NCLEX HELP!!!

[spfd]

i took the Nclex exam a few days ago and noticed that i didn't pass, although i know my stuff very very well.. i feel like i had alot of problems with priority questions. but not the type of the priority questions where you have to put the numbers in order. i mean something like for example.(this is not an nclex questions that i experienced.. its just an example of what im having problems with.)

"you arrive to an area in the hospital and you notice you have 4 critical patients. which one of these patients do you evaluate first?" something like that... again this is easy because im not a professional at asking questions but im using this as an example of prioritization... what are these type of questions called? because everywhere i look priority questions are for numbering...

i was studying the saunders book.. along with the cd-rom it comes with... the only priority questions i see on the cd are for putting steps in order (numbers..1,2,3,4,5,6 etc.)

i read on here that mosby's book for prioritization and delegation was good but i need more input on this. does anyone know of other books i can take a look at... i want to take the test again asap and i feel like this is my only weak area... thank you!!!

[IndianaRN2011]

You may want to take a look at Prioritization, Delegation, and Assignment by Linda Lacharity. This was a resource that I used in June when I took NCLEX and it was very helpful. Good luck!

[spfd]

ok thank you

[Double-Helix, BSN, RN]

For those questions you need to remember four things:

1. ABC's (Airway, breathing, circulation)

2. Which of the symptoms/situations is likely to cause the most immediate harm?

3. Which of these is not an expected symptom?

4. Don't add additional information.

1. The ABC rule is great for prioritizing. If your patient has any problems related toairway or breathing (shortness of breath, wheezing, smoke inhalation, needs suctioning, etc. You want to go to them first. If they have any circulation issues (possible compartment syndrome, symptomatic bradycardia, etc) they need to be seen after an airway issue. After that follow Maslow's heirarchy of needs.

2. Look for the symptoms that can quickly cause death or harm. Chest pain can be an MI which can cause death. Stroke symptoms can cause death. Sudden shortness of breath could be a PE which can cause death. Compartment syndrome can cause permanent nerve damage. Moderately high blood sugar, however, will not cause damage quickly. Think along those lines.

3. Think about the patient's condition and which option you would not expect in that situation. A common example is a post-op patient complaining of pain. That is expected. We expect a patient with an infection to have a high white count. We don't expect a that patient who just had a cast applied will complaint of severe pain and tingling in the limb.

4. This is the hardest thing for a graduate nurse. They love to think "What if...." What if that patient complaining of pain is having chest pain? What if that person with a non-working IV is receiving IV KCl and it has infiltrated and it necrotizing his tissues? But they key is don't add any information to the option. If the option doesn't say the patient is having chest pain, then you can know he's not having chest pain. Don't get caught up in overthinking the question and making every option into the worse case senario. Use only the information you have and use the three steps above to keep/eliminate each option.

[linsmirn]

If you are using Saunders 5th edition, chapter 8 is about delegation and prioritizing, so re-read it. Get the La Charity book. When they talk about prioritizing on the nclex, its usually referring to which pt would you see first, follow ABC's and Maslow's, you see the most unstable pt first. During crisis you see the stable pts first and see if they can help you take caare of the unstable. When it comes to delegation for example an LPN assign to stable pts and the RN takes the unstable. Anyways Saunders and La Charity goes over everything. Do practice questions, every book Ive used so far had a lot of prioritizing questions, Saunders, exam cram, kaplan etc:.

[caliotter3]

There is not much out yet about this type of question as it is still a "new" concept in the test. Get the resources mentioned and you will have what is currently available. Also, do not make this harder than it is. Just another way to answer a question. If you know the material behind it, you should be able to figure it out.