priority nursing questions

Nursing Students Student Assist

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Hey all,

Are there any good websites that give NCLEX questions with priorities? I seem to have a little trouble with these questions sometimes and would like more help with them

ex. A ct is 2 days post-op for an ORIF of the right arm. He is now exhibiting pain, fever of 102, and swelling. What is the priority nursig intervention?

A. elevate the arm on a pillow

B. administer Tylenol

C. notify physician

see, whenever I choose notify physician sometimes it is wrong and sometimes it is right. I just need more practice with these types of questions. Thanks for any help!

Specializes in CNA.
This is one of those times when notifying the physician is actually the right answer. MOST of the time that is not the correct answer...

I have an instructor who loves making "call the physician" the right answer.

But he's kind of a jerk.

Hey, OP,

sorry my baby question hijacked your thread :o

But it is really nice to know that I'm not the only one who reads a question and can rationalize just about any answer. My instructors love to point out how good I am at reading things into them. I always think I wouldn't have that problem, if they just put enough information in to start with.

On this particular question, I got stuck between what's a priority, and what's actually possible. I need to remember that NCLEX world is different from real world.

In a previous post someone questioned the purpose of the towel. It is to help shift the baby's weight off the vena cava.

~ Simmy

it is really nice to know that I'm not the only one who reads a question and can rationalize just about any answer. My instructors love to point out how good I am at reading things into them. I always think I wouldn't have that problem, if they just put enough information in to start with.

I'm with ya there!

the purpose of the towel. It is to help shift the baby's weight off the vena cava.

Thanks for the info! Interesting! So in terms of prioritizing, apparently oxygen on mom is prioritized higher than baby weight off vena cava? I'm imagining baby weight on vena cava doesn't occlude the vessel and so shifting baby weight might help increase blood flow but perhaps not as signficantly as increasing oxygen in mom's blood? Is that overthinking? :confused:

To me, this a very interesting and informative way to learn! Thanks for the discussion!

bump! Anyone have any more insight on this example priority question?

-prevent infection to mom (don sterile gloves prior to attempt to move baby)

-re-establish blood supply to baby (move baby off cord)

-increase O2 in cord blood (oxygen to mom)

-maximize blood supply to baby (towel under hips to shift baby weight off vena cava)

That makes more sense to me than some other explanations. I suppose "don sterile gloves" come before "move baby off cord" because it's pointless to put the gloves on if you do it after moving baby. Does that also mean that preventing infection to mom is an overall higher priority than re-establishing blood flow to baby?

And I still wonder, can the nurse know for sure that the cord is being compressed by baby? Or is that the most likely possibility based on the clinical evidence? Is cord compression pretty much the only explanation for the likely clinical presentation that isn't described in this question?

How do you become good at these type of questions? Im looking for a cheat sheet for first priorities airway obstruction, uncontrol bleeding, impaired gas exchange, repositioning. anything else?

Hey all,

Are there any good websites that give NCLEX questions with priorities? I seem to have a little trouble with these questions sometimes and would like more help with them

ex. A ct is 2 days post-op for an ORIF of the right arm. He is now exhibiting pain, fever of 102, and swelling. What is the priority nursig intervention?

A. elevate the arm on a pillow

B. administer Tylenol

C. notify physician

see, whenever I choose notify physician sometimes it is wrong and sometimes it is right. I just need more practice with these types of questions. Thanks for any help!

Will elevating it on a pillow fix the fever? (no)

Will Tylenol do anything for swelling? (no)

Is something going on that indicates the need for physician prescription or intervention? (possible infection, ? compartment syndrome)

It doesn't say there's a cast. so you can't worry about swelling inside one, but you could worry about compartment syndrome. That's gonna require a stat physician intervention for sure, to prevent permanent nerve damage and perhaps loss of limb. In any case, the pt needs to be evaluated stat for infection.

This (and the OB question) are also partly about risks for further injury, and thinking about how serious they could be. In the case of the arm, you could have permanent nerve or other damage from the swelling, not to mention other complications of infection with the hardware in there (it's an ORIF, remember). That one's also about scope of practice-- nursing measures are not going to fix the biggest risks of dangerous complications here.

With the baby, the number one worst thing that can happen to anybody in this scenario is anoxic damage to the baby. First thing, then, has to be to get the baby's head off the cord. You can treat an infection later (if it even develops)(and the lady parts isn't sterile, is it?), but you can't fix cerebral palsy.

"Prioritization, Delegation and Managment of Care" by Hargrove-Huttel and Colgrove

Tons of questions and rationales. It's been very helpful with prioritizing even if the content is a bit above my level right now. (I'm sure once I get done with med-surg this summer it will make much more sense.)

THanks. I will need to look into that book. I have a question which is highest priority infection or oxygen?

also what is an example of tissue perfusion?

THanks. I will need to look into that book. I have a question which is highest priority infection or oxygen?

also what is an example of tissue perfusion?

I think I explained oxygenating a baby vs. possible infection. Retread that and ask me again if you don't understand.

Perfusion is an important word you will hear often, and must understand well. Have you taken anatomy, or physiology yet? It means "blood flow."

Hey all,

Are there any good websites that give NCLEX questions with priorities? I seem to have a little trouble with these questions sometimes and would like more help with them

ex. A ct is 2 days post-op for an ORIF of the right arm. He is now exhibiting pain, fever of 102, and swelling. What is the priority nursig intervention?

A. elevate the arm on a pillow

B. administer Tylenol

C. notify physician

see, whenever I choose notify physician sometimes it is wrong and sometimes it is right. I just need more practice with these types of questions. Thanks for any help!

I haven't read all the responses so someone may have mentioned this but the Delegation and Prioritization book by LaCharity was a lifesaver for me. It breaks things up inti categories like Cardio, neuro etc and does only Prioritization/delegation questions.

I used Hurst review and the LaCharity book to study for boards but I wish I had know. About the LaCharity boom earlier. I would have used it throughout my program.

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