SAMPLE NCLEX-LPN
THE ULTIMATE CREDIT-BY-EXAM STUDY GUIDE FOR: NCLEX - LPN 1 st Edition
2/12/2024
Acknowledgements We would like to thank the author for their patience, support, and expertise in contributing to this study guide; and our editors for their invaluable efforts in reading and editing the text. We would also like to thank those at Achieve Test Prep whose hard work and dedication to fulfilling this project did not go unnoticed. Lastly, we would like to thank the Achieve Test Prep students who have contributed to the growth of these materials over the years.
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Contents
Introduction: Welcome to NCLEX - PN
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A. Exam Overview
1 5
B. Test-Taking Strategies
C. Exam Strategies
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Chapter 1: Safe & Effective Care Environment (Coordinated Care)
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A. Coordinated Care
17 31 42 48 50 54 60 61 82 85 88 90 92 98 60
B. Legal Requirements: Empowering Clients Through Legal Knowledge and Advocacy
C. Client & Continuity of Care
D. Information Technology in Healthcare E. Performance Improvement & Referrals
Chapter 1: Quiz & Answer Key
Chapter 2: Safe & Effective Care Environment (Safety & Infection Control)
A. General Safety B. Infection Control C. Nursing Assessment
D. Security and Emergency Plans E. Cardiopulmonary Resuscitation
F. Arterial Blood Gas
G. Emergency Response Plans & Disaster Management
H. Accident & Injury Prevention
I. Handling Hazardous and Infectious Materials
114 118 121 130 133 138 152 155 158 167 171 174 178 179 137
J. Reporting of Incidents, Events, Irregular Occurrences, or Variance
K. Safe Use of Equipment, Restraints & Safety Devices
L. Home Safety: Evaluating the Need for Home Modifications for Clients
Chapter 2: Quiz & Answer Key
Chapter 3: Health Promotion & Maintenance
A. Antepartum Care: Monitoring the Health of Mother and Baby
B. Intrapartum and Postpartum Care
C. Postpartum Care
D. The Aging Process, Developmental Stages, and Transitions
E. Health Screening F. High-Risk Behaviors G. Lifestyle Choices
H. Self-Care
I. Principles of Teaching and Learning
J. Physical Assessment: Techniques, Considerations, and Insights
181 190
Chapter 3: Quiz & Answer Key
Chapter 4: Psychosocial Integrity
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A. Addressing Abuse and Neglect
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B. Enhancing Behavioral Interventions: Nurturing Client Well-Being
C. Addressing Chemical and Other Dependencies
D. Coping Mechanisms E. Crisis Intervention
F. Cultural Awareness and Cultural Influences on Health
G. End of Life Care H. Family Dynamics
I. Grief and Loss Grieving J. Mental Health Concepts
K. Religious and Spiritual Influences on Health
L. Sensory and Perceptual Alterations
M. Stress Management N. Support Systems
O. Therapeutic Environment
P. The Nursing Process and Psychosocial Integrity
Chapter 4: Quiz & Answer Key
Chapter 5: Physiological Integrity (Basic Care and Comfort)
A. Assistive Devices
B. Understanding Elimination: Addressing Urinary and Bowel Needs C. Mobility and Immobility: Assessing, Addressing, and Promoting Well-Being D. Nonpharmacological Comfort Interventions: Tailoring Care for Client Comfort E. Nutrition and Oral Hydration: Nurturing Wellness Through Informed Care F. Personal Hygiene: Enhancing Well-Being Through Compassionate Care
G. Rest and Sleep: Nurturing Rejuvenation for Overall Well-Being
Chapter 5: Quiz & Answer Key
Chapter 6: Physiological Integrity (Pharmacological Therapies)
A. Client Safety: Managing Medication Effects and Interactions B. Blood Product Administration: Ensuring Safety and Efficiency C. Central Venous Access Devices (CVADs): Enhancing Care and Knowledge D. Mastering Medication Dosage Calculation and Administration E. Effective Medication Management: Actions, Outcomes, & Administration F. Pharmacological Pain Management: Ensuring Effective Relief G. Total Parenteral Nutrition (TPN): Comprehensive Management and Care H. Safe Medication Handling, Storage, & Administration: Best Practices
Chapter 6: Quiz & Answer Key
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Chapter 7: Physiological Integrity (Reduction of Risk Potential)
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A. Assessing and Responding to Changes in Vital Signs
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B. Nursing Procedures and Psychomotor Skills in Vital Sign Assessment C. Utilizing Pathophysiological Understanding in Vital Sign Assessment
D. Interpreting Invasive Monitoring Data
E. Understanding and Administering Diagnostic Tests F. Comprehensive Understanding of Laboratory Values G. Anticipating Potential Body System Changes
