sully75

To answer the question: I studied off and on for several months but I really wasn't doing too much of anything for the first couple. I crammed it the last month or so (quite unpleasant but that's kind of how I work). Like any of these tests, I think you need to study for the test as much as anything else. The questions in the ENA review book are generally fairly similar to the kind of questions you'll see, so generally I would expect questions at that level of detail and knowledge. You don't need to study deeper than that. The nice thing about Mark Boswell's youtube lectures was that he gave just a little more than you needed to know, so it set you up pretty well. Oddly enough I was getting 68-72s on all my practice tests (barely passing-passing is a 70), but I got an 86 on the actual test. Seems like most people get closer to their practice test grades. I'm a pretty good test taker, I think, but a pretty poor studier.

Hello, I just passed the CEN, first try. I've been an ER nurse for about 1.75 years now. I don't feel like I ever got great training, so I had to teach myself a lot. Some thoughts -Mark Boswell Youtube lectures are awesome and free. I listened to all of them, and took notes in a google doc about everything he said. In some ways it's kind of nice that you don't have the powerpoints in front of you because you have to write everything down. I reviewed my notes a day before the test and that helped tremendously. The lectures don't cover everything but they give you a pretty good start. The Toxocology lecture was definitely helpful. A little lacking on ortho maybe and that's a weak point of mine too. I need to catch up on that. -The ENA CEN review book is really good and kind of necessary. 5 book tests and 2 online tests. I did all of those tests and then carefully reviewed the answers and rationales. It definitely showed me stuff I was missing. -I also paid for the Jeff Solheim videos which are online. There's like 7 of them. The topics are pretty sporifice, but the electrolyte stuff was really worth knowing well and I'm glad I did them. Apparently he has a taped lecture series but I could never find it. -I also got a used, somewhat outdated copy of the Lippincot Q&A Certification review in Emergency Nursing. I got the 2005 edition on Amazon used very cheap. There are definitely a few outdated things in it but generally it was totally useable. The questions are HARD and that helped. I never finished the whole book but it was worth buying. I looked up a lot of stuff on youtube. There's a lot of good ER videos. Larry Melnick is some ER doctor who puts up a lot of live videos in the ER, some of them were helpful. Looking up things like placement for a needle decompression and other things that I've read about but never seen. -Be prepared to really hunt out an answer. For me the questions on the test were simpler as far as the knowledge required relative to the review book but took a little more figuring out, the answer wasn't obvious, you had to use your knowledge of the situation to piece together the answer. So I'd just be prepared for that. There were no major curve balls though. -The test is long, long, long. Just get ready for that. Anyway, good luck! It was totally worth doing. At this point I'm more clear about what I don't know than what I learned but it was helpful for illuminating that. And a special thanks to Mark Boswell. I appreciate your generosity very much.

Thought I'd bump this, somebody just downloaded the stuff I put up, so maybe it's still useful. Good luck to you NCLERs. At a certain point you'll forget that you even took it.

To sum up: I have about 5 months independent on the floor of a rural hospital and I'm doing ok on nights. I want to move back to my home city as soon as possible, with the eventual goal of working in the ED here somewhere (many hospitals in the area). Do you think travel nursing would be a way of working my way back into the market? I'm worried that applying from out of state is going to limit the attention my resume gets, and also I'm really, really sick of being lonely all the time, and would rather move sooner than later.

Hi There, I graduated last Summer and started working in Nov of 2010. I moved from a major metropolitan area to a rural area that I previously lived because there were no jobs in the city. I thought I might be able to resettle in the area (beautiful place). I had two months of training, and I've been on my own since January. I work nights. I'm doing pretty good on my own, haven't had too many problems (knock on wood, literally!). I can't say I feel super confident, but I feel as though I'm doing ok. I get freaked out sometimes, and definitely ask advice from the charge nurse a couple of times a night but in general I feel as though I carry my own. I'm very pleased that I really like a lot of the people I work with at night, and we have some awesome CNAs which make things pretty easy. I usually have 4-5 patients, occasionally have had 6. Sometimes it's easier with 5 than 3 because I find 3 makes me lazy. Cutting to the chase: Anyway. The job is going ok. I'm learning a lot, although not nearly as much as I was early on. I am not totally stimulated by med-surg, and feel bored a lot. More importantly, I'm extremely lonely as I'm single, living - literally - in the middle of nowhere and the area is mostly filled with retirees. So no dating prospects. And all my friends, basically everyone I love, and all the things I like to do, are in the city. My goal is to get back the my city, and to, at least eventually, work in a good ED there. I'm worried about getting further depressed where I am, and would really like to get out of there as soon as possible. It's been a really rough couple of months. I'm also worried that while I'm living out of state, it will be hard to find a job in the city. There are definitely a lot more jobs open now than when I was looking, and my friends who stayed all eventually found jobs (we have BSNs for the record). I have been getting a lot of emails about travel nursing opportunities in the city. I am still a relatively green nurse, but I have been wondering about taking a travel nursing job in the city so that I would be here for 3 or 4 months and could apply here. In the meantime diversifying my experience. I know that it would likely be stressful and hard, but I have to balance that against being away from my friends and really hating my life at the moment. At this point I feel like I'd rather be stressed out among my friends than sad and lonely away from them. Any thoughts?

