Phoenix4

So, follow up... I've had my first two shifts, my third is tomorrow. I had about 25 patients. The two aides handle clothing, toileting, feeding, but there is almost no interaction between the aides and the nurses. The RN (or LPN) on the wing handles meds, treatments, vital signs (they don't have aides do vitals). I had no idea that long term care moved so much faster than acute care! 25 patients, roughly 200 meds for the 4 pm scheduled meds. No ID bands, they move around all the time (so you can't just start at the first room and go down the hall like acute care, because they aren't there!). Most of the pics on the computer records aren't all that good, so I usually had to find an aide and ask where each patient was to give them meds. The first shift I was there started with the med cart "changeover" with the new med cassettes refilled. That meant that I couldn't start anything at all until almost 4 pm. When I wasn't done with 4 pm meds by way late, the LPN (who was in charge, she's very good) had to call the nursing director to decide how to handle it, ie which meds to just skip, and had to help me pass meds to get those finished up. The 2 hr "orientation" first (which they knew nothing about and were totally surprised, they said they usually just hand the keys to the traveler and that's it), then it was an 8 hr shift that became 12 hrs total. I was grateful for the orientation, at least I got some exposure to the computer records system. Some things though I wish they'd covered, like although they handed me the keys to the med room/narcotics stuff, no one said which key went to which thing! So I started with fumbling around trying to find the key to even get the med room open, trying every likely key before finally finding it. (There's a key to the med room, two keys for the medication cart {one for the whole cart, one for the narcotics drawer}, one key for the narcotic cupboard, one for the tackle box in the narcotic cupboard, another for the small tackle box that contains narcotics that need to be refrigerated. Naturally, I was fumbling with all those keys every time.) They had a room for me to stay in for the two nights in the assisted living part, it was plain but quite nice, and it was really good to not have to drive home after that. I slept pretty well from 1 am to 4 am the first night, but then of course tossed and turned from 4 to 8 am, thinking of all the treatments I didn't do at all (I did no treatments, dressing changes, or skin checks whatsoever). The second shift I could at least start at closer to the "real" time since there was no med cart change. I managed to get almost all the 4 pm meds done by 7 pm (and though 4 pm is the "big" med pass, they also have 5, 6, 7, 8 is another big one, 9, 10 and "bedtime" meds those vary more as to how many meds and how many patients get them). I did manage to get most of the meds done during the shift, still no treatments or dressing changes. I did still have to have help from the LPN on duty on the other wing to get the meds done. All their records are on the computer, and the first night I kept having trouble with the computer screen on the med cart seizing up and having to restart it. That probably cost me an hour. But, the real problem was likely that the battery was low because I took so long to get the meds passed out, so it didn't want to do its job. Which meant that if you can't see the screen, you have no clue what meds to give. I've never worked anywhere that CNA's didn't do vitals, is that typical? (No medication aides, etc.) The day nurses I took over for both commented that it was a huge workload for one person (as did another LPN who was working on the other wing). Yeah, that was encouraging... .NOT! Thankfully the LPN's from the other wing were helpful and tolerant. No breaks, no meals either day. Does this sound like a typical workload? I already feel just sick that I have to go back tomorrow! Maybe I should just give up nursing!

So a couple of follow up questions and a little bit of explanation. I took a job with a temporary staffing/travel agency, so I won't be a regular employee of the LTC, hence the 2 hr orientation. I've been out of nursing a while (raising kids), live in a large, sporificely populated state, and this part of the state I was told point-blank does not have a nursing shortage and no one would need to hire me anywhere locally. Must have job=I took what I could get. (And yes, I'm terrified. I'm not going in just blindly assuming everything will be fine. This is also why I appreciate SO MUCH people helping me with routines and suggestions!) My first shift is THURSDAY this week! (ACK!!) So follow up questions... It used to be in acute care, you had 1/2 hr before to 1/2 hr after the scheduled time to give the med to be considered "on time". I notice people are referring to an hr before and an hr after, is this an overall change in all areas, or is this usual for LTC but not acute care? (Starting med pass an hr before scheduled meds sounds like a great thing!) I'm not finding a "scope of practice" for CNA's in my state (even though they have to be certified, and you can look them up on the BON website). Is it usual for CNA's to do fingersticks? (I'm planning to ask about that at the facility too, but I'd like to have an idea of what's usual.) I'm praying for good CNA's, they are priceless! I was told once by a travel nurse that usually staff and facilities are pretty nice to travelers, because if they aren't, they won't come back :). Do you find that to be true? Or?? I'm open to any other thoughts, suggestions! And please know that I've appreciated EVERYTHING that people have taken their valuable time to contribute!

