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I passed! Thanks for all of your positive energy!

I took my NCLEX RN today and had 75 questions. I finished in 40 minutes, which is about the pace I used to take tests at in nursing school. Anyone have any advice/encouragement for me? I'm terrified I failed!

No problem. I used to rack my brain trying to come up with something big and impressive sounding and miss the obvious staring me in the face. Glad I could help. :)

We weren't allowed to tape lecture either. The instructors' rationale was that when students were allowed to tape lectures, some groups of friends would take turns coming to class and taping lectures for those who chose not to come. With the no taping rule, if you want to hear the lecture, you have no choice but to show.

Pain. There's significant pain with a pleural effusion, which can easily cause an increase in heart rate and blood pressure. Respirations are labored and shallow because of the pain of inspiration. The patient is tachypnic because shallow breathing does not necessarily provide adequate oxygenation. To maintain appropriate oxygen levels, more breaths per minute are necessary. Additionally, there can be empyema with fever, which could also cause tachycardia.

Me too. I'm a chunk, and doctors always assume that I'm ridiculously unhealthy. My blood sugars, my blood pressures, and my cholesterol levels are all beautiful. So phhhft. To the OP... I didn't suffer in nursing school being overweight. (I'm a size 16-18.) However, now, as a nurse, my ankles and knees hurt every day, and it's just generally a lot rougher on me than I thought it would be, especially given that I've never been a little girl. That being said, don't get down on yourself. Nursing school is hard enough; you don't need to worry about beating yourself up on top of it. Make little lifestyle changes when you think you can, and I'm sure that those pounds will eventually come off. Good luck!

When I was in school, I would take notes in lecture. Then, after lecture, I would do something called "whipping" my notes. I would sit down for an hour after lecture and review everything we had just talked about. I did that every week. Then, a week or so before the test, I would begin to re-write my notes into a typed (because I'm anal-retentive like that) study guide. I learn best by writing, so this gave me a chance to really review my notes and see what I didn't necessarily get. I would also incorporate the end-of-chapter bullet points from my text books into my study guide. The weekend before the test, I had a study group that met for breakfast and reviewed. That way, the studying wasn't all about seriousness. We were able to get together and commisserate about what was going on in our lives. I loved care plans, and no one else really did, so I would often come early to help people with their care plans. After care plan time, we would spend about 2 hours just reviewing our notes, identifying problem areas, and talking about ways that we had learned to remember things.

as far as your original question goes: hyperkalemia can cause cardiac arrythmia, which could have caused the original fall. hyponatremia can cause confusion, which can lead to a fall. hyperglycemia can cause seizure, leading to a fall a low hemoglobin and hematocrit could also lead to cardiac arrythmia. coag studies will determine if clotting times are decreased.decreased clotting times may lead to clots in inappropriate places. a ct for pe (pulmonary embolism) and thrombotic stroke, if not already done, may be ordered. additional, advanced clotting studies may be ordered increased clotting times may lead to bleeding in inappropriate places. monitoring for internal bleeding following a fall (i.e.: careful observation of vital signs; monitoring of pain, especially around the area where the patient fell) is important again, a head ct, if not already done may be done to r/o (rule out) a hemorrhagic stroke. hope this helps.

cardiac output is the amount of blood pumped by the heart per minute. the formula for cardiac output is: cardiac output in ml/min = heart rate (beats/min) x stroke volume (ml/beat) stroke volume is the amount of blood ejected from the left ventricle during systole. the formula for stroke volume is: sv = edv − esv (end diastolic volume-end systolic volume)

