lookup

Wow. I just got called yesterday for an interview for the PEDS Residency in the Intermediate ICU Unit (Step Down). The website says it is a 16 week program. Does anyone know the start date?

Please help . I will take the NCLEX soon and I have come across some conflicting information. The Kaplan question below indicates that with late decelerations during labor, the first thing we should do is shut off the pitocin. However the Kaplan book as well as other web resources, including this thread at AllNurses (https://allnurses.com/general-nursing-student/late-decelerations-uteroplacental-590015-page2.html), indicates that the order of interventions should be : 1. LLR position2. O2 @ 8-10 LPM3. Increase IV Fluid4. Pit off5. Call MD You switch to the LLR first because it is the quickest and easiest intervention to take and do that while you get her oxygen going. Then you keep going down the list.Kaplan Question: The nurse cares for a client in labor undergoing augmentation. The nurse notes 3 consecutive late decelerations on the client’s electronic fetal monitor tracing. Which of the following actions should the nurse take FIRST? 1. Turn off the infusion of oxytocin (Pitocin).2. Turn the client to her left side.3. Apply O2 by mask at 10 L of oxygen.4. Increase the infusion of lactated Ringer’s solution. ExplanationStrategy:“FIRST”indicates priority.1)CORRECT- priority action; cause must be stopped before implementing measures to increase oxygen flow to the fetus2) increase placental perfusion, but must stop Pitocin first3) increase the amount of circulating oxygen; but must stop Pitocin first4) increasing the rate of fluid administration not indicated; used for fluid volume deficitWhat will the NCLEX test expect? Thank you. ?

I just completed a phone interview for an RN new graduate program at a major hospital that included 4 scenario questions. Would anyone have some insights on what should be done if presented with the following: 1.) Pt is 6 hrs post-op and back on med/surg floor. Pain is 4 on a 10 scale after receiving all PRN meds. The spouse at bedside is very agitated concerning the pt's pain. (NOTE: I started by asking what the pain was immediately after surgery or at any time prior and the interviewer said I was making it more complicated than it was.) 2.) Pt is a 59 y/o female w/pneumonia. Pt becomes confused. Husband insists they see a doctor right now. (NOTE: I started my answer by assuming the confusion was d/t hypoxia r/t inadequate ventilation.) 3.) You are at a “pod” with 12 patients. There are 3 RNs and 1 NA. You have 3 pts assigned to you: one that is vomiting, one is requesting to ambulate, and one whose family is requesting that the bed be changed. (NOTE: I was puzzled as to the significance of having 3 RNs. It would seem that they are busy with their own pt’s and that this would not affect how I handle my 3 pts.) 4.) The doctor gave an order to DC the oxygen on a pt, which you did. Three hours later the pulse-ox is 87-89%. (NOTE: At this point, does it matter what the doctor’s order was?) I stumbled through some answers on all of them but in looking back I wish I was more creative, thorough, and organized. What do you think the interviewer was looking for with each of these questions? What points should I have made sure to hit? Any responses, however brief or elaborate, on all or some of these scenarios would be greatly appreciated. Thanks!:)

Thanks for your comments and suggestions.

I completed the KAPLAN NCLEX course a couple of months ago and will soon take the NCLEX. I would really appreciate it if someone could give me some insight into the KAPLAN question that follows. An older client diagnosed with pneumonia is admitted to the medical/surgical unit. The nurse should place the patient in a room with which of the following patients? 1. A 20-year-old in traction for multiple fractures of the left lower leg. 2. A 35-year-old with recurrent fever of unknown origin. 3. A 50-year-old recovering alcoholic with cellulitis of the right foot. 4. An 89-year-old with Alzheimer's disease awaiting nursing home placement. Explanation Strategy: Determine the transmission of organisms. (1) patients with fractures are considered "clean"; don't place with an infectious patient (2) don't know the cause of the fever (3) CORRECT - generalized nonfollicular infection that involves deeper connective tissue, both patients have infections (4) elderly are high risk for developing pneumonia A. In the KAPLAN class, we learned that pneumonia is categorized under Droplet precautions. Yet in this question it must be OK to put a pneumonia patient with another patient. Is this allowed for all the diseases listed under Droplet precautions? B. We also learned that skin infections are categorized under Contact precautions which requires a private room. Therefore why is it OK to put the cellulitis patient with another patient? C. Also, the explanation for answer choice 3 indicates that it is OK to partner the pneumonia and cellulitis patients because they both have infections, even though they are different infections. It is not clear to me why the fact that they both have infections makes it OK to partner them. Wouldn't they both then be at risk for catching each other's infections in addition to the one they already have? It seems the thinking is "These patients are already in bad shape so its not a big deal if we make them worse." Thanks for your help.:)

