20, 2008


Just a reminder:

3/24/08 @ 1:00pm in the EMSTI classroom, Scott from "KAPLAN" will give a one hour presentation on the benefits of KAPLAN, please spread the word! Even if you have attended other NCLEX reviews come and here what Scott has to say. This is a comment left on a previous blog form a recent graduate.

Harrison Cole said...Hi guys! For those who don't know me I just graduated last Dec. I took the Kaplan review and thought it was practically identical to the RN-NCLEX!!! I also did the Davis review which is great for content review. However, the Kaplan "Decision Tree" and "NCLEX-Land Rules" really made the difference come test time. To be honest, you know what you know by test day and you need a strong practice and test-taking strategy! Good luck on your last semester and your preparation for the RN-NCLEX! Sincerely, Harrison Cole, RN11:11 PM

Friday, March 7, 2008


Scott form KAPLAN will be giving a 1 hour presentation about the benefits of taking the KAPLAN review

March 24th at 1:00pm - EMSTI classroom off of March Lane
(Please do not park in the front of the building per NS department , this parking is for the customers and not for students)!!!!

Even if you are not 4th semester, come and get your questions answered and consider taking the Kaplan review being offered sometime in June. It is never to early to get a jump start on preparing for NCLEX!

******Please pass the word to all semesters!

Any questions please contact Cynthia Tinney 4th semester KAPLAN rep at candrtinney@sbcglobal.net

Saturday, March 1, 2008

N7 Pharmacology Diuretic Agents

Found at the EVOLVE website

Lilley: Pharmacology and the Nursing Process, 4th Edition

Multiple Choice Review Questions Chapter 25


Which of the following laboratory values should be assessed to pick up an adverse response to hydrochlorothiazide (HydroDIURIL)?

A.            Sodium levels

B.            Glucose levels

C.            Calcium levels

D.            Chloride levels


When teaching a patient why spironolactone (Aldactone) and furosemide (Lasix) are prescribed together, the nurse bases teaching on the knowledge that:

A.            Moderate doses of two different types of diuretics are more effective than a large dose of one type

B.            This combination promotes diuresis but decreases the risk of hypokalemia

C.            This combination prevents dehydration and hypovolemia

D.            Using two drugs increases osmolality of plasma and the glomerular filtration rate


The nurse will check the laboratory values of a patient who has started on furosemide (Lasix) because a known side effect of this medication is:

A.            Hyperchloremia

B.            Hypernatremia

C.            Hypokalemia

D.            Hypophosphatemia


A patient is admitted to the hospital with pneumonia and has a history of chronic renal insufficiency. The physician orders furosemide (Lasix) 40 mg twice a day because it:

A.            Will not cause potassium loss

B.            Is effective in treating persons with pulmonary congestion

C.            Is effective in treating persons with renal insufficiency

D.            Will increase pO2 levels


A patient taking spironolactone (Aldactone) requests assistance with dietary choices. The nurse would recommend all of the following except:

A.            Lean meat

B.            Bananas

C.            Apples

D.            Squash


The nurse would question the use of mannitol on which of the following patients?

A.            67-year-old patient who ingested a poisonous substance

B.            21-year-old head injury patient

C.            47-year-old patient with anuria

D.            55-year-old patient receiving cisplatin to treat ovarian cancer


Acetazolamide (Diamox) is used to treat all of the following except:

A.            Edema

B.            Metabolic acidosis

C.            Seizures

D.            Acute glaucoma


When preparing to administer furosemide (Lasix) intravenously, the nurse plans implementation based on knowledge that the medication should be administered no faster than:

A.            2 mg/min

B.            6 mg/min

C.            12 mg/min

D.            20 mg/min


Potassium-sparing diuretics may cause which of the following adverse reactions?

A.            Hyperkalemia, GI upset

B.            Confusion, drowsiness, ataxia

C.            Gynecomastia, decreased libido, impotence

D.            All of the above


A patient asks about taking potassium supplements while taking chlorothiazide (Diuril). The nurse 's best response would be:

A.            "You are correct about your concern. I will make sure that you get some right away."

B.            "I will call your doctor and let him know of your concern."

C.            "Potassium supplements are usually not necessary with this type of diuretic."

D.            "You are on a diuretic that is potassium-sparing, so there is no need for extra potassium."


The nurse would expect to administer which diuretic to treat a patient diagnosed with primary hyperaldosteronism?

