Nclex

Front 1

NCLEX blueprint

Back 1

-is organized according to the framework "meeting clients needs"
-there are FOUR major categories
-and SIX subcategories

Front 2

Client need 1
Safe and effective care environment

Back 2

-first subcategory: Management of care
-second subcategory: Safety and infection control

Front 3

Client need 2:

Back 3

-Health promotion and maintenance

Front 4

Client need 3

Back 4

-Psychosocial integrity

Front 5

Client need 4:
Physiological integrity

Back 5

-first subcategory: Basic care and comfort
-second subcategory: Pharmacological and parenteral therapies
-third subcategory: Reduction of risk potential
-fourth subcategory: Physiological adaptation

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Nursing interventions

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-independent: do not require supervision by others
-dependent: based on written orders of a physician
-interdependent: shared with other members
-exam includes questions that involve all 3 types of nursing interventions

Front 7

Reword the question

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-step 1: read each question
-step 2: look for hints, like adjectives: most, first, best, primary, and initial indicate that you must establish priorities
-the phrase: further teaching is necessary, indicates that the answer will contain incorrect information
-the phrase: client understands the teaching, indicates that the answer will be correct information
-step 3: reword the question stem in your own words so that it can be answered with a yes or a no, or specific bits of information
-begin your question with: what, when, or why

Front 8

Eliminate incorrect answer choices

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-step 1: do no look at any answers except answer choice 1
-step 2: read answer 1, repeat the reworded question after reading answer 1, does this answer the reworded question, if it is wrong eliminate it
-step 3: repeat step 2 with each remaining answer choice
-step 4: note answers remaining
-step 5: ask yourself which answer best answers the question

Front 9

Notify physician on exam

Back 9

-more often than not, the answer choices that states, call the physician, contact the social worker, refer to the chaplain, is the wrong answer
-usually there is something you need to do first before you make that call
-the exam does not want to know what the physician is going to do
-the exam wants to know what you will do in a given situation

Front 10

Strategies for Priority questions

Back 10

-recognize priority question
-they will ask: what is the best, most important, first, or initial response, by the nurse
-priority questions are an important component
-to help you select correct answers think: maslow, nursing process, safety

Front 11

Strategies for Priority questions
Strategy 1: Maslow

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-maslow hierarchy of needs is crucial to establishing priorities
-physiological needs has the highest priority and must be met first, includes oxygen, fluid, nutrition, temp, elimination, shelter, rest, and sex
-safety and security needs can be both physical and psychosocial
-love and belonging, client needs to feel loved by family and accepted by others, when a client feels self confident and useful, he will achieve the need of self esteem
-highest level of maslow is self actualization
-the client must experience fulfillment and recognize his or her potential
-in order for self actualization to occur, all of the lower level needs must be met

Front 12

Strategies for Priority questions
Strategy 1: Maslow
four step process

Back 12

-step 1, determine if the answers are both physiological and psychosocial, if they are apply step 2
-step 2, eliminate all psychosocial answers, maslow states that physiological needs must be met first, reactions to pain are considered psychosocial
-step 3, look at each of the answer choices that you have not yet eliminated and ask yourself if the answer choice makes sense with regard to the disease or situation in the question
-step 4, can you apply the ABCs

Front 13

Strategies for Priority questions
Strategy two:
Nursing process

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-involves the assessment and implementation steps of the nursing process
-assessment is the first step of the nursing process and takes priority over all other steps
-its is essential that you complete the assessment phase of the nursing process before you implement nursing activities
-dont implement before you assess
-step 1: read answers to establish a pattern, if they are a mix of assessment and implementation, use the nursing process strategy
-step 2: refer to the question, determine if you should be assessing or implementing
-step 3: eliminate answers and choose the best one

Front 14

Strategies for Priority questions
strategy three: safety

Back 14

-nurses have the primary responsibility of ensuring the safety of clients
-safety includes: meeting basic needs, reducing hazards that cause injury to clients, and decreasing the transmission of pathogens
-always think safety when selecting correct answers
-step 1: are all the answers implementations, if so use Safety strategy
-step 2: can you answer the question to the best of your knowledge, if not continue to step 3
-step 3: ask yourself, what will cause my client the least amount of harm, and choose the best answer

Front 15

Strategies for Management of Care questions

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-exam contains questions about delegation and assignment of client care
-rule 1: do no delegate the functions of assessment, evaluation, and nursing judgment
-rule 2: this is not the real world, do not choose answers based on decisions you may have done
-rule 3: delegate activities for stable clients with predictable outcomes, if unstable or the outcome of an activity no assured, do not delegate
-rule 4: delegate activities that involve standard, unchanging procedures, activities that frequently reoccur in daily client care can be delegated
-rule 5: remember priorities, you can see only one client or perform one activity when answering questions that require you to establish priorities
-step 1: reword the question, step 2: eliminate answers based on the Rules of Management, step 3: select an answer from remaining

Front 16

Strategies for Positioning questions

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-step 1: decide if the position for the client is designed to prevent something or promote something
-step 2: identify what it is you are trying to prevent or promote
-step 3: think about anatomy, physiology, and pathophysiology
-step 4: which position best accomplishes what you are trying to prevent or promote

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Strategies for Communication questions

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-"dont worry" answers, eliminate answers that offer false reassurance
-"lets explore" answers, choices that include the word "explore", avoid being a psychiatrist, the client must be allowed to verbalize the fact that he or she is sad, angry, fearful, or overwhelmed
-"why" questions, are ones that seek reasons or justification
-authoritarian answers, eliminate answers where the nurse is telling the client what to do
-nurse focused answers, eliminate answers that focus of the comment is on the nurse
-close ended questions, they discourage the client from sharing thoughts and feelings

Front 18

Strategies for Communication questions cont

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The correct response will usually contain one or both of the following:
-give correct information, offering information encourages further communication from the client
-is empathetic and reflects the clients feelings: reflection -nurse has heard and understands what the client is trying to communicate.

Front 19

Computer test strategies

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-adjectives most, first, best, primary, and initial indicate that you must establish priorities
-phrase "further teaching is necessary" indicates that the answer will contain incorrect information, look for negative information
-phrase "client understands the teaching" indicates that the answer will be correct information, look for true information
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