H. Potential Complications of Diagnostic Procedures and Treatments
I. System Specific Assessments
J. Effective Management of Therapeutic Procedures
Chapter 7: Quiz & Answer Key
Chapter 8: Physiological Integrity (Physiological Adaptation
A. Evaluating a Client's Adjustment to Health Changes, Illness, and Disease B. Navigating Body System Alterations and Therapeutic Interventions C. Understanding Fluid and Electrolyte Imbalances in Nursing Care
D. Navigating Hemodynamics in Nursing Practice
E. Managing Illness
F. Medical Emergencies: Swift and Skilled Interventions G. Identifying Pathophysiology in Acute or Chronic Conditions
H. Managing Unexpected Therapy Responses
I. Empowering Clients through Health Problem Management Education
Chapter 8: Quiz & Answers
NCLEX - LPN Study Guide: Conclusion
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Practice Exam
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Chapter 1: Safe & Effective Care Environment (Coordinated Care) Overview Inthefirstchapterofour NCLEX-LPN studyguide,wewillexploretheworldofclientcarewithafocus on safety andefficacy.Wewilldiscusstheartofharmonizingclientwell-beingandeffectivetreatment which entails skillful care management, and orchestrating treatment procedures that prioritize the clients'welfareandthededicatedhealthcarestaff.Moreover,themasteryofinfectioncontrolpractices formsacornerstoneforcultivatingasecureandhealth-consciouscareenvironment.Asyoupreparefor the NCLEX-LPN exam, it is important to know that approximately 18-24% of the questions revolve around the vital theme of Management of Care. Learning Objectives 1. Identify and explain the key elements of effective client care, including safety and efficacy measures. 2. Evaluate and apply strategies for harmonizing client well-being and effective treatment in various healthcare settings. 3. Understandtheroleofcaremanagementinprioritizingclientwelfareandfosteringcollaboration among healthcare providers. 4. Demonstrateproficiencyininfectioncontrolpracticesandtheirimportanceincreatingasecure and health-conscious care environment. A. Coordinated Care In the field of nursing, coordinated care refers to the process of organizing andcollaboratingwithall members of the healthcare team to provide safe and effective care forclients.Thisinvolvesensuring that all actions taken by the healthcare team align with the client's needs and preferences. Care coordination aims to improve client outcomes by promoting communication and collaborationamong healthcare professionals, ultimately leading toamoreefficientandstreamlinedhealthcareexperience forclients.Nursesplayacrucialroleinfacilitatingcarecoordination,actingasacentralpointofcontact and advocate for clients throughout their healthcare journey. Navigating the Landscape of Nursing Care Management Licensed practical nurses (LPNs) havemanyresponsibilities,duties,andtasks.Thesearebasedsolely on their scope of practice and level of competency. While there is some overlap in roles and responsibilities, each role isadistinctentityandtheymayalsocollaboratewithothermembersofthe healthcareteamtoensurethatclientsarereceivingthenecessaryservicesandresources.Let’sdiscuss these roles in further detail. At the end of this chapter, you should be able to:
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Eight Roles of the LPN Clinician
Aclinician'sdutiesencompasswhatmostpeoplewouldrefertoas"nursingcare."LPNsaresometimes referred to as the doctors' and nurses' eyes and ears. Compared to RNs or doctors, practical nurses frequentlyspendmoretimedirectlycaringforclients.Accurateandcontinuousassessmentisessential for a conscientious nurse.Clientsareseen,evaluated,andgivenmedicationinadditiontohavingtheir bandageschanged.WhilemanyLPNsworkaschargenurses,manymoreprovidedirectclientcare.The technical responsibilities of nursing are part of being a clinician. Manager LicensedPracticalNurseswillbeinvolvedinmakingsureclientcareplansareexecuted.Alargenumber ofLPNsareinvolvedindevelopingclientcareplansandassessingtheirefficacy.Itisanimportantroleof the LPN to oversee client and family education to assist withcareplanning.Inadditiontooverseeing clientcare,LPNsfrequentlyhavetosupervisetheircolleagues.Manyareteamleadersorchargenurses. It is common for LPNs to be tasked with overseeing nursing assistants. Advocate Anadvocateissomeonewhosupportsandsuppliesinformationtotheirclient.Advocacyofteninvolves standingupinsupportofaclientandtheirrights.Anurse,fulfillingtheadvocaterole,servesasthevoice forclientstoensurethattheirintrinsicrightsandneedsaremetwithinthehealthcaresystem.Thisrole involves discussing treatment options with the client and respecting their decisions, providing informationonadvocacytostaffmembers,actingasaclientadvocate,andutilizingadvocacyresources