The reason I ask is this: In my last semester of an accelerated BSN program I have a 6 day preceptorship at a local hospital. The preceptor I have is very good. This is actually the first time in the program we attempt to take over full responsibility for patients, with all charting included. (Clinical assignments in previous semesters have been somewhat scattered at different locations and with different nurses. They usually involved alot of "shadowing" while being released at times to do certain procedures on our own if the nurse felt confident with us.) On the 5th day I had the responsibility for 3 patients, with guidance from the preceptor on any procedures or equipment I was unfamiliar with. For the next day the plan is for me to take over her full load of 3-5 patients, which she feels I am capable of. My instructor from the school visited on day 5 and spoke with the preceptor who told her I was doing great in all areas she asked about. However, the preceptor stated I need to work on time management, although I was improving and things were going smoothly with the 3 patients I had. The preceptor stated she feels I am doing fine and she has no problem recommending me as "safe entry level" nurse, assuming the position includes some orientation and time with a preceptor (perhaps 5 days). Now, based upon this comment, my school is considering holding up my graduation. My preceptor is upset about this and thinks it is unreasonable to expect more from anyone after 5 days. Does this seem reasonable? While my preceptor does not think after the 6th day I will necessarily be able to "hit the ground running" at a new hospital, she very much wants to sign me off as a "safe entry level nurse" as it is stated on an evaluation form. Is it basically a "given" in the nursing world that when we use the term "entry level" nurse it will involve some orientation and time with a preceptor, even if there is no "new grad" program. Is that what you would assume it means? Is there any reason why I or my preceptor should think the term "entry level" should mean you will be expected to "hit the ground running"? I will talk to the director of the program at the school soon about what they mean by "entry level" on the evaluation form, but I wanted to gain some insight from people in the field about what you would reasonably expect the term to mean. Thank you.

Dear AlmostRN88, Does your hospital have a "new grad" program? Is the 8-10 week preceptorship considered a "new grad" program, or is that what they do in lieu of a "new grad" program.

I am about to graduate with a BSN in nursing. I would like to get in at a hospital with a "new grad" program. However, many hospitals do not have these. When a hospital hires a new graduate do they expect you to hit then floor running or do they still provide orientation, some initial extra training, and time with a preceptor, even if only for a few days?

Thanks for the responses. I didn't know there was an AllNurses FORUM specifically on this topic, as referenced in the above post. I even found a paper on this subject at https://allnurses.com/collective-bargaining-nursing/unionize-not-unionize-166810.html . This has been very helpful. I have done Google and ProQuest searches with limited success in finding good articles on this subject. If anyone knows of some particularly good published articles, that would be great.

Hello all, At my school I am currently involved in creating a presentation that will discuss the pros and cons of having a Nursing Union and the pros and cons of not having a Nursing Union. I have found some good (but not particularly great) sources about the benefits of nursing unions but have not found much on the benefits of not having a union. One question I have is: Do nursing unions contribute to nursing complacency? I imagine this could be a problem but I have not found any literature to back this up. Of course that is just one concern I can think of. I need to present more on both sides of the issue. Does anyone know of some good articles or other resources that address this topic? Thanks.

By caringrn11: To caringrn11: I put down the ED as my first choice when I applied. However, the nursing recruiter did not say anything about which department I was being considered for when she called for the interview. How did you learn which department/unit you are interviewing for?

Wow... I actually have an interview next week! I am preparing myself for standard interview questions. Should I expect any nursing scenario questions? Any advice or examples you can offer? Thanks!