This is SO incredibly helpful, I can't tell you all how much I appreciate that you've taken the time to share this with me. This will help me so much with making it through my first shifts! (And please, feel free to share any other thoughts!) God bless you!

Thank you!! These are definitely helpful to me! Please, anyone else feel free to chime in :)

Through various circumstances, I'll be going into a small LTC facility with basically 2 hrs of orientation. I realize that different facilities will be different, but could anyone describe a shift for me? Does this start with report like acute care? What types of "treatments" might there usually be? Etc. No detail is too small to be interesting and helpful to me. Hints and tips appreciated! What staff would be usual for say, 25 residents? Needless to say I'm very nervous, and want to provide good care! Thanks for any input!

Here's the link to the tutorial you can download and do. This is exactly the same one that you do before starting the actual NCLEX exam (and yes, it does ask dumb stuff like what color is orange :) ). It's just so you have a chance to see the screen format that is exactly what the NCLEX exam will be. http://www.pearsonvue.com/nclex/NCLEX_Tutorial.exe I was glad I'd done ahead of time, then I didn't feel I had to read through the questions and answers carefully (which just being me, I'd feel compelled to do if I hadn't seen them before). It totally doesn't matter or count toward your exam, it is only so you have a chance to see what the screen will look like, where the next button is, where the clock is, etc.

For some study and testing tips and a rating of how different resources compare in difficulty to the actual NCLEX-RN, see https://allnurses.com/nclex-discussion-forum/review-nclex-rn-607853.html and https://allnurses.com/nclex-discussion-forum/passed-1st-time-601909.html Hope those help some. Remember, you have plenty of time to take the exam. You do not have to even finish all 265 (if you even got the full number of questions) in 6 hrs. If you do not finish, the computer will determine passing on the average difficulty of the last 60 questions. So really, you have 6 hrs to do at least 75 questions (15 are questions they are trying out for future tests and they don't count toward your result). Download the tutorial ahead of time from the Pearson Vue website, it will help you to see the exact format before you even go in there. You have to do that very same tutorial at the beginning of the NCLEX, it will help you relax if you've already seen that much. Once the test starts, take your time. When you get something that you think, yikes, I don't know! Don't panic, don't just pick something and go to the next question. Take a deep breath, pray. Then read the question and answer options again. Look for clues, the abnormal thing, one that doesn't fit. You have time, so if you need to, take another deep breath and read it again before choosing an answer. All the best to all of you!

Success2011, a big key to NCLEX is to not worry about the time. Seriously. I agree totally to take your time, it's not about speed. The actual minimum number of questions to answer and be able to pass is 75. You can still pass if you only do 75 questions in the 6 hrs! You do not have to finish them all in the 6 hrs. So, there is truly no time pressure. Take your time and think each question through. If you feel yourself beginning to panic, stop, take a slow deep breath and when you're ready, read the question and answer options again. From a post in this thread I started: https://allnurses.com/nclex-discussion-forum/passed-1st-time-601909.html "remember, studying is largely LEARNING, use a comprehensive practice test once in awhile to gauge how you are doing with improving overall. That was really a big help to me with doing practice questions. It was a reminder that I didn't have to know everything (and we just can't know it ALL), and practice with questions that I might know only a little, or nothing about and how to handle that. When I first started studying, at a question I had no clue on, I'd feel immediate panic. Sometimes I found myself frantically picking something and moving on (usually wrong of course!). Don't go there! If you read a question and think, hm, really? I have no clue. Deep, slow breath. Ok, read it again. Read both question and answers. Still no clue? Maybe it's a med you never heard of (there are so many, it's pretty likely to happen) and asking about side effects, or pt teaching about it. Another deep breath. Is there any info you can infer from the question or answers, like do you recognize anything about the generic or trade name? Does the age, condition, history of the client tell you anything? Usually you can come up with some hint that will help narrow your choices. Ok, so what if you narrow it to two choices and still pick the wrong one? Forgive yourself, and move on. I kept trying to remind myself that NCLEX isn’t really trying to trick you, it’s trying to find out if you can avoid killing somebody the first week! (And I did think that the NCLEX had fewer “tricky” questions than a lot of the practice question sources.)" You can do this. You have plenty of time to stop and take a slow deep breath whenever you need to. Hope this helps! Phoenix4 Passed NCLEX-RN 1984 Passed NCLEX-RN 2011

