NCLEX-RN Tips

Thanks for sharing. And Congrats to you RN!

thank for the good source of nclex. congrat to you!:cheers:

Congrats!! How can I get this Kaplan MP3 download thing.

Congrats! May Gods bless you more.

congrats!!!!

I would first off like to thank everyone that has posted to this website for success stories about the NCLEX-RN.

I took the NCLEX the first time in January with 265 questions and failed. I was absolutely crushed. I took the HURST review course and felt confident that I would pass with 75 questions, but clearly I was wrong.

I recentely retook the NCLEX on March 7 with 76 questions and found out that I passed!

I'll keep this short and sweet, because I remember looking through post simply looking for ways to do things differently the second time around in efforts to pass. So...

THINGS I DID DIFFERENTLY THE 2nd TIME:

-I bought the Que Test on the Kaplan website for $299. I did ALL of the questions (about 1300). I usually did about 50-150 questions a day. My scores were ranging in the 60's. Kaplan says they want you to be in this range. The last quiz I took I got a 75 and was thrilled. I felt this was a definite indicator I was ready!

-I did the 45 day remedial course from Kaplan. On the days I would work (I was working full time), instead of doing que questions, I would just review a section, whether it was endocrine or respiratory. I would go over the section 3 or 4 times, then answer the questions from the remedial packet.

-I purchased LIPPINCOTT'S REVIEW FOR NCLEX RN book.This book was WONDERFUL! When I would go over a section such as Oncology in the Hurst book, I would go over the same chapter in this book to do review questions. This helped me apply the core information and to see exactly what the NCLEX thought was important.

-I purchased LaCharity's Prioritization, Delegation, and Assignment book. I had trouble on the first time on these topics and this book HELPED A LOT!

-I went over infection control. On my first test, I didn't review this at all. So I remembered this little saying to remember the precautions to take.

AIRBORNE PRECAUTION

My - Measles

Chicken - Chickenpox

Hez - Herpes Zoster (Disseminated)

TB - TB

Private room

Negative pressure with 6-12 air exchanges per hour

UV

Mask

N95 Mask for TB

DROPLET PRECAUTION

think of SPIDERMAN!

S - Sepsis

S - Scarlet fever

S - Streptococcal pharyngitis

P - Parvovirus B19

P - Pertussis

P - Pneumonia

I - Influenza

D - Diptheria (Pharyngeal)

E - Epiglottitis

R - Rubella

M - Mumps

M - Meningitis

M - Mycoplasma or meningeal pneumonia

An - Adenovirus

Private room

Mask

CONTACT PRECAUTION

MRS.WEE

M - Multidrug resistant organism

R - Respiratory infection - RSV

S - Skin infections

W - Wound infections

E - Enteric infections - clostridium defficile

E - Eye infections

Skin Infections:

V - Varicella zoster

C - Cutaneous diptheria

H - Herpes simplex

I - Impetigo

P - Pediculosis

S - Scabies, Staphylococcus

Private room

Gloves

Gown

When I finally was ready to retake the NCLEX, and my 45 day waiting period was over, I signed up for another test. This time, however, I signed up at a completely different testing center. I wanted to be at a completely different place, not thinking of what happened last time.

The day before the test, I didn't do ANYTHING. I simply relaxed. It was a pretty day outside, so I took a walk. I watched a few tv shows. This time, I didn't tell ANYONE I was taking the test, so I wasn't getting any text the day before telling me "good luck." I did this on purpose because I didn't want this too add to my anxiety.

-IF YOU HAVENT READ ANYTHING ELSE, PLEASE REMEMBER THIS STEP:

PRAY! I was very specific in my prayer. I asked God to allow me to have 75 questions. I'm not good with Pharm, SATA, or math questions so I asked to not have very many questions on those, but if I had to have some, I prayed it would be something I knew like the back of my hand.

I ended up getting 0 math questions. The pharm questions were ok. I was able to guess based on the ending of the name of the drug.

Whenever I would feel discouraged and overwhelmed, I would say "I can do all things through Christ who strengthens me."

A few days before my test, I saw a poster with the words "You can't worry and pray." I felt like the Lord was speaking to me. I had been praying all along and worrying at the same time. From that day on, I told myself to have faith.

