4th try Need help with priority not Delegation

ElenaTx · Feb 8, 2013

Always remember the ABC's. If you have a patient with respiratory distress or at a high risk for it (e.g. burns on face or neck) you always have to check on those first. When you answer questions like that try to think about the patient in the most critical condition. What can wait a little longer, what needs your immediate attention. Remember, the patients safety is your highest priority. Hope this helps! Good luck in your studies and your NCLEX.

St_Claire, ADN, RN · Feb 9, 2013

Pick up any version of Kaplan's book, it doesn't matter what year it is from because they have not changed the content in the book in years ( I have two books five years apart and they are the same word for word). There is a section in there that talks about Priority Questions, there are three strategies to use. Try those with the questions in the book and from any online question bank you can get your hands on. Google NCLEX 3500 and you will find a link to a website that has questions very much like the actual NCLEX and its free compliments of Salt Lake Community College (you will see SLCC in the web address). Good luck!!!

begosh · Feb 9, 2013

You have to approach each question independently....meaning...read the stem of the question...what does it deal with? is the problem ABC's, Maslows, does it have anything to do with patient being stable or unstable (what condition is making the patient unstable)? NCLEX will have multiple system dysfunctions listed...figure out what is the problem that needs fixing now.

For example (this is just an example): patient's breathing is 13 breaths/min, K+ 3.0, isolated PVC's...which should be addressed first? What is the highest priority for this client in this scenario? What is the problem that needs fixing now?

jojo23_ · Feb 9, 2013

I really need help on priority question with diseases who will you see first. I do understand delegation but the priority is really an issue for me. The last time I went I did la charity PDA without case study and still didn't pass with 265 questions. This time around I'm reading Mary Ann hogan book cover to cover and doing la charity PDA including case study. I feel if I can get that down packed I will pass. Pls help I'm ready to do anything to make this my last try because I see the finish line already. I know about :
Stable vs unstable
Acute vs chronic
Real vs potential
Expected vs unexpected
Which other tips do you guys have that will help me pass. Any Radom tips, pneumonic , anything pls Help

1. Emphysema client using purse lip breathing while ambulating down the hallway.

2. Patient admitted to the hospital with singed nose hairs after rescued from burning house.

3. A patient rushed to the emergency room after being stabbed by his girlfriend.

Who do you see first? And why?

As someone said treat every question independently.

Maslow

ABC

Acute vs Chronic

Real vs Potential

Unstable vs Stable

And what I personally add (like Acute vs Chronic) is:

Struggling vs Coping--- STRUGGLING patients need IMMEDIATE attention.

oloje1 · Feb 9, 2013

You have to approach each question independently....meaning...read the stem of the question...what does it deal with? is the problem ABC's, Maslows, does it have anything to do with patient being stable or unstable (what condition is making the patient unstable)? NCLEX will have multiple system dysfunctions listed...figure out what is the problem that needs fixing now.
For example (this is just an example): patient's breathing is 13 breaths/min, K+ 3.0, isolated PVC's...which should be addressed first? What is the highest priority for this client in this scenario? What is the problem that needs fixing now?

The client k+ 3.0 will be the priority because experiencing hypokalemiawhich can lead to ECG changes or arrhythmia

oloje1 · Feb 9, 2013

1. Emphysema client using purse lip breathing while ambulating down the hallway.
2. Patient admitted to the hospital with singed nose hairs after rescued from burning house.
3. A patient rushed to the emergency room after being stabbed by his girlfriend.
Who do you see first? And why?
As someone said treat every question independently.
Maslow
ABC
Acute vs Chronic
Real vs Potential
Unstable vs Stable
And what I personally add (like Acute vs Chronic) is:
Struggling vs Coping--- STRUGGLING patients need IMMEDIATE attention.

Ans 3.

Because pt can bleed to death and go in shock

KiyaRN · Feb 9, 2013

1. Emphysema client using purse lip breathing while ambulating down the hallway.
2. Patient admitted to the hospital with singed nose hairs after rescued from burning house.
3. A patient rushed to the emergency room after being stabbed by his girlfriend.
Who do you see first? And why?
As someone said treat every question independently.
Maslow
ABC
Acute vs Chronic
Real vs Potential
Unstable vs Stable
And what I personally add (like Acute vs Chronic) is:
Struggling vs Coping--- STRUGGLING patients need IMMEDIATE attention.

#2- ABC's first. The fact that the nose hairs were singed indicates that the airway may be compromised. Airway first.

Stab wound next because that is a circulation issue if the patient is hemorrhaging.

The emphysema patient is stable and managing his chronic condition with proper breathing.

There is a study guide floating around on the forum that is excellent. It includes many tips and mnemonics that are fun and help some of the toughest topics stick. Just remember...

ABCs

Maslows

Nursing process

(if there are both assessment and implement options in the answers-assess first; if all options are implementations- what makes sense, is relevant to the question asked, and is the safest?)

Good luck!

jojo23_ · Feb 9, 2013

Oloje1, KiyaSN is correct and for the reason she mentioned.

3. Did not mention assessment finding that would lead to the suspicion of shock. He got stabbed-- yes it's CIRCULATION but there was that one patient that needed your attention first.

--Airway takes priority. Anaphylactic reactions (bee stings, blood transfusion reactions, latex allergies,etc) all causes airway complications. They are seen FIRST.

In addition, be conscious of vocabulary used in questions. Didn't exactly know what "singed" meant?.. RED FLAG::: nose (think WOW!-- face/airway; something maybe going on here) & burning building.

Practice, Practice, Practice. :-)

KiyaRN · Feb 9, 2013

https://allnurses.com/attachment.php?attachmentid=8687&d=1310076980

Here is the link to the study guide...it is fantastic! You can do this!!!

acotusrn · Feb 9, 2013

1. Emphysema client using purse lip breathing while ambulating down the hallway.
2. Patient admitted to the hospital with singed nose hairs after rescued from burning house.
3. A patient rushed to the emergency room after being stabbed by his girlfriend.
Who do you see first? And why?
As someone said treat every question independently.
Maslow
ABC
Acute vs Chronic
Real vs Potential
Unstable vs Stable
And what I personally add (like Acute vs Chronic) is:
Struggling vs Coping--- STRUGGLING patients need IMMEDIATE attention.

Haha singed hair! that came out in my exam! #2 is airway!!!!

chibiRN · Feb 10, 2013

New admits/transfers/12 hr or less post op/new diagnosis patients should be considered to be "unstable" regardless of diagnosis or condition. For example, a patient 2 hours post-op hernia repair (even though it's a minor procedure) takes priority over COPD patient reporting SOB.

Also look a change in condition (any change!) needs to be seen ASAP.

Hope that helps. Good luck!