NCLEX-RN preparation - page 2

by jablonec 7,707 Views | 19 Comments

i would like to know if anyone has suggestions that can help me learn more about prioritizing and pharmacological questions? these are the two areas i am having difficulty with. any ideas would be appreciated.... Read More


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    Quote from RonnieMcDonald
    I just became a member of allunurses. com and I failed my NCLEX RN exam the first go round I am having difficulty accessing Suzzane`s Plan can some one help me PLEASE!!!??!!
    I am sorry that you failed your RN NCLEX. I know what you are going through. I failed my LPN NCLEX the first time. Two people failed the NCLEX out of a graduating class of 32, me and another girl. Word spread like wild fire. I worked on a temporary license, in which lpn's have to wear burgundy in the hospital, then when I failed the test, I had to wear green scrubs. I was down sized to a CNA. I had to walk in to work from wearing burgundy to green scrubs. Talk about humiliation :imbar. I know I had 45 firing days to study for this NCLEX. I got an NCLEX CD for my computer and practiced on the test questions everyday, never gave up. I went a second time for my NCLEX, and passed on the minimum questions it required for a passing score. I knew when the test logged off at 75 that I passed.
    I believe what helped me passed was simple.When you have a good nursing cd for NCLEX, and practice it EVERYDAY, this prepares your mind for test questions, and not just questions in particular,however; it prepares your mind to a mental state of "test readiness"...if this makes any sense. Moreover,your mind is being exposed/prepared for computer style tests, such as the nclex is. There is no way to go back and study everything in nursing to pass the NCLEX....impossible. Get a good RN NCLEX CD, practice it on your computer everyday, and you will see just how much your mind is being exposed and will be in a state of "test readiness." Good Luck

    Expose your Mind.
  2. 0
    Thank you sooooooooo much this was very helpful!!!! and congrats on passing your exam!!!!!
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    NCLEX ABCDZ STRATEGY

    A. Spend 1/3 of your time reviewing content you don't understand
    B. Spend 2/3 of your time answering test question
    C. Used most comfortable NCLEX review book for content.
    D. Begin with the area that is most difficult for you or area that are least familiar
    E. Use a good nursing reference manual or internet to find information
    F. Define the disease in terms of pathophysiological process and understand the disease process.
    G. Identify the early and late symptoms of disease
    H. Identify most important or life-threatening complication associated with the disease.
    I. Define the medical treatment.
    J. Identify nursing intervention associate with early and late symptom of disease process
    K. Identify what to teach patient and family to prevent in other to adapt to disease process.
    L. list the area you need to review.
    M. Answering question in a test mode will improve your test taking skills
    N. Each time you answer question, check the number of question you answered correctly that will motivate you to read and study more next time.
    O. Keep track of your score to see how you're improving in all area of your content.
    P. If you answer less than 65% correctly, these is a WARNING SIGNAL!! Spend lots of time reviewing content and stop doing question on the weakest area
    Q. If you answer 65-75% correctly your performance is improving and success is certain. Continue working with the content until your score is above 75%
    R. Every wrong answer, identify why you answered it wrongly.
    S. Practice 75- 85 question to known how you'll be prepared for NCLEX Exam and see how many you answered correctly
    T. Do understand the question first, formulate your answer of hand and compare with the option given to see how close your answer!!
    U. Anticipate Test question will increase in difficulty when you get the first question right!!
    V. Do not panic if someone finishes before you!!
    W. Do not CRAM CRAM!!
    X. Remember that you have learned a great amount of nursing knowledge and the exam is only designed to determine whether you're able to practice safely @ entry level
    Y. Keep a positive attitude and Pray!!
    Z. Wish you best of LUCK!!





    Question we all need to ask our self:
    1- what is CAT? It's tailored to match our individual competences level. We all have different level of competences.
    2- what are the minimum and maximum question? All candidate are required to answer @ least 60/70 question correctly and 15 question are sample question which are outscored.