DARLENESKY!!!! :clpty::smiley_aa:nmbrn::hpygrp::dancgrp::w00t: I am SO HAPPY for you!!! I knew you could do it!!!! Answered prayers!!!! Thank you so much for letting me know, I was hoping to hear how it went!! God bless!!!

Hi JLO, I'm looking at WGU's RN to BSN program right now. I'm not sure what your situation is, but you mention you have no nursing experience. WGU has several programs, programs for already licensed RN's are the RN to BSN, RN to MSN. The pre-licensure program (you start without an RN and eventually get a BSN), is only available in a few areas because of the on-site clinical required (certain areas in Utah and So. California, somewhere else too, I don't have the list in front of me). WGU is looking fairly attractive to me, partly because they will accept my previous college credits from quite some time ago. At the same time I'm a little concerned about the way they are structured, you always take essentially a full course load, you can't take just a couple of classes at a time. The up side is that you move at your own pace, it's not a specific number of hours that you have to do. Good luck with your choice!

You can totally do this!!!

Honestly, I'm hoping that there are some jobs :). My situation is a bit odd, I have an ASN, graduated 27 yrs ago, worked FT for 7 yrs in a variety of settings (college health service, med-surg floor, neuro briefly, OR, Medicare peer review office). I have not worked in nursing for 20 yrs, and just taken my NCLEX again and passed. So, the job hunt will soon be on for me (my self-employment work is at its height for the next couple of weeks yet). As you can imagine, trying to find people I used to work with and under has been challenging after 20+ yrs, so I'm concerned about being able to get references from nursing jobs. I've been self-employed for the last 10 yrs, so my work references would be from people who have worked with me, but not that I have been employed by. Any thoughts/suggestions for my situation?

Darlenesky, have you taken your NCLEX? How did it go? I've been praying for you!

Oh, Calzo, if you hate nursing (and I certainly hate many aspects of it myself), you really may want to consider doing something else entirely! It is totally NOT too late to do that. There are so many online possibilities that you can work at your own pace to get a degree in something else while keeping your regular paycheck for now. Look into CLEP exams, a great way to get college credit cheaper and faster and be able to apply those to the degree you want. (Read policies carefully, not all colleges accept them, but most do.) A friend told me about her dad who wanted to be a lawyer when he was 20. Not enough money, had to be working, etc. so he didn't. When he was 30, he wanted to be a lawyer, but was married, had kids, etc. so he didn't. When he was 40, he wanted to be a lawyer, but had kids starting college, bills, etc. so he didn't. At 50, he wanted to be a lawyer, but had almost all of his 10 kids in college ('nuf said on that kind of expense!), so he didn't. When he was 60.... he went to college and did, indeed, become a lawyer. So my question to you is what she asked me... In 10 yrs, how old will you be if you DON'T do what you wanted to?

