1
Revised 37-page NCLEX Study Guide
1. ABCs (Airway, Breathing, Circulation)
2. When in distress DO NOT ASSESS! Unless 2nd hand information is received.
3. Scenario
• Expected outcome with Disease Process
o Continue to monitor
o Document finding
• Unexpected finding with Disease Process
o Nursing intervention that must make a difference
o Call HCP
4. Mini Maslow’s
1) ABCs (& Pain unrelieved by meds)
2) Safety
3) Comfort (Pain)
4) Psychological
5) Social
6) Spiritual
5. STAT words → Pick the answer that failing to do so will kill or cause great harm
● Highest Priority
● Most Important
● Immediate Action
6. *Least Invasive First*
7. Secondhand Info → Any time you have 2nd hand info, the right answer is assess
∙ UAP ∙ Family
∙ Labs ∙ EMR
∙ EKG ∙ BP machine
8. Never ever take away the coping mechanism a patient uses during a crisis, except if the mechanism puts the
patient or others @ risk
9. Eliminate answer choices & DNR
10. Never withhold Tx! If you’re left with two answer choices and the options are to Tx, or watch the patient,
Pick Tx!
11. Anytime there’s a reversal from the norm, you must worry!
Ex: rebound tenderness (pain after you relieve pressure)
12. Stable Patients
∙ UAP ∙ LPN ∙ New nurse
∙ Graduate Nurse ∙ Float Nurse ∙ Travel nurse
13. Anytime you see excessive findings, That’s not normal!
14. Always empower your patient
15. If a question has “ ”, pick an answer that has what they’re feeling & not what they’re saying
16. 3 R’s of Psych
1) Reality – Functional psych patient
2) Reassure – Delirium
3) Redirect – Dementia
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Default Answers
1. Give meds either 1 hour before meal or 2 hours after meal
2. Give antacids 1 hour before med or 4 hours after med
3. When in doubt pick K (potassium)
4. 2 – 3 L of fluids
5. When in doubt pick answer that has you stay with patient
6. Anytime you see restless & ↓ level of consciousness = early sign always pick
7. Head of Bead → 30-45 degrees for any neuro patient
8. Elderly with acute onset confusion → UTI
9. Secretions will turn Orange/Red for meds
10. Anytime you have GI problem/exacerbation = NPO
11. All surgeries
1st 24 hrs – bleeding
48 hrs – infection
12. Check daily weights if it’s a fluid problem
13. Lateral position for maternity
14. Remove answer choices that are ‘absolutes’
Kaplan NCLEX Strategies
Kaplan RN Decision Tree
Step 1 – Can you identify the topic of the question
Step 2 – Are the answers assessment (get data) or implementation (to effect change)?
Step 3 – Apply Maslow: Are the answers physical or psychosocial? (Physical trumps psychosocial)
Step 4 – Are the answer choices related to ABCs?
Step 5 – What is the outcome of each of the remaining answers?
Rules for Delegation
RN ASSIGNMENT
● Cannot delegate assessment, teaching, or nursing judgement EAT, or planning
LPN/LVN ASSIGNMENT
● Assign stable with expected outcomes
UAP ASSIGNMENT
● Delegate standard, unchanging procedures
Five Rights of Delegation
RIGHT TASK – scope of practice, stable client
RIGHT CIRCUMSTANCES – workload
RIGHT PERSON – scope of practice
RIGHT COMMUNICATION – specific task to be performed, expected results, follow-up communication
RIGHT SUPERVISION – clear directions, intervene if necessary
Therapeutic Communication Tips
DO: DO NOT:
P a g e 2 | 63
, 3
● Do respond to feeling tone ● Do not ask ‘why’ questions
● Do provide information ● Do not ask ‘yes/no’ questions, except in the case of possible self-harm
● Do focus on the client ● Do not focus on the nurse
● Do use silence ● Do not explore
● Do use presence ● Do not say, “Don’t worry!”
P a g e 3 | 63
, 4
Who Do You See First?
Consider:
∙ Unstable vs. Stable ∙ Acute vs. Chronic
∙ Unexpected vs. Expected ∙ Actual vs. Potential
∙ ABCs
Common NCLEX Traps
∙ Do not ask “Why?” ∙ Do not ‘do nothing.’
