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How have you been studying? Did you get any books such as Saunders? I studied that one, and it was the best help for me. If you don't have it, I suggest getting the latest edition (or last edition if you borrow it, will be ok too) and review all the areas you have difficulty with. Use the CD it comes with and practice as many questions as you can daily. I used to do at least 50 or more questions a day. You will see the rationale with each question. You can take breaks. Then do at least 1 or 2 10 questions quizzes, and see how you do. The more questions you do, the better your chances or understanding how to answer NCLEX questions. But if you don't know some content, it can be difficult anyway. Try to figure out what content you are weak in, such as electrolytes, cardiac, endocrine, etc, and review those sections in the book, as much as you can. Also make sure you know how to prioritize since these questions are commonly asked in NCLEX now. Don't give up, some people pass their 3rd, even 4th or more times. Hopefully you will pass next time!

Thanks for that link. It was helpful, I'll send it to my friend. But do most math questions have the unit of measurement already, or do some leave it blank, and must be entered by the student? I don't remember that from my test.

Someone who is taking NCLEX soon asked me if the math questions must be answered with a zero (0) in front if it's a decimal point answer, such as 0.5, or .5? I took it last year, and only had 1 math question and honestly don't remember what it was. I don't know if NCLEX has changed this year or if it has always been the same rules for math questions. I don't know what to tell my friend. I also don't know if it's required to put down 'ml', or 'mg' after the answer, in the fill-in-the blanks. I just know that when I did Saunders practice questions, the math answers were given, and I didn't have to think about putting down the 'ml', etc. or the decimal point. Does anyone know?

Yes, I'm being very careful landmarking, taking my time, but isn't there capillaries in most areas? I wish I had practiced this in clinicals, but we never had the chance to do so. I just don't see how I'm supposed to look for a specific spot where there won't be any chance of capillaries, esp. if the body surface area is large, as in many overweight people that I've been assigned. But even in thinner pts, I landmark carefully and even try to 'look' and see if there are any visible veins, but of course capillaries close to muscle may not be visible. I'm just wondering if it's just a bit of blood from capillaries and not actually a vein. I'm just so frustrated, and never think I will get it right.

Thanks for your advice. But what exactly happens if the med happens to be injected with blood? I was under the impression there are no major arteries in the ventrogluteal area, and I thought the blood was probably just small veins. If there is any blood in the syringe does it always mean a major vessel is punctured, and would the med be absorbed too quickly? The dose is more than 1ml so I was told not to inject in the deltoid.

I never got a chance to give IM's during school, just watch and do them on a dummy in class. I have tried a couple times now that I just started nursing, but every time I draw up blood. I'm very careful to pinpoint the ventrogluteal site, since I was told it's preferred instead of the dorsal gluteal, to prevent hitting the sciatic nerve or blood vessels. But the few times I've tried, some blood came out and I had to draw up a whole new syringe of med. The nurse watching me didn't let me do it again. I just don't know why I keep hitting a vessel. Is it always necessary to draw up a whole new syringe when a bit of blood is drawn and exactly where should I be trying to prick to avoid getting blood? Also, if someone is very overweight where it's hard to make out the hip bones or waist, how do we know where the Ventrogluteal area starts? I feel so hopeless.

Thank you both for your responses, that was really helpful. :)

I am a recent graduate, about to take boards. But I am still confused about medication protocol and nurses' responsibility. I know that nurses are liable for any mistakes on meds, even if the doctor ordered it wrong. Nurses have to catch these errors. But when I was in clinicals and we checked each med, there were many times that some meds showed interactions with each other, but the doc still had ordered it. When I asked my professor she said that sometimes docs prescribe certain combo of meds even if there may be some interactions, as long as they aren't severe and not completely contraindicated. But when I read the info about meds and nursing, it always says that nurses must be aware of all side effects and interactions and notify the doc if they see anything wrong. But what if the doc did it while knowing the interactions? This happened many times during my clinicals and I never heard any nurse constantly calling the docs to check twice on their orders. My question is, do nurses have to check each med, with all possible side effects and interactions and call the doc each time, to make sure he did it right? What if they are minor interactions, could they possibly become major? My prof. said just to know the basics about the drugs but it's impossible to predict all possible side effects for each pt. and some interactions listed don't always happen and sometimes docs prescribe a combo of drugs for a reason. I just don't know where my responsiblity falls and it just seems like so much to know all facts/interactions on every single drug for every Pt. Some of them in clinicals had 7-8 drugs. I would look them up since we had time but as a nurse, is there enough time to look up each drug thoroughly? Are we supposed to be as informed as pharmacists? I studied alot of Pharmacology but no way can memorize every single drug and side effects, interactions with others, etc. It justs gets scary when I hear of stories where nurses got in trouble for giving a drug that had an interaction and they didn't notify the doc. How do you nurses do this daily?

