NCLEX Retakers Study Group

With empowerment, re-directing our way of thinking and positive affirmations with of course a schedule of practice exams, trainers and review daily, I believe we can do it.

For me I am doing the following:

online practice test

review from the book, once I review the areas I am weak in. I review my Saunders book for knowledge content that I need to improve on.

one more practice test

Books: Saunders for knowledge content, Kaplan for test-taking strategies, nclex 3500 so that I can practice SATA.

Any other feedback, I am open to it.

Hi natnat28 I am actually taking the practice tests online in order for me to see the SATA's. There are a handful of them in my Saunders book.

Hi everyone,

I started my review and although I had some anxiety built I relaxed before I started my review. I prayed right before my review and I took the practice exam before I even hit my Saunders book to review, so I can find some weak areas. I picked topics that I got wrong answers on and of course reviewed all rationales and reviewed my Saunders book.

I got a 56% on the practice test online-nclex RN 3500.

I read topics of where I went wrong and I am going to leave a link that really helped me to prepare for re-taking. This link came from one of the retakers here a while back when I joined a forum group called 'Random fact throwing' which I found so many retakers pass their NCLEX by checking in as a study group and just giving random facts for review and we also gave our daily test scores after reviewing. So here goes i'll be the first to start!

LabValues.nclex review2.docx

Here are my random facts. This is based on my Saunders book where I reviewed last night based on the areas I found myself weak in: Rh immunization for pregnancy

Rh immunization of Rhogam is given when an Rh incompatibility occurs, which only occurs if the mother is Rh negative and the baby being born is Rh positive. It does NOT occur when an Rh positive mom gives birth to an RH negative baby.

If some of the baby's red blood cells leak into RH-mom's system, then her body may produce antibodies to the Rh D factor (a condition called sensitization). These antibodies can cross the placenta and destroy the red blood cells in your unborn baby or in the next Rh-positive baby you have.

*In most cases, the mom will not be exposed to the baby's blood until she gives birth....... This usually means that first baby will NOT be affected.

*However, large amounts of the baby's blood can leak into the mother during delivery. If the mom is Rh negative, the next Rh-positive baby that she could have may have problems if the Rh-negative mom has developed antibodies

*Occasionally, in the following situations, some of the baby's blood may leak into the mom's blood system during pregnancy:

1. After amniocentesis or other invasive procedure

2. During a miscarriage or abortion

3. During an ectopic pregnancy

4. If the mom bleeds heavily during pregnancy.

Hi everyone,

I reviewed Spinal Cord Injury (SCI) today because I did poorly on SCI questions on my practice test. So ehre goes my fact finding and see my references at the bottom.

Last night I got a 47% out of 15 questions.

Today I received a 48% out of 25 questions which includes SATA questions, and I see I have lots to review for SCI.

Spinal Cord Injury

- a trauma in the spinal cord (partial or complete) that traumatize and disrupt the nerve tracts and neurons within our system. A spinal cord injury can be classified as either complete or incomplete

PATIENT WITH SPINAL CORD INJURY ASSESSMENT:

ACUTE RESPIRATORY FAILURE

COMPROMISED RESPIRATORY FUNCTION

SENSORY AND MOTOR PARALYSIS WITHIN OR BELOW LEVEL OF INJURY.

Spinal Shock

- is also called a neurogenic shock.

Assessment includes:

• DECREASE OR LOSS OF REFLEX ACTIVITY, FLACCID PARALYSIS, BRADYCARDIA.
  
• USUALLY OCCURS WITHIN SEVERAL HOURS RIGHT AFTER INJURY.
  
• LOSS MOVEMENTS OF MUSCLES (FLACCID PARALAYSIS), BOWEL AND BLADDER.
  

Autonomic Dysreflexia

- also known as autonomic hyperrefelexia.

- caused by stimulus to the bladder or bowel

- Try to limit the catheterization of spinal cord patients to once every 12-14 hrs.

Asessment includes:

• HYPERTENSION (SEVERE)
  
• HEADACHE (THROBBING)
  

- also known as autonomic hyperrefelexia.

Complications

● Orthostatic hypotension

◯ Occurs when the client changes position due to the interruption in functioning of the

automatic nervous system and pooling of blood in lower extremities when the client

is in an upright position.

◯ Nursing Actions

■ Change the client positioning slowly and place the client in a wheelchair that

reclines.

■ Use thigh-high elastic hose or elastic wraps to increase venous return. Elastic

wraps may need to extend all the way up the client’s legs and include the client’s

abdomen.

● Neurogenic shock

◯ Neurogenic shock is a common response of the spinal cord following an injury.

◯ Symptoms of bradycardia, hypotension, flaccid paralysis, loss of reflex activity

below level of injury, and paralytic ileus accompany spinal shock due to the loss of

autonomic function.

◯ Nursing Actions

■ Monitor vital signs for hypotension and bradycardia.

■ Treat symptoms with appropriate medications (vasopressors or atropine).

● Autonomic dysreflexia

◯ Occurs secondary to the stimulation of the sympathetic nervous system and

inadequate compensatory response by the parasympathetic nervous system. Clients

who have lesions below T6 do not experience dysreflexia because the parasympathetic

nervous system is able to neutralize the sympathetic response.

◯ Sympathetic stimulation is usually caused by a triggering stimulus in the lower part of

the body (refer to list under Nursing Actions).

◯ Stimulation of the sympathetic nervous system causes extreme hypertension, sudden

severe headache, pallor below the level of the spinal cord’s lesion dermatome, blurred

vision, diaphoresis, restlessness, nausea, and piloerection (goose bumps).

Stimulation of the parasympathetic nervous system causes bradycardia, flushing above

the corresponding dermatome to the spinal cord lesion (flushed face and neck), and

nasal stuffiness.

◯ Nursing Actions

■ Determine and treat the cause.

☐ Sit the client up (to decrease blood pressure secondary to postural

hypotension).

☐ Notify the provider.

☐ Determine the cause.

X Distended bladder is the most common cause (kinked or blocked

urinary catheter, urinary retention, or urinary calculi)

X Fecal impaction

X Cold stress or drafts on lower part of the body

X Tight clothing

X Undiagnosed injury or illness (kidney infection or stone, lower

extremity fracture)

☐ Treat the cause.

X Relieve the kink in the catheter or irrigate to remove blockage.

X Catheterize the client (use anesthetic ointment on the tip of the

catheter).

X Remove the impaction (use anesthetic ointment prior to removal).

X Adjust the room temperature and block drafts.

X Remove tight clothing.

X Assess for injury, such as lower extremity fracture or kidney/bladder

infection.

■ Monitor vital signs for severe hypertension and bradycardia.

■ Administer antihypertensives (nitrates or hydralazine).

◯ Client Education

■ Provide client education regarding potential causes of dysreflexia.

■ Instruct the client to space out fluid intake and increase frequency of intermittent

catheterizations if fluid intake is temporarily increased.

■ Provide a list of possible actions to pursue if an episode of dysreflexia does occur.

References:

Atitesting NCLEX review

allnursingnotes.com

Feel free to add to your random fact throwing anytime to motivate each other to review so we can get our study check-ins going!

How are you holding up on reviewing for your retake?