failed nclex 2x now taking kaplan

nursephillyphil, BSN, RN · Oct 7, 2013

Use those trainers to find out what content areas you're weak in, be it endocrine, cardiac, neuro, etc. Your scores are right on the mark, but any topic area like endocrine or OB that is below 60 you should brush up on.

Practice 50 Q's a day from Qbank.

This is the schedule my kaplan instructor gave us:

Study guide tips:

- Start getting familiar with your book by reviewing those things you saw you were weak in as I reviewed class questions. Read chapters 1 and 2 – they are filled with things you will want to know -View the Decision Tree and Strategy videos on line to reinforce what I covered in class.

-Start by doing Question trainers 1,2,3. Start with 1, take it in test conditions - no music, phone, snacks, dogs, cats, etc. Take it in one sitting without pausing/suspending.

-Once you complete a test, review each question, including those you got correct to make sure you understand the thinking used to get to the correct answer.

-When reviewing the test questions, look up every word, disease, test, procedure or med you didn't know. Do this with the question right in front of you, do not make lists of things to look up later.

-Reviewing thoroughly as you complete each test helps build your content foundation and the thinking needed for the best clinical judgment. With each test, the ongoing review process will help your scores to improve on tests done after.

-Test results are broken down into the client need areas of the test plan. Using that analysis from your tests, set up some QBank tests to give you questions in those weak areas. (See the other email for exact numbers: about 150/category with 200+ for Pharm)

**Take the majority of your tests using all areas of the test plan. Work to make your weak areas stronger! Don't ignore the strong areas - keep them strong, but start with the weaker areas.

-Question Trainers 1,2,3 are the lower levels of questions. Use them to evaluate content weaknesses.

-LEARN TO HUG THE TREE!!

Decision Tree Notes:

Rules and Tips, General Decision Tree

NCLEX is exam is textbook nursing - do NOT apply what you do or see at your work. It must be by the book.

-This also applies to things like what an LPN/LVN or an aide can do. NCLEX uses national guidelines - state practices may differ. Use the guidelines from the course book and this class.

-Your on line resources include video tapes of the course questions/explanations: Review of Questions, and videos of content review: Review of Content

-No strategy will replace a strong content base. There are NO shortcuts for real knowledge – not for this exam, and not at the bedside. We can give you tools to attack even a question you know nothing about with confidence – but YOU must practice and do the work we advise to be successful.

-Critical thinking: applying knowledge you have to a specific situation. It often involves validating information found in the stem.

-KNOW the Decision Tree!

-Correct answers are based on safest nursing judgment.

-Eliminate the wrong answers to get to the correct answer.

-DO NOT READ INTO QUESTIONS! Don't make up a story or ask "but what if...?"

-Background information is usually just distracting information. Do not let background information distract you - sometimes the age, gender, or even some of the medical info is just not important and distracts you into considering answers that do NOT solve the problem.

-Sometimes wrong answers reflect background information. Watch for a pattern like 3 answers all directed toward an item in the stem, and 1 answer directed toward a different item. Sometime the odd answer is actually addressing the real topic.

-Before you look at the answer choices, summarize the topic of each question into a phrase using your own words. Sometimes you'll need to look at the answers to determine the question's topic.

-Next, First, Best, Most, Initial: all indicate a prioritizing question.

-You get to do one thing and one thing only. Choose the answer that has the greatest impact on the patient's problem.

-Do not get ahead of the process...1 step at a time

-The answer MUST make sense in the context of the question.

-The time frame in the question is important

-Choose the answer with the desired outcome

-Accuracy is MUCH more important than speed

-Make no assumptions when reading answer choices or the question.

-Get to the right answer by eliminating wrong answers first.

-Always read ALL answer choices before selecting your answer. Even if you think you know the answer, evaluate ALL of them.

- Do not read things into an answer...don't say "what if", don't make up stories. -sometimes we are tempted by a familiar answer because we do not recognize the correct answer. If you have to make up stories to make an answer work stop, and rethink it.

-For this exam, you work in 'NCLEX Hospital'. You have all the time, staff, resources and equipment to do the perfect answer. If it's there, you have an order for it, the family know how to use the equipment in the answer choices. Forget the real world limits:)

-Priority questions ask you to see the 1 best thing of the answer choices.

-Think of doing ONE thing, then going home. You can make ONE call, ask ONE Question or give one piece of information to a patient. Of 4 good or true answers, which is BEST? Of 4 bad answers, which carries the WORST outcome?

Step 1 Identify the Topic

-FIRST, identify the topic of the question. You must know what the question

really is before you can consider answers.

- Read only the stem of the question - do not look at answers until you identify the topic, and put it in your own words.