I understand what you're saying. I also agree with the above posters about assisting women in labour as not being erotic or arousing, of course. But that doesn't mean all women will still be comfortable having a man touch her in private areas, even though she is not necessarily thinking that he will get aroused, etc. It simply may have to do with the fact that she is just very modest, or maybe her religious background etc. Sure in an emergency situation, I'm sure even the most modest women will be grateful for any health care worker, even if it's a male. But if she had a choice, there are some women who would just feel more comfortable with a female. I feel this way about regular OBGYN visits, where I prefer a female doc. I don't think male docs are not competent, it's not that at all. Nor do I feel they can be peverts. But it's just my comfort level, with spreading my legs and having a male stare at my most intimate parts. EVEN if he's not doing it for erotic reasons, I am still uncomfortable with this, or with a male examining my breasts. But that's just me, and maybe partly due to my upbringing. So I think women should be asked if they wouldn't mind a male examining them, in non-emergency situations. For example, I would definitely prefer a female nurse inserting a catheter in me, vs. a male nurse. It's just something too personal for me, and unless I didn't have a choice or was in too much pain to care or unconscious, I would much rather have a female doing this. Someone could say, well what if that female is a lesbian. fine, that's not my issue..I just don't feel comfortable with someone of the opposite sex manipulating or examing my genitals, period. I know there are times when i may have no choice, but my first choice would be a female doc or nurse, just because I feel better this way. After all, nursing is not just about giving meds or helping people get better physically, but it also is about giving a patient emotional support and empathizing with their emotional needs...and nurses don't necessarily have to agree with the patient's opinion or point of view, but just aim to make them as comfortable as they can.

I disagree also, that nurses don't make much everywhere. It really depends where you live. Maybe upstate NY makes much less, but in NYC, most new nurses I know are making at over 55K, some over 60K a year, and they don't have excessively long work hours, or too many patients. Of course, the cost of living is also more in NYC. Yet, I used to work in the city for only $45K, and I have a masters degree in social work. So nursing is not chump change, like the above poster said. There are plenty of other jobs where people make much less, and also more work in some cases.

Hope you can figure out what's best for you both. It's great that your husband can stay home so you don't have to worry about childcare. Yet, from my experience in an Accel Nursing program, it's not so much the childcare that people w/children have problems with (since there's even a childcare center in the school) and most have supportive husbands that help with childcare, chores etc..BUT it's the energy you need for actual schoolwork, studying, clinicals, etc. that may be a problem if you decide to get pregnant while still in school. I know some people have ok pregnancies and barely got morning sickness or any problems, but if this is your 1st preg. you really don't know how your body will react, and how you will feel during the 1st trimester or if you will have any complications which may require extra bedrest, etc. You may do just fine, but it's just something to keep in mind, which would probably make it a bit easier for you to weigh your options if it's worthwhile getting preg. ASAP or after your graduation, or at least very close to graduation. Good luck with whatever you decide. :)

I think male nurses can be just as competent as female nurses, but there is also the cultural perspective to consider. I am in the eastcoast US, where we have many different cultures/races coming to the hospital, and several cultures (esp. Middle Eastern or South American) do not feel comfortable with a male nurse. They may feel fine with a male doctor, but that is justifiable in their mind, since they 'see' doctors as a different level as nurses. It doesn't mean they think nurses are less competent, but they just have a different type of idealization of doctors and their roles, or maybe more respect, and that is mostly from yrs of socialization in their culture, etc. Yet, I have seen some Middle East. patients even reject male doctors, and prefer females, since only their husband is supposed to be the only man to see them naked. As for myself, I wouldn't mind a male nurse, but i have to be honest that I have always preferred a female OB..not because I think they are more competent..BUT because they are female like me, and are able to understand better where I'm coming from in terms of my description of pain of cramps, or 'strange' discharge i may have sometimes (something that I may feel embarrassed to talk with a man even thou he's a doctor). Plus I do feel kind of vulnerable with my legs spread out and have a male doctor looking. I know he's a professional, but I can't help feeling strangely vulnerable and hard to look in his eyes afterward. Besides, I had a male friend in med school and he tells me about some male residents in OB/GYN still think like 'males' and have honestly sometimes feel uncomfortable themselves when they have to examine an attractive young woman with a great body.