I think you're entirely right, Sue. I think the OP is out of his/her element. That's without a doubt. That's why I offered the advice to wait until the clinical setting, where there's a smaller group, and most people need to rely on their fellow students to accomplish tasks. I, too, was entirely out of my element when I started back to school -- I was the youngest, the only one without a serious relationship, I could go on and on. It wasn't until I took my classmates away from the large group dynamic that I actually started to make friends. Additionally, I entirely understand your own situation. I moved from a small town to the city, and when I go home now, my entire frame of reference is so much different than anyone's there. It's sometimes amazing to me that we only live 45 miles apart! Amj has maybe struck a nerve with me, because she sounds like people I work with who have a holier-than-thou attitude. I apologize, amj, if I've offended you at all. I guess I may be taking my personal experience with some of the exact words you've said in this thread, which were, when said by a coworker, meant to be a condemnation of the way that our unit interacts with each other. (For the record, the rest of us were just fine with our communication skills. :)) Thank you for spurring some interesting conversation, though!

Truth be known, I was always jealous of the stay-at-home moms in my program. They were able to send the kids off to school, then study. Their grades were always awesome. I was working 36-50 hours a week just to pay my bills, plus going to school, plus spending time on homework. That being said, once I became engaged, I found out how much work it is to just have another person in the house. We shared chores, and FH was able to get groceries if I was busy with classwork, he was able to cook dinner so that I could study longer, and so on. But still, I felt bad that I was taking away from our "us" time to study. It was even worse on the weekends that we had his son. Then I felt doubly bad for being a horrible person who was missing out on "parenting" time. I don't think anyone has it easy, per se. I think that there are pros and cons to each situation, and until you've been in both, it's hard to see the other side of the fence. Sometimes, the grass is greener, but there are often brown spots. :)

It's hard to make a blanket statement about people being clueless and not continuing the "flow of giving" if we don't know what you're giving that they're not returning. Because you didn't give examples of ways that you were giving to your classmates without them giving back, I gave some examples of ways that I have seen others give to their classmates. Again, I will say that what may be appropriate for you is not necessarily right for others. (I'm resisting the urge to quote the Diff'rent Strokes theme song here.) I just feel that there's a lot of negativity in parts of this thread surrounding people who don't respond to social situations in the same way others do, and I'm trying to point out that this will happen in school, in the workplace, and so on. I feel that you may be giving off a "vibe," if you will, that you are not the same as the people you are in school with, and that may be setting them on edge. I know it has certainly set me on edge in this post.

That's exactly how my grandmother would have been if we had not made the decision to not intubate her when she had pneumonia. She died of Lou Gehrig's Disease (ALS). I agree with Suesquatch. Write that DNR/DNI.

That's all good and well, but a lab value book or website will tell you that glycosuria is an indication of elevated blood sugar. Which, in turn, leads you to diabetes. If you google diabetes and UTI, which is your first hunch, you get several websites which support that theory. However, you need to then figure out what additional labs you would run to determine if the patient is in DKA and has a UTI, or if they're just a poorly controlled diabetic with a UTI. This can also come from google. Use your Google-fu, grasshopper.

I found myself in the same dilemma in my community college program. I think that sometimes, people take shy and reserved as aloof, even if that's not the intent, especially when it's obvious that you're a better educated person. (And even though you're not telling, I'm sure they know that you've at least done this college thing once. ) I don't have advice for you. I wish I did. I ended up leaving the community college and going to a diploma program, which had a large number of other students who already had at least a bachelor's degree. (One of my classmates was an engineer!) Just be good to yourself, surround yourself with supportive people outside of school, and don't worry too much. Your two years will be over in a flash. PS: I guess I do have a little advice. Wait until you start clinical. My first clinical group were some of the best friends I had in nursing school. I still keep in touch with a lot of them. The smaller group dynamic is a much different thing.

