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- NCLEX -
NOTAS DE UWORLD, KAPLAN AND NCLEX CRUSADE
Rudelay R Fernandez, RN
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TEMA 1: PRIORIDADES Y DELEGACIONES
NOTAS:
What is prioritizing care? Is deciding which needs or problems require immediate action and which ones could tolerate a delay in response until
later time because they are not urgent.
What is my priority? Evaluating and weight each competing task or process using the following criteria:
1. It is life-threatening or potentially life-threatening if the task is nor don e?
2. Would another patient be endangered if this task is done now or the task id left for later?
3. Is this task or process essential to patient or staff safety?
4. Is this task or process essential to the medical or nursing plan of care?
Level of priorities:
• High priorities – Life-threatening issues or that could result in harm to the client if they are left unaddressed.
• Intermediate priorities – Non-emergency & non-life-threatening issues are.
• Low priorities – Clients needs that are not directly related to the client’s illness or prognosis are.
At the time of prioritization there are 5 important points to follow:
1. Who is the patient? (age, gender, ethnicity, religious belief, mental status)
2. Problem or medical necessity of this patient? (which is the scenario, where is it, what objective & subjective information I have, which
are the symptoms for the diagnosis)
3. Central idea? (what is the main idea or problem)
4. Key words? (best nursing action, essential, early or late signs, immediate, initial, first action, most appropriate, most important, next, primary,
vital)
5. What is the question? (the most important, initial action, the best nursing action)
Priority Question Rules:
• To prevent complications.
• Usually can find more than one correct answer.
• Apply knowledge of physiopathology when establishing priorities for interventions with multiple clients.
• Prioritize the delivery of patient’s care.
• Cardiopulmonary resuscitation needs.
• Actual needs and actual problems take priority over wellness.
Priorities are stablished in the following order: First → Physiological needs (airway, circulation, breathing, vital signs, nutrition, elimination, sleep,
temperature, disability, sex), and Second → Safety & Security needs (physical, protection, security, altered mental status, abnormal laboratory
results, risk of infection, psychosocial, pain, feelings, education).
Thinking and checking always in :
…AIRWAY… gag reflex, dysphagia, anaphylaxis, epiglottitis, seizures, LOC
…BREATHING… absence of breath sounds, O2 administration, O2 status pulse oximetry, elevate HOB, incentive spirometry
…CIRCULATION… HR, BP, pulses, CPR, fluid status (deficit or overload), IVs, TPN, central lines, bleeding/hemorrhages
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…DISABILITY… neurological (AMS), GCS, strokes, traumas, LOC
…SAFETY… rugs, nightlights, falls, walking after narcotic administration, infection control, assessing for infection, hand washing, laboratory tests,
wound drainages, physical abuse, elderly abuse, child abuse, risk of suicide
When to call the HCP? When the nurse cannot address the client problem or condition because it is not within the nurse scope of practice, and it is
a life-threatening situation, then notify the HCP.
Steps of prioritization:
1. Do you have a mixture od physiological and psychological answers?
2. Eliminate all psychosocial answer choices.
3. Ask yourself if the remainder physiological answer choices make sense to the disease
4. Can you apply ABCs?
Don’t read and imagine more than into the question: Read every word in the question and determine specifically what the question is asking. Focus
in the subject of the question. Avoid the trap of reading beyond the circumstances presented in the question, avoid asking yoursel f.
Looking for key words:
Best Least appropriate Side effect
Early Most appropriate Toxic effect
Late Least likely Essential
First Immediate Next
Highest Initial Primary
Vital
Words that reflect assessments:
Ascertain Determine Monitor
Assess Gather Observe
Check Identify Recognize
Collect
Positive events: Include strategic words that ask you to select an option that is correct in regard to the information in the question. Ex: Which
statement by the client indicates understanding… Words: prioritize, first, implement, include, correct, initiate
Negative events: Include strategic words that ask you to select an option that is incorrect in regard to the information in the question. Ex: Which
statement by the client indicates a need for further teaching… Words: immediate, notify, intervene, clarify, risk
Comparable or alike answers: Look for options that are comparable or alike. If several options include the same concept, all of them are usually
incorrect.
Close-ended absolute words: Avoid absolute word meaning when answering. Close-ended absolute words always are incorrect, such as:
All Every Never
Always Must None
Yes No Only
Why
Nurse talking about her or himself answers: Avoid answers where nursing talk about her or himself as an example. They are always incorrect.
Pharmacological questions:
• Do not take an antacid with another oral medication, because the antacid will affect the absorption of the medication.
