Stressed to the point of exhaustion over NCLEX

sjalv · Jul 28, 2013

I have read hundreds of NCLEX topics on this forum and the conclusion I have drawn regarding this is that a little bit of anxiety is good, but a lot like you appear to have can do a lot of harm. You made it through nursing school. You have been studying. You could spend the next 10 years studying and still discover new information and still get questions wrong on your practice tests. Just go for it. If you fail, you can learn from your mistakes, improve on the areas you did worst in, and go at it again.

tiredofstudying1 · Jul 28, 2013

Thanks for your response. Its hard because I don't quite know if its random rare diseases and drugs that I've never heard of that I shouldn't stress about or if its stuff I should have learned in school that I need to know. I just want to take the test and be done with it but if I fail then that's another 45 days I have to torture myself studying.

Esme12, ASN, BSN, RN · Jul 28, 2013

moved to NCLEX for best response

finallydone14 · Jul 28, 2013

I don't think that there is anyone that feels completely ready when they get ready to take nclex. I know that I didn't. but what I did know is that I had put a lot of time in studying. Do a lot of questions... I think that's what helps the most because coming out of school the material should still be fresh. sure look over things but doing questions and reading the rationales are very helpful. The longer you put it off the more you have to study and that just makes your anxiety worse b/c you don't know what kind of questions that you'll get and you will constantly be feeling like you're missing something or that you haven't done enough. You will be fine!! Good luck and God bless!!

tiredofstudying1 · Jul 28, 2013

The material I learned in school is fresh however when I take tests I feel like alot of it is foreign to me- things I've never even heard of. And that worries me

nurseprnRN, BSN, RN · Jul 28, 2013

Focus a teeny bit less on the individual data points/facts/values and pay a lot closer attention to nursing process and critical thinking. You're aiming to have a better sense of the big picture. There's a reason for that.

With the increase in SATA questions to assess your ability to think critically, that's what should guide your whole thinking process. Sure, you need to know what a normal (or roughly normal) range for WBC or whatnot is. And in regular work --AND in NCLEX-- it's even more important to be able to recognize an abnormal value and think about what to do about it, including, perhaps "Get more information." Or to recognize a normal finding and look for other information to identify a problem (including deciding if there even is one).

Whatever else you do read, make sure it gives you the rationales for why the wrong choices are wrong as well as the right ones, right. This is where most people fall down-- they pick an answer that is factually true but is not the best answer for the situation as it would be assessed by a good

RN

.

NCLEX items are developed in part from knowing what errors new grads make and how. They tend to be of two kinds: inadequate information, and lack of knowledge (these are not the same thing). The goal of NCLEX is to pass candidates who will be acceptably SAFE in practice as NURSES. So-- they want to know what the prudent NURSE will do.

1) When confronted c 4 answers, you can usually discard 2 out of hand. Of the remaining two,

-- always choose the answer that (in priority order) makes the patient safer or gets you more information. "Can you tell me more about that?" "What do you know about your medication?" "What was the patient's lab result?"

-- NEVER choose the answer that has you turf the situation to another discipline-- chaplain, dietary, MD, social work, etc. It's often tempting, but they want to know about what the NURSE would do. See "always..." above.

2) "Safer" might mean airway, breathing, circulation; it might mean pull the bed out of the room and away from the fire; it might mean pressure ulcer prevention; or improving nutrition; or teaching about loose scatter rugs ... Keep your mind open. It might also mean "Headed down a better pathway to health." For example, while telling a battered woman who has chosen not to leave her partner that "studies show that he will do it again" is factually true (and that's why this wrong answer is often chosen), the better answer is to acknowledge that you hear her choice to stay and say "now let's think of a plan to keep you safe." This doesn't turn her off from listening to you, so she will trust you, acknowledges her right to choose, and helps her along a path to better safety.

3) Read carefully. If they ask you for a nursing intervention answer, they aren't asking for an associated task or action which requires a physician plan of care. So in a scenario involving a medication, the answer would NOT be to hang the IV, regulate it, or chart it; it would not be to observe for complications. It WOULD be to assess pt knowledge of the med/tx plan and derive an appropriate patient teaching plan. Only that last one is nursing-independent and a nursing intervention.

Again, they want NURSING here.

4) The day before the test, do not study. Research shows that your brain does not retain crap you stuff into it at the last minute-- musicians learning a new piece play the first part on Monday, the second part on Tuesday, and the third part on Weds. Then they do something else entirely on Thursday; meanwhile, behind the scenes, the brain is organizing the new info into familiar cubbyholes already stuffed with music, putting it ready for easy access. On Friday, the whole piece works much better.

What this translates for in test-taking land is this: The day before the test, you go to a museum or a concert, go take a hike, read a trashy novel, make a ragout, do something else entirely. Take a small glass of wine, soak in a nice hot bath in a darkened tub with a few candles on the sink, get a nice night's sleep.

5) On your way out the door in the morning, open the refrigerator door and read the mayonnaise jar label. Do what it says: Keep cool, do not freeze. Have fun, you almost-nurse, you!

Future Nurse T · Jul 29, 2013

I really understand you....lol....no I mean really because I am studying and taking my NCLEX next Monday. I know that this is a very tough exam to study for, tiring and anxiety producing. I was feeling the same way but the last weeks I been praying to help me control my nerves and calm down because no one can't think correctly when you have that massive adrenaline in your body. This can also affect how you answer questions. Take Deep Breaths...I know it's easier said than done but we must believe that we can do it!

tiredofstudying1 · Jul 29, 2013

I so appreciate everyone taking time to read my thread and respond to it. I didn't think posting on here would work but I have found peace in people responding to me saying they are going through the same thing and giving me advice. Everyone is like "oh your going to pass so stop worrying!" But they don't know what's on the test or how I'm doing or how I feel about myself and my scores so its so nice to have people respond who are in my shoes or have been n

swansonplace · Jul 29, 2013

Focus a teeny bit less on the individual data points/facts/values and pay a lot closer attention to nursing process and critical thinking. You're aiming to have a better sense of the big picture. There's a reason for that.