Hm. No particular advice, but I have to say that I hope you are not too old to consider doing this. I just retook my NCLEX and passed. I graduated 27 yrs ago, passed NCLEX then and worked 7 yrs in several different areas. I've spent the last 18 yrs homeschooling my kids and decided to study up and take the exam again. (My kids were my biggest encouragers as I studied!) My goals... well, getting a nursing job again (helping us get out of debt and helping kids in college), and I plan to take my ASN to BSN, maybe specialize after that. My oldest child is 31 (and in school specializing, he's interventional radiology tech now, heading for RPA). So, Calzo, if YOU are too old, I am WAY too old! I know that's no help, but given your question, I just had to offer this:lol2:

And I should have added, I put "minimally competent" in quotes like that not as some kind of slam or sarcasm, but because I think their determination of minimally competent could be debatable. But I know they're trying to have a system that works effectively in terms of both time and cost, and NCLEX computer-adaptive testing is it. We all know that many factors can influence how you do besides your actual competence, ie, being sick, psyched out by this test specifically, regular test anxiety, family/money problems, etc. etc. etc. When you go to actually take the exam, I'd suggest sitting down, taking a few slow, deep breaths first. Then do the tutorial (this should be familiar already, you can do the EXACT same tutorial on the PearsonVue website, do it ahead of time!). Take a few minutes to make sure you are as calm as you can be, a few more slow deep breaths. Then start. Don't rush this, you actually do have plenty of time. Even if you didn't finish all 265 q in the allotted time, you can still pass. The computer will simply look at the last 60 q and see if you are consistently over that 50% right of the minimally competent graduate nurse. So, you truly DO have enough time to take the time to relax, take a deep breath, pray, move on. All the best to you!

Chriscast1, employers only know if you are actively licensed or not, they don't get a score. Even when NCLEX gave a score (I actually ran across my original score sheet from 27 yrs ago!), that score wasn't given to the employer. They only knew if you passed, since you got a license, not whether you'd passed spectacularly or barely. Since NCLEX is now not really "scored", there isn't really a score to send to an employer even. Remember that NCLEX has a difficulty rating of the questions (we don't know what it is, but they do). They know that someone who is "minimally competent" can answer about 50% of the questions at that level of difficulty correctly. When the test taker gets a question right, the next question is a little harder, get it wrong and the next one is a little easier. They work this so that everyone taking it will get about 50% right/50% wrong. What we're trying to do when taking the test is to have our 50% right be at a higher difficulty level than what they deem the "minimally competent" graduate nurse will be answering getting 50% right. I hope that makes sense. It's really kind of an odd system, but I can see why it would be effective. (I read over their descriptions of the test methodology several times before it completely made sense to me!) Darlene, I'll email you about the Exam Cram book and CD. Praying for NCLEX success for all of you! (Pray for me as I start job hunting )

Hang in there! This is a great idea to encourage each other. I hoped to encourage other NCLEX takers and give some study tips and info that helped me in these two threads: Review of NCLEX prep books https://allnurses.com/nclex-discussion-forum/review-nclex-rn-607853.html Passed 1st time... and 2nd time https://allnurses.com/nclex-discussion-forum/passed-1st-time-601909.html Many threads here were a great help and encouragement to me as I prepared to take the NCLEX!

Praying for your success on your NCLEX, maritelrn!

