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  1. Why are SATAs so hard? Did you know that anxiety makes it hard for you to recall information? Imagine you are sitting down to take the NCLEX and the first question is a SATA. Maybe you missed a lot of SATAs in nursing school and have learned to fear them. The question is about beta blockers and you KNOW this – you know all there is to know about beta blockers, but you freeze – your anxiety has blocked your brain. Students tent to find SATA questions intimidating and we often avoid what we don’t like. Many students don’t practice SATAs because they hate them so much. You may have been taught to approach all SATA questions as True/False. This is only one strategy – and certainly not the ONLY strategy. All NCLEX questions are about the textbook standard of care. Don’t get sidetracked by something you encountered in clinical. Students often rush through a question without really understanding what the question is really asking. Students will often choose an answer because it sounds good – but it is actually wrong. Make sure the answers you choose apply to the problem in the question. TIPS Avoid anxiety by mastering content and have NCLEX test-taking strategies Figure out what the question is really asking. You need to identify the problem that requires resolution. Try asking, “What is the problem here?” Only choose answers that directly apply to the problem – choose answers that are immediately necessary, relevant and specific. Choose answers that reflect safe nursing care that applies to MOST people (avoid outliers) Run each answer through a T/F filter, while remembering that this is not the only strategy to use Ask yourself: Would the answer option help the patient, harm them or do nothing? This is super useful for intervention questions. Are two of the answers connected or very similar? If you pick one, then you have to pick the other. This rule applies for conflicting answers as well. Don’t choose two answers that are opposites. Use common sense PRACTICE Practice Questions For each question, try to answer it on your own first, then scroll down to see my discussion of the correct answers. #1 Pharmacological Therapies The nurse teaches a client about the use of clonidine hydrochloride transdermal patches. Which statement by the client indicates they have understood the teaching? Select all that apply A. “I remove my patch every morning before I take a shower and put a new one on in the evening.” B. “I should alternate between putting the patch on my right arm and then my left arm.” C. “I should move slowly when I stand up so I don’t fall.” D. “If I have any side effects, I need to remove the patch right away.” E. “This medication takes a few weeks to start working.” F. “If I feel sleepy, even if it’s the middle of the day, I can take a nap.” Strategy Look for the items that are correct or “right” by asking yourself, “Is this something a client would say if they understood the directions?” Or even simpler, “Is this a true statement about clonidine hydrochloride transdermal patches?” You must have a good understanding of nursing content. Review what you know about these patches. What are they used for? How are they applied? How long does it take for the drug to take effect? What are the side effects? If you can’t recall anything about the medication, try reading the answer options for clues. The clues I see are 1. It’s a patch and 2. It may cause sleepiness and orthostatic hypotension – this might be enough info to help you recall that clonidine is an antihypertensive (a centrally acting alpha2-adrenergic agonist that can also cause drowsiness, fatigue, dizziness, orthostatic hypotension, urinary retention and dry mouth.) A. “I remove my patch every morning before I take a shower and put a new one on in the evening.” This statement is FALSE. The patches should stay in place for a week, even while showering. B. “I should alternate between putting the patch on my right arm and then my left arm.” CORRECT: This answer is TRUE. The site should be changed with each application. C. “I should move slowly when I stand up so I don’t fall.” CORRECT: This is always a good idea! TRUE, but did you catch yourself "second guessing?" Maybe you have this little voice in your head that whispers "if it's too easy, it can't be right" - IGNORE that voice. D. “If I have any side effects, I need to remove the patch right away.” FALSE – Clonidine needs to be stopped gradually over several days to avoid rebound hypertension E. “This medication takes a few weeks to start working.” FALSE F. “If I feel sleepy, even if it’s the middle of the day, I can take a nap.” CORRECT: TRUE – another one that is always a good idea! #2 Reduction of Risk A toddler has honey-colored crusts, fluid filled vesicles and redness around the mouth and arm pits/axillae. Which statement by the child’s parent indicates further teaching is needed? Select all that apply A. “I need to isolate my child for a week.” B. “The irritation was caused by my child using his pacifier.” C. “I will use an antibiotic cream to treat this infection.” D. “I should wash my hands before and after application of the topical antibiotic.” E. “I should keep a food diary to discover what is causing this.” F. “He can go back to daycare after we have used the antibiotic cream for 24 hours.” Strategy You are looking for "something wrong". The real question that is being asked is, “What is incorrect about etiology and treatment for this disease?” Or even better, “What is incorrect