Hi there, Looking to switch jobs potentially and don't have time to wait to take ACLS at my current job. I'd like to pay somewhere to take it. Any suggestions for a place to take it in MA, preferably the Boston area? I can pay, of course.

Yup...I talked to the Board Of Nursing (was scared to bring it up but I finally did) and they said that they include prereqs in the 2 years. Funny though, that brings me to exactly 24 months. I really sped through the process. Didn't have a college level math or science class before that. I'll be in coastal Maine. I know it well, looking forward to it!

Hello All, I got offered a job in Maine and I'm working on getting licensed there. I graduated from an accelerated BSN program recently, this will be my first job. On the Maine Board of Nursing website, it says something about graduating from a program of "at least 2 years". My BSN program was 14 months but I already have a batchelors degree and a lot of prerequisites. I'm a little concerned there may be some hitch up, as it asks you to state the length of your program on the application. I'm just going to fill out the application and hope for the best, but is this a possible problem? I believe Maine has some accelerated BSN programs of its own. Thanks!

Hello All, I'm applying for jobs online in a really tight market (MA). I'm finding jobs to apply for (starting to look at some less well known hospitals). I'm a new-grad. It definitely feels like dropping your resume into an abyss though. I've heard people suggest putting a suit on and walking into HR offices with your resume. Sounds like a good idea, but it's also a lot of time/energy invested. Wondering if it would be worth the time to apply for 20 jobs online just to put my resume in the hands of some HR secretary. Any thoughts? Thanks!

I'm a guy, 35. For whatever that's worth. I find myself rolling my ankle occasionally. I wear them too often (they are basically my only pair of good shoes...job hunting and broke). I do find that when I roll my ankle, it scares me, but it doesn't hurt much. I'm not sure if I realize that I'm doing it earlier and have some reflex to protect my ankle, but as of yet (knock on wood) I've been ok. Not sure what the alternative would be. I know my feet would be screaming in sneakers or whatever the alternative is. One thing I might consider is Nike Air sneakers. They are very low and are sort of supposed to feel like being barefoot but with a bit of support.

I just passed the NCLEX (75 questions) and I'm job hunting right now. I have sold most of my books on Amazon, at least the theory and review books and things I definitely won't need. I'm definitely keeping my pharm textbook because there's a lot of stuff in there I'd like to refer to. And my pathophysiology book. At least...I think I'm keeping that. My med-surg book is worth a lot of money though (Lewis). In school I found it bloated and unreadable, way too much information and not really helpful in answering questions. I'm tempted to sell it. Do you think I'll need that on the floor for my first job? Since it wasn't helpful in school, I'm not sure it will be helpful at work either. But I don't want to sell it if I'm absolutely going to need it. Have you used your med-surg or Perry and Potter since you graduated? Thanks!

It's all fading into memory at this point, but I would say expect strange questions on all those topics. Most important thing to me is be emotionally prepared to guess between two answers.

I realized that the mnemosyne file I uploaded had some of the categories shut off (you can do that to study certain things). I re-uploaded it and I think it's working now, you should have more questions if you use it. Very interested if any of this was helpful for anyone.

That's cool. I'm sure everyone's test is different. Most people from my program seemed to feel pretty much the same after talking about it though. I had one question out of 75 where I felt pretty confident I knew the answer, even that one was a little weird. Most people I've spoken to were sure they were failing at 75. Anyway, I'm sure it's different for everyone.

Sorry, if it's not clear, you have to download the mnemosyne program, and then download the database and open it (from the file menu) into the program.

oh yeah Fetal heart rate. Awesome thing on that study guide, a better explanation pasted on the bottom of the word doc. Pasted here: Glad it's helping.... Tessa about the 311 take 120-160 as the general base, so take 120-30 = 90 then 160-130 = 130 so the HR range for an infant is 90-130 (that's the 3 of the 311 formula) then take 90-10 = 80 and 130-10=120 so the HR range for a toddler is 80-120 then subtract 10 from 80 and 120 to get a HR range for a preschooler of 70-110 and the other #s written next to these figures, are the RR for these age groups... hopefully that doesn't confuse you more.. Think: 311 (Fetal HR 120-160) HR RR -[30] 90-130 Infant 30-60 -[10] 80-120 Toddler 20-30 -[10] 70-110 Preschooler 16-22 For blood pressure, I think it's 70/50 90/55 100/60 112/65 (double check this, I'm forgetting, possibly). But if you start with 70/50, add 20, 10 and 12 to the systolic. The diastolic moves up in 5s. Pretty easy to remember that way.