With the increase in SATA questions to assess your ability to think critically, that's what should guide your whole thinking process. Sure, you need to know what a normal (or roughly normal) range for WBC or whatnot is. And in regular work --AND in NCLEX-- it's even more important to be able to recognize an abnormal value and think about what to do about it, including, perhaps "Get more information." Or to recognize a normal finding and look for other information to identify a problem (including deciding if there even is one).

Whatever else you do read, make sure it gives you the rationales for why the wrong choices are wrong as well as the right ones, right. This is where most people fall down-- they pick an answer that is factually true but is not the best answer for the situation as it would be assessed by a good
RN
.
NCLEX items are developed in part from knowing what errors new grads make and how. They tend to be of two kinds: inadequate information, and lack of knowledge (these are not the same thing). The goal of NCLEX is to pass candidates who will be acceptably SAFE in practice as NURSES. So-- they want to know what the prudent NURSE will do.

1) When confronted c 4 answers, you can usually discard 2 out of hand. Of the remaining two,
-- always choose the answer that (in priority order) makes the patient safer or gets you more information. "Can you tell me more about that?" "What do you know about your medication?" "What was the patient's lab result?"
-- NEVER choose the answer that has you turf the situation to another discipline-- chaplain, dietary, MD, social work, etc. It's often tempting, but they want to know about what the NURSE would do. See "always..." above.

2) "Safer" might mean airway, breathing, circulation; it might mean pull the bed out of the room and away from the fire; it might mean pressure ulcer prevention; or improving nutrition; or teaching about loose scatter rugs ... Keep your mind open. It might also mean "Headed down a better pathway to health." For example, while telling a battered woman who has chosen not to leave her partner that "studies show that he will do it again" is factually true (and that's why this wrong answer is often chosen), the better answer is to acknowledge that you hear her choice to stay and say "now let's think of a plan to keep you safe." This doesn't turn her off from listening to you, so she will trust you, acknowledges her right to choose, and helps her along a path to better safety.

3) Read carefully. If they ask you for a nursing intervention answer, they aren't asking for an associated task or action which requires a physician plan of care. So in a scenario involving a medication, the answer would NOT be to hang the IV, regulate it, or chart it; it would not be to observe for complications. It WOULD be to assess pt knowledge of the med/tx plan and derive an appropriate patient teaching plan. Only that last one is nursing-independent and a nursing intervention.
Again, they want NURSING here.

4) The day before the test, do not study. Research shows that your brain does not retain crap you stuff into it at the last minute-- musicians learning a new piece play the first part on Monday, the second part on Tuesday, and the third part on Weds. Then they do something else entirely on Thursday; meanwhile, behind the scenes, the brain is organizing the new info into familiar cubbyholes already stuffed with music, putting it ready for easy access. On Friday, the whole piece works much better.
What this translates for in test-taking land is this: The day before the test, you go to a museum or a concert, go take a hike, read a trashy novel, make a ragout, do something else entirely. Take a small glass of wine, soak in a nice hot bath in a darkened tub with a few candles on the sink, get a nice night's sleep.

5) On your way out the door in the morning, open the refrigerator door and read the mayonnaise jar label. Do what it says: Keep cool, do not freeze. Have fun, you almost-nurse, you!

Do you have any suggestions for SATA questions?

Lemuel_RN · Jul 29, 2013

Ok so I take my nclex in less than two weeks and I spend most nights either crying or feeling like I'm going to vomit because I am so stressed and worried about it. Our school did ATI and I have a tutor who is quite frankly not much help. Whenever I take an ati test I feel like I know nothing. So in June I took Kaplan and really liked that class. But my scores are alright I guess. Some were in the 40's but QT 4 was a 52% and then QT 5 was a 54% and I took QT 6 yesterday and got a 56%. Kaplan told us that you need a 54% to pass NCLEX so I've been trying to ease myself by saying if the last two Kaplan tests I took were the nclex I would have passed. I really don't want to postpone the test but I also will feel so ashamed and embarrassed if I don't pass. I have told no one when my test is for that very reason. Everyone I know has taken it already and that makes me feel even more pressure to take it. I just don't know if I'm ready... Any advice? Thanks to anyone who takes the time to read this and reply 

you are not alone, i too failed this NCLEX once, i was so frustrated coz i can't afford to take it anymore, but all of my family and friends and people here in allnurses.com helped my spirit to rise up again, now i will start studying again but this time, i have to invest with review center, like kaplan. i think that purchasing a review will help me coz i have been out of school for 3 years, and NCLEX is way different than the Phil Board exam. in sutdying, i will start on my weak areas, not forgetting my strong areas.. just keep your faith, we can do this, we can become RNs soon and help those who are in need. :yes: :yes: :yes: :yes: :yes:

tiredofstudying1 · Jul 29, 2013

Do you have any suggestions for SATA questions?

What I have learned from SATA questions is that I really just need to think about them. I have to slow down and really look at each individual answer. Kaplan has a 50 question SATA only quiz that I took and only got 14 of them right so they are no doubt hard. But according to Kaplan they are also higher level questions so if you are seeing them on your test than that is a good sign. I've also heard from friends who have recently taken it that the SATA were not as hard as the practice ones from our ATI. There is no secret to answering them unfortunately, I've just really learned to take my time on them since I am a speedy test taker.