A.            Spironolactone (Aldactone)

B.            Amiloride (Midamor)

C.            Triamterene (Dyrenium)

D.            Furosemide (Lasix)


The nurse prepares to administer which diuretic to treat a patient suffering from acute pulmonary edema?

A.            Spironolactone (Aldactone)

B.            Amiloride (Midamor)

C.            Triamterene (Dyrenium)

D.            Furosemide (Lasix)


When assessing for therapeutic effects of mannitol, the nurse would expect to see:

A.            Decreased intracranial pressure

B.            Decreased excretion of therapeutic medications

C.            Increased urine osmolality

D.            Decreased serum osmolality


When assessing a patient for side effects of triamterene (Dyrenium), the nurse would specifically monitor for:

A.            Hypokalemia

B.            Hypoglycemia

C.            Hyperkalemia

D.            Hypernatremia


The patient asks the nurse why the doctor prescribed acetazolamide (Diamox), a diuretic, to treat gout. The nurse responds based upon the knowledge that:

A.            Diamox causes an alkaline urine, which facilitates the elimination of uric acid

B.            Diamox increases alkalinity of the urine, thus decreasing the formation of uric acid

C.            Diamox causes an acid urine, which facilitates the elimination of uric acid

D.            Diamox decreases alkalinity of the urine, thus decreasing the formation of uric acid

N7 Pharmacology Antihypertensive Agents

Found at the EVOLVE website

Lilley: Pharmacology and the Nursing Process, 4th Edition


Multiple Choice Review Questions Chapter 24


Which of the following statements, if made by your patient, signifies that additional patient teaching regarding antihypertensive treatment is required?

A.            “I will check my blood pressure every day and take my medication when it is over 140/90.”

B.            “I will include rest periods during the day to help me tolerate the fatigue my medicine may cause.”

C.            “I will change my position slowly to prevent feeling dizzy.”

D.            “I will not mow my lawn until I see how this medication makes me feel.”


An annoying side effect of ACE inhibitors that may be minimized by switching to an angiotensin receptor-blocking agent includes:

A.            Orthostatic hypotension

B.            A dry, nonproductive cough

C.            Fatigue

D.            Hypokalemia


Which of the following should not be taken concurrently with ACE inhibitors?

A.            Lasix

B.            Morphine

C.            Colace

D.            Potassium


Direct-acting vasodilators have which of the following effects on the heart rate?

A.            Heart rate decreases

B.            Heart rate remains significantly unchanged

C.            Heart rate increases

D.            Heart rate becomes irregular


The nurse would plan to administer which of the following calcium channel blocking agents to a patient with cerebral arterial spasms following a subarachnoid hemorrhage?

A.            Amlodipine (Norvasc)

B.            Diltiazem (Cardizem)

C.            Nimodipine (Nimotop)

D.            Verapamil (Calan)


The nurse would question an order for a calcium channel-blocking agent in a patient with:

A.            Angina pectoris

B.            Increased intracranial pressure

C.            Hypotension

D.            Dysrhythmia


Which of the following statements would be appropriate during discharge teaching for a patient receiving clonidine (Catapres)?

A.            “Your blood pressure should be checked by a physician at least once a year.”

B.            “Increasing fluid and fiber in your diet can help prevent the side effect of constipation.”

C.            “Excessive exercise or prolonged standing is not a problem with clonidine as it can be with other antihypertensive agents.”

D.            “If you are having difficulty with the common side effect of excessive drooling, notify your physician so your dosage can be adjusted.”


When explaining different medication regimens to treat hypertension during a community education program, it would be accurate to state that African-Americans probably respond best to which combination of medications?

A.            ACE inhibitors and diuretics.

B.            Diuretics and calcium antagonists

C.            Diuretics and beta-blockers

D.            ACE inhibitors and beta-blockers


Labetalol (Normodyne) and carvedilol (Coreg) are classified as:

A.            Beta-blocking agents

B.            Alpha1-blocking agents

C.            Combined alpha- and beta-blocking agents

D.            Calcium channel blockers


During assessment of a patient diagnosed with pheochromocytoma, the nurse auscultates a blood pressure of 210/110 mm Hg. The nurse would expect to administer which of the following medications?

