New Saunders comprehensive NCLEX-RN review

turnforthenurse, MSN, NP · Dec 17, 2010

Does any one have the 5th edition? I purchased the 4th a couple of months before the 5th came out and was just wondering what the difference was. I know there are alternative format questions but is there a whole lot of difference besides that change?

I bought the new 5th edition because I am studying for the NCLEX. It seems like they have added some new info because I noticed some text differences in chapters between the two editions, but in overall "thickness" of the book, the 5th edition is actually slightly skinnier than the 4th. Some questions from the 4th edition are repeated again in the 5th but there are also new questions. I haven't tried out the CD yet. Overall format of both editions are the same.

One thing I like about the 5th edition is that there are "PRIORITY NURSING ACTIONS!" boxes that include all of the necessary steps in the correct order. This is helpful for reviewing especially for those SATA questions. It gives all of the steps and then the rationales. It is also helpful to get you thinking about prioritization and delegation which are crucial skills! For example, from the cardiovascular disorders chapter:

Actions to take if a client develops pulmonary edema

1. place the client in a high Fowler's position

2. administer O2.

3. assess the client quickly, including assessing lung sounds

4. ensure an intravenous access device is in place.

5. prepare for the administration of a diuretic and morphine sulfate.

6. insert a foley catheter as prescribed.

7. prepare for intubation and ventilator support, if required.

8. document the event, actions taken, and the client's response.

"Pulmonary edema is a life-threatening event that can result from sever heart failure. In pulmonary edema, the left ventricle fails to eject sufficient blood, and pressure increases in the lungs because of the accumulated blood. The client is immediately placed in a high Fowler's position with the lungs in a dependent position to reduce pulmonary congestion and relieve edema. Oxygen is always prescribed, usually in high concentrations by mask or cannula to improve gas exchange and pulmonary function; the goal is the keep the oxygen saturation above 90%. The client is then assessed quickly, including checking the lung sounds. Next it is important to ensure that an IV access device is in place for the administration of a diuretic and morphine sulfate. Furosemide, a rapid-acting diuretic, will eliminate accumulated fluid. Morphine sulfate reduces venous return (preload), decreases anxiety and also decreases the work of breathing. A foley catheter is inserted to measure output accurately. The nurse then prepares for intubation and ventilator support, if required. The nurse stays with the client and provides reassurance. Vital signs are monitored and a cardiac monitor is used to monitor the heart rate and for dysrhythmias. The lung sounds are monitored for crackles, decreased breath sounds, and for a response to treatment. A weight measurement will also determine the response to treatment. Other interventions may include the administration of digoxin to increase ventricular contractility and improve cardiac output, bronchodilators for severe bronchospasm or bronchoconstriction, medications to facilitate myocardial contractility and enhance stroke volume, and vasodilators to reduce afterload, increase the capacity of the systemic venous bed and decrease venous return to the heart. The nurse finally documents the event, actions taken, and the client's response." (Silvestri, 2011, p. 807)

-Silvestri, L.A. (2011). Saunders comprehensive review for the NCLEX-RN examination (5th ed.). St. Louis, MO, El Sevier Inc.

^^ Just to give you an idea.

Both editions are still in full-color with pretty much the same pictures/diagrams. I personally think the 5th edition has more of those "boxes" than the 4th edition. Both editions are organized in the same way (exam prep, issues in nursing, nursing sciences, fundamental skills, maternal nursing, growth & development, pediatric nursing, then adult med-surg, each chapter separated by body system as well as medications pertaining to each system and then a comprehensive test at the end). The 5th edition also includes a chapter on physical examination & health assessment.

The thing about the new 5th edition is that it supposedly reflects the new NCLEX-RN test plan, which it talks about in the actual book:

(Category: % of questions)

Management of Care: 16-22%

Safety and Infection Control: 8-14%

Health Promotion & Maintenance: 6-12%

Psychosocial integrity: 6-12%

Basic Care & Comfort: 6-12%

Pharmacological & Parenteral Therapies: 13-19%

Reduction of Risk Potential: 10-16%

Physiological Adaptation: 11-17%

I haven't used the CD yet, but the book claims that the CD contains new audio and video questions, which are potential alternative-format questions on the NCLEX. The 4th edition CD features 4,214 practice questions including alternative-item formats but I honestly don't remember any audio/visual questions, hot spot items, chart/exhibit or graphic option-type stuff. The 5th edition CD contains more than 4,500 practice questions. According to the book, the CD for the 5th edition also includes "audio review summaries that cover the core areas of pharmacology, fluids & electrolytes and acid-base balance."

You would honestly probably be okay with the just the 4th edition. My roommates graduated this past May when they just switched over to the new NCLEX-RN test plan and they studied with the 4th edition (in addition to an NCLEX review course) and they did just fine. Personally, I like the 5th edition, but I wouldn't say there is a HUGE difference between the two.

