Tips for NCLEX_RN

[Biggirl4]

:redlight: Maslow's Hierarchy: the main two to focus on are physiological needs and Safety & Security.

Physiological needs- food, water, oxygen, shelter, rest, sex,

temperature, elimination

Safety & Security- Physical (what is threatening the pt.)

Psychological (knowledge and understanding,

What to expect)

:) look at your answer choices and eliminate all the psychological answer choices. Physiological needs must be met first! Can you apply the ABC's (airway, breathing, circulation, cardiac). if an answer involves maintaining the airway, or breathing problems, it is the correct one. if the answer pertains to the cardiovascular system that would be correct. if the ABC's don't apply ask yourself what is the highest priority? this is your answer.

Ex: A pt is being treated for heart failure with diuretic therapy. which of the following best indicates to the nurse that the pts condition is improving?

1. pts weight has remained stable since admission.

2. pts systolic BP has decreased

3. there are fewer crackles heard when auscultating

tthe pts lungs

4. pts urinary output is 1500cc's per day

The answer is #3(rationale: crackles are due to pulmonary edema and a decrease in crackles is a sign that pulmonary edema is decreasing. #1 pts weight should be decreasing,#2 is a distractor BP should decrease but may be due to other causes, #4 a distractor, pts urinary output is within normal limits

Look for hints in the wording of the question stem: most, first, best, initial essential, vital, immediate, highest, priority, indicate that you must establish priorities.

Further teaching is necessary: indicates the answer will contain incorrect info.

The phrase client understands the teaching indicates the answer will be correct information.

The phrase most accurate: indicates that more than one answer will sound good. You may see expected words in an answer choice that is not correct.

if you come across a question that you are unfamiliar with or you do not know what the question is asking you, read the answers to obtain clues, then try to reword the question using the clues.

Prioritization: who would the nurse see first? who should the nurse transfer from the unit during a disaster? the nurse would always see the patient who is least stable FIRST (condition may be life threatening, or moving pt may cause further harm), ABC's apply. the nurse would always transfer the patient who is most stable (condition is not life threatening and outcome is predictable).

PRIORITIZING USING ABC'S

Ex: The client with a diagnosis of cancer is receiving morphine sulfate 10 mg subcutaneously every 3-4 hours for pain. when preparing the plan of care for the client, the nurse includes which priority action?

1.monitor the clients temperature

2. monitor the urine output

3. encourage the client to cough and deep breath

4. encourage increased fluids

The correct answer is #3(rationale; use the abc's, morphine suppresses the respiratory reflex).

PRIORITIZING USING MASLOW'S HIERARCHY

EX: The nurse is reviewing the plan of care for a pregnant client with a diagnosis of sickle cell anemia. which nursing diagnosis, if stated on the plan of care, would the nurse select as receiving the highest priority?

1. Anxiety

2. Ineffective individual coping

3. Altered Body Image

4. Fluid volume deficit

The correct answer is #4(rationale: the physiological needs come first! Options 1, 2 & 3 are eliminated because they are all phsychological and physiological needs are first! Always eliminate the psychological needs. :rotfl:

Nursing Process: Assessment & Implementation

The nurse should ALWAYS ASSESS first! then implementation. Implementation is done after assessment.

Ex: The nurse is teaching a client with diabetes mellitus about dietary measures to follow. The client expresses frustration in learning the dietary regimen. the nurse would initially:

1. Identify the cause of the frustration

2. continue with the dietary teaching

3. notify the physician

4. tell the client that the diet needs to be followed

the correct answer is #1 (rationale; The initial action is to identify the cause of the frustration,assessment is the first step, options 2,3 &4 are implementation steps of the nursing process.)

[lliu0082000]

hi biggirl,

i don't agree with you the answer is #3. because the pt with diuretic therapy, when the condition is improving; first look is urinary output is with normal limits and the answer is #4.

i don't get why you chose #3.

can some one tell me more and i want to understand.

thank you

ex: a pt is being treated for heart failure with diuretic therapy. which of the following best indicates to the nurse that the pts condition is improving?

1. pts weight has remained stable since admission.

2. pts systolic bp has decreased

3. there are fewer crackles heard when auscultating

tthe pts lungs

4. pts urinary output is 1500cc's per day

the answer is #3(rationale: crackles are due to pulmonary edema and a decrease in crackles is a sign that pulmonary edema is decreasing. #1 pts weight should be decreasing,#2 is a distractor bp should decrease but may be due to other causes, #4 a distractor, pts urinary output is within normal limits

[Biggirl4]

hi biggirl,

i don't agree with you the answer is #3. because the pt with diuretic therapy, when the condition is improving; first look is urinary output is with normal limits and the answer is #4.

i don't get why you chose #3.

can some one tell me more and i want to understand.

thank you

ex: a pt is being treated for heart failure with diuretic therapy. which of the following best indicates to the nurse that the pts condition is improving?

1. pts weight has remained stable since admission.

2. pts systolic bp has decreased

3. there are fewer crackles heard when auscultating

tthe pts lungs

4. pts urinary output is 1500cc's per day

the answer is #3(rationale: crackles are due to pulmonary edema and a decrease in crackles is a sign that pulmonary edema is decreasing. #1 pts weight should be decreasing,#2 is a distractor bp should decrease but may be due to other causes, #4 a distractor, pts urinary output is within normal limits

the answer is #3 rationale, you are thinking of the question in terms of what the diuretic does, the question is asking you what is a s/s that the pts pulmonary edema is improving. it is not asking you what the diuretic is supposed to be doing or how you know that the diuretic therapy is working. most heart failure begins with the left ventricular failure and progresses to failure of both ventricles. if pulmonary edema is not treated, death will occur because the patient is literally drowning in their own fluids. what is the main s/s of left sided heart failure pulmonary edema(adventitious sounds caused by accumulation of fluid in the lungs).

[Biggirl4]

hi biggirl,

i don't agree with you the answer is #3. because the pt with diuretic therapy, when the condition is improving; first look is urinary output is with normal limits and the answer is #4.

i don't get why you chose #3.

can some one tell me more and i want to understand.

thank you

ex: a pt is being treated for heart failure with diuretic therapy. which of the following best indicates to the nurse that the pts condition is improving?

1. pts weight has remained stable since admission.

2. pts systolic bp has decreased

3. there are fewer crackles heard when auscultating

tthe pts lungs

4. pts urinary output is 1500cc's per day

the answer is #3(rationale: crackles are due to pulmonary edema and a decrease in crackles is a sign that pulmonary edema is decreasing. #1 pts weight should be decreasing,#2 is a distractor bp should decrease but may be due to other causes, #4 a distractor, pts urinary output is within normal limits

remember abc's: airway, breathing circulation

i hope this helps you, let me know

[michw2]

Remember ABC's: airway, breathing circulation

I hope this helps you, let me know [/quote

Thank you this is great