A.            Nadolol (Corgard)

B.            Phentolamine (Regitine)

C.            Dobutamine (Dobutrex)

D.            Verapamil (Calan)


When administering nitroprusside (Nipride) intravenously, the nurse ensures that:

A.            The medication is protected from light

B.            The IV infuses no faster than 2 mcg/min

C.            The patient’s blood pressure is monitored every 2 hours

D.            The initial bolus is infused over 5 minutes


The nurse would monitor for reflex tachycardia in a patient receiving which classification of antihypertensive agents?

A.            Calcium channel blockers

B.            Cardioselective beta-blockers

C.            Nonselective beta-blockers

D.            Direct-acting vasodilators


A patient prescribed prazosin (Minipress) does not have a history of hypertension. The nurse would assess for what disorder for which this medication is also used?

A.            Pulmonary emboli

B.            Obstructive benign prostatic hyperplasia

C.            Seizure disorder

D.            Subarachnoid hemorrhage


ACE inhibitors and angiotensin receptor blockers both work to decrease blood pressure by:

A.            Preventing the formation of angiotensin II

B.            Enhancing sodium and water resorption

C.            Increasing the breakdown of bradykinin

D.            Inhibiting aldosterone secretion


A priority nursing diagnosis for patient’s taking an antihypertensive medication would include:

A.            Alteration in cardiac output related to effects on the sympathetic nervous system

B.            Knowledge deficit related to medication regimen

C.            Fatigue related to side effects of medication

D.            Alteration in comfort related to nonproductive cough

Answers: 1a, 2b, 3d, 4c, 5c, 6c, 7b, 8b, 9c, 10b, 11a, 12d, 13b, 14d, 15a

N7 Pharmacology Antianiginal Agents

Found at the EVOLVE website

Lilley: Pharmacology and the Nursing Process, 4th Edition

Multiple Choice Review Questions Chapter 23


Which of the following instructions should be included in the discharge teaching for a patient discharged with a transdermal nitroglycerin patch?

A.            “Apply the patch to a nonhairy, nonfatty area of the upper torso or arms.”

B.            “Apply the patch to the same site each day to maintain consistent drug absorption.”

C.            “If you get a headache, remove the patch for 4 hours and then reapply.”

D.            “If you get chest pain, apply a second patch right next to the first patch.”


Nitrates relieve angina pain by reducing preload, which is:

A.            Blood volume within the heart

B.            Pressure within the heart

C.            Pressure against which the heart must pump

D.            Oxygen demand of the heart


Which is a NOT a common side effect of nitroglycerin?

A.            Blurred vision

B.            Flushing

C.            Headache

D.            Hypotension


Which of the following statements by the patient demonstrates a need for further education regarding nitroglycerin?

A.            “If I get a headache, I should keep taking my nitroglycerin and use Tylenol for pain relief.”

B.            “I should keep my nitroglycerin in a cool, dry place.”

C.            “I should change positions slowly to avoid getting dizzy from the nitroglycerin’s effect on my blood pressure.”

D.            “I can take up to five tablets at 3-minute intervals for chest pain.”


Calcium channel blockers reduce myocardial oxygen demand by reducing afterload, which is:

A.            Blood volume within the heart

B.            Pressure within the heart

C.            Pressure against which the heart must pump

D.            Contractility of the heart muscle


Which of the following nitrate preparations or dosage forms has the longest duration of action?

A.            Sublingual nitroglycerin

B.            Sublingual isosorbide dinitrate

C.            Oral isosorbide dinitrate

D.            Transdermal nitroglycerin patch


In order to prevent the development of tolerance, the nurse instructs the patient to:

A.            Apply the nitroglycerin patch every other day

B.            Switch to sublingual nitroglycerin when the patient’s systolic blood pressure elevates to >140 mm Hg

C.            Apply the nitroglycerin patch for 14 hours each and remove for 10 hours at night

D.            Use the nitroglycerin patch for acute episodes of angina only


Before administering isosorbide mononitrate (Imdur), a priority assessment would include:

A.            Serum electrolytes

B.            Blood urea nitrogen (BUN) and creatinine

C.            Blood pressure

D.            Level of consciousness


The patient asks how nitroglycerin should be stored while traveling. The nurse’s best response would be:

A.            “You can protect it from heat by placing the bottle in an ice chest.”

B.            “It’s best to keep it in its original container away from heat and light.”

C.            ‘You can put a few tablets in a resealable bag and carry in your pant’s pocket.”

D.            “It’s best to lock them in the glove compartment of your car to keep them away from heat and light.”


Patient teaching regarding sublingual nitroglycerin should include which of the following statements:

A.            “You can take up to five doses every 3 minutes for chest pain.”

B.            “Chew the tablet for the quickest effect.”

C.            “Keep the tablets locked in a safe place until you need them.”

D.            “Sit or lie down after you take a nitroglycerin tablet to prevent dizziness.”


What is the best way to prevent tolerance to nitrates when using the transdermal patches?

A.            Leave the old patch on for 2 hours when applying a new patch

B.            Apply a new patch off for 24 hours once a week

C.            Leave the patch off for 24 hours once a week

D.            Remove the patch at night for 8 hours, and then apply a new patch in the morning


Which of the following statements indicates that the patient understands discharge teaching about nitroglycerin?

A.            “I will need to refill my prescription once a year in order to maintain potency.”

B.            “I will need to keep the nitroglycerin stored in the bottle it comes in.”

C.            “I will take a nitroglycerin tablet every 15 minutes until my chest pain is gone.”

D.            “I should take a nitroglycerin tablet 2 hours before I want to engage in activity that will cause chest pain.”


A patient who is taking sublingual nitroglycerin is complaining of flushing and headaches. The nurse’s best response would be:

A.            “This is a normal response to your chest pain.”

B.            “Stop taking the nitroglycerin because you are probably allergic to it.”

C.            “These are the most common side effects of nitroglycerin. They should subside with continued use of nitroglycerin.”

D.            “These symptoms are not related to your sublingual nitroglycerin. You should notify your doctor for diagnostic testing.”


When applying nitroglycerin ointment, the nurse should:

A.            Use the fingers to spread the ointment evenly over a 3-inch area

B.            Apply the ointment to a nonfat, nonhairy part of the upper torso

C.            Massage the ointment into the skin

D.            Apply two thick lines of ointment over the prescribed measured area on the nitroglycerin paper


When titrating intravenous nitroglycerin, the nurse monitors:

A.            Blood pressure

B.            Heart rate

C.            Chest pain

D.            All of the above


A patient receiving intravenous nitroglycerin at 20 mcg/min complains of dizziness. Nursing assessment reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. The nurse’s best response would be to:

A.            Assess the patient’s lung sounds

B.            Decrease the intravenous nitroglycerin by 10 mcg/min

C.            Increase the intravenous nitroglycerin by 10 mcg/min

D.            Recheck the patient’s vital signs in 1 hour


Nitrates relieve angina pain by reducing afterload, which is:

A.            Blood volume within the heart

B.            Pressure within the heart

C.            Pressure against which the heart must pump

D.            Oxygen demand of the heart


During patient teaching, the nurse explains that nitroglycerin relieves chest pain primarily by:

A.            Decreasing the workload of the heart

B.            Vasoconstriction of the coronary arteries

C.            Increasing oxygen demand of the heart

D.            Reducing anxiety related to pain

N7 Pharmacology Positive Inotropic Agents

Found at the EVOLVE website

Lilley: Pharmacology and the Nursing Process, 4th Edition

Multiple Choice Review Questions Chapter 21


An expected outcome associated with the administration of digoxin is:

A.            Increased heart rate

B.            Decreased heart rate

C.            Decreased urinary output

D.            Decreased blood pressure


The patient has a serum digoxin level drawn and it comes back 0.4 ng/mL. The nurse recognizes that this is:

A.            Below the therapeutic level

B.            A therapeutic level

C.            Above the therapeutic level

D.            A toxic level


A patient is taking digoxin 0.25 mg and furosemide (Lasix) 40 mg. When the nurse enters the room, the patient states, “There are nice yellow halos around the lights.” An appropriate nursing action at this point would be to:

A.            Evaluate the patient for other symptoms of digoxin toxicity

B.            Withhold the furosemide

C.            Administer the medication as ordered

D.            Document the findings and reassess in 1 hour


The patient weighs 44 lb and is to be digitalized. The digitalizing dose is to be 0.03 mg/kg in three divided doses. How much will the nurse administer per dose?

