ben catch-a-dog: spontaneity at it's best

TEST SMART: HOW TO PASS NCLEX

I. Prioritizing - Means ranking the client’s problems in order of importance depending on:

• Issue of the question
• Clinical setting
• Client’s condition
• Needs/problems that require immediate attention

A. Priority

1. High priority - life threatening conditions if untreated would result in harm/injury
2. Intermediate priority 
3. Low priority

B. Guides for prioritizing

1. Keywords or key phrases
2. Maslow’s Heirarchy of Needs Theory

• Physiological needs are the first priority (Airway, Breathing, Circulation)
• Pain
• Safety

    3. Steps of the Nursing Process

• Assessment vs. Implementation (Assess first)
• Expected outcome

C. Other priorities

1. Most acute/least stable patient
2. Complication of the disease condition (not an expected outcome)

II. Delegation and Assignment-making

A. Principles and Guidelines

1. Ensure client safety
2. Focus on what the question is asking for
3. Determine which activity can be delegated safely and legally.
4. Match the activity on the basis of the nurse practice act.
5. Provide adequate supervision (supervise RNs who are new grads.)

B. Who can do that?

1. Unlicensed personnel - Noninvasive tasks and basic client care activities that include the following:

• Ambulation
• Bathing
• Client support
• Grooming
• Hygiene measures
• Positioning
• Range-of-motion exercises
• Skin care
• Some specimen collection, such as urine or stool.

   2. Licensed Practical or Vocation Nurse - Certain invasive tasks and client care activities that include the following:

• Administering oral medications
• Administering intramuscular and subcutaneous injections
• Changing dressings
• Irrigate wounds
• Monitoring an intravenous flow rate
• Suctioning
• Urinary catheterization

   3. Registered Nurse - Some of the tasks and client care activities that only the registered nurse can perform are as follows:

• Administering intravenous medications
• Leading others and managing the client care environment
• Teaching
• Using the nursing process: assessment, analyzing data, planning client care, implementing care and evaluating care

III. Test-taking Techinique

A. Identify the parts of a question

1. Case situation
2. Question stem

B. Read the question carefully. Look for keywords or phrases in the case situation and stem the question

Examples:

1. What is an early sign of shock?
2. What is the initial nursing action? Indicates that options are correct and you have to prioritize.
3. Which statement by the client indicates understanding of the instruction? Indicates a true response questions
4. Which statement by the client indicates the need for additional teaching? Indicates a false response question

C. Identify the issue. (What is the problem asking?)

D. Use the process of elimination. Involves reading each question and removing options that are incorrect and do not address the issue of the question.

E. Avoid asking yourself “what if?” or “reading into the question”. Means that you are considering issues beyond information presented in the question. Moves you off track with regards to what the question is asking.

F. Additional tips and strategies

• Eliminate options that contain absolute words e.g. all, always, never, none, only
• Focus on nursing rather than medical interventions.
• Ensure that all parts of an option are correct.
• Look for an umbrella option. (more comprehensive answer)
• Visualize the information (arrange in sequence/order)
• Look for the option that relates to the question.
• Don’t expect the test to end after 75 questions!

Source: (Nocturalnurse)