appropriately. As a client advocate, the nurse will effectively communicate and collaborate with the client and other healthcare professionalstopromote,uphold,andprotecttheclient'srights,interests, and choices. This is especiallytruewhenclientsarenotabletoprotecttheirownrights.Thisincludes advocating for their autonomy, self-determination, and righttoacceptorrejectanytreatments.Nurse advocates alsoworktoeducateclientsandtheirfamiliestomakeinformeddecisionsabouttheircare. Tofulfilltheiradvocacyrole,nursesmustbeknowledgeableaboutavailableresourcesandhowtoutilize them appropriately. This may involvereferringclientstosocialworkersorotherexternalresources,as wellasfollowingformalprocessesandprocedureswithintheirfacility.Theadvocacyroleofanurseisan integral part of nursing practice and is essential in promoting the rights and well-being of clients. Educator Theeducationalroleofanurseismultifacetedandessentialtotheoverallwell-beingofclients.Nurses have the responsibility of educating clients about their medical conditions, treatment options, and self-caremeasures.Thiseducationshouldbeginatadmissionandcontinuethroughoutaclient'sstayin the hospital. The ultimate goalofclienteducationistoempowerclientstotakecontroloftheirhealth andmakeinformeddecisionsabouttheircare.Anurse'sroleinclienteducationincludesassessingthe client's learning needs and preferences, providing information in an understandable and effective manner,andevaluatingtheclient'sunderstanding.Nursesmustuseappropriatelearningstrategiesand
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educationaltools,suchaswrittenmaterials,audiovisualaids,andhands-ondemonstrations,toensure that the information is effectively conveyed. Nurses should also consider the client's cultural background, educational level, and socio-economic status when designing educationalsessions.Care plans are developed by RNsandcarriedoutcollaborativelybyboththeRNandLPN.Itisimportantto evaluate which learning style(s) your clients prefer andencourageclientstoaskquestions.Alearning assessment is conducted at the time of admission and assists the nurse in planning care. Counselor WhenfulfillingtheroleofcounselorLPNscanhelpclientsandfamiliesexploreideasandfeelingstoward healthcareandillness.Thenurseisresponsibleforfacilitatingtheclient'sdecision-makingprocessand promoting their overall well-being. Through counseling, the nurse provides support, resources, and educationtohelpclientsandfamiliesdevelopself-careabilitiesandmakeinformedchoicesabouttheir health.Someclientshaveadifficulttimeacceptingadiseaseoritstreatmentoptions.Thiscanbeseen in various scenarios, such as developmentalchanges,acuteorchronicillness,orend-of-lifecare.Itis the role of the LPN to assist clients with these health transitions and ensure they understand their options. This might involve providing emotional support and resources and assisting clients in developing coping mechanisms to manage their stress and anxiety. Consultant Theroleofapracticalnurseinvolveseffectivelycommunicatingwithvarioushealthcareprofessionalsto ensurethehighestlevelofclientcare.AsanLPN,oneofthemainresponsibilitiesistoconsultwiththe RNsupervisorsregardingclientassessments,careplans,andanychangesinclientconditions.Insome healthcare settings, LPNs may also communicate directly with physicians. Effectivecommunicationis essentialintheconsultingroleofapracticalnurse.Itnotonlyensuresthatallhealthcareprofessionals areonthesamepagewhenitcomestoclientcare,butitalsohelpsinidentifyinganypotentialissuesor concerns that may arise. By sharing a holistic view of the client, LPNs can help RN supervisors and physiciansmakeinformeddecisionswhenitcomestocreatingandimplementingcareplans.Inaddition to consulting with other healthcare professionals, LPNs also need to communicate effectively with clients and their families. This includesprovidingeducationontheirhealthcareneeds,addressingany questions or concerns they may have, and keeping them updated on their treatment plans. Researcher Research is an essential function ofthepracticalnurse'sroleinprovidingoptimalcaretoclients.Asa researcher, the LPN plays a supportive role in identifying problems within a client's care plan and evaluating the client's needs. This is done through careful observationandassessmentoftheclient's condition and any changes that may occur. LPNs haveauniquepositioninthehealthcareteam,often beingthefirsttonoticeandreportanyissuesthatmayarise.Tofindasolutiontotheidentifiedproblem, the LPN will use evidence-based practice to conduct their research. This involves identifying and understanding the standard of practice for a specific condition or treatment and then using this knowledge to find the best possible treatment option for the client.
