NCLEX June 2018

Nursing Students NCLEX

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Hey all! First off, congrats to everyone who graduated this year (and those who graduated in any previous year)!!! My day was May 11th, and it still feels so surreal. Also unreal. Probably because I'm busting my butt studying for this crazy NCLEX thing that's looming on the horizon! In that regard, it feels like nothing has changed haha.

I scheduled my NCLEX for mid-June, because everything else that was available felt too late or too early, and I'm still feeling skeptical about the day I chose. But it's definitely motivated me to keep a decent study schedule going. And if anything, like if I feel super unprepared, I can always reschedule to a later date, but I'm trying to avoid this. I've been using UWorld, trying to do at least 50 questions a day, and then doing questions/reviewing Saunders on 3 specific systems a day, just to brush up on it. I also plan to start utilizing Mark Klimek's audios when I find time to sit and listen. The week before the NCLEX, once my review of systems is (hopefully) complete, I will do at least 150 questions a day. Then, like many others, I will not study at all the day before the exam, and Monday, June 11th is the big day!

That being said, I saw a bunch of other threads for people who were taking the NCLEX during a specific month, so I thought I'd go ahead and do the same for the month of June! I like the idea of us building each other up, supporting each, crying to each other, offering insight or advice or tips that we may know... the list goes on. Anybody taking the NCLEX in the month of June, or even early July? Anybody freaking out like me??? "RN" is so close I can almost taste it! Ahhhhhh!

Specializes in Telemetry.
Congratulation!!! Please if you don't mind, can you tell us how the exam went? How many sata questions you got and if it was generally difficult. Getting into panic mode as my exam draws near.

I had 20 SATA, 3 pictures (as in picture options as A,B, C,D...not hotspot), no audio, 1 EKG strip (which was fine with me since I've been working as a graduate nurse on a telemetry unit since my graduation last month), and a lot of prioritization questions. My school included Hurst review in our tuition but I honestly think Uworld helped me way more than Hurst.

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I had 20 SATA, 3 pictures (as in picture options as A,B, C,D...not hotspot), no audio, 1 EKG strip (which was fine with me since I've been working as a graduate nurse on a telemetry unit since my graduation last month), and a lot of prioritization questions. My school included Hurst review in our tuition but I honestly think Uworld helped me way more than Hurst.

Wow your hardwork has paid afterall. How did you use u-world? Did you finish all the questions and what were your scores if you don't mind me asking.

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Specializes in Critical Care.
Congratulation!!! Please if you don't mind, can you tell us how the exam went? How many sata questions you got and if it was generally difficult. Getting into panic mode as my exam draws near.

It was somewhat similar to an ATI comprehensive exam, in that it was just a bunch of the most random stuff. I had 3 ECG's to interpret, only 10 SATA's, one question that had a picture of something to identify (I had no clue what it was lol), several questions about various isolation precautions, which was weird to me but whatever, and then a lot of prioritization/nutrition/teaching questions. I was happy about those because I always do well on those types of questions! It was definitely a mixed bag and while there were questions that I felt very confident about there were a lot that were tough. I feel like ATI was a good prep resource even though I hated doing it.

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Specializes in Telemetry.
Wow your hardwork has paid afterall. How did you use u-world? Did you finish all the questions and what were your scores if you don't mind me asking.

I purchased Uworld near the middle of February and did a few questions daily while still in the nursing program. I graduated April 28th and after that date, I increased the number of Uworld questions I did daily. I actually did not finish the whole Qbank. I had about 900 questions left before my NCLEX today. Anyhow, I made sure to pay close attention to the rationales and I wrote the really hard or interesting ones down in a notebook. I worked full time as a graduate nurse immediately after graduation and I also am married with 4 young children (8, 5, and a set of twins that just turned 2 this past Saturday) so I did not get to do hundreds of questions everyday.

My average after all the Uworld questions was 69.8% which was in the 95th percentile. I only did 1 self-assessment about 2 weeks before today and it told me I had a very high chance of passing the NCLEX. A few days after the self assessment they send you a more detailed email about your strengths and weaknesses and I focused more on those areas. All in all, Uworld was very similar to the NCLEX today.