A.            0.2 mg

B.            0.3 mg

C.            0.4 mg

D.            0.6 mg


The therapeutic effects of digoxin include:

A.            Positive inotropic, negative chronotropic, and negative dromotropic

B.            Positive inotropic, positive chronotropic, and negative dromotropic

C.            Negative inotropic, negative chronotropic, and negative dromotropic

D.            Positive inotropic, negative chronotropic, and positive dromotropic


Which of the following would alert the nurse to suspect early digitalis toxicity?

A.            Loss of appetite with slight bradycardia

B.            Heart rate <40>

C.            Tachycardia and diarrhea

D.            Confusion and visual changes


Phosphodiesterase inhibitors have an added advantage in treating heart failure because they cause a positive inotropic effect and:

A.            Vasoconstriction

B.            Vasodilation

C.            Platelet inhibition

D.            Bronchodilation


The nurse reviews a patient’s laboratory values and finds a digoxin level of 10 and a serum potassium level of 6.2. The nurse would notify the health care provider and anticipate administering:

A.            K+ aliquots

B.            Atropine

C.            Epinephrine

D.            Digoxin immune FAB


Assessment of a patient receiving a positive inotropic agent would include which of the following? (Choose all that apply)

A.            Lung sounds

B.            Daily weights

C.            Apical pulse

D.            Serum electrolytes


Which of the following drugs is used for short-term management of severe heart failure?

A.            Milrinone (Primacor)

B.            Atropine

C.            Digoxin immune FAB

D.            Propranolol (Inderal)

N7 Pharmacology Antidysrhythmic Agents

Found at the EVOLVE website

Lilley: Pharmacology and the Nursing Process, 4th Edition

Multiple Choice Review Questions Chapter 22

Antidysrhythmic Agents


Indications for the antidysrhythmic drug lidocaine include:

A.            Bradycardia

B.            Ventricular arrhythmias

C.            Atrial arrhythmias

D.            Heart block


When giving adenosine, it is important to remember to:

A.            Give it as a fast intravenous push.

B.            Give it intravenous push slowly over 5 minutes

C.            Offer it with food or milk

D.            Prepare to set up for an intravenous drip infusion


A serum lidocaine drug level of 3.0 is considered:

A.            Subtherapeutic

B.            Therapeutic

C.            Elevated

D.            Toxic


Adenosine is used to treat:

A.            Atrial fibrillation

B.            Atrial flutter

C.            Paroxysmal supraventricular tachycardia (PSVT)

D.            Second-degree Wenckebach


Sodium channel blockers are considered which class of antiarrhythmic drugs?

A.            Class I

B.            Class II

C.            Class III

D.            Class IV


Ibutilide (Corvert) is a class III antiarrhythmic drug that is used for:

A.            Treatment of PSVT

B.            Conversion of recent-onset atrial fibrillation and flutter

C.            Conversion of life-threatening ventricular arrhythmias

D.            Treatment of arrhythmias in patients with acute renal failure


Before administering a dose of an antiarrhythmic drug to an assigned patient, the nurse should assess the patient's:

A.            Urine output and specific gravity

B.            Temperature and pulse rate

C.            Apical pulse and blood pressure

D.            Peripheral pulses and level of consciousness


Which of the following classifications of drugs is used to treat both hypertension and dysrhythmias?

A.            Sodium channel blockers

B.            Calcium channel blockers

C.            Angiotensin-converting enzyme (ACE) inhibitors

D.            Direct-acting vasodilators


Calcium channel blockers have which of the following pharmacodynamic effects?

A.            Positive inotropic effect

B.            Coronary vasodilation

C.            Positive chronotropic effect

D.            Positive dromotropic effect


Amiodarone toxicity is evidenced in which body system?

A.            Cardiovascular

B.            Pulmonary

C.            Renal

D.            Hematologic

What are your top 3 song choices for graduation?