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Collaborator LPNs play an essential role in the client care team. We work closely with other healthcare team members, such as registered nurses (RNs), certified nursing assistants (CNAs), physicians, physical/occupational/speech therapists, dietitians, and volunteers, to ensure that our clients receive thebestpossiblecare.Eachmemberoftheteamhastheirownuniquescopeofpractice,whichincludes specifictasksandresponsibilities.AsLPNs,ourscopeofpracticeconsistsofprovidingdirectclientcare, such as administering medications, wound care, and assisting with activities of daily living. The collaborationofanLPNinvolvessharinginformation,solvingproblems,andworkingtogetherasateam to provide the best possible care for our clients. Resource Management Allnursesareresponsibleforprovidingsafeandcost-effectivecaretoclientsandhelpingthemattainor maintaintheirindependence.TheLPN,incollaborationwiththeRN,willdevelopan individualizedcare plan for eachclient,consideringtheirneedsandgoals.Thecareplandevelopmentmustincludeinput from the client and family/caregiver. The involvement of clients and theirfamiliesintheplanningand developmentofhealthcareserviceshasbeenshowntoimproveclienthealthandqualityoflife.The care plans should incorporate evidence-based research from medical literature and other resources. In additiontostartingthecareplanforeachclient,nursesshouldalsoevaluateandrevisetheplanasthe client'sconditionprogresses.Whentheclientisreadytobedischargedfromthehospital,nursesshould ensure that the client has all the necessary information required for discharge procedures, such as medication instructions, follow-up visits, and any future tests. LPNs are team leaders or charge nursesandfrequentlyhavethedutyofmanagingnursingassistants. CasemanagementforLPNs(LicensedPracticalNurses)involvescoordinatingandoverseeingthecareof clients across different healthcare settings and services. LPNsplayanimportantroleinassistingwith case management tasks under the direction of registered nurses (RNs) and other healthcare professionals. Some aspects of LPN case management include: 1. Collaboration : LPNs collaborate with RNs, doctors, social workers, and other healthcare professionals to ensure comprehensive care for clients. 2. Assessment : LPNs gather information about clients' conditions, needs, and preferences to assist in developing care plans. 3. CarePlanning :TheLPN’skeyroleistoensurethatcareisrenderedbasedontheclient'scare plans. The care plan is developed based on the client's medical conditions, treatments, and goals.Theymaycontributetocareplandevelopmentbyprovidingvaluableinsightsbyreporting information to the registered nurse. 4. Communication :LPNscommunicatewithclients,families,andotherteammemberstoensure everyone is informed about the client's progress and needs. 5. ResourceCoordination :LPNsmayhelparrangeappointments,tests,andtreatments,ensuring seamless transitions between different healthcare settings.
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6. Client Education : LPNs educate clients and families about treatmentplans,medications,and self-care strategies. 7. Documentation : LPNs maintain accurate and up-to-date records of client assessments, interventions, and outcomes, ensuring continuity of care. 8. Advocacy :LPNsadvocateforclients'needsandpreferences,ensuringtheyreceiveappropriate care and services. Case Management Case Managers are nurses that specialize in care coordination and organizeclientcare,collaborating with healthcare providers to ensure that clients receive the services they need in a timely and cost-effective manner. Case managers also advise clients, ensuring they have accesstoallnecessary resources to improve their health . The case managerutilizesthecriticalpathwayapproachtoprovide safe and cost-effective individual care to each client. Critical pathways, also known as clinical pathways or clinical maps, are management plans that display goals for clients and provide the sequence and timing of actions necessary to achieve these goals with optimal efficiency. LPNs play a significant role inbothdirectclientcareandcasemanagement.Ingeneral,LPNsconduct more direct carethanRNs,butwithinthatrole,manyarealsoperformingcasemanagementfunctions suchasassessments,careplanning,collaborationwithotherhealthcareteammembers,andfollow-ups. LPNs regularly assistRNCaseManagerswiththeircaseloads,particularlyduringbusyperiods.Workis often carried out in teams in a collaborative, negotiated environment. Nursing Models Below are the 4 standard nursing models used in today's healthcare environment. Each model is tailoredtomeettheneedsoftheindividualclientandthepopulationreceivingcare.Nursescantakea holistic approach to providing care through these models while ensuring client safety and cost containment. 1. PrimaryNursing :PrimaryNursingisarelationship-basedpracticewheretheRegisteredNurse (RN) actively provides total client care. This approach is very labor-intensive and requires an appropriate amount of nurses. Organizations that utilize the primary nursing model do not employ LPNs. 2. Team Nursing : Team Nursing is a model that consists of a teamleaderprovidingsomeclient care while delegating specific tasks to other nursing members, including unlicensed assistive personnel.AllTeammembersareworkingwiththesameplanofcaretoachievethesamegoals and outcomes. 3. Total Care : Total Care is a client-focused or case-method nursing model in which one RN is responsible for all aspects of a client's care. This model does not utilize LPNs or unlicensed assistive personnel in the acute care setting.