information about impetigo.” If you can’t recall information about impetigo, now is the time to review! When doing practice questions, be sure to study the content you miss. A. “I need to isolate my child for a week.” CORRECT: This statement is FALSE – Treatment for impetigo involves using good handwashing techniques. Notice this answer is in conflict with answer F, so don’t choose both.” B. “The irritation was caused by my child using his pacifier.” CORRECT: FALSE – Impetigo is a bacterial infection caused by staph or strep. It is related to poor hygiene or exposure to infection. Remember - we are looking for "something wrong", so the correct answers are the wrong ones. C. “I will use an antibiotic cream to treat this infection.” TRUE – knowing impetigo is a bacterial infection helps with this choice. Don’t get distracted by knowing that antibiotics can also be oral – this isn’t actually a true false question – don’t get distracted by your strategy – stick to the main question: “What is incorrect information about impetigo.” D. “I should wash my hands before and after application of the topical antibiotic.” This is always a good idea as it reduces risk of spreading the infection - TRUE E. “I should keep a food diary to discover what is causing this.” CORRECT: FALSE – The skin lesions do not suggest a food allergy. F. “He can go back to daycare after we have used the antibiotic cream for 24 hours.” The child is contagious for 24 hours after starting antibiotics so this is TRUE. This answer is in conflict with “A” so be sure not to choose both. #3 Basic Care and Comfort The nurse manager determines that which clients on the unit are at risk for developing a pathological fracture? Select all that apply A. A 38 yr-old male diagnosed with bone cancer a year ago. B. A 45 yr-old male newly diagnosed with type 2 diabetes. C. A 50 yr-old male taking corticosterone for 3 years. D. A 58-yr-old female who has been a vegetarian for 10 years. E. A 62-yr-old male who has played soccer for the last 5 years F. A 72-yr-old female diagnosed with osteoporosis 4 years ago. Strategy This question is asking who is at risk for a pathologic fracture. Be sure you don’t overthink this question. I immediately start looking at age and gender, but I know that pathological fractures don’t have anything to do with age or gender, unless you link them to osteoporosis, which is more likely in older women…I am going down a rabbit hole and thinking about menopause now…and STOP! This question is about PATHOLOGIC FRACTURE!! Focus! (this is how I talk to myself…hope you are smiling a little). A. A 38 yr-old male diagnosed with bone cancer a year ago. CORRECT: This person is at risk (risk factor = bone cancer) B. A 45 yr-old male newly diagnosed with Hypertension. No risk – no relationship between this disease and pathologic fracture C. A 50 yr-old male taking corticosterone for 3 years. CORRECT: Long term cortisone therapy puts you at risk for weakened bones D. A 58-yr-old female who works night shift and sleeps most of the day. CORRECT: Low sunlight exposure leads to low levels of vitamin D and vitamin D helps your body absorb calcium. This one is a hard one! E. A 62-yr-old male who has played soccer for the last 5 years No risk – this person is actually lowering their risk by engaging in physical activity F. A 72-yr-old female diagnosed with osteoporosis 4 years ago. CORRECT: Spontaneous fractures can occur due to osteoporosis To Sum Up If you know you’ve “messed up” on a question, the best thing you can do is move on. Take a deep breath and remember that you can’t get them all right! Giving yourself space for grace will reduce your anxiety and allow you to access all that impressive nursing knowledge. What type of questions do you want to practice? References NCSBON info about Next Generation NCLEX Project Getting Ready for the Next Generation NCLEX® (NGN): Frequently Asked Questions
  2. kulak

    My NCLEX-RN Experience

    To say the least, the NCLEX experience for me was one wild rollercoaster ride! One hour I would be fine and confident, the next hour my emotions would flip upside-down and I would feel anxious and insecure. I often went to this forum for help and support, to see how others felt, and how other people prepared and dealt with this situation. Now that it's over, and I have conquered the dreaded NCLEX-RN, I will share my experience with the intent to help those that are on their NCLEX journey. As mentioned above, I took the exam about 2 weeks ago, and passed with 75 questions. It was my first attempt. I took the whole thing very seriously, treating it as my job. After graduating, I took 3 weeks off for vacation to rest. During the following 2 months that I prepared, I studied every single day, and did not go out at all. I got up at 5 am, started studying at 7 am, and finished at 6 pm. Every evening, I took a walk around my neighborhood for 1 hour, and went to bed at 9 pm. It was a rigorous routine, but I knew it was what I had to do to succeed. I did 75-100 questions a day, chewing and digesting all the rationales thoroughly. In total, I did over 3000 questions. About the anxiety, it is a normal part of this journey. In fact, a little nervousness helps you stay on point, so it is okay. Whenever I got really nervous, I did deep breathing exercises, and called my family for support. As for the actual preparation, I first made a plan. First, I need a solid foundation of content knowledge upon which I could build on, in regards to applying the knowledge to NCLEX