-**Practice: to not anticipate, guess or jump ahead to what you THINK the answer will be – your brain will get stuck there and you will not be ‘open’ to a different answer! Just get the topic – nothing else.

-Use the answer choices to confirm, or identify the topic.

--answer choices can help us focus in on the actual topic

Step 2 Assess vs Implement-

--Assessments gather info or data. Actions that result in data/info, like ‘get an O2 Sat’, or ‘do a fingerstick’ are Assessments. They are actions that give you information.

-Assessments may be subjective or objective data.

-Implementations are actions based on assessments. Things like teaching, offering suggestions, repositioning, starting an IV, reporting to supervisor, calling the doc – those are implementations. Before we can take action we must have sufficient assessment to act safely.

-the question will give you information, and that may include nursing assessments like what the nurse observes, pt history, pt complaints, lab data, etc. This may be enough information for you to act/implement, or you may need more data before acting. The answer choices will help you decide.

-If there is assessment in the stem, and there are no assessment answers, then you don’t need any further assessment. It doesn’t matter if you think you DO want more info, if it isn’t there as an option, forget it!

-If there ARE assessment answers, ask if the assessment makes sense. Just because we generally assess before implementing, does not mean that just ANY assessment will do. It must be appropriate. If there is no appropriate/correct assessment, you MUST implement.

-Validation simply means that you have some info in the stem, and you feel that more is needed to confirm what you think is happening. So, if you have some assessment in the stem, and there is an assessment answer that makes sense to do before taking any action – then you will select that.

-When considering implementations, the same principles apply. No matter how much you want to implement, if there is no appropriate implementation answer, you need to look at assessing.

-Ask yourself why you would take this action, does it make sense in the situation they gave you, and what will happen if you select this rather than any other answer.

-If the question asks what “action” would you take, this does NOT mean you will implement – remember, ‘actions’ may be either assessments OR implementations.

-If the answers are all implementations, or all assessments: you can't eliminate answers based on asses. vs Implementation, so you go to step 3, Maslow.

-keep moving through all the steps, if one doesn't apply, move right on to the next step

Step 3: Maslow!

- Physical needs take priority over psychosocial needs

-Select answers that reflect physical needs over those that reflect psychosocial needs.

-For this test, pain is considered Psychosocial. It's more important to stop the bleeding than to reassure/comfort them - you can only do ONE thing.

-if we treat the pain, but we don't stop the bleeding...they will die. They will be pain-free, but still dead.

-Exceptions to this are pain from an MI and pain from kidney stones: also consider sickle cell and compartment syndrome. With significant pain situations, like sickle cell crises, or a burn situation, carefully consider the other answers. If they are inappropriate or wrong for the situation, then they may be looking for the pain answer. Think about what the outcome will be as you consider each answer given.

-Teaching is psychosocial – If you are having an MI, treatment takes priority over teaching. P/S: answers generally will not save life or limb: for nclex your priority is to save them!

Step 4 ABC’s-

-When considering the physical answer choices, think ABC’s

-ABCs are the top priority. An airway problem takes priority over a breathing problem. A breathing problem takes priority over a circulation problem.

-Just because something is an airway answer, doesn’t mean you just pick it – it must make sense, and be valid or appropriate for the problem or situation in the stem. If not, eliminate it and consider other answers.

-If an injury, burn, side effect, reaction or complication effects anything above the waist, consider the airway/breathing answers, if any.

Step 5: Evaluate outcomes:

-With each answer choice ask yourself – what will happen if I select this? Is it safe? Does it answer the topic of the question?

**Always use step 1, Identify the Topic, and step 5: Evaluate the outcome of the answer choice. You have many other strategies to consider for questions – keep them handy in your mind at all times. Kaplan gives you the tools to succeed!

A. Study Plan: Practice every day

1. Count the number of weeks between the end of class and test date

2. Divide 1300 Q Bank Questions /by number of weeks

ex. 1300/4 weeks = 325 questions/week

3. Divide by 7 for # questions/day

ex. 325 questions/7 = 46 questions/day

4. Make out a schedule with # questions/day or week

5. Plan time for remediation, content review after each test

6. Space out Question Trainers evenly during the schedule

7. Review any categories where you score

Sample 4 week schedule:

Assumes Diagnostic, QT1, QT2, QT 3, & Readiness are complete

S M T W T F S

Week 1 __ __ __ __ __ __ __

50 100 QT4 50 50 off 100

Week 2 __ __ __ __ __ __ __

off 100 QT5 50 50 100 50

Week 3 __ __ __ __ __ __ __

off 50 QT6 100 50 100 50

Week 4 __ __ __ __ __ __ __

100 QT7 50 50 50 50 Test

See Chapter 2 in the book for other week schedule variations.

