OMG I PASSED 2nd time - I hope this will help others

well i'm a foreign graduated nurse from the Philippines (study there because cheaper and BSN 4 years). I just took my 2nd Nclex Rn Exam yesterday in Oakland Ca. and it took me 1 hour and 30 mins to take i think 120 questions (turned off the question counter after i saw 90) I had atleast 9-12 SATA, 1 Medication Dosage Problem, about 12-15 Meds and other priority question.. It is the most nerve wreaking exam i ever took.. After the exam i waited 20 mins to do the pearson vue trick on my phone.. i got the good pop out but i'm not sure yet since it's only 20 mins after the exam.. i drove home and atleast 2 hours have passed i tried again in the computer and still the good pop out.. OMG I WAS SO HAPPY THAT I ACTUALLY PASSED THE EXAM!!!

My experience in the exam during the 1st take was horrible.. I relied on the Kaplan review 500 dollars (waste of money) they only give u a review book and the questions in their q bank were so vague and confusing.. the live classes were just the instuctor going over couple of questions that u can easily read from the rationale at home and i think the instructor would have gotten the answer wrong without her folders.. I took the exam after Kaplan 240 question later, did the pearson vue trick find out i failed... i took this experience badly for 2 weeks depressed and another month to just enjoy my small freedom to review again..

my review consisted of:

Prioritization, Delegation, and Assignment by Linda A. Lacharty

----As everyone says this is the book to have, alot of questions from this book will be seen in the nclex.. (not the same question but almost the same format) The way the questions are written, the rationale, and how the book was structured was well designed so u can pass and be comfortable with nclex questions ( i score close to 67-74% in every chapeter in this book..)

Saunders 4th Edition Nclex Reviewer

----best content book..read this book before taking the exam specially for those foreign graduate nurses like myself.. so much information in this book that will never be thought by foreign schools, machines, tests, even cultural and spiritual differences is discussed in this book a must have..

Exam Cram Question Book

----want to be comfortable with the Nclex questions.. this is the way to do it.. repetition of questions means reinforcement of the contents, rewording of the questions means critical thinking, 250 question per practice test, endurance to test, mock nclex exam by cd.. shows ur weakness in which part of the exam ur weak at ( i was always below average in Safety and Infection Control)

All Nurses Infection Control Mnemonic

----Infection control My, Chicken hez Chicken Pox, SPIDERMAN, VCHIPS,

and another thing i found her "i'll post later"

----trouble with pharma drugs like i did.. this is the thing for you

My study plan was like this:

Every 3-4 Days i read a Chapter in saunders, write down in a small notebook what was the pyramid points and what i thought were note remembering in the chapters. Pyramid points are the nclex question topics so u should really focus on those. After that i find the corresponding topic in saunder withthe La Charty books (ex: if i finished Cardiac System and Medications i look for the cardiovacular section in La Charity and do the questions) with this i was able to answer the La Charity Question and Reinforce what i read in Saunders and do critical thinking questions also.. I did this for about 1 and half months.. also atleast 80-150 questions a night from the exam cram cd.. i didn't like the saunder c.d. because it was more content base and i realized from my 1st exam thats not the type of questions nclex RN gives u..

I did question from the exam cram book every weekend 1 exam consisting of 250 questions in one sitting doing atleast (73-76%) in each exam but with the repetitions of the same type of questions but different wordings it helped me think of what answers to look for what answer to take out and whats the best answers to use..

During the last week i just stayed infront of my computer studied infection control and the other pharma i got from allnurses.com and did the mock exam by exam cram... doing atleast 2-3 mock NCLEX EXam every day really helped me with confidence and what to study on specially when u can see what topics u are weak so u can study on it..

Hope this helps ppl and thank you so much ALLNURSES.COM AND IT'S MEMBERS FOR THE STUDY TIPS, AND EVERYTHING. YOU HELPED ME PASSED MY NCLEX R.N. AN I HOPE I CAN HELP OTHER ALSO

PHARMA:

Pharmacology - Know Indication/Action/Effect

Prefix/Suffix

-ase = thrombolytic

-azepam = benzodiazepine

-azine = antiemetic; phenothiazide

-azole = proton pump inhibitor, antifungal

-barbital = barbiturate

-coxib = cox 2 enzyme blockers

-cep/-cef = anti-infectives

-caine = anesthetics

-cillin = penicillin

-cycline = antibiotic

-dipine = calcium channel blocker

-floxacin = antibiotic

-ipramine = Tricyclic antidepressant

-ine = reverse transcriptase inhibitors, antihistamines

-kinase = thrombolytics

-lone, pred- = corticosteroid

-mab = monoclonal antibiotics

-micin = antibiotic, aminoglycoside

-navir = protease inhibitor

nitr-, -nitr- = nitrate/vasodilator

-olol = beta antagonist

-oxin = cardiac glycoside

-osin = Alpha blocker

-parin = anticoagulant

-prazole = PPI's

-phylline = bronchodilator

-pril = ACE inhibitor

-statin = cholesterol lowering agent

-sartan = angiotensin II blocker

-sone = glucocorticoid, corticosteroid

-stigmine = cholinergics

-terol = Beta 2 Agonist

-thiazide = diuretic

-tidine = antiulcer

-trophin = Pituitary Hormone

-vir = anti-viral, protease inhibitors

-zosin = Alpha 1 Antagonist

-zolam = benzo/sedative

-zine = antihistamine

Pharm Facts

-Don't give non-selective beta-blockers to patients w/respiratory problems

-Vitamin C can cause false +ive occult blood

-Avoid the 'G' herbs (ginsing, ginger, ginko, garlic) when on anti-clotting drugs (coumadin, ASA, Plavix, etc)

-ASA toxicity can cause ringing of the ears

-No narcotics to any head-injury victims

-Mg2+ toxicity is treated with Calcium Gluconate

-Do not give Calcium-Channel Blockers with Grapefruit Juice

-Oxytocin is never administered through the primary IV

-Lithium patients must consume extra sodium to prevent toxicity

-MAOI Patients should avoid tyramine:

oAacados, bananas, beef/chicken liver, caffeine, red wine, beer, cheese (except cottage cheese), raisins, sausages, pepperoni, yogurt, sour cream.