style situations. Second, I need to master NCLEX strategies by doing practice questions. Doing just questions alone won't help you - you need to have a solid content base, and only then will practice questions be of any use to you. For content, I used Saunders NCLEX Comprehensive Review. In addition, I often looked up things in my textbooks, and researched difficult concepts online for clarification. The Saunders online question bank that comes with the book has simple, content-based questions. These are nothing at all like the questions on the actual NCLEX exam, but they are good for reinforcing your content base, and for boosting your confidence as you get them right. I recommend this book for your content base. I also purchased the NCSBN Learning Extension course - the 3 week subscription. Although it is the cheapest course ($50), it was a mistake. The content part of the course was verbose and way too in-depth. I did the whole question bank of 1400 questions, and it only messed me up. There were grammatical errors, most of the questions only gave rationales for the right answer, and many of the answers I found later to be incorrect. As a result, I had to throw everything out of my head and basically start over and relearn everything. Don't waste your time and money on this course. In terms of content, let me just say that learning happens through the entire journey, as you find out information that you may not have been taught in nursing school. Even when I was doing practice tests, I was learning new things. I learned a lot during my NCLEX journey. After I felt I had a solid handle on content, I went on to do practice questions. I got the LaCharity Prioritization, Delegation, and Assignment book. This was the single best resource, and I know that I would not have passed if it weren't for this book. It is a book of really good questions that are comparable to the actual NCLEX exam. I sure got my behind kicked by this book! But at least I got it kicked then, and not on the actual test! Prioritizing is huge on the NCLEX, and this book prepares you well - presenting scenarios involving delegation and health conditions as they relate to nursing. This book is like NCLEX boot camp, and I am glad I did every page of it. Next, I had to tackle my fear of Select All That Apply (SATA) questions. I got Lippincott's NCLEX-RN Alternate-Response Questions book. I liked that next to every question they show the level of difficulty of the question. I also did the entire book; their questions were good. I strongly recommend both of these books for questions, but if I had to choose only one, I would pick the LaCharity book. In addition, I took advantage of Kaplan's online freebies. They offer a free NCLEX practice test, strategies seminar, and sample class. Those were helpful. And now, the actual exam! 3 days before my exam, I slowed my pace, and just did practice tests. I did my best to keep up a positive attitude. The day of my exam, I went in with the intent of just going in and getting through with it. Noise-cancelling earphones and a roomy cubicle made a good environment for a massive exam like the NCLEX. The questions in the preceding module of the exam are just there so you know how to use the system - they don't count toward your result, but they do take away time from your 6 hours. Just skip over them and move on to your exam. The questions got harder as the exam progressed, which is what should happen. I got about 8 - 10 SATAs, which by the way is not an indicator of how you're doing. Rather, it is the difficulty of questions that matters. I know that in the beginning I got some easy questions wrong, but later on I got hard ones right, which is what counts. I know this because my exam shut off at 75 questions, and about a week later I got my license. Throughout the whole exam, I felt like I was guessing. With the noise-cancelling headphones on, I heard my heart thudding as though it was about to burst out of my chest. My heart really started racing as I approached #75, and almost stopped when I hit "next" after 75, and got the blue screen on my monitor. I shuffled out of the test center in dismay, and just broke down in the elevator. I cried and trembled, and I had no idea why. Only after a half an hour did I regain control of myself. The next few days afterward, I did my best to think of anything other than the NCLEX. I listened to music and watched movies - something I didn't do for the whole summer. This was an unforgettable experience that is comparable to a first love. Honestly, I have no idea how I got through this exam, successfully, but it seems I was properly prepared. Some points to remember are that there is so much information, that it is impossible to know everything. The different health conditions, the meds ... Just do your best and know at least the general stuff - something that you can hang your hat on. Know infection control, prioritizing, delegation, and labs by heart. Remember, the exam is testing whether or not you are safe to practice nursing. Use your critical thinking skills to apply your content base to given scenario. If you believe in a Higher Deity, set aside time do that, because it helps. I believe luck is a factor in all this. Good luck to all those in their pursuit of the RN license. Study hard, and keep your nerves in check! Worrying and biting your nails will only ruin you - it is sticking to the grindstone and working hard (learning content/ answering questions) that will get you through this incredible NCLEX journey.