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4. Functional Nursing : In this model, specific tasksanddutiesareassignedtothenursingteam members. These tasks may include monitoring vital signs, administering medications, or providingwoundcare.Thisnursingmodelensuresthateachclientreceivesthenecessarycare withoutduplicatingservices.Functionalnursingtasksaredelegatedbasedonthestaff’sscope of practice and competency level.
Mastering the Art of Delegation: A Vital Nursing Skill Delegation is the transfer of the nurse's responsibility for a task while retaining professional accountability. Delegation is an indispensable skill for nurses. It is essential to pinpoint the perfect person for anygiventask,clarifythetasks,andensuretheyunderstand.Itisnecessarytoensurethat the person given the task has the authority to carry it out. Appropriate delegation to unlicensed assistive personnel (UAP) is vital as the nurseremainsresponsibleforthetaskdelegated.Assessing thecompetencyandscopeoftheUAPisacrucialpartofdelegation.Asanurse,youshouldbeprepared to provide aid, monitor, and appreciate a job well done. Nursesshouldrefrainfromentrustingnonprofessionalpersonnelwithanyofthefollowing: nursing evaluations; identification of diagnosis, care goals, progress plans; or interventions that necessitate specialized knowledge and expertise.
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Chapter 2: Safe & Effective Care Environment (Safety & Infection Control) Overview This chapter of the NCLEX-LPN exam focuses on providing safe and effective care environments for clientsbyapplyingkeysafetyandinfectioncontrolprinciples.Questionsinthistopicareaaredesigned toassesstheapplicant'sknowledgeofpreventinginfectionsinhospitalsettings,keepingclientssafein theirhomes,andidentifyingenvironmentalandhealthhazards.Approximately 10-16% oftheexamwill cover this area, making it important to gain a thorough understanding of this topic. Learning Objectives 1. Identify aspects of accident/error/injury prevention and develop an emergency response plan. 2. Apply ergonomic principles and demonstrate a safe protocol for handling hazardous and infectious materials. 3. Discuss home safety measures and utilize equipment safely and appropriately. 4. Explain how to correctly report incidents, events, irregular occurrences, and variances, and develop and implement a security plan. 5. Understandthestandardprecautions,transmission-basedprecautions,surgicalasepsis,andthe use of restraints and other safety devices. A. General Safety AspartofyourpreparationfortheNCLEXexam,reviewsafetyissuesandthevariouselementsofclient safety and accident prevention that are specific to different age groups, including infants, toddlers, school-agechildren,adolescents,adults,andolderadults(geriatricclients).Whenconsideringparticular safety measures, such as fall risks in a hospital setting, the age of the client should be taken into consideration. Providing a safe environment may require severalinterventionsbasedontheidentified client risk. Utilizationofrestraintsinthehospitalsettingisahigh-riskintervention.Understandingand following the organizational policy is key. Maintaining a safe environment for a client with seizure precautions includes ensuring the appropriate suction and oxygen equipment are available at the bedside.Lastly,besuretoeducateparents/caretakersonproperpreventionstrategiesforinfantsafety, such as placing them on their backs after eating and while sleeping and utilizing the appropriate car seats for their age. 1. Infants : Parentsorcaretakersshouldbeeducatedabout infantsafety andtheirresponsibility to take proper precautions to prevent injury. It is crucial to place infants on their backsafter eatingandwhilesleepingandtousecarseatsfortransportation.Thisagegroupisathighrisk for falls and burns . At the end of this chapter, you should be able to:
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2. Toddlers : Safetyissuesariseduetotheir mobilityandcuriosity ,includingpoisoning,choking, and drowning. Keep medications, poisons, and cleaning supplies in locked cabinets.Toddlers should be transported only in car seats. 3. School-age children : As they spend time in school and play with friends, new safety risks emerge.Emphasizetheimportanceof trafficsafety,watersafety,firesafety,andawareness of the dangers posed by strangers . Children should use car seats and/or booster seatsuntil theycanproperlyfitadultseatbelts,typicallyataround4'9",80lbs,andbetweenages8and 12. (Age and height/weight requirements may vary by state.) 4. Adolescents :Adolescents'senseof independenceandinvincibility, alongwiththeiraccessto cars,createrisks.Focusondrivereducation,alcoholandsubstanceabuseeducation,andsexual health information. 5. Adults : Safety risks for adults encompass home, workplace, and leisure activities . Educate adults about motor vehicle, fire, and firearm safety. 6. Older adults : Safety is impacted by aging issues , both physical and cognitive, particularly concerning fallsandmedicationsideeffects .Thepossibilitiesofelderabuseandmotorvehicle accidents also increase for older adults. B. Infection Control To effectively address questions about infection control, it's essential to grasp some fundamental informationaboutetiologicagentsandthechainofinfection.Anetiologicagentreferstoanypathogen capable of causing an infection, such as bacteria, fungi, protozoa, rickettsiae, and helminths. TheChain of Infectioncomprises six key elements: 1. Pathogen : This is an infectious agent, such as a bacteriaor virus. 2. Reservoirs : These are environments that support the growth and reproduction of infectious agents. Reservoirs can be animate or inanimate. Examples of human systems acting as reservoirs include blood, respiratory, gastrointestinal, reproductive, and urinary systems. 3. Portalofexit :Thisreferstothesitefromwhichinfectiousorganismsleaveahost'sbody.Anyof the aforementioned systems can serve as portals of exit. 4. Method of transmission : This describes how an infectious organism is transferred from a reservoirtoahost.Threeprimarytransmissionmethodsincludedirectcontact,indirectcontact via a vector, or airborne transmission. 5. Portalofentry :Thisisthelocationthroughwhichaninfectiousagententersasusceptiblehost. A portal of entry may also be connected to a system acting as a reservoir. 6. Susceptiblehost :Thisreferstoaclient,staffmember,oranyindividualatriskofcontractingan infection.
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Let's delve deeper into the six key elements of the chain of infection .
Pathogens Bacteria : Exhibit diverse morphologies, behaviors, and reactions in laboratory diagnostic tests. Their shapescanrangefromrodsandcirclestospheresandspirals.Pathogenicbacteriacancauseinfections by releasing toxins into human tissue. When tested in the laboratory, some bacteriaareclassifiedas gram-positive, while others are gram-negative. Bacilli are rod-shaped bacteria, cocci are round-shaped , and spirochetes are spiral-shaped . For instance,Bacillusanthraciscausesanthraxandisagram-positiveaerobicmicroorganism.Examplesof cocci include staphylococcus and streptococcus, while spirochetes can cause conditions like syphilis and Lyme disease.
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Bacteria'sreactionstolaboratorytestingcanvary. Gram-positive bacteriarespondtogramstainingdue totheirthickwallscontainingpeptidoglycanandteichoicacid. Gram-negative bacteria,whicharemore common, lack such a reaction because of their thin walls, which comprise a lipid membrane with endotoxins like lipoproteins and lipopolysaccharides. Bacteria can also be categorized based on their ability to resist color changes during staining procedures. Acid-fast bacteria resist decolorization when stained with Ziehl-Neelsen or Kinyoun stain. Thefour phasesof bacterial growth are as follows: ● Lag Phase : Bacteria acclimate to the environment,maturewithoutdivision,andundergoRNA synthesis to prepare for rapid growth. ● Log Phase : Rapid and continuous growth occurs untilnutrients are depleted. ● Stationary Phase : Depletion of necessary nutrients leads to growth cessation and reduced metabolic activity. ● Death Phase : The bacteria's life cycle ends.
Viruses: Arecomposedof RNA,DNA,andproteinswithanouterlipid-proteincoat .Theyaresmaller than bacteria and possess varying host ranges. Some viruses impact multiple species, while others affect only a specific species.