    What's Test Anxiety and how to deal with it?
    1-feeling insecure about our performance
    2-worry over something you've no control over
    3-thinking about what people might feel if you failed
    4- unpreparedness
    5- worry about time allotted to finish the test

    5 Bad habit of anxiety
    1- smoking or drinking more frequently
    2- biting nails, fidgeting with hairs etc
    3- trouble falling asleep
    4- daydreaming
    5- eat more/less food
    All these factors contribute to inability to perform effectively while preparing for an exam. I know is not possible to eliminate all these, but always keep them under control. Always have it in mind the exam is given in other to test your ability but not to punish you. Look at the exam as not being forced on you, but as a requirement to move up in your career.

    How is your study environment? Try to study in a quite zone with less distraction and external noise because they will interfere with the ability to concentrate and learn. Study in a comfortable and relaxed environment.
    How long did you study? Donít study for long hours! You might end up not understanding but cramming!!

    Do you have study mate? Study with others who you think have the same ability or know more than you. If youíre an average student, do not study with student who always made A's because they will always skip material that's necessary for you to review. Neither study with student who made C's because they will end up having to study material is of any importance.

    Keep sufficient time available for yourself to study on your own and never study too long with your study group. Keep your study group serious.

    Keep the study group small, because if the study groups are large, there is a greater tendency to become distracted.

    Do not come for study review unprepared!!

    Used prepared test question in the review book as a guide to help out.

    Take the comprehensive test at the back of the test.

    Always test in a test mode i other to keep track of your performance

    Develop used of flash cards

    Pause after reading and jot down the important point for reference

    Take a practice test that you think will be included in the test

    Review the area of weakness first in other to have time to review again before the exam

    After a month of studying practice the pretest/comprehensive test at the back of the study guide to see how you're doing. Have you improved?

    Relax a day before the exam and get sufficient sleep. You need to be physically and mentally alert!!


    CONTACT PRECAUTION


    Private room: if possible or cohort if private room is not available.


    Gloves: when entering the pt room and remove before exit the pt room. change gloves after having contact with infective material that may contain high concentration of microorganism or fecal material or wound drainage.


    Hand washing: wash hands after removing gloves and before leaving the room.


    Gown: when entering the pt room, if anticipating that clothing will have contact with the pt such as incontinence, diarrhea, ileostomy, colostomy and wound drainage


    Pt transport: ensure precautions are maintained to reduce risk of transmission
    Equipment: single, but if common equipment is used, clean and disinfect between pt.

    DROPLET PRECAUTION


    Pt placement: private room, cohort or maintain spatial separation of 3 feet from other pt or visitor. Cohort if private room is not available.


    Mask: wear mask when working w/i 3 ft of a pt or upon entering the room


    Pt transport- limit transport of pt to essential purpose only. Use surgical mask on the pt during transport.

    AIRBORNE PRECAUTION


    Pt placement: private room with negative air pressure with 6-12 air change/ hr. Discharge of air outdoors or hepa filtration. If air is recirculated, keep room door closed and pt in the room.


    Respiratory protection: wear N95 respirator when entering the room of a pt with known or suspected person with infection such as pulmonary TB. Also suspected pt should not enter the room of a pt with known or suspected of having measles (rubeola), varicella (chickenpox). If suspected pt must enter, the pt must wear N95 respirator.
    Respirator or surgical mask is not required if immune to measles and varicella.


    Pt transport: limit transport of pt from to essential purpose only. Use surgical mask on pt during transport.

    The NCLEX Hospital is NOT THE REAL WORLD!
    Correct responses are Textbook answer
    You will have enough staff and equipment to properly care
    for the patients.
    You only have one patient in the NCLEX hospital so choose
    your answers accordingly.
    In your Study Zone, everything is perfect theory and perfect
    situation.
    Read ALL of the answer choice before choosing a response.
    Utilize Maslow! Physiological needs will take priority over
    psychosocial needs.
    NEVER delegate: assessment, teaching or evaluation.
    Delegate based on competency not preference.
    Choose open-ended questions. This provide for therapeutic
    communication.
    You should choose to stay with the client if all physiological
    needs have been met.
    Remember the 3 components for psychosocial questions:
    Reality, Validation and Reorientation.
    Choose responses that give true, factual information.
    Memorize normal lab values.
    Be familiar with sign and symptoms of abnormal lab values.
    Review standard norms. Do not choose responses based
    on your own experience
    Let us add you to the NCLEX Wall of Fame


    Phenytoin (Dilantin) is an anticonvulsant medication


    Chlorpromazine (Thorazine) is more likely to be used PRN when a client is experiencing agitation associated with schizophrenia.