  3. Okay, okay, okay! Let me get this straight, is it true if you get a lot of select all that apply questions on the nclex that means you're passing? Because I been hearing a lot of people say it's a good sign. When I think about it, I have a friend who only got 4 sata questions and she failed. Then I got another friend who got about 10 she passed. Is this myth true? How many of you failed the Nclex and only gotten a few sata questions? 👎 How many passed and gotten a lot of sata questions? 👍Or did you fail and still get a lot of sata questions? Or who passed and only gotten a few? Let's take a poll on this one. Write back with your responds.
  4. 1st Attempt at the NCLEX I graduated from nursing school with a BSN in December '15. My school has a very high passing rate on the first attempt, so I had no doubt I would pass, after all, I was B+/A student in nursing school, how bad could NCLEX really be. I didn't take NCLEX seriously. I scheduled my exam for February, was getting 50s-60s on Kaplan Q bank, got 58% of Readiness test. I did 50 NCLEX questions per day, read the rationales for every wrong answer, and that's it, I figured that all of the knowledge I had from nursing school was good enough, plus it's impossible to re-read everything. When I took the exam, the computer shut off at 114 questions and I got a big FAIL 2 days later. The only thing I used was Kaplan Q bank. 2nd Attempt at the NCLEX Okay, this is not as easy as I thought. I underestimated the exam and it was my fault. I took me about a month before I started studying again due to family problems (BIG mistake to wait that long). I decided that I didn't use Kaplan right, so I wanted to give it a try one more time. This time I watched every single video in Kaplan, did every question trainer and took notes on anything that was new to me or felt was important, as I continued using the Q bank questions that were left. I reviewed every right and every wrong answer to make sure I understood why they were wrong. I also bought NCSBN, finished the course while taking notes, and did half of their questions (scored around 70-75% on them). In addition, I used Saunders Q&A review. I studied for about 4-5 hours a day every day except weekends for about 2 months before I felt like I was ready to try again. Went to take the test, got to 240 questions and ran out of time. I was devastated. I used Kaplan fully, Saunders Q&A review and NCSBN course. 3rd Attempt at the NCLEX I cried, I cried, I cried. After all, I really tried last time, and it didn't work. Watching my classmates getting jobs while I still couldn't pass the exam made me feel so dumb. It was getting closer to summer, all of my friends were making plans to go out, and all I thought about was NCLEX. I knew I had to finish this before I can finally relax. I downloaded the NCLEX Mastery app and bought Lippincott's Q&A. I also watched lots of Youtube videos on tips, downloaded a study guide for all nurses and other study aids and tricks that I found online, and I reviewed them every once in a while. I used NCLEX mastery everywhere I went. Even when I went to a birthday party, I couldn't allow myself to have fun so I was on my phone doing NCLEX questions from the app. I did around 200 NCLEX questions daily for around 2 months before I tried again. I went in August, got all 265 questions and a big FAIL 2 days later. I used NCLEX Mastery app, Lippincott's Q&A and notes/tips that I found online 4th Attempt at the NCLEX At this point, NCLEX became my life. I cut everyone off from my life. My friends, my family. I saw no future ahead of me, the only thing I saw was NCLEX. Everyday. Every night. I even had dreams where I was studying, then I woke up and went to the library to study, fell asleep at night and got more dreams where I study (can I say I was studying 24/7? lol). I was falling into a depression because if I'm already doing everything that's in my power and can't pass....then how am I supposed to pass? What if I'm not meant to be an RN? What am I missing? Do I really have to re-read every single thing? But that's over 1000s pages, how am I supposed to memorize that? Even if I'll know every