Help with Psych NCLEX questions

Whispera, MSN, RN · Feb 23, 2009

One thing I know for sure about the test is that in psych as well as other areas, you have to pay attention to safety first. In med-surg it's Airway/Breathing/Circulation, etc. In psych if there's an answer that attends to what you'd need to do FIRST to keep both patient and staff safe, both medically and free from harm to self or others, that's likely to be the answer.

Jules A, MSN · Feb 24, 2009

When I was practicing NCLEX questions I paid a lot of attention to the rationales especially when I didn't understand an answer. Good luck.

erjunkie8 · Feb 25, 2009

is a patient who is hearing voices to harm a priority? I always thought that would be my main concern.. seems I am not always right.

Whispera, MSN, RN · Feb 25, 2009

yes safety is your main concern, but I'd need more information on what you mean to give you a good idea of how you would answer an NCLEX question about that...

RochesterRN-BSN, BSN, RN · Feb 27, 2009

yes.....ABCs in medical and safety in psych. Also you should know all the serious side effects of psych meds that can be fatal-- like serotonin syndrome, neuroleptic malignant syndrome, etc.--meds that can cause medical emergencies basically. Knowing your EPS associated with antipsychotics-- like TD, akesthesia, dytonic reactions.....and the meds used to treat these problems. I had a lot on therapeutic communication. How to deal with a dellusional patient.....make sure you understand the difference between passive and active suicidality. Gero psych is big too-- understanding their unique needs. How some medical problems can present as behavior problems--ie a UTI in an older adult can cause confusion, hallucinations, etc. brain injuries, brain and liver cancer can cause changes in behavior--liver because of the amonia levels, lymes disease, syphillis.(to name just a few)...psych meds not good for this population. Understand delerium--a medical emergency that causes behavioral symptoms and is often missed. Understand alzheimers. And remember to think about using other staff to manage patients when trying to prioritize where you need to be-- like when they give you 4 patient scenarios and ask you which patient YOU need to attend to first.......remember you can have techs stay with a patient that is just in need to 1:1 supervision until you can get there.

Well hope this stuff helps--tried to think of the things that I remember needing to know or that are important that they may question you on.

Good luck......

Cree8ive1 · Feb 28, 2009

Another tidbit I heard from a fellow student is, yes, safety first, but if that's not a concern in the given question, focus on which of the answers in the bank focuses on the client's feelings. It isn't always the case (which is why NCLEX test-taking strategies boggle me somewhat -- they don't apply all the time), but it has helped me in a couple of test-taking situations. Good luck!

erjunkie8 · Feb 28, 2009

yes safety is your main concern, but I'd need more information on what you mean to give you a good idea of how you would answer an NCLEX question about that...

I was trying to figure out the priority in this case. If they gave you a list of patients and who to see first would this person who is hearing voices to harm more of a priority? I saw somewhere else someone mentioned having a tech watch them... sounds great but I am not sure what nclex wants me to know?

it's frustrating when it's confusing.. :) thank you..

truern · Mar 1, 2009

I was trying to figure out the priority in this case. If they gave you a list of patients and who to see first would this person who is hearing voices to harm more of a priority? I saw somewhere else someone mentioned having a tech watch them... sounds great but I am not sure what nclex wants me to know?
it's frustrating when it's confusing.. :) thank you..

Absolutely!! Anytime a psych patient is hearing voices, especially ones that tell them to do harm to themselves or others, that's a PRIORITY.

Whispera, MSN, RN · Mar 1, 2009

absolutely the patient hearing voices to harm is a priority! Are you asking if that patient is first priority? That would depend on what else is going on. I don't understand how anyone could think it's not a priority--what other things are you thinking are the priorities?

erjunkie8 · Mar 3, 2009

absolutely the patient hearing voices to harm is a priority! Are you asking if that patient is first priority? That would depend on what else is going on. I don't understand how anyone could think it's not a priority--what other things are you thinking are the priorities?

i cant remember off hand.. but whne I thought about it afterwards I was unsure. A similar question was asked later and I thought "oh no did I get it wrong"..

RochesterRN-BSN, BSN, RN · Mar 5, 2009

I think we can all agree that we would need to know the scenarios of all 4 patients to know exactly what patient would be priority.....