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It was somewhat similar to an ATI comprehensive exam, in that it was just a bunch of the most random stuff. I had 3 ECG's to interpret, only 10 SATA's, one question that had a picture of something to identify (I had no clue what it was lol), several questions about various isolation precautions, which was weird to me but whatever, and then a lot of prioritization/nutrition/teaching questions. I was happy about those because I always do well on those types of questions! It was definitely a mixed bag and while there were questions that I felt very confident about there were a lot that were tough. I feel like ATI was a good prep resource even though I hated doing it.

Thanks! This was very helpful..

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I purchased Uworld near the middle of February and did a few questions daily while still in the nursing program. I graduated April 28th and after that date, I increased the number of Uworld questions I did daily. I actually did not finish the whole Qbank. I had about 900 questions left before my NCLEX today. Anyhow, I made sure to pay close attention to the rationales and I wrote the really hard or interesting ones down in a notebook. I worked full time as a graduate nurse immediately after graduation and I also am married with 4 young children (8, 5, and a set of twins that just turned 2 this past Saturday) so I did not get to do hundreds of questions everyday.

My average after all the Uworld questions was 69.8% which was in the 95th percentile. I only did 1 self-assessment about 2 weeks before today and it told me I had a very high chance of passing the NCLEX. A few days after the self assessment they send you a more detailed email about your strengths and weaknesses and I focused more on those areas. All in all, Uworld was very similar to the NCLEX today.

Thanks so much! Am also using u-world and concentrating a lot on the rationales. I hope it works for me too..Wish me luck lol..

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Specializes in Telemetry.
Thanks so much! Am also using u-world and concentrating a lot on the rationales. I hope it works for me too..Wish me luck lol..

You will do great! Wishing you nothing but luck!!

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Hey all! First off, congrats to everyone who graduated this year (and those who graduated in any previous year)!!! My day was May 11th, and it still feels so surreal. Also unreal. Probably because I'm busting my butt studying for this crazy NCLEX thing that's looming on the horizon! In that regard, it feels like nothing has changed haha.

I scheduled my NCLEX for mid-June, because everything else that was available felt too late or too early, and I'm still feeling skeptical about the day I chose. But it's definitely motivated me to keep a decent study schedule going. And if anything, like if I feel super unprepared, I can always reschedule to a later date, but I'm trying to avoid this. I've been using UWorld, trying to do at least 50 questions a day, and then doing questions/reviewing Saunders on 3 specific systems a day, just to brush up on it. I also plan to start utilizing Mark Klimek's audios when I find time to sit and listen. The week before the NCLEX, once my review of systems is (hopefully) complete, I will do at least 150 questions a day. Then, like many others, I will not study at all the day before the exam, and Monday, June 11th is the big day!

That being said, I saw a bunch of other threads for people who were taking the NCLEX during a specific month, so I thought I'd go ahead and do the same for the month of June! I like the idea of us building each other up, supporting each, crying to each other, offering insight or advice or tips that we may know... the list goes on. Anybody taking the NCLEX in the month of June, or even early July? Anybody freaking out like me??? "RN" is so close I can almost taste it! Ahhhhhh!

Hi! I'm just waiting on my ATT, but I hope to be getting it any day now! I've been using UWorld and doing about 75-100 questions every day. My email is [email protected]. Thank you!

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thanks

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Hi! Congratulations and good luck on your exam! I haven't received my ATT yet but hoping to take it within the next month or so!

Can you send me that audio too? My email is [email protected]

Thanks!!

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Hello Everyone!

I test early July and have been studying on and off since March. I have been studying non stop since end of May ranging about 80-90 questions a day. I am very nervous about taking the nclex but I know this is only one more thing to tackle before getting that RN after my name :)

Thank you!

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hello, I made up some notes while studying and thought I would share incase anyone else found them to be helpful. It basically just summerizies key points to focus on. I use it as an outline so when I come across practice questions I add specific details that correalte. Hope this helps. I will add other disorders as I do them.

Renal Take-Away Points

Urinary Tract Infections (UTIs)

â– Upper UTIs (pyelonephritis, renal abscesses, interstitial nephritis) are less common, but may be more severe than lower UTIs (cystitis,prostatitis, and urethritis).*

â– In most hospital-acquired UTIs, the cause is frequently instrumentation of the urinary tract or catheterization.