Wow, this ended up much longer than I'd expected! But hopefully this is helpful to you as you select NCLEX prep materials. Please keep in mind that this is only my opinion and experience as I prepared for the NCLEX:twocents:. 27 yrs after graduating nursing school, not having worked in nursing for 20 yrs, I passed NCLEX in 75 Q, 1 hr. I didn't do any online review courses, only studied from these books. Comments and reviews of NCLEX prep books, in order of general difficulty of questions, easiest to hardest : Saunders 5th Ed. Comprehensive Review (I did not read all the content, I tried to prioritize and go over areas I felt I was weak or topics I thought more common and therefore possibly more common topics on NCLEX) I did use the CD for questions and did around 3000 Q from here. This has a pre-test that you can then print off a suggested 6 week study schedule. Really it just lists out all the chapters in the book in a different order every time you try the pre-test. It doesn't ever leave out any chapters, no matter how well you do on them, or suggest going over it twice if you do poorly on that topic. It wasn't quite what I expected in that regard. It is quite a detailed content review, maybe a little more than I really wanted. It's easy to get overwhelmed with it. I think this would be a great book for during nursing school though. Saunders 4th Ed. Q&A I did do most of the Q in the book, I used this CD a little, but I liked the format and appearance of the CD with the 5th Ed. Comprehensive Review book, so mostly used that one. Both these Saunders items are about the same in difficulty of questions. I would say they are a little easier than NCLEX. I was glad to start with easier questions though to help encourage me. For both these Saunders books you download the CD program to the computer and don't have to insert the CD in order to use the program. The next three are about the same in difficulty, a little harder than Saunders, and I think these are about the same difficulty as the actual NCLEX. I think NCLEX was a little less convoluted in the way the questions were asked, the real thing is actually more straightforward than most of the practice materials. Hurst NCLEX Review book (this is the book you can buy from Amazon or at a book store, NOT the online course materials). I did most of this book. The CD isn't all that impressive, not lots of questions. I think the real strength of this book is the decision making (much more straightforward and practical than I found Kaplan to be), and the great charts of information she includes as content review. This really helped me with organizing and memorizing a lot of detailed content. CD program is loaded on the computer. Exam Cram content review and questions book. This had maybe not quite as much content as I'd hoped for, but still very good. The questions are challenging but not unreasonably difficult. It did throw me a little that the questions are the end of each content review section don't necessarily deal with the information that was reviewed in the section. The CD was good, you must have the CD in the computer to use it. I did go all the way through this, only did one of the 275 Q practice exams. I saw a note at the beginning of the book that said if you get 90% right on the practice questions, you should have a good chance at passing NCLEX. Honestly, I found that pretty intimidating, and I think that might be a little inflated. Most sections I think I was getting around 75-85%. Kaplan NCLEX Review books, 2009-2010 and 2010-2011. Again, these were the paperback review books, NOT the online course materials. I got these from the library. It was surprising to me how different the content portion of these books was. The 2009-2010 includes a little explanation and a picture of the "decision tree", the 2010-2011 does not. The CD practice questions and the practice tests in each book were very similar however. I found the decision tree to be more frustrating than helpful. You've probably already learned things like, "What is the question really asking?" "Are you taking an action, gathering information, evaluating an action?" "Does the answer actually make sense and answer what they were asking?". Those you already know from nursing school, or you wouldn't have passed. I felt it wasn't worth the time it would take me to memorize all the decision tree steps and I'd be better served by using that time differently. Kaplan QTrainers (the ones posted online, NOT the actual online review course) I'm guessing these are older questions, and there are some errors (not a lot, but some), probably due to not catching that an answer should be changed when the question was edited. These questions are similar in difficulty to the Kaplan review books mentioned above. I did most of these that I found online, never at one sitting, I just didn't have the time to do that, scores were mostly low 70's. I do think that these, Hurst, Kaplan, Exam Cram, are similar in difficulty to the actual NCLEX, but NCLEX is more straightforward. Harder than NCLEX: Lippincott's Alternate Format Questions. Alternate formats are in general harder, just because if you don't click exactly in the right spot, or have all the steps selected, or every step in exactly the right order, boom, the question is wrong. There is NO partial credit on NCLEX. I think if you work through this and get anywhere from 50% to 75%, you're doing well. I meant to use the online audio questions, but just didn't get there, so I really didn't practice any audio at all. I'd suggest using this off and on while you are doing some other question resource, it can get discouraging if you're not doing as well as you hope. I did want to use it since most resources only have a few alternate format questions to practice with. Davis Q&A, I bought this toward the end of my studying and I'm glad I didn't get it sooner. I'd have been pretty discouraged if I'd started with this one. A lot of the questions are tricky, definitely harder than NCLEX. I loved that it was set up topically, so you could go directly to questions on the areas that you are weaker in. I think the practice exams are a little easier than the questions in the topical sections. While the book part is great, the CD stinks. It's visually not as pleasant to use as Saunders or Kaplan, and there are more errors in this than in any other resource I used. (I didn't find any errors at all in the book though.) That really throws off your CD practice scores (and I know they are errors, like a pediatric med being 12.5 mg and their answer is 125 mg). I ended up not using the CD, but definitely used the book and was glad I did. I like the format of the book with the questions on one side of the page and answers on the other. Prioritization, Delegation and Assignment by LaCharity. I saved this to do near the end of my studying. The chapters at the beginning are more helpful than the case studies. This was definitely helpful in covering PDA topics, well worth doing. The questions are challenging and involved, harder than NCLEX for sure. This format as the questions at the beginning of the book, all the answers are at the back. I did look at some free online resources, the best of those are mostly things I found on allnurses NCLEX forum (like the infection control mnemonic). Mostly though, I was concerned that there might be some errors and I wouldn't realize they were wrong, so I was pretty careful about freebies. Although everyone has ways they find work best to study, I'd suggest spending no more than 2-4 hrs per day studying and even then taking breaks as you study. That gives your brain a chance to "file" that information before you put more in. Use charts, mnemonics, drawings, lists, whatever works for you. Review a couple of those at the beginning of your study session, do questions, review one list, do questions, review lab values, etc. When you are changing the amount and style of input periodically, that helps that filing process too. I liked to write down one of the infection control mnemonics, then do some questions, review some lab values, more questions, review a med, take a break, that kind of thing. I also change books, some days work on the CD, some days only in a book, some days only flashcards, mnemonics, labs. Best thing about using review books... You can work at your pace, take breaks as needed, learn that you don't have to know it all. It gives you a chance to get over that instant panic if you read a question and think, "Wow, I have no clue!" When you realize that it will happen, I think you have a chance to calm down and try to reason it out rather than panic and just pick something. Using books from different publishers gives you a chance to see questions that are written in a different style (though it surprised me how often questions seemed to repeat from one publisher to another!). I really hope this helps someone, especially if you are like me and can't afford an online review course! God bless all of you working hard to prep for your NCLEX!

