UK nurse with NCLEX Confusion Syndrome

[UKtoTX]

Hello guys,

UK nurse taking my NCLEX in a month *gulp* and neck-deep in cranial nerves, malignant neuroleptic syndrome, Merperdine, Cullen sign, McBurney's point, SQ emphysema and everything else prepping for this text throws at you. I was hoping some people out there could help me clarify a few things:

1) The Kaplan Decision Tree - What does the "Is Validation Required?" trick mean? I assumed it meant, "Do you have a medical order?" which really threw me for a loop because in scenarios where you're prioritzing either 1) giving a drug or fluids or 2) calling the physician (which is rarely the right answer, right?), I'm wondering can I assume I have an order if an option is there or do I have to worry about dependent vs independent nursing interventions? My review told me that if the option is there in NCLEX world, you can confidently assume it has a medical order. Which brings me back to the Kaplan Decision Tree - is this step saying that the trick is "Do You have a medical order?" **sigh** Everything in NCLEX higher questions feels like a trick and one review will contradict another.

2) Delegating to CNAs and nursing students. Does anyone have a definitive resource for working this stuff out? Eg, in one question I did, a wrong answer was that a CNA couldn't do a blood glucose stick on a diabetic patient and report the result because "it required extra training", yet on another question the correct answer was allowing an experienced CNA to logroll a spinal surgery patient, which surely requires extra training too, but how the heck do you know???

Same with nursing students, they're trainee nurses so I assume they require some level of supervision so how do you know for sure what they can do? Often there is no cut and dry, you're guessing.

3) Does anybody go into this exam feeling well prepared? I felt prepared until like yesterday when feeling great about maternal-newborn I did some higher level questions in Lippincott's and one question was asking me to order the exact stages of Leopald's Maneuvers and another seemed to require memorization of Biophysical profiling to score a fetus - does safe nursing require an eidectic memory??? Generally I'm scoring anything from 60 - 90s on Lacharity, 50s on Lippincott's Alternate Format, 70s on Mary Ann Hogan and 60s on Kaplan. I'm just so confused about if I'll ever be ready.

Feeling a little tachycardic ... someone take my pulse =)

[arden26]

Hi. I just saw your posting. Sadly I have NO IDEA what the answers are, but I hope you passed! I'm also a UK trained RN, took NCLEX in March 2011 - passed solely due to to a passing miracle - & believe me, I feel your pain! Not only extraordinarily confusing & contradictory questions, but nothing - absolutely nothing - we did in our UK training prepared us for it. I qualified in '92 (London teaching hospital) when the training still incorporated paeds, psyche, etc. It was absolutely a Monkey-See-Monkey-Do education without reference to science, pharmacology, microbiology, dietetics or even venepuncture (which every US nursing assistant can perform proficiently). So I'm guessing you also qualified in the dim & distant past, since current UK training doesn't cover these areas & doesn't meet US testing reqs?

[UKtoTX]

Hey there, thanks for your sympathy :) I did pass on my first go with something like 78 questions. I wasnt sure I has passed though because it was very hard. I must say though by the time I took it I was pretty confident in the basics but when youre in there you feel like youre getting them all wrong dont you? I trained in the 2000s but did get sufficient maternal-newborn, paeds, psych and med-surg training. Learning the US way though involved a lot of independent study. I do wish Id met you on here in August. I felt so lonely bc noone else really understood the stress of undertaking this exam. Have to admit though, I think it is very doable - it's all really about safety - that's the central concept. Where do you work now?