NCLEX-RN Review-Chris Q. 💉🩺 "Initial Session"
WELCOME!!!!!!!
!!!!!!KEEP IT SIMPLE!!!!!!!! We do NOT need to complicate things
Remember, when you are studying, it is about quality, not quantity!!!!!
Rule of Thumb
3-4 days/week (3-4 hrs.)
NCLEX Study Techniques
Don't JUST DO practice questions (that is NOT true studying) that is working on test taking skills. Remember, knowledge comes first, so you need to review topics & material to lock in the knowledge
How can we know what to do, if we don't know what's wrong with the patient? Always determine the Differential Diagnosis (These are the different conditions/diseases that may be happening?)
When you are studying don't popcorn from topic to topic, stay organized and don't study any more than 3 subcategories per day
Med-Surg (adult health)
Neurological
EENT
cardiac
Respiratory
GI
GU/Renal
Monday
Adult Health (neuro, cardiac, musculoskeletal)-2 hours
Pharmacology
When you are studying write things down, use a dry erase board. This helps with repetition & retainment
Neuro
Strokes (ischemic stroke vs hemorrhagic stroke vs TIA
Types of Seizures
ICP
When you are studying, be able to answer the following questions
"The 6 Pillars of Studying"
What is the pathophysiology of the disease or injury?
How will the patient present? (Signs/Symptoms)-Minimum of 7-10 (Not just the obvious ones)
How do we determine and diagnose the condition? (Labs/Diagnostics)
What are the Nursing Interventions? (Non-pharmacological)
Positioning, comfort, safety, nutrition, etc.
What are some pharmacological interventions?
Patient education (3-4 things)
Ischemia (Stable angina)-small blockage
A lack of oxygenated blood to the myocardium (Heart muscle)
Injury (Unstable angina)-larger blockage
An injury to a portion of the heart muscle due to prolonged ischemia
Infarction (Muscle DEATH!!!!!!!)
Example-Cardiac
Myocardial Infarction (ACS) Acute coronary syndrome
Pathophysiology-Death to a portion of the myocardium due to a complete blockage in the coronary arteries. Due to CAD (Atherosclerosis)
Signs & Symptoms-Crushing or a pressure type CP, Pain will radiate to the left jaw/shoulder/arm, pale/cool/clammy, SOB, Dyspnea, Syncope (passed out), Dysrhythmias, N/V, ST elevation on 12 lead, Anxious/feeling of impending doom
Diagnostics-12 Lead EKG, Cardiac Enzymes (Troponin, CK, and Myoglobin), Chest x-ray, CBC, Electrolytes
Nursing Interventions-Place in a semi or high fowlers position, Oxygen, keep the pt. NPO, prepare for Cath lab, TPA-checklist (Clot busting drugs)
Pharmacological interventions-Oxygen, Aspirin, Clopidogrel (Plavix), Nitroglycerin, Morphine, Consider Beta blockers
Patient education-
NCLEX Test-Taking Techniques
Different Words=Same Meaning
Kidney Stones=Renal Calculi=Nephrolithiasis
Thyrotoxicosis=Thyroid Storm
Addison's Disease=hypoadrenalism
Differentiating Signs/symptoms... (Dyspnea-Asthma, COPD, PNA)
They are extremely deliberate about the words they use!!!!
(What would you do first? Most appropriate action? Actions? Definitive Tx?)
Most appropriate action=What will benefit your pt. the most!!!!
Do NOT use current, clinical, or past experience to answer the question (perfect book world)
ALWAYS read the last sentence first!!!! Then go to the top and read the entire question (That is what they are asking)
Dangerous words in answers to avoid!!!☠️
Always
Never
Only
Solely
Sometimes
Probably
Usually
Maybe
All
Any definitive statements
Least invasive to the most invasive on priority questions
You have a 22 y/o F patient who has a history of asthma, presents to the ED in respiratory distress, anxiety, she has audible wheezing and is cyanotic around the lips. What would be the most appropriate intervention?
A. High flow O2 vis NRB mask at 10 LPM
B. Place in a high fowlers position
C. Obtain an ABG
D. Initiate a nebulized treatment of Albuterol
Do NOT re-invent the wheel...Don't choose an answer which has already been done in the question
Example-Pt. arrives in the ED c/o severe SOB and has audible wheezing. The pt. states she took her MDI of albuterol and a nebulizer PTA without relief
If there are 2 directly opposite answers, 1 of them will typically be correct Hypotension & HTN Bradycardia & Tachycardia
Acute conditions ALWAYS beat out Chronic conditions!!!!
Less than 12 hrs. post-op beats out greater than 12 hrs. post-op
Remember, on priority questions we ALWAYS go least invasive to most invasive!!!!! Start LOW & go SLOW!!!
Critical Rules ☠️
Do NOT ADD anything to the question. We can only go off what the question tells us!!!
NO assumptions. If the question does not say it....it does NOT exist
Do NOT obsess over the # of questions
Always pay attention to the age & gender of the pt.
Get rid of wrong answers first, and be able to explain why you are getting rid of it
ACUTE conditions ALWAYS beat out Chronic conditions
Post-Op complications less than 12 hours ALWAYS beat out post-op complications > 12 hours
Prioritization
SAFETY!!!!!! (falls/injuries/violent pts, aggressive pts, suicide)
Treat Immediate Life Threats=STOP any external bleeding
AIRWAY (Open/Patent)-tongue, upper airway swelling, blood, broken teeth, stridor, gurgling, dentures, mucus, secretions)
BREATHING/oxygenation-Spo2, chest R/F, skins, LOC, 1st s/sx of Hypoxia=anxiety/agitation/restlessness, RR, lung sounds
CIRCULATION-BP, HR, Cap refill, LOC, s/sx of internal bleeding
DISABILITY (Neuro)-AOx4, AVPU, GCS, Pupil signs
FEVER-Sepsis/infection, Heat related emergency, Head injury
PAIN-No one has ever died from pain!!!!
CAUTION!!!!!
Expected findings, especially in chronic diseases are not a priority!!!!
SATA
If you are unsure=leave it blank
You get penalized for over guessing
3 correct answers=you chose 2/3=2 pts/out of 3 pts
Notify the MD!!!!!! Not the best option
Remember, you do NOT need orders for anything
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