NCLEX-RN Test Study Guide

NCLEX-RN Test Study Guide TABLE OF CONTENTS NCLEX TEST RESOURCES.................................................................................................................4 INTRODUCTION TO THIS GUIDE................................................................................................5 TESTING AND ANALYSIS.................................................................................................................7 INTRODUCTION TO THE NCLEX...................................................................................................9 THE NCLEX SCORING SCALE........................................................................................................10 GENERAL STRATEGIES....................................................................................................................11 STRATEGY 1: UNDERSTANDING THE INTIMIDATION...........................................................................11 STRATEGY 2: FINDING YOUR OPTIMAL PACE.....................................................................................13 STRATEGY 3: DON’T BE A PERFECTIONIST..........................................................................................15 STRATEGY 4: FACTUALLY CORRECT, BUT ACTUALLY WRONG............................................................16 STRATEGY 5: EXTRANEOUS INFORMATION.........................................................................................16 STRATEGY 6: AVOIDING DEFINITES.....................................................................................................18 STRATEGY 7: USING COMMON SENSE.................................................................................................18 STRATEGY 8: INSTINCTS ARE RIGHT...................................................................................................19 STRATEGY 9: NO FEAR..........................................................................................................................19 STRATEGY 10: DON’T GET THROWN OFF BY NEW INFORMATION....................................................20 STRATEGY 11: NARROWING THE SEARCH...........................................................................................20 STRATEGY 12: YOU’RE NOT EXPECTED TO BE EINSTEIN....................................................................21 RESPIRATORY CONDITIONS.......................................................................................................21 CIRCULATORY SYSTEM...................................................................................................................35 COURSE OF CIRCULATION......................................................................................................................36 THE HEART..............................................................................................................................................37 CARDIOVASCULAR CONDITIONS............................................................................................................40 ARRHYTHMIAS REVIEW..........................................................................................................................53 CARDIAC FAILURE REVIEW.........................................................................................................55 ENDOCRINE REVIEW.......................................................................................................................57 MICROBIOLOGY REVIEW..............................................................................................................68 2 Copyright © StudyGuideZ. All rights reserved. CHARACTERISTICS OF BACTERIA TYPES...............................................................................................68 IMMUNOGLOBULIN ISOTYPES.................................................................................................................74 CYTOKINES REVIEW...............................................................................................................................74 PHARMACOLOGY................................................................................................................................78 MEASUREMENT EQUIVALENTS...................................................................................................87 DRUG DISTRIBUTION......................................................................................................................90 BIOTRANSFORMATION OF DRUGS..........................................................................................93 DRUG ELIMINATION................................................................................................................................94 GENERAL PHARMACOKINETICS REVIEW.............................................................................96 PHARMACODYNAMIC TERMS...................................................................................................................98 AUTONOMIC NERVOUS SYSTEM RECEPTORS........................................................................................98 SPECIFIC PEDIATRIC CONDITIONS.......................................................................................99 TUMOR REVIEW................................................................................................................................108 GI REVIEW...........................................................................................................................................110 EYE, EAR, AND MOUTH REVIEW..............................................................................................118 DISORDERS OF THE EYE......................................................................................................................118 DISORDERS OF THE