Oh, one more thought..you said your husband wants to be able to play with your children and meet his grandkids..i understand this..but if you have a child in 2 yrs (after you finish your nursing program) will that really make much of a difference regarding how old he will be when your child is 8-10 yrs old for example? If your husband is 39 when you have a child, he will be 49 when the child is 10 yrs old. , vs. 47-48 if you wanted to get pregnant now. Not much difference..it's not like he will be 58. I think that 1 -2 yr wait would be worth it, if you can get your degree first, and don't have to worry about juggling schoolwork a newborn (getting up at night, losing sleep) or toddler while going back to school.

I agree with the others that there is no 'perfect' time to have a child, but I do believe that it's better to get your education completed if you can, before your first child. I know people that are going to school and have children, and they seem to do ok, but they all admit it's not easy, and if they had to do it all over again, they would have decided to complete their degree before they had children. Life is not the same for everyone though and different people have different opportunites, circumstances, etc. BUT if you are in the position to get your degree now, before you have children, I think it's the best idea, in my opinion. I am also in an Accelerated program right now, and can tell you that it IS intense and you have to study alot, and I could not see myself doing this program with a newborn or even a toddler for that matter. There are a few students who got pregnant in our program and have already missed alot of clinical days due to morning sickness, etc. Plus, if they give birth before the program is finished, they may not be able to get back into the swing of clinicals immediately after giving birth. No one knows how a birth will go, if they need a c-section, etc. The school will not necessarily pass them just because they were out for pregnancy. They may have to repeat the semester + pay again. If you finish by 29, and work for a year (if you decide that), and get pregnant by 30 or even 31, that's still a good age. I know that after age 35, they say it's more risky but I do know many people who have had children in their mid-late 30s and perfectly healthy babies. Even if you didn't want to wait a year to get work experience, and just get pregnant at 29 (if you're very nervous about waiting), that's also another option. I think late 20s is the best age for pregnancy anyway..I mean emotionally since at this age we are more mature and maybe better prepared, etc. I think it would be easier for you to get the Accel. program done FIRST, and then if you really want to get pregnant, do it, and you can always wait to start a job afterwards. But seriously, many women have more than 1 baby in their early-mid 30s.

I'm a nursing student, but have a personal health issue, that I need advice about. I've been having very heavy periods for the past couple yrs due to a 4cm submucosal fibroid (i'm 31 yrs old). I tried taking BC pills (Othro Tri Cyclen) but they made me bleed even more btw periods. My OBGYN tested my hemo in June and it was 10, so she said I was just mildly anemic and to take iron pills. But all summer I've had even heavier bleeding, sometimes passing huge clots (some even almost the length of my pad), and I called my doc and she said it was normal to pass clots with fibroids. My period last over 7 days, but I do bleed between periods, sometimes a big gush that soaks up one pad in less than 1 hr. But that only happens for 1 day or so, then it stops. Yet, last week I got my hemog tested and it's 8.5 g/dl. Is it possible for it to go down so fast in 4 mos? I also have noticed that my inner eyelids are not dark pink anymore, but a pale color, almost skin color. I also have these pale whitish bands on my fingernails,like they are starting to lose color. My doc said just to take more iron, 3 times a day, with Vit. C. But my question is will this be enough to reverse the anemia, esp. since I'm still bleeding so much? I wanted to try the pill that can stop menstruation for a few months, but my doc doesn't recommend it. What are my other options? I think I should find another doc but right now my insurance is not that great as a student (it's only for emergencies), and since I've been to this OBGYN for years, she lets me make payments later. I am afraid that my hemo will fall even more. I have also noticed that when I go up just 1 flight of stairs, I'm out of breath. I used to excerise regularly and never had that problem. I hope one of your experienced OBGYN nurses can tell me what I should do, or anyone with info about this. I would greatly appreciate it.