B. NCLEX-RN Prep Style Tests: 3 - 100 item tests in Q Bank

C. Review Pearsonvue & NCSBN websites and tutorial

D. Question Trainer Summary:

Take each test in one sitting in test-like conditions. Students have the option to suspend, though it is not recommended.

Content Assessment Tests:

*Use to assess categories

QT 1: 75 questions

QT 2: 75 questions

QT 3: 100 questions

> Target score: 65

Application & Analysis Level Tests:

*Space out in weeks prior to testing to assess progress

QT 4: 150 questions 3 hours Target score: 65

QT 5: 150 questions 3 hours Target score: 65

QT 6: 200 questions 4 hours Target score: 60

QT 7: 265 questions 6 hours Target score: 60

[COLOR=#1a1a1a] (***Take QT 7 one week before [COLOR=#1a1a1a]testing:[COLOR=#1a1a1a] score of 60 = ready to test!)

E. Creating a Q Bank Quiz:

1300+ NCLEX RN exam style questions

*to create customized Subcategory Qbank tests, use the previous test results with NCLEX client need categories

*If you are consistently scoring lower in several content areas, it is advisable to build some tests (although a limited number) from that area. (There are approximately 150 questions/client need category; Pharmacology has 200. See below.) Don't use them all up at once: ex. don't do 3 50-item Safety category tests

*Kaplan strongly recommends that you also build your Qbank test from All areas of the test plan so that all content is kept fresh in your minds.

*Don’t forget to take the 3 NLCEX-RN Style Quizzes in the Q Bank area!

Step 1: Select Timed Test or Tutor mode

Recommend timed to help practice because it is a timed test.

Use the tutor mode only the first time.

Step 2: Select Questions Reuse mode (4 options)

A. Unused only:

Use in the beginning and

on topics for which you show proficiency

B. Unused and incorrect:

Use when you are struggling with a specific topic and

have missed many questions on tests for that subject

C. Incorrect only:

Use right before you take your NCLEX

(great way to make sure you have properly remediated & will not make similar mistakes on test day)

D. All items:

Use in the beginning and at the end for review.

Step 3: Select test content

4 main categories; 8 subcategories

A. Select the categories where you:

*need remediation based on tests

(Diagnostic, Readiness, & Question Trainers)

*have content errors or questions

*had problems with class-session questions

B. Alternate Subcategory tests with All Content tests to keep your memory fresh

Step 4: Calculate Number of questions available

# ?’s Client Need Category

141 Management of Care

149 Safety and Infection Control

150 Health Promotion and Maintenance

157 Psychosocial Integrity

137 Basic Care and Comfort

217 Pharmacological/Parenteral Therapies

111 Physiological Adaption

144 Reduction of Risk Potential

Divide up your several lower Categories among your 50 item tests

Example: combine 3 categories for 16 questions/category in a 50 question test

** When you choose a category: click on # of questions left in lower left to see # remaining.

Step 5: Select number of questions (max: 50 per test)

Doing more than 150/day is unnecessary & non-productive

Overall goal for Q Bank scores is 60

F. Reviewing the Results

Make sure you plan time to remediate each test. You will want to look up correct and incorrect answers.

1. Content: look up immediately. Do not make a list of topics to look up later: cramming is ineffective.

2. Incorrect topic ID:

Read the rational. If the rationale is not about the topic you considered, the topic was incorrectly identified

*Practice identifying topics: write down in 3 words: compare to rationale

*Use step 1 of the Decision Tree

3. Missing the pattern

Students often choose the second best answer.

Reasons include

1) not following the Decision Tree steps

2) not thoughtfully considering each answer choice

3) not recognizing patterns in the answer choices

4) content deficiency

4. Did you miss the questions because you did not eliminate incorrect answers first?

Steps 2, 3, & 4 of the Decision Tree can help you to identify answer choices that are not a priority or do not relate to the topic.

Work through the steps of the DT so you can think about which answer choices can be eliminated

5. Did you miss the questions because you tried to identify the correct answers right away withoutapplying clinical judgment?

If so, you did not think through the steps of the Decision Tree. This will put you at risk of identifying answers that may look correct, but may not be a priority.

Slow down and think through the steps

#NurseB · Oct 7, 2013

nursephillyphil, that's some great advice!!!!!! Thank you!!!

nursephillyphil, BSN, RN · Oct 7, 2013

no probs, good luck to you both!

Natasha A., CNA, LVN · Dec 1, 2015

nursephillyphil did you also use the Kaplan question client needs videos?