By repeating scriptures and having faith, God allowed me to pass my test on the 2nd try.

I am now a registered nurse!

Don't give up! Praise Him in Advance!

Congrats HelloM1M1 & RNTN!! This post is awesome. Thank you everyone for the helpful reviews & tips. I will be sitting for NCLEX next week, I'll let you know how it goes, but until then just keep PRAYING PRAYING PRAYING!

Hi I m Amrita ..I took my nclex rn exam..I don't pass..now taking Kaplan course but not having confident about exam bz of 1 failure result..and I don't know how to read and wht to read..bz so tired and not getting good grade in my practice test at home ...so wht I do???plzzz. Guide me and help me out..

Hello all ... studying for my Rn Nclex and just found these... I think its very helpful so want to share with you all too :)

Questions on Positioning

Many graduate nurses are not comfortable answering these questions because:

• They don't understand the whys” of positioning

• They don't know the terminology

• They have difficulty imaging the various positions

Since many illnesses affect body alignment and mobility, you must be able to safely care for these clients in order to be an effective nurse. Correspondingly, these topics are also important on the NCLEX-RN® exam. The successful test taker must correctly answer questions about impaired mobility and positioning.

Immobility occurs when a client is unable to move about freely and independently. To answer questions on positioning, you need to know the hazards of immobility, normal anatomy and physiology, and the terminology for positioning.

If you have difficulty answering positioning questions, the following strategy will assist you in selecting the correct answer.

Step 1. Decide if the position for the client is designed to prevent some*thing or promote something.

Step 2. Identify what it is that you are trying to prevent or promote.

Step 3. Think about anatomy, physiology, and pathophysiology.

Step 4. Which position best accomplishes what you are trying to prevent or promote?

Does this sound a little confusing? Hang in there. Let's walk through a question using this strategy.

Immediately after a percutaneous liver biopsy, the nurse should place the client in which of the following positions?

1. Supine.

2. Right side-lying.

3. Left side-lying.

4. Semi-Fowler's.

Before you read the answers, let's go through the four steps outlined above.

Step 1. By positioning the client after a liver biopsy, are you trying to prevent something or promote something? Answer: You position a client after this procedure to prevent something.

Step 2. What are you trying to prevent? Answer: The most serious and

important complication after a percutaneous liver biopsy is hemorrhage. How did you know that you are trying to prevent hemorrhage? You accessed what you know about a liver biopsy.

Step 3. Think about principles of anatomy, physiology, and pathophysi*ology. What do you do to prevent hemorrhage? Answer: You apply pres*sure. Where would you apply pressure? On the liver. Where is the liver? On the right side of the abdomen under the ribs.

Step 4. How should the client be positioned to prevent hemorrhage from the liver, which is on the right side of the body?

Now look at your answer choices.

(1) Supine. If you lay the client flat on his back, no pressure will be applied to the right side. Eliminate.

(2) Right side-lying. If you lay the client in a right side-lying position, will pressure be applied to the right side? Yes. Keep it in for consideration.

(3) Left side-lying. No pressure is applied to the right side. Eliminate.

(4) Semi-Fowler's. If you lay the client on his back with head partially elevated, no pressure is applied to the right side. Eliminate.

The correct answer is (2). Some students select (3) because they don't know normal anatomy and physiology. Some students select (4) because semi-Fowler's position is used for a lot of reasons.

Things to Remember

• Even if you didn't memorize what position to use before, during, and after a procedure, think about the question for a moment. You can figure out what position is needed.

• You cannot figure out the correct position if you do not know what the terms mean (supine, Trendelenburg, Fowler's).

• You cannot figure out a correct position if you do not know anatomy and physiology. If you think the liver is on the left side of the body, you are in trouble!

• You cannot figure out a correct position if you do not know what you are trying to accomplish. If you couldn't remember that a complication after a liver biopsy is hemorrhage, your best hope of selecting the correct answer would be to throw a dart.

• To those students who think in images, you should form a men*tal image of each position. Picture yourself placing the client in each position, and then see if the position makes sense.

