NCLEX Mark Klimek (Part 1) Exam Questions With 100% Correct Answers

NCLEX Mark Klimek (Part 1) Exam Questions With 100% Correct Answers "Decide Sickest v.s. Healthiest" With prioritization, answers will always have these 4 parts: - answerAge- Irrelevant because all humans are important Gender- Irrelevant because all humans are important Diagnosis Modifying Phrase (*Most important*) Ex: Of prioritization Ex: Angina pectoris with unstable BP v.s stable vitals with a myocardial infarction (Angina pectoris is the highest priority at this time because they have unstable vitals due to the "modifying phrase". - answerPrioritization 4 Rules to Prioritization - answeracute beats chronic, fresh post op 12hrs beats med surg, unstable beats stable, tie breaker is which organ Acute beats chronic "not ABCs" Which would be your priority? A person with COPD A person with Appendicitis A person with CHF - answerThe person with appendicitis would be the priority and the right answer because it's an acute problem. Fresh post op- "12 hours" beats medical or other surgical problems -Doesn't matter how bad or dangerous the surgery is Which patient would be the priority in this situation? A person with COPD A person with Appendicitis A person with 2 hour post op hysterectomy A radial neck dissection A 48 hour post right frontal craniotomy - answerThe 2 hour post hysterectomy would be the priority because it's a fresh post op. *Stable vs Unstable On notes - answer EX: "Severe colic pain with kidney stones" or "mild pain with chest x ray" is the priority? - answerThe mild pain with chest pain is the priority because that should not happen and they are unstable. With the kidney stones, that is an expected finding= stable. Ex: Which would be the priority? A 16 year old female with meningococcal meningitis who has had a temp of 103.8 since admission 3 days ago/ A 67 year old male with IBS who spiked a temp of 100.3 this afternoon. - answerThe priority in this one would be the IBS patient because the fever is new and unexpected with IBS and has changed since last assessment. The meningitis patient has been unchanged and that is an expected finding with the disease. 4 things that are ALWAYS unstable that are the only expectation to these rules: - answerHemorrhage High fevers above 105= seizures Hypoglycemia= "Ex: 8" Pulselessness or Breathlessness When is pulselessness and breathlessness the lowest priority? - answerAT A SCENE OF AN UNWITNESSED ACCIDENT IF YOU WITNESS= HIGHEST PRIORITY!!!! 3 THINGS TO THAT RESULT IN A BLACK TAGE OF AN UNWITNESSED ACCIDENT: - answerPulselessness Breathlessness Fixed & dilated pupils even if still breathing "The tie-breaker" for Prioritization: The more vital the organ the increase the priority- "The organ mentioned in the modifying phrase" Order for the organs? - answer1. Brain 4. Liver 2. Lungs 5. Kidneys 3. Heart 6. Pancreas Which is priority? A 23 y.o M w/ CHF w K+ of 6.6 and no EKG changes. A chronic renal failure patient with creatinine of 24.7 and pink frothy sputum. An acute hepatitis pt with jaundice and increased ammonia levels which you can't seem to arouse. - answerThe hepatitis patient due to "which you can't seem to arouse"= BRAIN PRIORITY!!!! Angina pectoris with crushing chest pain not relieved by 3 sublingual nitros. Unstable condition here= "pain not relieved...." rest of sentence= stable - answer! You can NOT delegate the following to an LPN: - answer1. Starting an IV 2. Hanging/mixing IV meds 3. Pushing IV push meds "With IV's, they can maintain and document the flow" 4. Administer blood or mess with central lines (flushing, dressing, etc) 5. Plan care "Only can implement it" 6. Perform or develop teaching -Can only reinforce the teaching the RN already taught. 7. Take care of unstable patients 8. The "1st" of anything Ex: The LPN can't do the first tube feed, but can do the next if stable The LPN can ambulate post op, but not the first time 9 LPNS are not allowed to do the following assessments Admission Discharge Transfer 1st one after a change in pt's condition