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Discussion

MONA

On the NCLEX, do you think morphine or oxygen comes first for an MI?

I just encountered a Q about this on Kaplan.

I put oxygen because I thought "airway".

But the right answer was morphine FIRST. O2 2nd.

So I guess for the purpose of the NCLEX, we use MONA in that order??

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I graduated in December. We were taught OMAN, though our text book said MONA. Faculty said OMAN was more current. Keep in mind, though, that NCLEX runs about three years behind what's taught in schools, so MONA is probably what they're looking for. (I had one MONA question on my exam.) Don't sweat teachers not being on the same page for MONA or OMAN, though. The answer options on the NCLEX are written in very obvious ways. They don't split hairs.

I feel retarded....but....what does the A stand for? We weren't taught this acronym....or maybe it just got lost in everything else I learned LOL

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A is for aspirin

OMG I feel like an idiot.

So if I see Oxygen first, or Morphine first..not BEST, but first. On the NCLEX...which would be first. We were taught nitro before morphine in school, but the NCLEX isn't school...that 1 question might fail me or pass me

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I asked my Kaplan instructor and she said morphine.

"Morphine is a very high priority because it vasodilates and allows the oxygen to get to the heart tissue. So oxygen alone is not good enough. A question asking you to decide between the 2 is rare - but if you have to I would say morphine first."

Luckily that Q wasn't on my test yesterday.

and then the rationale was the priority was to reduce pain, decrease metabolic demand, increase cardiac output etc and that O2 would be implemented after morphine.

This is exactly what we were told in school.

MONA is one of the "exceptions" to your ABC's.

That's what gets me...certain schools teach certain things differently. Kaplan might say morphine first, the NCLEX people might think differently..I still want to know what the NCLEX people say because they make the question that may determine if I fail or not...because you know they love MASLOW...and pain is PSYCHological...not PHYSiological. I don't really agree with Maslow in all cases. Sex is physiological...that's more important than a safe environment. So if I have a patient who wants to stick his finger in a light socket, sex and food are more important than providing an evironment with covers over the plugs. I missed that question in Kaplan about a manic pt who was doing all kinds of crazy things that would kill her. She was on an airplane wing! But it said the PRIORITY is to give her food and rest since she hasn't eaten in 3 days instead of the answer I picked....provide a safe environment. Back to the light socket or plug, if she wants to stick her finger in a light socket because she's manic..I think that would kill her faster than if she waited a few hours to eat while I make her surroundings safe.

That's what gets me...certain schools teach certain things differently. Kaplan might say morphine first, the NCLEX people might think differently..I still want to know what the NCLEX people say because they make the question that may determine if I fail or not...because you know they love MASLOW...and pain is PSYCHological...not PHYSiological. I don't really agree with Maslow in all cases. Sex is physiological...that's more important than a safe environment. So if I have a patient who wants to stick his finger in a light socket, sex and food are more important than providing an evironment with covers over the plugs. I missed that question in Kaplan about a manic pt who was doing all kinds of crazy things that would kill her. She was on an airplane wing! But it said the PRIORITY is to give her food and rest since she hasn't eaten in 3 days instead of the answer I picked....provide a safe environment. Back to the light socket or plug, if she wants to stick her finger in a light socket because she's manic..I think that would kill her faster than if she waited a few hours to eat while I make her surroundings safe.

The schools are supposed to be structuring their entire nursing curriculum around the NCLEX Blueprint...which is published every year and is what not only nursing schools teach....but it also determines what publishers is going to publish in the textbooks for nursing school.

The NCLEX Blueprint isn't even a mystery...it's available to the general public.

In regards to your question...I can't answer for Kaplan, but I would wager that Kaplan had that question wrong.

She isn't going to be eating much if her behavior kills her first.

SAFETY always takes priority over physiological needs.

As my instructor put it...."below the Maslow's triangle...you have DEAD".

Justwannab09 and the rest of us viewing this thread, keep in mind that allow Kaplan stands behind their answers they admit they could be outdated. Your explanation about the action of morphine is right on.

and then the rationale was the priority was to reduce pain, decrease metabolic demand, increase cardiac output etc and that O2 would be implemented after morphine.

i read that rationale on nclex4000 it said the same thing. Morphine, Oxygen, Nitro, then Aspirin.

I checked my Med/surg book just now. It said give Oxygen first to prevent further ischemia of the cardiac tissue. BUT it also says on another page to give the Sublingual nitro first to accomplish the same thing. It said both come first bascially lol. And I've seen countless places that said regarding drugs....you do Sublingual Nitro every 5 minutes for 15 minutes BEFORE Morphine. Nitro will decrease preload and afterload and it works immediately, plus treats the pain.....morphine is given for pain UNRELIEVED by Nitro.

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