• Enteric-coated and sustained-release tablets should not be crushed, and capsules should not be opened.
• The client should never adjust or change a dosage or abruptly stop taking a medication.
• The patient should not take OTC medications or any other medications (herbal preparations) unless they are approved for use by the HCP.
• Avoid alcohol and smoking.
• If the question identifies a medical diagnosis, try to link the medication and the diagnosis.
• Recognize the common side effect associated with each medication classification and then relate the appropriate nursing interventions to
each side effect.
SAARE Method:
▪ Stable vs. Unstable. → unstable patients have priority. Vital signs are abnormal, there are major complications, and death may be imminent.
▪ ABCs. Vs. No ABCs. → ABCs patients have priority . Is there an answer choice where ABCs is compromised?
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▪ Acute vs. Chronic. → acute diseases have priority. A patient condition with an abruptly onset and short duration, rapidly progressive, and in
need of urgent care. Less than 3 months.
▪ Real vs. Potential risk. → real diseases have priority . Real or actual is a problem to an etiology manifested by signs and symptoms.
▪ Expected vs. Unexpected. → unexpected effects have priority. Using the Maslow hierarchy.
When deciding which client to assess first, the test taker should: Determine whether the signs/symptoms the client is exhibiting are normal or
expected for the client, and after eliminating the expected options, the test taker should determine which situation is more life-threatening.
Assessment vs. Implementation:
Assessment → Is the process of establishing a data profile about the client and his or her health problems (subjective and objective data); give you
information.
Implementation → Is the care you provide to your clients; does not give you information.
Steps:
1. Establish a pattern. If the answer choices are a mix of assessment and implementation, use the nursing process (assessment vs.
implementation) strategy.
2. Refer to the question to determine whether you should be assessing or implementing.
Priorities in a disaster triage:
Delegation: Process of transferring performance of a selected nursing task in a situation to an individual who is competent to perform that specific
task. The nurse who delegates maintains accountability for the task.
Rights of delegation:
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- NCLEX -
NOTAS DE UWORLD, KAPLAN AND NCLEX CRUSADE
Rudelay R Fernandez, RN
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Guide Answe
TEMA 1: PRIORIDADES Y DELEGACIONES
NOTAS:
What is prioritizing care? Is deciding which needs or problems require immediate action and which ones could tolerate a delay in response until
later time because they are not urgent.
What is my priority? Evaluating and weight each competing task or process using the following criteria:
1. It is life-threatening or potentially life-threatening if the task is nor don e?
2. Would another patient be endangered if this task is done now or the task id left for later?
3. Is this task or process essential to patient or staff safety?
4. Is this task or process essential to the medical or nursing plan of care?
Level of priorities:
• High priorities – Life-threatening issues or that could result in harm to the client if they are left unaddressed.
• Intermediate priorities – Non-emergency & non-life-threatening issues are.
• Low priorities – Clients needs that are not directly related to the client’s illness or prognosis are.
At the time of prioritization there are 5 important points to follow:
1. Who is the patient? (age, gender, ethnicity, religious belief, mental status)
2. Problem or medical necessity of this patient? (which is the scenario, where is it, what objective & subjective information I have, which
are the symptoms for the diagnosis)
3. Central idea? (what is the main idea or problem)
4. Key words? (best nursing action, essential, early or late signs, immediate, initial, first action, most appropriate, most important, next, primary,
vital)
5. What is the question? (the most important, initial action, the best nursing action)
Priority Question Rules:
• To prevent complications.
• Usually can find more than one correct answer.
• Apply knowledge of physiopathology when establishing priorities for interventions with multiple clients.
• Prioritize the delivery of patient’s care.
• Cardiopulmonary resuscitation needs.
• Actual needs and actual problems take priority over wellness.
Priorities are stablished in the following order: First → Physiological needs (airway, circulation, breathing, vital signs, nutrition, elimination, sleep,
temperature, disability, sex), and Second → Safety & Security needs (physical, protection, security, altered mental status, abnormal laboratory
results, risk of infection, psychosocial, pain, feelings, education).