I didn't use any of the online review courses, just books and a few online resources. Saunders (4th ed Q&A, 5th ed content review), Lippincott's Alt format Q&A, Hurst (just the book, it's 2008 I think), Exam Cram content book, Davis Q&A. The infection control tips from here, and reading posts here led me to the QTrainers that were posted online and NCLEX 3500 online. I spent about 10 hrs/week studying for about 5 months. More than about 2 hrs at a time is just too much, information gets muddled more easily that way. (And I do generally take a few min breaks during that 2 hrs too, same reason.) Your brain is wonderful and amazing, give it a chance to carefully file away what you are learning. Just like a paper filing system, if something is properly filed and correlated with other things already in the file, you will be able to find it and pull it back out when you need it. While I'll start another thread with a detailed review of each of those sources (at least from my point of view ), I have a few study suggestions to offer, hoping they will be helpful to someone. Study smart, it's not so much about the time you spend, it's about filing away that info carefully. So you are letting your wonderful brain make connections between what you already know and new info. When you come across something that is new info about something you already know... such as... you already know that hypokalemia is K+ less than 3.5, maybe you run across that that can cause a U wave on the ECG and want to remember that. Ok, stop there. Write it down, draw it out, picture it vividly in your mind. Spend a couple of minutes on that. I had a hard time with Cushings/Addison's and which one had high or low K+. So, I pictured the C for Cushings and the letter K+ below it. Every time I read something about Cushings, I pictured that, so now no problem remembering that when I need it. When you have some fact or item that has two sides, like that Cushings has low K+ and Addison's has high K+... don't stress over trying to remember both of them. Pick one, whichever has some feature that makes it easier for you to remember it (I picked Cushings with K+, just because C and K make the same sound). Use whatever mental picture, rhyme, trick that works for you and spend a little bit of time picturing it, vividly, intensely. You need to get it past short term memory and into long term. Short term memory is about 18 seconds long, so you have to take the time to get it past there. The more vividly you picture what you want to remember, the easier it will be to remember. Ok, so you've picked the one that clicks for you, pictured it, gotten it into long term memory, what about the other one? Well, the other one is the other one. You don't have to spend the time to make another picture, get that first one imprinted in long term memory, then the second one is just the other one! This works GREAT with any opposites. If you are using a source that has questions divided up by topic, try reviewing the topic, at least briefly, in a content review book, then do the questions on it. Use the questions as a learning process. You can even look up the answers you don't know as you go. It isn't a reflection of what you knew off the top of your head, true, but remember, studying is largely LEARNING, use a comprehensive practice test once in awhile to gauge how you are doing with improving overall. That was really a big help to me with doing practice questions. It was a reminder that I didn't have to know everything (and we just can't know it ALL), and practice with questions that I might know only a little, or nothing about and how to handle that. When I first started studying, at a question I had no clue on, I'd feel immediate panic. Sometimes I found myself frantically picking something and moving on (usually wrong of course!). Don't go there! If you read a question and think, hm, really? I have no clue. Deep, slow breath. Ok, read it again. Read both question and answers. Still no clue? Maybe it's a med you never heard of (there are so many, it's pretty likely to happen) and asking about side effects, or pt teaching about it. Another deep breath. Is there any info you can infer from the question or answers, like do you recognize anything about the generic or trade name? Does the age, condition, history of the client tell you anything? Usually you can come up with some hint that will help narrow your choices. Ok, so what if you narrow it to two choices and still pick the wrong one? Forgive yourself, make a note of that particular drug and something to remember about it, and move on. I kept trying to remind myself that NCLEX isn’t really trying to trick you, it’s trying to find out if you can avoid killing somebody the first week! (And I did think that the NCLEX had fewer “tricky” questions that a lot of the practice question sources. Hopefully this can help and encourage someone, and I’ll be posting a detailed review later today or tomorrow of all the sources I used that may help others determine what will help them the most.

