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
- High priority - life threatening conditions if untreated would result in harm/injury
- Intermediate priority
- Low priority
B. Guides for prioritizing
- Keywords or key phrases
- 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
- Most acute/least stable patient
- Complication of the disease condition (not an expected outcome)
II. Delegation and Assignment-making
A. Principles and Guidelines
- Ensure client safety
- Focus on what the question is asking for
- Determine which activity can be delegated safely and legally.
- Match the activity on the basis of the nurse practice act.
- Provide adequate supervision (supervise RNs who are new grads.)
B. Who can do that?
- 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
- Case situation
- Question stem
B. Read the question carefully. Look for keywords or phrases in the case situation and stem the question
Examples:
- What is an early sign of shock?
- What is the initial nursing action? Indicates that options are correct and you have to prioritize.
- Which statement by the client indicates understanding of the instruction? Indicates a true response questions
- 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)
Azithromycin is one of the world’s best selling antibiotics. It is derived from erythromycin. Because of its non-specific nature, it is prescribed for a wide variety of infections, including the following: ear infections, strep throat, pneumonia, cellulite, sinus infection, Lyme disease, pertussis, salmonella, pelvic inflammatory disease and chlamydia.
Side effects include diarrhea, nausea and vomiting. Like with most antibiotics, oral contraceptives are not effective during the cycle(s) during which the drug is consumed.
Azithromycin comes in three forms: oral suspension, IV injection or tablets. It’s most commonly seen in tablet form as the “Z-pak” (6 doses, the first day including a double dosage) or “Tri-pack” (3 doses).
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Hepatitis is the wide spread inflammation of the hepatocytes. It is a disease that affects the function of the liver. Viral Hepatitis includes A,b,c,d and e viruses.
Hepatitis A ***Fecal-Oral, contaminated waters, food. handwashing! intimate contact contact can occur (naked cuddling, oral sex) 2-4 weeks incubation. earliest symptoms are GI upset. Also do SEROLOGICAL testing, to check for the antigen. usually self limiting. We do have a vaccine, but not greatly used in U.S.
Hepatitis B - ***Parenteral methods, tattoos, sex, acupuncture. immigrants! vaccine, part of childhood immunizations and also healthcare providers are required. But disease can be cleared on its own for some people. (once cleared, are no longer carriers.) 2-6 month incubation.
Hepatitis C - ***CHRONIC most common reason for liver transplantation! must be sober for 1 year to be on a transplant list. transmission BLOOD to BLOOD. no semen.. HEP C can live one week in the air! Also can be due to cocaine sharing through the nasal cavity. It is not transmitted in semen. (i dunno why the picture says it is) It will never clear. Can be transmitted through toothbrushes and razors cuz of bleeding.
Hepatitis D - Defect in RNA so it requires HEP B to replicate, so the virus replicates a lot faster, incubation is only 3 weeks. Will always have bilirubin excess in their body, with light stool and dark urine, early on.
Hepatitis E - *WATERBORNE not seen often in the US.
Fulminant hepatitis- means all of your liver cells have died and failed to regenerate. Because our liver is the only organ with that regenerative property, once all cells die, and there is no more regeneration, you are considered to have fulminant hepatitis.
Chronic Hepatitis - is the chronic inflmmation and it increases your chances of developing prime site liver cancer as well as cirrhosis.
In the setting of liver cancer, there is increased pressure to due to the actual cancer tissues growing in and around the liver. Radiation and chemotherapy don’t work n the liver, so a patients best bet is to have a transplant.
Liver transplantation candidates; end stage liver disease (without varicies) and patients with PRIMARY liver cancer NOT metastatic disease.
Patients turned down for transplantation; alcoholics or substance abusers, and those with metastatic cancers, because taking out a portion of the lier that was infected would not prevent REINFECTION. And a patient must be sober for 1 year before even getting put on the transplant list.
Post Transplantation, the nurses role:
Pay close attention to graft rejection and infections. Most likely time is 4-10 days after transplant. S/sx: tachycardia, fever, RUQ pain, jaundice and increase in liver enzymes. remember that delayed graft rejection can occur at any time. TREAT PATIENTS with immunosuppressant drugs, like Tacrolimus (Prograf) also Corticosteroids, like prednisone. (acute) Two main side effects of Prograf, are Hypertension and renal insufficiency. And always remember when administering corticosteroids like prednisone you have to monitor for hyperglycemia, because it can alter their CHO metabolism.