Servingshots · Dec 19, 2010

Thanks soo much for the reply! I think im going to pick up the fifth because im a little ocd when it comes to books.

melmarie23, MSN, RN · Dec 19, 2010

The 4th edition CD most definitely did not have audio/visual or hot spot questions. I used that to study for my NCLEX this summer. I think its great that the 5th edition had this as the NCLEX is now using those types of test questions (though as of this summer when I took the exam they were just sample questions. Luckily I never received any out of the 75 questions that were thrown at me).

GeneralJinjur · Dec 19, 2010

I installed the 5th CD last night and it's nicer than the 4th. It has a nifty comprehensive test that will generate a 6-week study plan based on what you missed. I had done a 265 question test the night before in NCLEX 4000 to identify my gaps and this Saunders test came up with pretty much the same results in 75 questions.

Another thing I liked about the CD was how I can access both the rationale and the test-taking tips for each question. I only recall seeing the rationale on the 4th CD, though it could have been there and I would have missed it because the interface was so dang clunky! I liked those test-taking tips for the questions involving drugs/diseases that I've never heard of. I'm sure there will be at least a couple of those on the NCLEX.

melmarie23, MSN, RN · Dec 19, 2010

I installed the 5th CD last night and it's nicer than the 4th. It has a nifty comprehensive test that will generate a 6-week study plan based on what you missed. I had done a 265 question test the night before in NCLEX 4000 to identify my gaps and this Saunders test came up with pretty much the same results in 75 questions.
Another thing I liked about the CD was how I can access both the rationale and the test-taking tips for each question. I only recall seeing the rationale on the 4th CD, though it could have been there and I would have missed it because the interface was so dang clunky! I liked those test-taking tips for the questions involving drugs/diseases that I've never heard of. I'm sure there will be at least a couple of those on the NCLEX.

I believe that the 4th did have test taking tips with each questions. You had to click another tab once you got the results and rationales.

I cannot speak more highly of the 4th edition. It really helped me study and pass. I have no doubt that the 5th isnt just as good if not better. Saunders makes great, comprehensive products.

Servingshots · Dec 19, 2010

did anyone use any other books along with the comprehensive saunders to study or does that one suffice?

melmarie23, MSN, RN · Dec 19, 2010

my school used ATI, so I used those books as well. And some of my textbooks.

caliotter3 · Dec 19, 2010

The Linda LaCharity book on prioritization is used by many.

turnforthenurse, MSN, NP · Dec 20, 2010

did anyone use any other books along with the comprehensive saunders to study or does that one suffice?

the Reviews & Rationales NCLEX-RN Review by Pearson Prentice Hall is another great book. It's not in color like the Saunders but very comprehensive. It comes with a CD but unfortunately I have a Mac and it is incompatible

I guess the Hesi exams are also study tools I have used. I had to take mandatory exams for classes but after a few days they e-mail you your results and you can view your strong and weak areas and then develop a "study packet" on the Evolve website based on your weaker areas (or strong ones, too!) It's pretty useful, I think.

Servingshots · Dec 20, 2010

the Reviews & Rationales NCLEX-RN Review by Pearson Prentice Hall is another great book. It's not in color like the Saunders but very comprehensive. It comes with a CD but unfortunately I have a Mac and it is incompatible
I guess the Hesi exams are also study tools I have used. I had to take mandatory exams for classes but after a few days they e-mail you your results and you can view your strong and weak areas and then develop a "study packet" on the Evolve website based on your weaker areas (or strong ones, too!) It's pretty useful, I think.

I was actually thinking to get that one also because I have a couple that I bought for my other classes and I LOVE THEM!!!

GeneralJinjur · Dec 20, 2010

Since Melmarie mentioned that the 4th edition had tips for each question, I opened it this morning to see what else I'd missed. The 4th also has a comprehensive test that will develop a 6-week study plan. I ran the test and it is identical to the 5th, except for 2 questions. Doh! The moral of the story is that I wouldn't rush to replace the book if you already have the 4th edition.

Other books I have used and liked are the NCLEX-RN Q&A Made Incredibly Easy and the Mosby Comprehensive Review. The Incredibly Easy book is great because all the answers are across the same page, so you get instant feedback instead of flipping back and forth. The Mosby book has a good disk and I love how the correct answer is highlighted. It saves me reading all the wrong answers and getting muddled. A friend and I went shopping the other day to check out new books and we really liked Davis' Comprehensive Review, which is along the same lines and has a CD. It has the answers across the page and the questions were difficult. Since we've already got NCLEX 4000 plus these other books, it seemed a little silly to buy yet another book. I really doubt I'm going to do more than 12,000 questions in the next 3 weeks!