god that was a ramble. couple more things to know backwards and forwards: know your L&D stuff backwards and forwards Know the order of maneuvers (totally blanking on the name) to find out where the baby is in the womb Dig toxicity med calcs, do a bunch, not that hard, get you some points antidotes, particularly coumadin and warfarin know your veal chop (it's on the study guide I posted) definitely MAOIs, drug and food interactions really know your allergy stuff (banana allergy=latex allergy, etc) the more obscure the better Oh yeah, the "random fact throwing thread" is worth a couple of hours of reading through. If you don't know something on there, look it up. I made it through about 20 pages of that before I got bored. Learned a ton. Partly I think finding crude ways of organizing really intricate info is helpful. Like immunizations...so confusing. Every single one is different, but a number of them are like 2 4 6 months. Then there are a few that are after 1 year. Or whatever. I've already forgotten (that's what I was looking at in the car before I went into the test). But try to at least bunch them into groups. Then if you have time figure out each little detail. But start with crude knowledge and pair it down. Ok I'm going to stop. HOpe that helps.

I passed the NCLEX last week with 75 questions. I thought I'd share some observations quickly (now I'm job hunting, which is my new nightmare!) -So here's my NCLEX theory: if you are doing really well, like you are going to pass in 75 questions, they are just going to throw ridiculous questions at you. No matter how well prepared you are, you are just not going to get every one of them right. Honestly, out of 75 questions, I felt like I got 3 questions where I was pretty sure I knew the answer. Even then, I wasn't sure. Ok so my theory is that if you are getting those higher level, bizarre questions, you are doing really well. I don't think they expect you to get more than 50% of them right. Maybe even less. If they throw a crazy one at you, and you get it wrong, they give you a slightly less crazy one. Get that one right, and you are back to the crazy one. Guess right on that one, then they give you an even more insane one. Guess right on that one, and they are going to give you an impossible one. So if you keep on that track, you are going to feel like you are 100% failing. But really the scary thing is if you feel like you know the answer to every question. That's how you know you are doing not that great. When it got to question 75 I was sure that I was absolutely failing, but then the computer shut off. I was pretty sure I passed, only because I didn't think I'd fail outright at 75 questions. I thought they'd play with me for a while before I failed. So anyway, point being: eliminate choices. If you can throw out 2 choices, you are down to 50% chance of right or wrong. At those high level questions, if you can get 50%, it's my feeling that you are going to pass, even if you have no idea what they are talking about. Things that helped a lot: Mnemosyne, this incredibly awesome flashcard program: Welcome to the Mnemosyne Project | The Mnemosyne Project Seriously, you have to use this. Saved me. Just dump anything you want to learn in it, in the form of a question. It will quiz you, and depending on how well you do, it will ask you again shortly (if you can't remember it) or in a day or more (if you got it correct, without effort). It's so good. Seriously, download this program. Ok here's a link to my mnemosyne database: Mnemosyne NCLEX.mem - File Shared from Box.net - Free Online File Storage I take no responsibility at all for the info in there. It helped me a lot, but I was dumping stuff into it as I went, so there may be errors. Use at your own risk. For pharm, they are going to give you crazy stuff you have no idea about. However, they may make 3 of the choices things that you do know. So, being familiar with the normal stuff is essential. I made up a list from a couple of other lists, and from questions I got on practice. I think I got part of it from a thread called "63 key drugs" here, but I can't remember (again, all this was done in a fog of studying). Again, use at your own risk. Assume all the info is wrong. If I were you, I'd erase all my notes and put your own in. The act of looking up these drugs and making this spreadsheet were what really helped me. Ok here's that: NCLEX MEDS.xls - File Shared from Box.net - Free Online File Storage Remember, all the info is wrong, so you should double check everything. Meds: know your darn insulins (that's in the mnemosyne database), digoxin, lasix, beta blockers and how they differ from other hypertensives, MAOIs, drug-food interactions, immunizations. Know which drugs are nephro and ototoxic (definitely!!!) If I were you, and I didnt' know any meds at all (I seriously didn't, before I started studying 6 or so weeks before the test, I might go through that list of drugs, maybe 5 at a time, and read about them, specifically, taking notes on each one. Lehne might be good for that. Honestly I was all over the place in my studying and wasted a lot of time on it, but I couldn't find a good list of drugs to study. So...hopefully that will help you. Also, there's a chapter in Lehne, that tells you how different receptors work (anti-cholinergic/cholinergic/nicotinic, etc). It would be good to integrate that. I kinda thought about it in a very crude fashion, and it was helpful. If you know the basics solidly, that's better than knowing tons of hard stuff badly. There's a thread here called "my study notes" or something like that. It's awesome. Ok, just found it...here it is: Best study guide (my notes) - Nursing for Nurses I made it into a word doc: Someones great study guide.doc - File Shared from Box.net - Free Online File Storage So so great. I also put some of it into the mnemosyne database. Know this stuff backwards and forwards. Here's a list of signs that was pretty helpful: harlequin sign - definition of harlequin sign in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia. and reflexes: reflex - definition of reflex in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia. Oh and re: study guides, I started with Saunders, bought Lipincott (I think) 5000 questions (something like that), Exam Cram 5 tests (that was a waste of money), and I had a bunch of Prentice-Hall Reviews and Rationales for individual subjects (these were great for school, but for NCLEX prep were kind of a waste of time...actually a total waste). Oh and the Kaplan test strategies book, which is, for what it is, really good. By far the best book I found was the Mosby Illustrated Study Guide for the NCLEX: Amazon.com: Illustrated Study Guide for the NCLEX-RN So so good. Really helpful funny little drawings for certain things, the exact right amount of info, and it's pretty easy to read (Saunders language is really painful to read after a while...everything is seperated into individual sentences, it drove me crazy). I wish I'd had the Mosby book way earlier in my studying. I got it a week before the test but it helped a ton. It also has great med sections for each chapter. It's like half the size of Saunders, but way better in my mind. That said, the Saunders CD is really great. The questions are harder than the ones in the book (which are a little too easy I think). Another thing: No practice test really has anything to do with the NCLEX. The questions on the real NCLEX are weirder than anything you find in a book. Even Kaplan. I guess if you took the hardest Kaplan questions, and subtracted the other 80%, and made the whole test like that, that's kind of what it was like. That's why you have to get really good at guessing, because you are just not going to know the answers to all of them, and you have to accept that without freaking out. That's all I got. Hope that helps.

