• A blood pressure cuff that’s too narrow can cause a falsely elevated blood pressure reading.
• When preparing a single injection for a patient who takes regular and neutral protein Hagedorn insulin, the nurse should draw the regular insulin into the syringe first so that it does not contaminate the regular insulin.

• Rhonchi are the rumbling sounds heard on lung auscultation. They are more pronounced during expiration than during inspiration.

• Gavage is forced feeding, usually through a gastric tube (a tube passed into the stomach through the mouth).

• According to Maslow’s hierarchy of needs, physiologic needs (air, water, food, shelter, sex, activity, and comfort) have the highest priority.

• The safest and surest way to verify a patient’s identity is to check the identification band on his wrist.

• In the therapeutic environment, the patient’s safety is the primary concern.

• Fluid oscillation in the tubing of a chest drainage system indicates that the system is working properly.

• The nurse should place a patient who has a Sengstaken-Blakemore tube in semi-Fowler position.

• The nurse can elicit Trousseau’s sign by occluding the brachial or radial artery. Hand and finger spasms that occur during occlusion indicate Trousseau’s sign and suggest hypocalcemia.

• For blood transfusion in an adult, the appropriate needle size is 16 to 20G.

• Intractable pain is pain that incapacitates a patient and can’t be relieved by drugs.

• In an emergency, consent for treatment can be obtained by fax, telephone, or other telegraphic means.

• Decibel is the unit of measurement of sound.

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• Unlike false labor, true labor produces regular rhythmic contractions, abdominal discomfort, progressive descent of the fetus, bloody show, and progressive effacement and dilation of the cervix.

• To help a mother break the suction of her breast-feeding infant, the nurse should teach her to insert a finger at the corner of the infant’s mouth.

• Administering high levels of oxygen to a premature neonate can cause blindness as a result of retrolental fibroplasia.

• Amniotomy is artificial rupture of the amniotic membranes.

• During pregnancy, weight gain averages 25 to 30 lb (11 to 13.5 kg).

• Rubella has a teratogenic effect on the fetus during the first trimester. It produces abnormalities in up to 40% of cases without interrupting the pregnancy.

• Immunity to rubella can be measured by a hemagglutination inhibition test (rubella titer). This test identifies exposure to rubella infection and determines susceptibility in pregnant women. In a woman, a titer greater than 1:8 indicates immunity.

• When used to describe the degree of fetal descent during labor, floating means the presenting part isn’t engaged in the pelvic inlet, but is freely movable (ballotable) above the pelvic inlet.

• When used to describe the degree of fetal descent, engagement means when the largest diameter of the presenting part has passed through the pelvic inlet.

• Fetal station indicates the location of the presenting part in relation to the ischial spine. It’s described as –1, –2, –3, –4, or –5 to indicate the number of centimeters above the level of the ischial spine; station –5 is at the pelvic inlet.

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• According to Kübler-Ross, the five stages of death and dying are denial, anger, bargaining, depression, and acceptance.

• Flight of ideas is an alteration in thought processes that’s characterized by skipping from one topic to another, unrelated topic.

• La belle indifférence is the lack of concern for a profound disability, such as blindness or paralysis that may occur in a patient who has a conversion disorder.

• Moderate anxiety decreases a person’s ability to perceive and concentrate. The person is selectively inattentive (focuses on immediate concerns), and the perceptual field narrows.

• A patient who has a phobic disorder uses self-protective avoidance as an ego defense mechanism.

• In a patient who has anorexia nervosa, the highest treatment priority is correction of nutritional and electrolyte imbalances.

• A patient who is taking lithium must undergo regular (usually once a month) monitoring of the blood lithium level because the margin between therapeutic and toxic levels is narrow. A normal laboratory value is 0.5 to 1.5 mEq/L.

• Early signs and symptoms of alcohol withdrawal include anxiety, anorexia, tremors, and insomnia. They may begin up to 8 hours after the last alcohol intake.

• Al-Anon is a support group for families of alcoholics.

• The nurse shouldn’t administer chlorpromazine (Thorazine) to a patient who has ingested alcohol because it may cause oversedation and respiratory depression.

• Lithium toxicity can occur when sodium and fluid intake are insufficient, causing lithium retention.

• An alcoholic who achieves sobriety is called a recovering alcoholic because no cure for alcoholism exists.

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