NCLEX was not easy

postmortem_cowboy · Feb 15, 2007

I passed at 85 as well, but knew walking out of it that i'd failed just as many of you. You guys gotta' critical think, although it seems hard, that's what VN/PN school has taught you to do... on questions like the prioritizing ones, you have to think about what they're asking. We were taught to work the questions backwards.

Somewhere there's a question... alot of the time 80% of the bulk of the question material isn't even pertinent to the question being asked. It's just filler to try and screw you up and get you confused. Find the question it's asking, disregard and information that isn't pertinent to the question asked. Doesn't make sense if the question is:

How many pills do you give a patient of Norvasc 5mg to get a 10mg dose, and have to sift through, his BP was 160/88, his pulse was 70, respirations are 18... all non-pertinent information in regards to the question. We already know his BP is high if we're giving Norvasc, so that's redundant.

I had numerous questions like that. Another thing that helped me, we had a clinical instructor who literally made us ask "why why why". Anytime you'd go to her with a question, this is what she'd ask, and she'd make you rationalize your own answer. It sounds silly but it works. Why why why do you care what his BP is if we already know he's taking Norvasc but need to know how many pills to give, what's his pulse got to do with the number of pills and his respirations don't have anything to do with it either.

Prioritizing is a toughie, but think of it in this respect, who has the greatest potential of croaking on you as a patient? Someone posted a for instance on a 2 hour post op appy, 4 hour post Hip FX, and 6 hours post op Hysterectomy. Why why why... who's got the greatest potential of dying?

If you rationalize it out, the answer is obvious. Is the post hysterectomy stable? yes, complaining of pain, yes, they're not saying she's bleeding or anything else, and she's been out of surgery long enough the anesthetic is wearing off, stable. The hip fracture is new, (4 hours old they're probably still in ER at this point) unless they stated that the femur is broken and that she's having difficulty breathing (possible PE) or some other form of distress, pain is expected with a fracture, they hurt, stable. Whos the newest out of OR? the appy, is the patient multiple hours past being out of OR? yes, although remember, all patients coming out of OR are going to spend about an hour or so in recovery, so this patient probably has just gotten back to the M/S floor in the previous hour or less. New M/S patients coming from OR/Recovery have to have Vitals taken every so many minutes for the first hour to make sure the anesthetic is wearing off. Who's the less stable of the three, or who takes priority? Who has the potential to die on you with almost no notice? And who's still got a large portion of anesthesia in their system? Answer is obvious if you work through it. The fact that all of them are complaining of pain, well put yourself in their shoes, if you broke a hip, had your appendix taken out or your uterus removed, wouldn't it be painful? of course, so that's irrelevant information, it's expected and that's why we have PRN orders for pain meds, that can be taken care of. What the question is asking is who takes priority, two stable patients or one that's just come to the floor within the last hour from OR...

On questions like those, you can't read into the information given, it's cut and dry, this patient is this, this patient is that. Greatest potential of croaking takes precidence, period.

We could set up that very same question in another fashion, three patients all in ER, One is an appy with a white count of 20,000 with minor pain, another is an HIV patient that's complaining of a cold with chest pain on expiration and coughin up clear mucus, and a third who came in with a wrist fracture stating 10/10 pain with no crepitous and no malformation of the wrist/arm/hand. Who has the greatest potential to die right there in the ER? the wrist is going to be painful, granted, but won't die over it, the HIV patient, has a cold, but unless it's stated he's in late stages of HIV/Aids, it probably won't hurt him that much to get a shot in the butt of rocephin and sent home to wait the cold out. The appy with the extremely high white count could be that the appendix has burst, if that happens, now we have a patient who could crash on us at any minute. Remember, who has the greatest potential to die on the spot, and that's your priority.