â– Clinical manifestations include dysuria, burning on urination, frequency, urgency, nocturia, incontinence, hematuria, and suprapubic or pelvic pain.*

â– Diagnosis is made by urine culture and sensitivity (C&S).*

â– Medical treatment involves antibiotics; pyelonephritis usually requires a longer course of treatment.

â– Preventive measures include showers rather than tub baths, females cleaning from front to back, liberal intake of fluids, avoidance of urinary tract irritants (coffee, tea, colas, alcohol), void every 2 to 3 hours and after intercourse, and acidify the urine with vitamin C or cranberry juice

Renal Calculi*

â– Stones form more often in dehydrated persons.*

â– Clinical manifestations depend on the location of the stone, presence of obstruction, infection, and edema, but can include pain and discomfort, hematuria, nausea, vomiting, and diarrhea.*

â– Diagnosis is made by x-rays of the kidneys, ureters, and bladder (KUB); ultrasound; or urography/pyelography.*

â– Medical treatment involves opioid analgesics and stone removal.*

â– Most patients can pass a stone 0.5 to 1 cm in diameter; larger stones can be removed through ureteroscopy,extracorporeal shock wave lithotripsy (ESWL),or endourologic methods.*

â– Urine should be strained and stones sent for analysis; calcium-based stones are the most common.

Bladder Cancer*

â– Risk factors are cigarette smoking; exposure to environmental carcinogens; recurrent or chronic urinary tract infections; bladder stones; high urinary pH; high cholesterol intake; pelvic radiation therapy; and cancers in the colon, prostate, or rectum of males.*

â– The most common symptom is painless gross hematuria; changes in voiding or urine may also occur.*

â– Diagnosis is made by cystoscopy and biopsy.*

â– Simple, superficial tumors can be removed by transurethral resection or fulguration; invasive or multiple tumors require a cystectomy, removal of the bladder.*

■Bacillus Calmette-Guérin, which is an attenuated live strain of Mycobacterium bovis, is an effective treatment for recurrent bladder cancer; it works by enhancing the body's immune response.

Acute Renal Failure (ARF)*

â– ARF is the abrupt loss of kidney function over a period of hours to days, but it is usually reversible.*

â– The major categories are prerenal caused by hypoperfusion, intrarenal caused by parenchymal damage, and postrenal caused by obstruction; acute tubular necrosis is the most common cause of ARF in hospitalized patients.*

â– Clinical manifestations include olguria (less than 500 mL urine output/d) or anuria (less than 50 mL urine output/d); increased creatinine, BUN, and other nitrogenous waste products; hyperkalemia;metabolic acidosis; calcium and phosphorous imbalances; fluid volume excess; failing blood pressure regulation; and anemia.*

â– Preventive measures include providing adequate hydration, preventing/treating hypotension promptly, monitoring urine output in hospitalized patients, monitoring renal function, preventing/treating infections promptly, catheter care with removal of catheter as soon as possible, and monitoring drug levels of nephrotoxic medications (such as gentamicin).

â– Medical treatment includes identifying the underlying cause, treating fluid and electrolyte imbalances, and hemodialysis if needed.

â– Nutritional therapy includes a high-carbohydrate diet with restriction of foods high in protein, potassium, and phosphorous.

RAPID RESPONSE TIPS

Situation, background, assessment, and recommendation

Example:

The situation, background, assessment and recommendation (SBAR) technique has been recognized as the best practice for standardized communication in health care by The Joint Commission. The SBAR technique provides an effective method for standardizing communication and bridging gaps in situations such as hand-offs, patient transfers, critical communications, and telephone calls. SBAR promotes quality and patient safety by improving communication efficiency and accuracy.

â– Situation-The patient has abnormal lab values.*

â– Background-The patient was admitted with a 5-day history of vomiting and she is now in ARF.*

â– Assessment-Her lab values are as follows: potassium 5.9 mEq/L, creatinine 3.6 mg/dL, and pH 7.30.*

â– Recommendation-I suggest a consult with nephrology and a line placement for dialysis; consider administering Kayexalate.

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