First of all, I want to say that YOU CAN DO IT! THINK POSITIVE!!!!!! If you weren't already a "minimum competency nurse" then you wouldn't have made it this far. Believe in yourself and just "get more right than wrong...not trying to make 100"
Secondly, I found some strategies that may or may not be taught in the HURST Review
These points need to be running through your mind as you answer questions. Make them your mantra!
* Pick least Invasive First
Hurst Review Services 2
* Pain never killed anyone
* Never release traction UNLESS you have an order from the MD to do so
* Polyuria--Think shock first
* If you have never heard of it.... Don't pick it!
* Anytime you see fluid retention... Think heart problems first
* Stay away from restraints as long as you can... Remember the NCLEX is a perfect world.
* Do not pick an answer that delays care or treatment.
* Never pick an answer that does not allow your patient to speak.
* Select a "patient focused" answer.
* With priority questions... Remember you can only send one message to the NCLEX lady... so you must pick the "killer" answer
* ADH--Think H2O
* Aldosterone--Think sodium AND water
* With SIADH--TOO many letters TOO much WATER
* More Volume--More Pressure
* Less Volume--Less Pressure
* Anytime you see the words "assessment" or "evaluation" think pertinent signs and symptoms
* There will not be a test questions unless there is something to WORRY about...
* Assume the WORST
* If there is something you can do about the problem first... do that before calling the doctor
* Hypoxia may be the first sign of respiratory acidosis
* With restless patient... think hypoxia first
* Limit protein in kidney patients EXCEPT with Nephrotic syndrome
* Like illness can be put in the same room together
* If there are any long term consequences to your patient with the answer you pick, you should not pick that answer.
* Assess before implementing
* If you have a fluid problem you have a Na problem too
* If you have a fluid problem... you will do I&O and daily weights
* "Always" and "whenever" are TOO definite
* Read the questions.... Then decide what you are WORRIED about... then pick an answer that you can do to SOLVE the problem
* If you see words like "assessment" or "evaluation" in the stem of the question.... Think pertainate signs and symptoms. The presents or absence of the signs or symptoms.
* You can't use medical dx in a nursing diagnosis
* You will report something "new" or different" or "possible" to the next shift nurse.
* If you can narrow the answers down to 2 answers... pick the more life threatening answer.
* Anytime you have a magnesium or calcium question... think muscles first.
* Digoxin + hypokalemia= toxicity
* You elevate veins and dangle arteries.
* Always worry if the rate decreased with a pacemaker
* Never pick an answer that puts your work off on anyone else
* Never pick an answer that does not allow your patient to speak
* Never pick an answer that ignores or brushes off the patient's compliant.
* If the answer is not applicable to the situation... don't pick it.
* They will be happy if you get more right than wrong... We are not trying to get a 100!