Essential Positions to Know for the NCLEX-RN® Exam

Position Therapeutic Function

Flat (supine) Avoids hip flexion, which can compress arterial flow.

Dorsal recumbent Supine with knees flexed; more comfort- able.

Side lateral Allows drainage of oral secretions.

Side with leg bent (Sims's) Allows drainage of oral secretions; decreas*es abdominal tension.

Head elevated (Fowler's) Increases venous return; allows maximal lung expansion.

High Fowler's: 60 to 90 degrees Fowler's: 45 to 60 degrees Semi-Fowler's: 30 to 45 degrees Low Fowler's: 15 to 30 degrees

Feet and legs elevated Increases blood return to heart; relieves pressure on lumbrosacral area.

Feet elevated and head Used to insert CVP line, or for treat*ment

lowered (Trendelenburg's) of umbilical cord compression.

Feet elevated 20 degrees, Increases venous return; used for shock.knees straight, trunk flat,and head slightly elevated(modified Trendelenburg's)

Elevation of extremity Increases venous return. Increases blood volume to extremity.

Flat on back, thighs flexed, Increases lady partsl opening for legs abducted (lithotomy) examination.

Prone Promotes extension of hip joint. Not well tolerated by persons with respiratory or cardiovascular difficulties.

Knee-chest Provides maximal visualization of rectal area

Positioning Facts:

1. Air/Pulmonary Embolism (S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom) --> turn pt to left side and lower the head of the bed.

2. Woman in Labor w/ Un-reassuring FHR (late decels, decreased variability, fetal bradycardia, etc) --> turn on left side (and give O2, stop Pitocin, increase IV fluids)

3. Tube Feeding w/ Decreased LOC --> position pt on right side (promotes emptying of the stomach) with the HOB elevated (to prevent aspiration)

4. During Epidural Puncture --> side-lying

5. After Lumbar Puncture (and also oil-based Myelogram)--> pt lies in flat supine (to prevent headache and leaking of CSF)

6. Pt w/ Heat Stroke --> lie flat w/ legs elevated

7. During Continuous Bladder Irrigation (CBI) --> catheter is taped to thigh so leg should be kept straight. No other positioning restrictions.

8. After Myringotomy --> position on side of affected ear after surgery (allows drainage of secretions)

9. After Cataract Surgery --> pt will sleep on unaffected side with a night shield for 1-4 weeks.

10. After Thyroidectomy --> low or semi-Fowler's, support head, neck and shoulders.

11. Infant w/ Spina Bifida --> position prone (on abdomen) so that sac does not rupture

12. Buck's Traction (skin traction) --> elevate foot of bed for counter-traction

13. After Total Hip Replacement --> don't sleep on operated side, don't flex hip more than 45-60 degrees, don't elevate HOB more than 45 degrees. Maintain hip abduction by separating thighs with pillows.

14. Prolapsed Cord --> knee-chest position or Trendelenburg

15. Infant w/ Cleft Lip --> position on back or in infant seat to prevent trauma to suture line. While feeding, hold in upright position.

16. To Prevent Dumping Syndrome (post-operative ulcer/stomach surgeries) --> eat in reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low CHO and fiber diet, small frequent meals)

17. Above Knee Amputation --> elevate for first 24 hours on pillow, position prone daily to provide for hip extension.

18. Below Knee Amputation --> foot of bed elevated for first 24 hours, position prone daily to provide for hip extension.

19. Detached Retina --> area of detachment should be in the dependent position

20. Administration of Enema --> position pt in left side-lying (Sim's) with knee flexed

21. After Supratentorial Surgery (incision behind hairline) --> elevate HOB 30-45 degrees

22. After Infratentorial Surgery (incision at nape of neck)--> position pt flat and lateral on either side.

23. During Internal Radiation --> on bedrest while implant in place

24. Autonomic Dysreflexia/Hyperreflexia (S&S: pounding headache, profuse sweating, nasal congestion, goose flesh, bradycardia, hypertension) --> place client in sitting position (elevate HOB) first before any other implementation.

25. Shock --> bedrest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified Trendelenburg)

26. Head Injury --> elevate HOB 30 degrees to decrease intracranial pressure