Just wanted to pass along my recomendation for this book. I really wish I'd found it earlier. I wish I had it in school. Really good. Just the facts, just what you need to know. It's like 400 pages shorter than Saunders, but I think there is close to the same amount of info in there. There are really good drawings about different conditions. It's relatively easy to read. I'm finding all the info I need in there, mostly. When something is a little unclear I go to Saunders, but for the most part I think this is much more organized. The CD is really good. I think the questions are mid-level to upper level in difficulty, maybe not as bad as Kaplan but still pretty difficult. Like I said, if I'd had this 3 weeks ago, I'd be a lot better off. It's quite good. I think this, along with the Lippincott 5000 questions book would be a really good combination. I have a number of the Prentice Hall reivews and rationales, which were pretty good for school but I found not that helpful for studying for the NCLEX.

Just wondering if people have seen random lab values showing up on the NCLEX? Like, do I need to know the value of CPK? Or just knowing what it means if it is elevated? Or do I need to know it at all? Just wondering how much effort I should put into memorizing. I'm not good at lab values in general, so still working on my basics.

ps use at your own risk. I'm not a pharm master and have no idea if these are the best drugs to study. I stole a list from another post, that I've since lost, and combined it with the 63 I have above. I'm also going to add drugs from the review book of the review class I took at some point. (Sorry for not crediting the list I stole, just so behind right now I can't take time to find it, but it was really helpful). Anyway, no more apologies but I hope this helps.

I've been working on my list more and putting some more info into it. It's a little rough now, but I've been adding drugs as I see them in review questions (if it seems like a not-totally-random drug that I'll probably never hear about again). Anyway, I made up a google doc of the spreadsheet I'm working on. It's here: Welcome to Google Docs Let me know if you can't access it. If there is something missing that's really obvious, please let me know. I'll be adding more to it, right now I realize that I don't know much about peds, so I'm studying that instead of doing more pharm work. August 19th, baby! Wish me luck. Sulll

That's helpful, thanks! Congrats! What's the infection control menomic? I don't know any good menomics. If you have any to share, I'd love to hear them.

Aug 19. Moved it up from the 30th because I was so bored and not really studying. Now I'm hoping to do nothing but study for 2 weeks. I've been at it off and on for 2 weeks already. Everyone from my program seems to be passing, so that makes me feel better.

you should seriously check out this program: Welcome to the Mnemosyne Project | The Mnemosyne Project Type in the stuff you want to memorize. It asks you how well you know the stuff and shows the cards to you of the stuff you don't know more often, till you know it. It's really great.