    Heparin is not pass on through breast milk.

    Metoclopramide hydrocloride (Reglan) stimulates motility of upper GI tract, contraindicated with possibel hemorrhage of GI tract, used to treat nausea of chemotheraphy.

    Dexamethasone (Decadron) - oral steroids have ulceragenic properties and need to be administered with meals
    Babinski reflex disappear approx. one year

    Extrusion reflex disappears between three and four months of age

    Fetal heartbeat can be heard at 12 weeks

    Appearance of any decelerations of the fetal heart rate (FHR) during NST should be immediately evaluated by the physician

    Impetigo is a superficial bacterial skin infection most common among children 2 to 6 years old.

    Increased systolic pressure and widening pulse pressure indicates increased intracranial pressure.

    Docusate sodium (Colace) is a stool softener

    Levodopa (Larodopa) reduces the rigidity and tremors, which facilitates mobility for the client


    A salem sump tube is inserted for gastric immobility, to drain gastric contents in drug overdosage for gastric lavage or for initial enteral feeding to allow monitoring of feed absorption

    Diabetic acidosis - fruity breath odor

    Diabetes insipidus (DI) is a condition characterized by excretion of large amounts of severely diluted urine, which cannot be reduced when fluid intake is reduced. It denotes inability of the kidney to concentrate urine.

    Dissociative Identity Disorder is a psychiatric diagnosis that describes a condition in which a single person displays multiple distinct identities or personalities, each with its own pattern of perceiving and interacting with the environment

    Client receiving cyclophosphamide (Cytoxan) usually develop alopecia four to five weeks after starting treatment

    When irrigating the ear, Water that is too cool can elicit dizziness when it comes into contact with the tympanic membrane

    Muscle weakness and lethargy are signs of hypokalemia which can occur on the 3rd day after a burn; hypokalemia is caused by diuresis.
    Diabetic ketoacidosis is frequently associated with dehydration; fluids should be encouraged.

    Garamycin (Gentamycin) adverse reaction includes ototoxicity.

    Extreme tearing, redness, foreign body sensation are symptoms of viral conjunctivitis; highly contagious; children restricted from school until sympthoms have resolved, 3 - 7 days

    Librium (antianxiety) medication is pharmacologically similar to alcohol; is used effectively as a substitute for alcohol in decreasing doses to comfortably and safely withdraw a client from alcohol dependence.

    Expectorating thick yellow mucus is indicative of pneumonia.

    When administering soapsuds enemas, hold the irrigation set 12-18 inches; too high causes rapid distention and pressure in intestine causing rapid expulsion of solution, poor defecation, damage to mucous membranes.

    Normal potassium is 3.5 - 5.0 mEq/L


    Rebound hyperglycemia = Somogyi effect

    Meningís is the triad of nuchal rigidity, photophobia (intolerance of bright light) and headache

    Placenta produces hormones that make the cells insulin-resistant; as pregnancy progresses, these hormones increases; if insulin requirement is decreased, this indicated that the placenta is not functioning appropriately

    When inserting subclavian triple lumen catheter to be used for TPN, position the client in supine with the client's head low and turned away from the insertion site-- produces dilation of neck and shoulder vessels, making entry easier and preventing air embolus

    Clients with meningitis are placed on droplet for at least 24 hours

    Any time the pulse rate drops below the preset rate on the pacemaker, the pacer is malfunctioning; the pulse should be maintained at a minimal rate set on the pacemaker

    Hemophilia is a sex-linked disorder. A mother who is a carrier has a 50% chance of passing the faulty X chromosome to her daughter, while an affected father will always pass on the affected gene to his daughters. A son cannot inherit the defective gene from his father.

    There are two main types of hemophilia. If you have hemophilia A, you have little to no clotting factor VIII (8). About 9 out of 10 people with hemophilia have type A. If you have hemophilia B, youíre missing or have low levels of clotting factor IX (9).