I'm sad to say that this does sound a little judgmental. However, that being said, I think I can at least speak for myself when I say that at the gym, the last thing I'm interested in is acknowledging anyone. It has nothing to do with who that person is or isn't, but more to do with the fact that I am in the zone when I'm in the gym. For me, a workout isn't a social experience, unless I go to the gym with someone to, say, walk on the treadmill while we catch up. I'm sorry if you think that's rude, but it's just how I am. You don't say how you've been taken advantage of, but I have a thought on this, as well. If you're doing things like offering notes to other students, of course they're going to take them. And if they see, for example, that your notes are neatly written and well organized, they may be embarrassed to hand over their scrawled mess. If you're buying lunch for classmates, that's awesome. However, maybe they weren't planning on eating until they got home because there's no money to eat out. Or maybe they were going to be satisfied with a sandwich from the cafeteria, or the dollar menu at McDonald's. But if you say, come on to lunch with us... I'll pay!, of course they'll take you up on that. You offered, and they don't want to be excluded just because they don't have the money. However, whether you've paid or not, they still don't have the money to take you out in repayment, or to pay you back. Do you see how this works? It sounds like you may not have had much exposure to the idea of not having much -- I'm not sure, and if I'm wrong, I apologize -- but it's embarrassing to tell someone that you can't return their favor because you don't have enough money. I hope this gives a little bit of understanding on a tough topic. :imbar

What credits will transfer is, unfortunately, up to wherever you want to transfer. If you're thinking about it, ask the school you're considering to do an informal credit audit to see what you'll be able to take with you. In my program, I was able to bring all of my science and social science (i.e.: Human Growth and Development) classes with me from the community college. That being said, if you feel that you're not being well prepared for NCLEX, I would definitely lose a few credits in a transfer to a more successful program. I did, and am so glad that I did. I can understand needing to understand speculum examinations in order to assist an MD, but they're definitely out of the scope of practice for an RN, at least in my state. The only skill that we learned that nurses don't really perform frequently is eye and ear examination with the opthalmoscope and otoscope. After that, I can say everything I learned in school, I'm able to practice. If you're not happy with the way that your current class is being run, I would suggest talking to the teacher. If she's not able/not willing to help you, then definitely talk to your dean of students, or, if you're in a bigger program, the head of the nursing program. They should be able to provide some input on what is an acceptable amount of time to allow students to complete an assignment. I hope this helps, and I hope you're able to resolve your problems, or at the very least, make a decision that's right for you and your education. Good luck!

The other thing that you need to remember is that nursing school tests are a lot different than regular tests. I certainly was shell-shocked at the beginning of each semester when I took a new instructor's tests -- I didn't know that there were that many ways to ask a question! When I was in your shoes, which wasn't too long ago, I went to the instructor and asked if she had any suggestions on how to study for her exams. Was there something that, as she looked at my tests, she could identify that I didn't understand? I also made a list of each question I missed, the kind of question it was (knowledge, application, analysis), and why I missed it (did I not read it correctly? did I circle the wrong answer, even though I knew the right answer? did I just not know?). From that, I was able to find a pattern and work from there to solve it. Good luck, and hang in there. Patho is HARD. PS: If you're going to a two-year or four-year school, why not try taking a business class? See if you like that any more than you like your nursing classes.

First off, I hope you mentioned the nurse's attitude to your instructor. We don't need to lose more nurses because the ones we have can't keep their attitudes in check. Secondly, when you're assigned your patient for the day, introduce yourself to their nurse. Explain what you can do independently, what you need your instructor for, and what you need the nurse's okay to do. Each program has different rules, and so it gets confusing to try to remember that students from school X can do a, b, and c, but students from school y can do d, e, and f. Maybe mention something you heard in report, just to show that you were definitely paying attention and took the information to memory. Another thing to do is to make sure that you're communicating well with your staff nurse. For example, I had a student this week who didn't tell me that my patient was still febrile. Not a big deal, since the doctors had made the decision to ride out the fever, but it could have been. Make sure to report off to your staff nurse any time you leave the floor, in case something should happen. That nurse will need the most up to date information she can get. I just recently went from being a student to HAVING students, so I understand your frustration. These are just some of the things that make me feel more comfortable when a student is caring for my patients. After all, once you leave, I'm responsible for anything that's happened that I may or may not know about.