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Mark Klimek Nclexgold - Lecture notes 1-12
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Mark Klimek Nclexgold - Lecture notes 1-12
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lOMoARcPSD|22125334Mark Klimek Nclexgold
- Lecture notes 1-12
, lOMoARcPSD|22125334
GOLD 1
Nothing is impossible- the word itself says
“I’m Possible”
NCLEX TIPS
1) Do not read into the question- never assume anything that has not
been specifically mentioned (in the question) and do not add extra
meaning or history to the question—do not make up a story to validate
choosing an answer
2) NCLEX land is set at Utopia General Hospital- you have all the time,
all the resources, and all the staff you need!
3) Least invasive to most invasive – least restrictive to most restrictive
(restraints are rarely a good choice)
4) Avoid using absolutes- always, never, must, etc.
5) Assess the client first before implementing a treatment or action—if there’s
a choice that pertains to assessment of the patient—it is usually the
answer – assess unless in distress
6) Priority goes to assessments and answers that deal with the patient
(patient-focused) directly and not with machines/monitors/equipment
(unless the question is specifically asking about them)
a. Ex: Auscultate fetal heart rate before checking the monitor
7) If it is the FIRST time doing something for or with the patient (such
as vital signs upon admission to the floor/unit, or when a transfer is
involved), the NURSE must complete the assessment- including vital
signs
8) If patient is an adult, answers with family options can be ruled out
(unless patient is not competent to make own decisions)
9) In emergency situations (mass casualty), patients with greater chance
to live are treated first
10) If you are asked about the FIRST action you would take in a
prioritization/discrimination question think: “If I can only do one
action, and then I must go home, what will the outcome be?”
11) Therapeutic communication- reflect feelings and provide correct
information
12) Do not ask “why” questions (or yes/no) and do not say “I understand”
13) An answer that delays care or treatment is usually wrong (Ex: reassess
in 15 minutes, monitor the patient for a continuation of symptoms)
14) When determining interventions to enhance a client’s wellness, consider
options that promote healthy nutrition, regular exercise, proper weight
maintenance, proper rest, and avoidance of harmful chemicals (nicotine)
and risk-taking behaviors (not wearing a seat belt)
15) If two of the answer choices are the exact opposite, one is probably
the answer (ie. bradycardia, tachycardia)
, lOMoARcPSD|22125334
16) If two or three answers are similar, none are correct (*be careful—
sometimes answers may seem similar but in fact are saying
something different)
17) Always look for the UMBRELLA option—one that is a broad
universal statement and usually contains the concepts of the other
options with it—often the correct answer
18) If you have never heard of an answer—do not eliminate it—work around
it…if you can safely eliminate all other answers, that is your answer—if you
are down to two answers and you know one answer is right, go with what
you know
19) Prioritize actual problems over potential problems
20) DO NOT leave the patient – think safety
21) DO NOT “do nothing”- you always have to do something
22) If the question is about endorsement—always report anything new or
different to the next shift
23) Only select “document” if the assessment is normal
24) Put patients with the same or similar diagnoses in the same room-clean
vs. dirty patients
25) Never increase a patient’s fluids to “catch up”
26) Answer SATA questions as true or false for each answer option
27) Rephrase the question in your own words—this ensures you understand
what the question is asking—if you cannot rephrase the question, you do
not know what the topic is
28) If you cannot determine the topic of the question, read all answer choices
to help you understand the problem (look for patterns)
29) Try not to determine the answer before reading the answer choices—
NCLEX uses traps and answers that scream “pick me” but are wrong
30) More often than not, pain will not be your answer -- pain is
considered psychosocial—exception to this rule are signs and
symptoms of compartment syndrome
31) Try to focus on the here and now as much as possible
32) With positioning questions- you are trying to prevent or promote
something—evaluate the outcome of each option
33) When the question asks what is ESSENTIAL—think SAFETY
34) If you do not know what a word means, try to break it down using
medical terminology
a. Ex: Rhabdomyosarcoma – muscle (myo), tumor (sarcoma) →
tumor of the muscle tissue
b. Same idea applies to medications- use suffixes and prefixes to
recognize classifications
35) Make an educated guess—if you can’t make the best answer for a
question after carefully reading it, choose the answer with the most
information
36) When in doubt, SAFETY
2
, lOMoARcPSD|22125334
“Keep them breathing, keep them safe”
Prioritization Techniques
● Prioritize systemic vs. local (life before limb)
● Prioritize acute before chronic
● Prioritize actual before potential future problems
● Prioritize according to Maslow’s- physiological needs before psychosocial
(acute safety can take priority- ATI)
● Recognize and respond to trends vs. transient findings (recognizing a
gradual deterioration)
● Recognize signs of emergencies and complications vs. “expected
client findings”
● Apply clinical knowledge to procedural standards to determine the
priority action- recognizing that the timing of administration of
antidiabetic and antimicrobial medications is more important than
administration of some other medications
How to tackle- WHO DO YOU SEE FIRST- questions:
● Who is your most stable patient? ELIMINATE ANSWER
● Who is your most stable patient (of the 3 remaining)? ELIMINATE
ANSWER
● Who is your most unstable patient (of the 2 remaining)? Airway?
Breathing? Circulation? SELECT ANSWER
Transmission-Based Precautions
AIRBORNE
MTV
M- measles
T- TB
V- Varicella (chicken pox), varicella zoster (disseminated shingles)
*Private room- negative pressure with 6-12 air exchanges/hr, mask, N95
Chicken pox can be rapidly transmitted to other clients—should be isolated
quickly and placed in negative pressure room
3
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