single symptom and intervention for every disease, that still doesn't guarantee that I'll pass, because the exam is all about prioritizing and critical thinking. I drove to the library and studied every single day (1 day off a week) from the time I wake up (10am-11am) until late evening (10pm-11pm). I purchased the UWorld. I did 75 questions in untimed tutor mode and took notes on every single question (yes on every single question, unless you know the topic in your sleep). I had around 7-8 pages of handwritten notes after finishing the 75 questions. I continued using the NCLEX Mastery app everywhere I went and before sleep. I also made drugs notecards, I wrote down every single med that I saw and didn't know. In the end, I had around 400-500 notecards that I reviewed DAILY until the day of my exam. I also created isolation precaution note cards that I reviewed daily. I created a huge binder so I could keep everything organized, put all of the online notes/tips and my handwritten notes there. I reviewed that binder DAILY before doing the 75 Uworld questions and every day I added more drug cards and handwritten notes to the binder to study. I kept doing that since the beginning of September until a week before my exam date on October 24th. When I had a week left, the only thing I changed was I started doing Uworld in timed non-tutor mode instead of the untimed tutor (still reviewed and took notes on every question). 1 day before the exam I didn't do any more questions, I just reviewed my notes and my note cards. The next day I had the exam at 8 am, I woke up at 5 am (I went to sleep early so I guess it worked! haha), ate healthy breakfast, drove to the testing center and reviewed my binder and notecards before going in. I said the prayer. My computer shut off at 140 questions, and I freaked out. I was sure I failed because near the end I wasn't getting any of those "bolded" or priority questions. 2 days later I found out I PASSED! It felt so surreal. I used Uworld, NCLEX Mastery app, LaCharity Prioritization, Delegation & Assessment book and notes/tips I found online. Here are some NCLEX study tips that I wish someone would have told me: Keep a consistent schedule what you're going to study and when (might not seem like it's important, but it is) Don't take too many "days off" between studying, or else you'll start to forget and will have to do everything all over again. You have to study every single day or at least every other day if you want to retain information. Studying for a week and taking 3-4 days break will not lead to anything good. While taking NCLEX, treat it just like any other practice test, it will ease your anxiety Treat all of your timed practice tests just like actual NCLEX Before clicking 'next', tell yourself "okay, so if I won't help this person, they will die. The rest will not die and can wait". If it makes sense to you, click 'next' On SATA, not every option relates to your questions. The answer might seem good and look like it won't do any harm, but if it has nothing to do with what the question is asking, then it's the most likely wrong answer Note cards are probably the best way to memorize drugs Embrace it, become a nurse on an emotional level (start thinking like a nurse even in everyday life) You can do it! 🙂 Don't give up and don't stop believing! NCLEX resources that worked for me: UWorld!!!! It truly prepared me for SATA. The questions seemed harder than the actual exam. LaCharity. The questions seemed harder than the exam, and I feel like it really trained my critical thinking. NCLEX Mastery app. The questions are also tough + you can use this app everywhere you go Lippincott's Q&A. It was alright, it also had alot of challenging questions, and it trained my critical thinking, but not as good as LaCharity. NCLEX resources that did not work for me: Kaplan. Fully finished the course and didn't work. NCSBN. I felt like their course wasn't detailed enough, and the questions didn't give good rationales. Saunders Q&A. I feel like the questions were too easy, I was getting 80s-90s on it and still failed Feel free to message me if anyone wants any of my notes or needs any help! 😀