Sort of a long story.... I graduated from nursing school in 1984. Not a misprint. 1984. I took the RN boards in July '84 and passed. (So long ago it was pencil and paper, the exam took 2 days, 6 hrs/day and was only offered twice a year.) For 7 yrs I worked full time in several different areas, college health service, med-surg, a brief stint on neuro, OR, and peer review organization. During this time my husband was in college. We had two children when he started college, the third was born during his 20 credit semester in engineering school. After he graduated, I stayed home with our children and the 4th child was born. We homeschooled our children for 17 years, and the youngest graduated from our homeschool in 2010. I've had a few different self-employment ventures, but not worked in nursing since 1991. This year I decided, after much prayer and consideration, to study up and take my NCLEX-RN again. I verified with the state board that I could even do that, and began to study. Aug 4th, 8am, I took the NCLEX-RN and passed in 75 Q, 1 hr. The testing people were very nice, noise wasn't a problem (VERY small testing room, only about 12 computers), and it really wasn't too cold either, a tee-shirt was fine. My state, being a low population area, has its ups and downs. The down side is fewer jobs and lower pay. The up side, well, they are a whole lot faster now than 27 yrs ago. By 4:13 pm the SAME day, I had an email from BON "Congratulations, you passed the NCLEX-RN, your license number is..." By Friday, my name was on the BON website, and by Saturday I had received my license in the mail. THIS CAN BE DONE! Take a slow, deep breath, let it out softly.... YOU can do it! Each time you find yourself tightening up and getting anxious, stop, pray, take that deep breath and start again. I think one huge reason to do lots of review questions is that you can learn that you don't have to know it all. To not panic if you see a question that you have no clue about. Take that slow breath and look it over again, don't just pick something and move on. Likely you can do some reasoning to at least improve your chances of answering it correctly. Thank you all for the contributions you make to this forum, suggestions and encouragement that people have offered before and after their exams! :[anb]: My favorite verse... Deut. 31:8, "The Lord Himself goes before you, and He will be with you. He will never leave you nor forsake you. Do not be afraid, do not be discouraged." :BDCk::clpty::smiley_aa:anpom:

Thanks, I appreciate that! That's what I'd learned too, so you can imagine my surprise when the first source said you'd check for bladder distention first, and then the second source said massage the fundus first.

Question... I had a similar practice question in two different sources. Basically, post-delivery mom having heavy bleeding, what do you do first? One source gave the right answer as assess for bladder distention, the other source had massage the fundus as the right answer. (The rationale on that one said that bladder distention would also cause the uterus to be unable to properly clamp down.) So, if, as in the case of these questions, you have to pick ONE, which is right?

Congratulations! :nmbrn::smiley_aa