MOUTH................................................................................................................121 DISORDERS OF THE EAR......................................................................................................................123 OBSTETRICS/GYNECOLOGY......................................................................................................125 DERMATOLOGY REVIEW..............................................................................................................133 AXIAL SKELETON.............................................................................................................................139 APPENDICULAR SKELETON........................................................................................................140 MUSCULOSKELETAL CONDITIONS.........................................................................................146 SAMPLE QUESTIONS......................................................................................................................155 ANSWER KEY......................................................................................................................................175 3 Copyright © StudyGuideZ. All rights reserved. VALUABLE NCLEX RESOURCE LINKS....................................................................................182 SPECIAL REPORT– QUICK REFERENCE LESION REVIEW.........................................183 SPECIAL REPORT- HIGH FREQUENCY TERMS..................................................................186 DEFINITION OF ROOT WORDS................................................................................................192 PREFIXES..............................................................................................................................................196 SUFFIXES..............................................................................................................................................198 NCLEX Test Resources Free NCLEX Practice Tests Financial Aid Facts Scholarship Help Study Tips and Information 4 Copyright © StudyGuideZ. All rights reserved. Introduction to this Guide Your NCLEX score is one of the most critical elements to your qualification to become a nurse, so it is naturally much too important for you to take this test unprepared. The higher your NCLEX score, the better your chances of passing the boards. Careful preparation, as described in this expert guide, along with hard work, will dramatically enhance your probability of success. In fact, it is wise to apply this philosophy not only to your board’s exam, but to other elements of your life as well, to raise you above the competition. Your NCLEX score is one of the areas in the licensure process over which you have a substantial amount of control; this opportunity should not be taken lightly. Hence, a rational, prepared approach to your NCLEX test as well as the rest of the licensure process will contribute considerably to the likelihood of success. Keep in mind, that although it is possible to take the NCLEX more than once, you should never take the test as an “experiment” just to see how well you do. It is of extreme importance that you always be prepared to do your best when taking the NCLEX. For one thing, it is extremely challenging to surmount a poor performance. If you are looking to take a “practice” run, look into review course, professionally developed mock NCLEX examinations, and, of course, this guide. This guide provides you with the professional instruction you require for understanding the traditional NCLEX test. Covered are all aspects of the test and preparation procedures that you will require throughout the process. Upon completion of this guide, you’ll have the confidence 5 Copyright © StudyGuideZ. All rights reserved. and knowledge you need for maximizing your performance on your NCLEX test. 6 Copyright © StudyGuideZ. All rights reserved. Testing and Analysis It won’t take you long to discover that the NCLEX is unlike any test you’ve taken before, and it is probably unlike any test you will ever take again in your academic career. The typical high school or college test is a knowledge-based test. The NCLEX, however, is application-based. What does this mean to you? It means that you’ll have to prepare yourself in a completely different way! You won’t simply be reciting memorized facts as they were phrased in some textbook, and you won’t be applying any learned formulas to specific problems that will be laid out. The NCLEX requires you to think in a thorough, quick and strategic manner…and still be accurate, logical and wise. This test is designed to judge your abilities in the ways that the licensure boards feel is vital to the success of first year nursing graduate. To some extent, you have already gradually obtained these abilities over the length of your academic career. However, what you probably have not yet become familiar with is the capability to use these abilities for the purpose of maximizing performance within the complex and profound environment of a standardized, skills-based examination. There are different strategies, mindsets and perspectives that you will be required to apply throughout the NCLEX. You’ll need to be prepared to use your whole brain as far as thinking and assessment is concerned, and you’ll need to do this in a timely manner. This is not 7 Copyright © StudyGuideZ. All rights reserved. something you can learn from taking a course or reading a book, but it is something you can develop through practice and concentration. The following chapters in this guidebook will lay out the format and style of the NCLEX as well as give you sample questions and examples of the frame of mind you’ll be expected to take. If there is one skill that you take with you from your preparation for the