NCLEX Test Taking Tips

NCLEX test taking strategies from KAPLAN EXPECTED OUTCOMES What is the expected outcome?
What is the best action for the expected outcome? QUESTION? Read the stem one time. Read the answer choices for clues to topic. Reword question using clues from answer choices. ANSWERS? Read the stem. Identify the topic. Read the answer choices. Identify the nursing concept contained in answer choices. MASLOW Recognized that answers are both physical and psychosocial. Eliminate psychosocial answers. Does this make sense? ABCs, but dont read into the question. ASSESS VS IMPLEMENT Recognize both assess and implement answers. Read stem to decide whether to assess or implement. (If assessment was done in the question, time to implement. If not, assess before implementing) Select best assessment or implementation. SAFETY All answers must be implementations. Try to answer based on knowledge if you cant What will cause the client the least amount of harm? Do no harm. REAL WORLD Dont use real world experience to answer NCLEX exam questions. You have the time, the staff, and the equipment. If it is an answer, it is already ordered. Take care of the patient first. The exam tests your judgment. THERAPEUTIC COMMUNICATION Eliminate dont worry. Eliminate Explore answers. You are not a psychiatrist. Dont ask why? in any form. Eliminate authoritarian answers. Do not tell the patient what to do. Eliminate focus on the nurse answers. Choose answers that give correct information and are empathetic and reflect the patients feelings. POSITIONING Are you trying to prevent or promote? What are you trying to prevent or promote? Think A&P, Patho. DELEGATION Do not delegate: assessment, teaching, or evaluation Delegate care for stable patients with expected outcomes. Delegate tasks that involve standard, unchanging procedures. Stable vs unstable.
Essential Positions Flat (supine). Avoids hip flexion, which can compress arterial flow. Dorsal recumbent. Supine with knees flexed, more comfortable. Side lateral. Allows drainage of oral secretions. Side with leg bent (Sims). Allows drainage of oral secretions and decreases abdominal tension. Head elevated (Fowlers). Increases venous return, allows maximal lung expansion. High Fowlers 60-90 Fowlers 45-60 Semi-Fowlers 30-45 Low Fowlers 15-30 Feet and legs elevated. Increases blood return to heart, relieves pressure on lumbrosacral area. Feet elevated and head lowered (Trendelenburgs). Used to insert CVP line, or for treatment of umbilical cord compression. Feet elevated 20 degrees, knees straight, trunk flat, and heal slightly elevated (Modified Trendelenburgs). Increases venous return, used for shock. Elevation of extremity. Increases venous return, increases blood volume to extremity. Flat on back, thighs flexed, legs abducted (lithotomy). Increases vaginal opening for examination. Prone. Promotes extension of hip joint. Not well tolerated by persons with respiratory or cardiovascular difficulties. Knee-chest. Provides maximal visualization of rectal area. HOT SPOTS for lung sounds Tricuspid area: space between ribs. Two ribs up from the bottom, in the fifth intercostal space at the lower left of the sternal border. Angle of Louis: manubrial sternal junction at the second rib Aortic and pulmonic areas: second intercostal space. Erbs point: third intercostal space. Mitral area: fifth intercostal space and the left mid-clavicular line. Point of maximal impulse (PMI): the impulse of the left ventricle is felt most strongly, on an adult, left fifth costal space in the mid-clavicular line. On an infant: lateral to the left nipple. Dont pass the buck! Assess/implement before calling the doctor. Use real world experience to visualize the scenario, but the textbook to answer the question. MASLOWS: physiological first: oxygen, fluid, nutrition, temperature, elimination, shelter, rest, sex. Safety and security is next, and for NCLEX, pain is psychosocial. Next is love and belonging, self-esteem, and selfactualization. Nursing process: assess, analyze, plan, implement, evaluate.
Reword the question stem. Begin with WHAT, WHEN, WHY. Reword so it can be answered with a yes or no or a specific bit of information. What is the question really asking? Most/first/best/initial= priority. Requires teaching= look for an incorrect answer. Understands= look for correct information. Read the answers for clues on the topic. . Does this answer the reworded question? Answer each select all that apply as if each answer were a true/false question. If it is true, then it applies. Critical thinking: Observation Deciding what is important Look for patterns/ relationships Identify the problem Transfer knowledge from one situation to another Apply knowledge Discriminate between choices/actions. Evaluate according to criteria established. Think: 1. Maslows 2. Nursing process 3. Safety

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NCLEX test taking strategies from KAPLAN EXPECTED OUTCOMES What is the expected outcome?

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