Reviewing NCLEX-RN Questions

[miwinelover]

I recently finished taking my last nursing class (Med\Surg V-Critical Care)before leadership and unfortunately I (along with 7 out of 17) did not pass.

I passed Clinical with flying colors but could not get beyond the test taking in theory. When I spoke with the instructor regarding helpful hints for taking the tests and for studying for the summer before starting class again in the fall, she told me that I needed to look at NCLEX books and practice application and analysis questions. She stated that all of the questions on exams are at the application level and above. (Whatever "above" means--she metioned it 2 times)

Anyway, I am asking for ANY suggestions as to which NCLEX review books or programs are mostly this level. I have a few NCLEX review books, but none seem to be at this level of questioning, most seem to be at knowledge and comprehension levels. (She states I need questions beyond this.)

THANKS:nurse:

[Daytonite, BSN, RN]

saunders comprehensive review for the nclex-rn examination by linda anne silvestri has the critical thinking strategy in it. you also should read the information on this thread:

• https://allnurses.com/forums/f50/looking-test-taking-stratagies-224581.html - looking for test taking strategies (on the nursing student discussion forum)

the basic strategy for answering critical thinking (application type) questions is as follows, you must:

• know and consider the normal anatomy and physiology
  
• know and consider abnormal anatomy for the disease in question
  
• know and consider the resulting signs and symptoms when the disease occurs and how they proceed from mild to fatal - each sign and symptom can be related back to the pathophysiology of the disease
  
• know and consider how the doctor diagnoses and treats the disease in question
  
• know nursing interventions for the signs and symptoms you are being asked about
  
• know the steps of the nursing process and what goes on in each of the steps and consider how they are affecting the question you are being asked
  
• know and consider the principles behind the actions being done - there are many kinds of principles: principles of nursing, principles of biology, principles of chemistry, principles of physics, etc.
  
• read the stem of the question carefully and answer that because the test makers try to trip you up by distracting you with conflicting information they give you in the answer choices that sounds good but has no relationship to what the question is asking for
  
• ask yourself "why" a patient is experiencing some sign or symptoms to get at the underlying problem. nursing like other disciplines treats the problem/signs and symptoms.

a lot of information has to be considered when contemplating the correct answer choices of nclex (application type) questions. it helps to use the nursing process which is a problem solving method in considering your decisions:

1. assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
   
2. determination of the problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
   
3. planning (write measurable goals/outcomes and nursing interventions)
   
4. implementation (initiate the care plan)
   
5. evaluation (determine if goals/outcomes have been met)

here's an analogy on problem solving and the nursing process that might help you understand what the practical application of the nursing process can do for you:

you are driving along and suddenly you hear a bang, you start having trouble controlling your car's direction and it's hard to keep your hands on the steering wheel. you pull over to the side of the road. "what's wrong?" you're thinking. you look over the dashboard and none of the warning lights are blinking. you decide to get out of the car and take a look at the outside of the vehicle. you start walking around it. then, you see it. a huge nail is sticking out of one of the rear tires and the tire is noticeably deflated. what you have just done is step #1 of the nursing process--performed an assessment. you determine that you have a flat tire. you have just done step #2 of the nursing process--made a diagnosis. the little squirrel starts running like crazy in the wheel up in your brain. "what do i do?" you are thinking. you could call aaa. no, you can save the money and do it yourself. you can replace the tire by changing out the flat one with the spare in the trunk. good thing you took that class in how to do simple maintenance and repairs on a car! you have just done step #3 of the nursing process--planning (developed a goal and intervention). you get the jack and spare tire out of the trunk, roll up your sleeves and get to work. you have just done step #4 of the nursing process--implementation of the plan. after the new tire is installed you put the flat one in the trunk along with the jack, dust yourself off, take a long drink of that bottle of water you had with you and prepare to drive off. you begin slowly to test the feel as you drive. good. everything seems fine. the spare tire seems to be ok and off you go and on your way. you have just done step #5 of the nursing process--evaluation (determined if your goal was met).

the career of an rn is about problem solving, so the ability to think critically (bring together a lot of information before making a decision) is extremely important. this is why you take pre-requisite science classes and are now having to learn not only nursing theory, but the pathophysiology and treatment of all kinds of medical diseases and conditions as well as what other licensed healthcare disciplines do for patients. rns are more and more becoming managers of patient care and this requires a broad knowledge way beyond fluffing pillows, giving shots and starting ivs.

[RheatherN, ASN, RN, EMT-P]

do you have any students that are ahead of you or recently graduated? or maybe even an instuctor may have a book or 2 you can buy (students) or even borrow. some books i really dont like to study from, you have to get a feel on what works for you. they have many diff styles. but as Daytonite mentioned, i really like the saunders one.

nclex books really do help, i have used them throughout and they really make you think different. if you dont think they are helping or even pertaining to what you are doing, trust me, they DO! it helps you get the whole picture. so when you do test, you are testing at a level that you are practicing at, so its not as high stress.

there is a book- something like test taking strategies for nurses, its a green cover, and man did that book help. you wouldnt think that reading a book on how to take a test would work, but it TOTALLY does! our "counselor" at school is awesome for helping, see if you have someone you can go to get help from school with.

GL!!

If you want it....you can do it!!

-H-