NCLEX, this should be it. 8 Copyright © StudyGuideZ. All rights reserved. Introduction to the NCLEX The purpose of the NCLEX is to establish a standard method of measurement for the skills that have been acquired by nursing school graduates. These skills are considered critical to the healthcare profession. The principle behind the NCLEX is similar to the SAT’s that are required for application to American colleges. Although these tests are similar experiences in some respects, the NCLEX is a much more challenging and complex. Fortunately, the NCLEX does not change very dramatically from year to year. What this means to you, is that it has become possible for quality practice tests to be produced, and if you should take enough of these tests, in addition to learning the correct strategies, you will be able to prepare for the test in an effective manner. The NCLEX is not just a multiple-choice test. Fill in the blank questions and multiple right answer questions have been added to the test. Although these types of questions are not the majority of questions asked on the NCLEX. The main point is that the content has stayed the same. The nursing principles tested prior to these changes are still the same. The content has remained relatively the same. If you understand the content material of the exam, the type of testing question won’t matter. 9 Copyright © StudyGuideZ. All rights reserved. The NCLEX Scoring Scale The minimum number of questions asked on the NCLEX-RN exam is 75. The maximum number of questions is 265. The exam is offered in CAT format which means the difficultly of the questions varies significantly. If you miss a question, the computer will give you an easier question. If you get it right, then you will get harder questions. Many NCLEX test takers freak out if computer shuts off after 75 questions, or if they have to take the maximum number of questions. The main point is to be prepared to go the distance. Don’t be sprinter and concentrate for 100 questions and then let your concentration begin to fade. Likewise, don’t stress on how many questions you have to take. You won’t know the outcome until you get your scores, so don’t stress out. Take some time for yourself and do something fun following the exam. NCLEX Tips 1. Arrive early to the testing center. 2. Bring multiple forms of idea. 3. Wear layered clothing. 4. Get a good night’s sleep before the test. (Don’t cram) 5. Use a study partner when preparing for the exam. 6. Be familiar with the format of the exam. 7. Know your medical terminology. 8. Limit your distractions preparing for the exam. 9. Take time to unwind and reduce stress as you prepare. 10 Copyright © StudyGuideZ. All rights reserved. 10. Remember if you don’t pass, you can retake the exam. General Strategies Strategy 1: Understanding the Intimidation The test writers will generally choose some material on the exam that will be completely foreign to most test takers. You can’t expect all of the medical topics to be a topic with which you have a fair amount of familiarity. If you do happen to come across a high number of topics/cases that you are extremely familiar with, consider yourself lucky, but don’t plan on that happening. Each case and scenario will be slightly different. Try and understand all of the material, while weeding out the distracter information. The cases will also frequently be drawn from real world experiences. Therefore, the passage that you will face on the test may almost seem out of context and as though it begins in the middle of a medical process. You won’t have a nice title overhead explaining the general topic being covered but will immediately be thrown into the middle of a strange format that you don’t recognize. Getting hit by strange sounding medical topics that you don’t recognize, of which you may only have a small exposure, is just normal on the NCLEX. Just remember that the questions themselves will contain all the information necessary to choose a correct answer. 11 Copyright © StudyGuideZ. All rights reserved. 12 Copyright © StudyGuideZ. All rights reserved. Strategy 2: Finding your Optimal Pace Everyone reads and tests at a different rate. It will take practice to determine what is the optimal rate at which you can read fast and yet absorb and comprehend the information. This is true for both the flyover that you should initially conduct and then the subsequent reading you will have to do as you go through and begin focusing on a specific question. However, on the flyover, you are looking for only a surface level knowledge and are not trying to comprehend the minutia of details that will be contained in the question. Basically, skim the question and then read the question slowly. With practice, you will find the pace that you should maintain on the test while answering the questions. It should be a comfortable rate. This is not a speed-reading test. If you have a good pace, and don’t spend too much time on any question, you should have a sufficient amount of time to read the questions at a comfortable rate. The two extremes you want to avoid are the dumbfounded mode, in which you are lip reading every word individually and mouthing each word as though in a stupor, and the overwhelmed mode, where you are panicked and are buzzing back and forth through the question in a frenzy and not comprehending anything. You must find your own pace that is relaxed and focused, allowing you to have time for every question and give you optimal comprehension. Note that you are looking for optimal comprehension, not maximum comprehension. If you spent hours on each word and memorized the question, you would have maximum comprehension. That isn’t the goal though, you want to optimize how much you comprehend with 13 Copyright © StudyGuideZ. All rights reserved. how much time you