Wayne.

prayer · Feb 16, 2007

THANKS A LOT IT AND WAYNE.. THAT REALLY HELPED ME ALOT. I SHOULD HAVE TALKED TO YOU ALL BEFORE THE TEST.. WAYNE IT SOUND AS IF YOU HAD SOME REALLY GOOD INSTRUCTORS.. WELL I DIDNT. THE ONE WE HAD THAT WAS REALLY GOOD LEFT OUR SECOND SEMESTER AND IT WAS DOWNHILL SINCE. I DID WELL IN SCHOOL THOUGH.. WAYNE IF U HAVE ANY MORE GOOD TIPS OR BOOKS I SHOULD STUDY PLEASE FEEL FREE TO EMAIL ME AT [email protected]. YOU ALSO IT.. THANKS GUYS I KNOW I AM GOING TO PASS NEXT TIME....:roll

prayer · Feb 22, 2007

ANYONE GOT ANY GOOD MED HINTS FOR THE NCLEX. I HEARD A LOT A PHARM WAS ON SOME OF MY CLASS MATES TEST... OR SOME HINTS TO REMEMBER THE SIDE EFFECTS TO THE CLASSES OF THE MEDS

karyn09 · Feb 22, 2007

I just took my NCLEX-PN in CA yesterday. I stopped at the max - 205 questions. In regards to "PRAYER" - I got a ton of med questions that asked WHEN do you give the meds...at bedtime/morning on empty stomach/morning with breakfast, etc. I think about 100 questions were on meds & 100 were on prioritization. It's only DAY 1 for me - I heard that here in California, if you pass you'll get your results in 2 weeks...if you fail, you get your results in 4 weeks. So I must wait...day 1 down...

babydoll99_99 · Feb 22, 2007

I just got my results today and I passed YAY!!! The NCLEX was HARD. I graduated from my program with a 4.0 and did TONS of practice questions with Saunders-PN, and nothing prepared me for what that test was. I passed with 85 questions, so I must have learned something, but there were diseases and meds on mine that I had never even heard of.

I will say that Saunders-PN prepared me for the format of testing. I was very comfortable with the way they asked the questions, and what they were trying to ask. I would practice with the CD that comes with the book and do the 100 question exams at least once a day. Focus on the areas you know you are weak on, because the way the test is set up you will get more questions on those cause you tend to miss more so it flip flops back and forth between easy and harder on that subject.

baylay · Feb 22, 2007

Babydoll99_99: Thank you for that post! I take mine on Monday and am so nervous I can't think straight. And I've been practicing from Saunder's so that makes me feel better. Someone posted that it wasn't anything like Saunder's so I was lost how to study but now I'm better.

I can't wait to get this overwith. This is the hardest!

ITsurvivor06 · Feb 22, 2007

prayer, my experience was exactly like babydoll's. as for meds, i had maybe 10 med questions, and i swear i had never heard of any of them. i too used the saunders cd, but many of the questions on the exam were really, really hard, and i don't feel the preparation i did helped much. sometimes i was sure none of the answer choices was correct! i was sure i failed, but i passed at 85. and again, i had never heard of any of the meds. so it's a crapshoot as far as preparation. good luck-i'm sure you'll do fine!!

babydoll99_99 · Feb 23, 2007

Remember, almost everyone walks out of the test thinking that they failed. If the questions are super hard that means you are at a more difficult level of the test and it is actually a good thing for passing. There is a really good thread that helped me before the test here.

https://allnurses.com/forums/f197/i-hope-helps-199121.html

This was really helpful for getting me into the frame of mind for testing. GOOD LUCK!

baylay · Feb 23, 2007

Thanks babydoll99_99! That thread hit it right on! I printed it out to read it again when I need it.

I feel as ready as I think I can be and I WILL pass when I take the test Monday. (thinking positive thinking positive)

babydoll99_99 · Feb 25, 2007

You will do GREAT! Good Luck! Keep us posted on how you do.

baylay · Feb 28, 2007

Ok. Took it yesterday. Am feeling the same way you all are posting you feel! It shut off at 85 and the questions were nothing I thought they'd be. No calculations, about 10 meds. knew 5 of them, the others had never heard of. The rest of the ques. were all across the board but what was hard was the choice of answers. They all seemed really close so it was hard figuring out the better one. Or they all seemed wrong! With Saunders it was much easier and I had no problem.

I didn't feel too bad when I left but after getting home I looked up some and realized I was wrong.

Now to wait for the Calif. snail mail! How many days???

babydoll99_99 · Mar 1, 2007

I'm sure you did great! Remember you can get 40% of the questions wrong and still pass. That is the way the test is set up. I'll keep my fingers crossed for you :)