-Don't give atropine for glaucoma - it increases IOP

-Don't give ant-acids with food -- b/c it delays gastric emptying.

-Don't give Stadol to Methadone/Heroin Preggo's -- cause instant withdrawal symptoms

-Insulin - clear before cloudy

-Don't give meperidine (Demerol) to pancreatitis patients

-Always verify bowel sounds when giving Kayexelate

-Hypercalcemia = hypophosphatemia (and vice versa)

-Radioactive Dye - urine excretion

-Signs of toxic ammonia levels is asterixis (hands flapping)

-D10W can be substituted for TPN (temporary use)

-Dopamine and Lasix are incompatible

-Hypoglycemic shivers can be stopped by holding the limb, seizures cannot (infants)

-Common symptom of aluminum hydroxide - constipation

-Thiazide diuretics may induce hyperglycemia

-Take iron with Vit C - it enhances absorbtion - Do not take with milk

-B1 - For Alcoholic Patients (to prevent Wernicke's encephalopathy & Korsakoff's synd)

-B6 - For TB Patients

-B9 - For Pregnant Patients

-B12 - Pernicious anemia, Vegetarians.

-Complications of Coumadin - 3H's - Hemorrhage, hematuria & hepatitis

-FFP is administered to DIC b/c of the clotting Fx

-Mannitol (osmtic diuretic [Head injury]) crystallizes at room temp - use a filter needle

-Antianxiety medication is pharmacologically similar to alcohol -used for weaning Tx

-Administrate Glucagon when pt is hypoglycemia and unresponsive

-Phenazopyridine ( Pyridium)--Urine will appear orange

-Rifampicin -- Red-urine, tears, sweat)

-Hot and Dry = sugar high (hyperglycemia)

-Cold and clammy = need some candy (hypoglycemia)

-Med of choice for V-tach is lidocaine

-Med of choice for SVT = adenosine or adenocard

-Med of choice for Asystole = atropine

-Med of choice for CHF is Ace inhibitor.

-Med of choice for anaphylactic shock is Epinephrine

-Med of choice for Status Epilepticus is Valium.

-Med of choice for bipolar is lithium.

-Give ACE inhibitors w/food to prevent stomach upset

-Administer diuretics in the morning

-Give Lipitor at 1700 since the enzymes work best during the evenin

-Common Tricyclic Meds - 3 syllabes (pamelor, elavil)

-Common MAOI's - 2 syllables (nardil, marplan)

-TPN has a dedicated line & cannot be mixed ahead of time

-RHoGAM -- Given at 28 weeks & 72 hrs postpartum

-Do not administer erythromycin to Multiple Sclerosis pt

-Benadryl and Xanax taken together will cause additive effects.

-Can't take Lasix if allergic to Sulfa drugs.

-Acetaminophen can be used for headache when the client is using nitroglycerin.

-Dilantin - can not give with dextrose. Only give with NS.

Addison is skinny ( hypoglycemic, you get weight loss, you got weakness, and you get postural hypotn) Cushing is fat ( hyperglycemic, you get moon face big cheeks, and you retain a lot of Na and fluid)

-Never Give via IVP:

oKCL

oHeparin

oIbuprofen

oInsulin

oDobutamine

oASA

oAlbumin

oAcetaminophen

-Insulin:

oRapid: lispro - onset

oShort: Regular - onset ½ - 1 hr. Peak: 2-3hr. Duration: 4-6 hr

oInt: NPH or Lente - onset: 2 hr. Peak 6-12 hr. Duration: 16-24hr

oLong: Ultralente - onset 4-6 hr. Peak: 12-16 hr. Duration: >24hr

oV.Long: Lantus - onset 1 hr. Peak: None. Duration: 24 hr continuous

-Anticholergic Side Effects:

oCan't See

oCan't Pee

oCan't Spit

oCan't Sh*t

-Hypocalcemia - CATS

oConvulsions

oArrythmias

oTetany

oSpasms & Stridor

-Hyper Kalemia Causes: 'MACHINE'

oMedicationa (ace inhibitors, NSAIDS)

oAcidosis (metabolic & repiratory)

oCellular destruction (burns, traumatic injuy)

oHypoaldosteronism, Hemolysis

oNephrons, renal failure

oExcretion (impaired)

-Signs of increased K ' Murder'

oMuscle weaknes

oUrine - olyguria, anuria

oRespiratory distress

oDecreaed cardiac contractility

oECG Changes

oReflexes - hyperreflexia, or flaccid

-Substance Poisoning and Antidotes

oMethanol -- Ethanol

oCO2 -- Oxygen

oDopamine -- Phentolamine

oBenzo's (Versed) -- Flumazenil

oLead -- Succimer, Calcium Disodium

oIron -- Deferoxamine

oCoumadin -- Vitamin K

oHeparin -- Protamine Sulfate

oThorazine -- Cogentine

oWild Mushrooms - Atropine

oRat Poison - Vit K

-Parkland Formula: 4cc * Kg * BSA Burned = Total Volume Necessary

o1st 8hrs - ½ total volume

o2nd 8hrs - ¼ total volume

o3rd 8 hrs - ¼ total volumes