Thinking and checking always in :
…AIRWAY… gag reflex, dysphagia, anaphylaxis, epiglottitis, seizures, LOC
…BREATHING… absence of breath sounds, O2 administration, O2 status pulse oximetry, elevate HOB, incentive spirometry
…CIRCULATION… HR, BP, pulses, CPR, fluid status (deficit or overload), IVs, TPN, central lines, bleeding/hemorrhages
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& Fully
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&Worked
Fully Uworld,
by rudelay
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Answers Kaplan,
r fernandez
Answers Nclex
| Complete
|rn| Crusade
Complete
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Exam Exam
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Guide Answe
…DISABILITY… neurological (AMS), GCS, strokes, traumas, LOC
…SAFETY… rugs, nightlights, falls, walking after narcotic administration, infection control, assessing for infection, hand washing, laboratory tests,
wound drainages, physical abuse, elderly abuse, child abuse, risk of suicide
When to call the HCP? When the nurse cannot address the client problem or condition because it is not within the nurse scope of practice, and it is
a life-threatening situation, then notify the HCP.
Steps of prioritization:
1. Do you have a mixture od physiological and psychological answers?
2. Eliminate all psychosocial answer choices.
3. Ask yourself if the remainder physiological answer choices make sense to the disease
4. Can you apply ABCs?
Don’t read and imagine more than into the question: Read every word in the question and determine specifically what the question is asking. Focus
in the subject of the question. Avoid the trap of reading beyond the circumstances presented in the question, avoid asking yoursel f.
Looking for key words:
Best Least appropriate Side effect
Early Most appropriate Toxic effect
Late Least likely Essential
First Immediate Next
Highest Initial Primary
Vital
Words that reflect assessments:
Ascertain Determine Monitor
Assess Gather Observe
Check Identify Recognize
Collect
Positive events: Include strategic words that ask you to select an option that is correct in regard to the information in the question. Ex: Which
statement by the client indicates understanding… Words: prioritize, first, implement, include, correct, initiate
Negative events: Include strategic words that ask you to select an option that is incorrect in regard to the information in the question. Ex: Which
statement by the client indicates a need for further teaching… Words: immediate, notify, intervene, clarify, risk
Comparable or alike answers: Look for options that are comparable or alike. If several options include the same concept, all of them are usually
incorrect.
Close-ended absolute words: Avoid absolute word meaning when answering. Close-ended absolute words always are incorrect, such as:
All Every Never
Always Must None
Yes No Only
Why
Nurse talking about her or himself answers: Avoid answers where nursing talk about her or himself as an example. They are always incorrect.
Pharmacological questions:
• Do not take an antacid with another oral medication, because the antacid will affect the absorption of the medication.
• Enteric-coated and sustained-release tablets should not be crushed, and capsules should not be opened.
• The client should never adjust or change a dosage or abruptly stop taking a medication.
• The patient should not take OTC medications or any other medications (herbal preparations) unless they are approved for use by the HCP.
• Avoid alcohol and smoking.
• If the question identifies a medical diagnosis, try to link the medication and the diagnosis.
• Recognize the common side effect associated with each medication classification and then relate the appropriate nursing interventions to
each side effect.
SAARE Method:
▪ Stable vs. Unstable. → unstable patients have priority. Vital signs are abnormal, there are major complications, and death may be imminent.
▪ ABCs. Vs. No ABCs. → ABCs patients have priority . Is there an answer choice where ABCs is compromised?
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Guide
Page 3
, 6/12/23, 9:10
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kaplan
4| Verified
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crusade
Questions
Questions
nursing
& Fully
tips
&Worked
Fully Uworld,
by rudelay
Worked
Answers Kaplan,
r fernandez
Answers Nclex
| Complete
|rn| Crusade
Complete
Verified
Exam Exam
Questions
Preparation
Preparation
& Guide
Fully Worked
Guide Answe
▪ Acute vs. Chronic. → acute diseases have priority. A patient condition with an abruptly onset and short duration, rapidly progressive, and in
need of urgent care. Less than 3 months.
▪ Real vs. Potential risk. → real diseases have priority . Real or actual is a problem to an etiology manifested by signs and symptoms.
▪ Expected vs. Unexpected. → unexpected effects have priority. Using the Maslow hierarchy.
When deciding which client to assess first, the test taker should: Determine whether the signs/symptoms the client is exhibiting are normal or
expected for the client, and after eliminating the expected options, the test taker should determine which situation is more life-threatening.
Assessment vs. Implementation:
Assessment → Is the process of establishing a data profile about the client and his or her health problems (subjective and objective data); give you
information.
Implementation → Is the care you provide to your clients; does not give you information.
Steps:
1. Establish a pattern. If the answer choices are a mix of assessment and implementation, use the nursing process (assessment vs.
implementation) strategy.
2. Refer to the question to determine whether you should be assessing or implementing.
Priorities in a disaster triage:
Delegation: Process of transferring performance of a selected nursing task in a situation to an individual who is competent to perform that specific
task. The nurse who delegates maintains accountability for the task.
Rights of delegation:
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