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Chapter 3: Health Promotion & Maintenance Overview Welcome totherealmofHealthPromotionandMaintenanceontheNCLEX-LPN®exam.Approximately 6-12% ofthequestionsonthiscrucialtestpertaintothisessentialcategory.Withinthisdomain,youwill encounter inquiries centered around expected growth and development principles, preventative measures,earlydetectionofhealthissues,andeffectivestrategiestoattainoptimalwell-being.Gaining asolidunderstandingoftheseconceptswillequipyouwiththeknowledgeneededtoexcelinthisvital area of nursing practice. So, let's dive in and explore the key components of Health Promotion and Maintenance to help you succeed on your NCLEX-LPN® journey. Learning Objectives 1. Apply knowledge of ante/intra/postpartum and newborn care to support clients effectively during these stages. 2. Understand the Aging Process 3. Identify developmental stages and transitions and their relevance to client health. 4. Implementstrategiesforhealthpromotion,diseaseprevention,andriskassessmentinnursing practice. The Role of the LPN in the Maternal/Child Setting TheLPNscopeofpracticeisestablishedbyeachstate'sNursingPracticeAct,accordingtotheNational CouncilofStateBoardsofNursing.SomestatesenableLPNstodelegatetoandoverseeLPNsandother unlicensed assistance professionals. Individual states establish criteria for the precisejobsthatLPNs may perform. To address the duties that an LPN may undertake, it is required to refertothenursing process, which was developed as a framework for nursing standards of practice in clinical care. Assessment, diagnosis, planning, execution, and evaluation are the five processes in the nursing process. According to the LPN's scope of practice, the LPN is only involved in four of these five processes; the diagnosis step is kept for physicians, APRNs, and RNs. ● Assessment : In the assessment phase,theLPNincludesbasicdatacollectionthatisusedfor assessment. They can collect basic data, compare it against standard measures, andidentify anycorrelationswiththefindings.Themainmethodsusedtocollectdataarehealthinterviews, physical examination, and observation. ● Diagnosis : Although the LPN cannot determine a nursing diagnosis, they assist the RN in determiningtheproblemsandpriorityoftheclientthroughpromptandaccuratecommunication of client needs. At the end of this chapter, you should be able to:
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● Planning : The LPN can collaborate in the planning phase; care plans provide a course of directionforpersonalizedcaretailoredtoanindividual’suniqueneeds,subjecttothereviewand approval of the RN. ● Implementation : During the implementation phase, the LPN is expected to deliver the determinedinterventionspertheclient'scareplan,whichtheRNmustdetermine.TheLPN/LVN applies communication skills for educating clients and addressing client and family concerns. ● Evaluation :TheLPNcontributestotheevaluationofindividualizedinterventionsrelatedtothe care plan or treatment plan. The RN evaluates the progress toward the goals/outcomes identifiedinthepreviousphasestogetherwiththeLPN/LVN,whocanprovideobservationsand suggestions for the accomplishment of the plan of care. The Association of Women’s Health, Obstetrics and Neonatal Nursing recommendsthattherolesand responsibilitiesoftheLPNbeconsistentwiththestatenursepracticeactgoverningthelocationwhere the LPN practices as well as consistent with organizational policies and individual training and experience. Depending on those factors, appropriate tasks may include but are not limited to the following: ● Newborn care : collecting vital signs, performing glucose testing, conducting phlebotomy and newborn screening, facilitating skin-to-skin, providing parent/family education, bathing the newborn, assisting with newborn feeding, and introducing newborn education classes. ● Postpartum care : performing dressing changes, collecting vital signs, performing glucose testing, removing or inserting indwelling urinary catheters, using a bladder scanner, assisting with ambulation/fall prevention, activities of daily living and prevention of infant drops, conductingphlebotomy,providingperinealcare,educatingclient/family,providinglactationand feeding education, and discharge education. ● Labor, delivery, and recovery : collectingmaternalvitalsignsofalaboringclient,chaperoning duringsensitiveexaminationsandtreatments,performingglucosetesting,removingorinserting indwelling urinary catheters, facilitating skin-to-skin during the golden hour, offering assistive support during delivery, providing client/family education, assisting during emergency events, taking client histories, conducting phlebotomy, perineal care, and assistance with ambulation. A. Antepartum Care: Monitoring the Health of Mother and Baby Antepartumcare,alsoknownas prenatalcare ,iscrucialtoensuringthehealthandwell-beingofboth theexpectantmotherandtheirbaby.Thiscomprehensivecarebeginsthemomentaclientdiscoversshe is pregnant and continues for several weeks after the baby is born. This section will explorethekey components of antepartum care and emphasize the importance of monitoring various aspects of the mother's health and the developing fetus. ● Calculating the Expected Delivery Date and Monitoring Fetal Development : One of the priorities in antepartum care is calculating the expected delivery date. Calculation of the expecteddeliverydateisdonebyaddingsevendaysandninemonthstothefirstdayofthelast