    Pincher grasp present at nine months of age

    Posterior fontanels closed by two to three months

    Phobias involves projection and displacement.

    An infant with fetal alcohol syndrome will have a small head circumference, low birth weight and underveloped cheekbones.
    Hydromorphone hydrochloride (Dilaudid) is a narcotic analgesic used for moderate to severe pain, monitor vital signs frequently.

    Chlorpromazine hydrocloride (Thorazine) extrapyramidal side effects includes akathisia (motor restlessness), dystonias (protrusion of tongue, abnormal posturing), pseudoparkinsonism (tremors, rigidity), dyskinesia (still neck, difficulty swallowing)

    1 grain (gr) = 60mg

    Right upper quadrant pain to diagnose cholecyctitis

    Tremors, elevated temperature and pain symptoms are indicative of an alcohol-related problem

    Long term use of ceftriaxone sodium (Rocephin) can cause overgrowth of organisms; monitoring of tongue and oral cavity is recommended.


    Client with hypothyroidism are very sensitive to narcotics, barbiturates and anesthetics

    When performing a Rinne tests, the stem of a vibrating tuning fork is held against the mastoid bone until the child indicates that she can no longer hear the sound. Then the tuning fork is moved in front of the auditory canal.

    Clomiphene citrate (Clomid) induce ovulation by changing hormonal effects n the ovary. It alters estrogen and stimulating follicular growth to produce a mature ovum.

    Naproxen sodium (Naprosyn) is an NSAID used as analgesic; side effects include headache, dizziness, GI distress, pruritus and rash. Assess the patient for fluid retention and dizziness.

    Cortisol is responsible for converting proteins and fat into glucose; is also an antiflamatory agent.

    Verapamil (Isoptin) is indicated for the treatment of supraventricular tachycardias, so the client's heart rate should be checked prior to administration

    Breastfeeding mothers are advice to increase their caloric intake because milk productions requires an increase of 500 calories per day.

    Digoxin increases the force of myocardial contraction.

    Pacemaker increase the cardiac output; acts to regulate cardiac rhythm.

    Quinidine prevent premature ventricular contractions (PVCs); antiarrhythmics

    Lasix prevent systemic overload; diuretics

    With lead poisioning, milk provides a large amount of vitamin D; vitamin D optimizes deposition of lead in the long bones; purpoase of the treatment is to remove lead from the blood and soft tissues.

    An intravenous pyelogram (IVP) is an x-ray examination of the kidneys, ureters and urinary bladder that uses contrast material.

    SIDS is a support group of parents who have had an infant die from sudden infant death syndrome

    SHARE is a support group for parents who have lost a newborn or have experienced a miscaarriage

    RESOLVE is a support group for infertile clients

    CANDLELIGHTERS is a support group for families who have lost a child to cancer

    Accurate intake and output is the best indicator for fluid status.


    Women need 1200-1500 kcal/day (men need 1500-1899 kcal/day); women need 15mg/day of iron (men need 10mg/day); with pregnancy 30mg required

    Hemolytic reaction when transfusing blood includes chills, headache, backache, dyspnea, cyanosis, chest pains, tachycardia, and hypotension.

    Glycosylated Hemoglobin assay (BhA1c) test indicates how well blood sugar has been controlled during the past 6-8 weeks.

    Primary goal of a reminiscing group for geriatric clients is to review and share their live experiences with the group members.

    Symptoms associated with hypercalcemia are constipation, decreased reflexes, decreased muscle strength.

    Miller-Abbott tube provides intestinal decompression; intestinal tube is often used for treatment of paralytic ileus

    Promethazine hydrocloride (Phenergan) - nurse should check patency of the patient's vein; extravasation will cause necrosis.

    Buerger's disease - digital sensitivity to cold; vasculitis of blood vessels in upper and lower extremities.

    Continuous bladder irrigation (CBI) is necessary because it enables urine to keep flowing; prevents formation of clots that can lead to obstruction and spasm in the postoperative TURP client.
    Pain related to a gastric ulcer occurs about one-half to one hour after a meal and rarely at night; is not helped by ingestion of food

    To auscultate patient's right middle lobe (RML), RML is found in the right anterior chest between the fourth and sixth intercostal spaces.
    Characteristics of Mania --- agitation, grandiose delusions, euphoria, difficulty concentrating

    Characteristics of Schizophrenia -- Paranoia, hallucinations, disturbed thought processes, hypervigilance.