spend reading each question. Practice will allow you to determine that optimal rate. 14 Copyright © StudyGuideZ. All rights reserved. Strategy 3: Don’t be a Perfectionist If you’re a perfectionist, this may be one of the hardest strategies, and yet one of the most important. The test you are taking is timed, and you cannot afford to spend too much time on any one question. If you are working on a question and you’ve got your answer split between two possible answer choices, and you’re going back through the question and reading it over and over again in order to decide between the two answer choices, you can be in one of the most frustrating situations possible. You feel that if you just spent one more minute on the problem, that you would be able to figure the right answer out and decide between the two. Watch out! You can easily get so absorbed in that problem that you loose track of time, get off track and end up spending the rest of the test playing catch up because of all the wasted time, which may leave you rattled and cause you to miss even more questions that you would have otherwise. Therefore, unless you will only be satisfied with a perfect score and your abilities are in the top .1% strata of test takers, you should not go into the test with the mindset that you’ve got to get every question right. It is far better to accept that you will have to guess on some questions and possibly get them wrong and still have time for every question, than to analyze every question until you’re absolutely confident in your answer and then run out of time on the test. 15 Copyright © StudyGuideZ. All rights reserved. Strategy 4: Factually Correct, but Actually Wrong A favorite ploy of question writers is to write answer choices that are factually correct on their own, but fail to answer the question, and so are actually wrong. When you are going through the answer choices and one jumps out for being factually correct, watch out. Before you mark it as your answer choice, first make sure that you go back to the question and confirm that the answer choice answers the question being asked. Strategy 5: Extraneous Information Some answer choices will seem to fit in and answer the question being asked. They might even be factually correct. Everything seems to check out, so what could possibly be wrong? Does the answer choice actually match the question, or is it based on extraneous information contained in the question. Just because an answer choice seems right, don’t assume that you overlooked information while reading the question. Your mind can easily play tricks on you and make you think that you read something or that you overlooked a phrase. Unless you are behind on time, always go back to the question and make sure that the answer choice “checks out.” 16 Copyright © StudyGuideZ. All rights reserved. 17 Copyright © StudyGuideZ. All rights reserved. Strategy 6: Avoiding Definites Answer choices that make definite statements with no “wiggle room” are often wrong. Try to choose answer choices that make less definite and more general statements that would likely be correct in a wider range of situations and aren’t exclusive. Example: A. The nurse should follow universal contact precautions at all times in every case. B. The nursing assistant completely demonstrated poor awareness of transfer safety. C. Never allow new medications to be accessible on the unit. D. Sometimes, the action taken by the aide was not well planned. Without knowing anything about the question, answer choice D uses the term “sometimes,” which has wiggle room, meaning there could have been a few strong points and weak points about the aide’s performance. All of the other answer choices have a more definite sense about them, implying a more precise answer choice without wiggle room that is often wrong. Strategy 7: Using Common Sense The questions on the test are not intended to be trick questions. Therefore, most of the answer choices will have a sense of normalcy about them that may be fairly obvious and could be answered simply by using common sense. 18 Copyright © StudyGuideZ. All rights reserved. While many of the topics will be ones that you are somewhat unfamiliar with, there will likely be numerous topics that you have some prior indirect knowledge about that will help you answer the questions. Strategy 8: Instincts are Right When in doubt, go with your first instinct. This is an old test-taking trick that still works today. Oftentimes if something feels right instinctively, it is right. Unfortunately, over analytical test takers will often convince themselves otherwise. Don’t fall for that trap and try not to get too nitpicky about an answer choice. You shouldn’t have to twist the facts and create hypothetical scenarios for an answer choice to be correct. Strategy 9: No Fear The depth and breadth of the NCLEX test can be a bit intimidating to a lot of people as it can deal with topics that have never been encountered before and are highly technical. Don’t get bogged down by the information presented. Don’t try to understand every facet of the nursing management process. You won’t have to write an essay about the topics afterwards, so don’t memorize all of the minute details. Don’t get overwhelmed. 19 Copyright © StudyGuideZ. All rights reserved. Strategy 10: Don’t Get Thrown Off by New Information Sometimes test writers will include completely new information in answer choices that are wrong. Test takers will get thrown off by the new information and if it seems like it might be related, they could choose that answer choice incorrectly. Make sure that you don’t get distracted by answer choices containing new information that doesn’t answer the question. Example: Which conclusion is best supported? A: Hyponatremia can cause the anxiety presented in this case. Was anx