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menstrual period. However, it isessentialtounderstandthatonlyasmallpercentageofbirths occur preciselyonthisestimateddate.Apregnancyisconsideredfull-termbetweenweeks 37 and 42 , withbirthsoccurringbeforeweek37classifiedasprematureandthoseafterweek42 considered overdue. ● Documenting the Mother's Current Health and Preexisting Health History : Obtaining the expectant mother's current health and previous health history forms a fundamental part of prenatalcare.Gatheringdataon bloodpressure,weight,lifestyle,familyandgenetichistory, supportsystems,perceptionofpregnancy,andpreviouscopingmechanisms isessential.In cases where a strong support system is lacking,connectingtheclientwithaprenatalsupport groupcanbebeneficial.Additionally,identifyinganyprevioususeofdenialorfantasyascoping mechanisms necessitates appropriate referrals. ● Medication Management and Rh Factor Testing : Careful attention must be paid to the medications the expectant mother is using, including prescribed, alternative, and over-the-counter drugs. Category X medications with high fetal risk should be avoided. Rh factortesting isnecessaryunlessbothparentsareRh-negativeorthemotherisRh-positive.If the mother is Rh-negative andthefatherisRh-positive,Rho(D)immuneglobulin(RhoGAM)is administered in the 28th week and following delivery to prevent Rh incompatibility issues. ● Diagnostic Procedures: Ultrasounds and Amniocentesis : Noninvasive diagnostic procedures suchas ultrasounds playavitalroleinconfirmingfetalviability,gestationalage,fetalanatomy, and placental location. Amniocentesis , a procedure where amniotic fluid is withdrawn for analysis, is performed after the 14th week, typically for women over age 35 or those with a family history of genetic or metabolic problems. ● MonitoringFetalHealthandMaternalNutrition :Duringroutineprenatalexams,monitoringthe fetal heart rate, which should range from 120 to 160 beatsperminute,isessential.Nutrition also plays a crucial role in prenatal care and education. Pregnant teenagers have specific nutritional needs, requiring more protein, calcium, and phosphorus due totheirongoingbone growth.Properweightgain,limitedto 22to27 pounds,isvitaltopreventingcomplicationslike preeclampsia. ● Prenatal Education (Normal Pregnancy Events and Danger Signals): Providing expectant mothers with prenatal education is essential to keeping them informed and prepared for pregnancy events. Examples include quickening, thefirstfetalmovementusuallyfeltbetween 17 and 19 weeks. Braxton Hicks contractions, whichsomewomenmayexperienceafterthe 20th week,arealsoaddressed.Additionally,recognizingandunderstandingdangersignalslike vaginal bleeding, severe abdominal pain, and decreased fetal movement iscrucialforprompt medical attention. ● Comprehensiveantepartumcare :Acornerstoneofsafeguardingthe healthandwell-beingof bothmotherandbabyduringpregnancy .Bycloselymonitoringvariousaspectsofthemother's healthandfetaldevelopmentandacknowledgingculturaldifferences,healthcareproviderscan ensure a positive and healthy pregnancy experience for expectant mothers and their families.
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Chapter 4: Psychosocial Integrity Overview
Psychosocial well-being , just like physiological health, constitutes a fundamental requirementforall clients.Itembodiestheequilibriumofpsychologicalandsociologicalfactors,anequilibriumthatcanbe disturbed during instances of stress, illness, or crisis. Any challenges to an individual's emotional, mental,andsocialwelfarehavethepotentialtodisruptthisbalance.Evenslightalterationsinadaptive and coping reactions might lead to unproductive patterns of thought, communication, emotion, and behavior. As acaregiveraddressingclients'psychosocialneeds,it'scrucialtobepreparedfor,discern, and evaluate these sorts of reactions. In the NCLEX-LPN examination, roughly 7-13% of thequestionswillpertaintopsychosocialIntegrity. Thissectioncentersonadvocatingforandbolsteringtheemotional,mental,andsocialwelfareofclients confronting demanding circumstances, as well as clients with acute or chronic mental health disorders. Learning Objectives 1. Demonstrate the ability to assess and intervene in various psychosocial scenarios, including abuse and neglect, substance use disorders, coping mechanisms, and sensory alterations. 2. Develop skills in crisis intervention, stress management, and therapeutic communication techniques to effectively address client needs and concerns. 3. Recognize the impact of culturalinfluencesonhealth,religiousbeliefs,andspiritualpractices, and provide culturally sensitive care to diverse client populations. 4. Explain family dynamics'influenceonclientwell-beingandprovideappropriatecare,including end-of-life care and support. 5. Describethestagesofgriefandlossandgraspfundamentalconceptsrelatedtomentalhealth conditions and their treatment approaches. 6. Identify and utilize support systems in client care plans while also employing behavioral interventions to promote positive client outcomes. 7. Createatherapeuticenvironmentthatconsiderssensoryandperceptualalterations,enhancing client comfort and safety.
A. Addressing Abuse and Neglect Empowering Prevention and Intervention
WithinthecontextoftheNCLEXstudyguide,thetopicofabuseandneglectencompassesvariousforms, including physical abuse , physical neglect , sexual abuse , emotionalabuse, and neglect .Familiarity withone’sstate'slawsregardingthereportingofsuspectedorconfirmedabuseiscrucial.Furthermore, one must possess the ability toidentifyfactorsthatcontributetotheriskofabuseandneglectandto recognize indicators that may suggesttheirpresence.Understandingtheseaspectsispivotalforone’s role in subsequent care.
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