    Meniere's disease - Stand in front of the patient so that the client does not have to turn her head to see the nurse; by decreasing movement of the client's head, vertigo attacks may be decreased.

    Use standard precautions is method of transmission is saliva, feces and blood; use contact isolation if fecal incontinence.

    Play theraphy is suggested for children undergoing a stressful event because they have difficulty putting feelings into words; play is how they express themselves.

    Normal PT 11-15 sec, normal Hgb male : 13.5-17.5 g/dl, female: 12-16 g/dl

    Normal BUN 10-20 mg/dl, normal creatinine 0.6-1.2 mg/dl

    Normal Ca+ 4.5-5.3 mEq/L

    Normal AST (SGOT) 8-20 U/L, normal ALT (SGPT) 8-20 U/L

    Fluid challenge test is used to rule out dehydration as the cause of oliguria. Expected response after a fluid challenge on normally functioning kidneys is an increase in urine output; will occur if low urine output is due to dehydration; if it is due to acute renal failure, there will continue to be oliguria.

    Normal specific grativity is 1.010-1.030

    Chlorpromazine (Thorazine) medication is contraindicated for the treatment of alcohol withdrawal symptoms; medication will lower client's seizure threshold and BP, causing potentially serious medical consequences.

    Low intestinal obstruction, nurse would anticipate that the client's abdomen will be distended, nausea, vomiting; no stool, as motility distal to (below) the obstruction would cease

    Why are we not using beef or pork insulin and only human insulin? Human insulin does not cause the formation of antibodies because the protein structure is identical to your own.
    Approx. 65% of AIDS clients demonstrates a progressive dementia staged according to severity of debilitation; late stage is classified by cognitive confusion and disorientation.

    Two major side effects of haloperidol (Haldol) is hematologic problems primarily blood dsyscrasia and extrapyramidal symptom (EPS)
    Tee93, npepito, mstacyi, and 2 others like this.
  4. 0
    WOW!!! thank you soooooooo much!!!! Ive never had it broken down to me like that!!!! I really really appreciate this!!!
  5. 0
    Does any body know of a good CD with nothing but NCLEX RN practice questions on it that I can purchase?
  6. 0
    that is some great advice thanks. are you available for tutoring?? I am gonna print your message so I can look at it often.
    thanks so much
  7. 0
    The best way to monitor fluid status is Daily Weight, not I&O
  8. 0
    Hi, i heard about your plan and was wondering how can i acquire it. Desperately in need of passing nclex rn.
  9. 0
    @ KAYBDT6 wow.. nice notes.. i have them saved and printed.

    @ anyone.

    I was wondering if anyone have a schedule that they follow to study for nclex? I tried making me one on the Saunders CD but i didnt follow it cos at the back of my mind i knew that i made it up and i dont really have to follow or if i fall behind i can always catch up and never go back to it. IDK i was thinking maybe if i see a schedule ( that is not made my me) then i might stick it to more. if your willing to help please post it to me. TY!

    about me: I have bout 1 month til i finish nursing school. I have been coming in here every day for tips on how to prepare for nclex. I have also started doing questions (not much just here and there on my ipod only and I am doing very poor on them). I am also getting very nervous. HELP!
  10. 0
    If your school is worth a darn, you should be prepaired enough for the test and should take it immediatly after graduating. My school failed to give me information I had requested about the application process for licensure and with my history it took me over six months to get cleared to test. Those before me told me that the saunders 4th edition was the closest in regards to content and question style. I study'd the application type questions and multiple selection type. When you are getting mostly multiple selection type questions during your NCLEX exam, you know you are doing well as those are the more difficult and thus '"money" questions. Infection control will be all over the test. I had some L&D, only one lab value but you should know the basics anyhow... nothing for me on any insulins but I would damn sure know at least one so I could rule out others... It is a very broad based test... relax and no, cramming will not make you pass...good luck ya'll


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