∙ Do not leave the client. ∙ Do not read into the question
∙ Do not persuade the client. ∙ Do not pass the assignments to someone else
∙ Do not say, “Don’t worry!”
Strategies
● Only use textbook nursing – textbook knowledge
● Pain is psychosocial, unless, it’s severe, acute, & unrelenting
● If it’s a position question, is it going to prevent or promote something – position, prevent, promote
● Teaching/learning – use T/F on each answer
● Risk Questions – use Risk Factors
● If the answers have an absolute in them, do not pick them
● Question that have the phrase ‘And Then’ – did they miss something
Important Lab Values
WBC 4K – 11K
RBC 4–6
Hgb 12 – 16, 0r 12-18
Hct 36 – 48, or 37-52
Platelet 150K – 400K
BUN 6 – 20, or 7-22
Creatintine/ 0.6 – 1.2
Lithium
Urine 85 – 135,
Clearance (GFR)=maintain above
60
Uric Acid 250 – 750 mg
Na 135 – 145
Cl 95 – 105
Ca 8.5 – 10.5
K 3.5 – 5.0
PO 2.5 – 4.5g
Mag 1.6 – 2.6, 4-7 if pregnant
and receiving Tocolytics
Warfarin INR 2.0 – 3.5
Heparin PT 10 – 13 Seconds
PTT 25 – 35 Seconds
P a g e 4 | 63
Revised 37-page NCLEX Study Guide
1. ABCs (Airway, Breathing, Circulation)
2. When in distress DO NOT ASSESS! Unless 2nd hand information is received.
3. Scenario
• Expected outcome with Disease Process
o Continue to monitor
o Document finding
• Unexpected finding with Disease Process
o Nursing intervention that must make a difference
o Call HCP
4. Mini Maslow’s
1) ABCs (& Pain unrelieved by meds)
2) Safety
3) Comfort (Pain)
4) Psychological
5) Social
6) Spiritual
5. STAT words → Pick the answer that failing to do so will kill or cause great harm
● Highest Priority
● Most Important
● Immediate Action
6. *Least Invasive First*
7. Secondhand Info → Any time you have 2nd hand info, the right answer is assess
∙ UAP ∙ Family
∙ Labs ∙ EMR
∙ EKG ∙ BP machine
8. Never ever take away the coping mechanism a patient uses during a crisis, except if the mechanism puts the
patient or others @ risk
9. Eliminate answer choices & DNR
10. Never withhold Tx! If you’re left with two answer choices and the options are to Tx, or watch the patient,
Pick Tx!
11. Anytime there’s a reversal from the norm, you must worry!
Ex: rebound tenderness (pain after you relieve pressure)
12. Stable Patients
∙ UAP ∙ LPN ∙ New nurse
∙ Graduate Nurse ∙ Float Nurse ∙ Travel nurse
13. Anytime you see excessive findings, That’s not normal!
14. Always empower your patient
15. If a question has “ ”, pick an answer that has what they’re feeling & not what they’re saying
16. 3 R’s of Psych
1) Reality – Functional psych patient
2) Reassure – Delirium
3) Redirect – Dementia
P a g e 1 | 63
, 2
Default Answers
1. Give meds either 1 hour before meal or 2 hours after meal
2. Give antacids 1 hour before med or 4 hours after med
3. When in doubt pick K (potassium)
4. 2 – 3 L of fluids
5. When in doubt pick answer that has you stay with patient
6. Anytime you see restless & ↓ level of consciousness = early sign always pick
7. Head of Bead → 30-45 degrees for any neuro patient
8. Elderly with acute onset confusion → UTI
9. Secretions will turn Orange/Red for meds
10. Anytime you have GI problem/exacerbation = NPO
11. All surgeries
1st 24 hrs – bleeding
48 hrs – infection
12. Check daily weights if it’s a fluid problem
13. Lateral position for maternity
14. Remove answer choices that are ‘absolutes’
Kaplan NCLEX Strategies
Kaplan RN Decision Tree
Step 1 – Can you identify the topic of the question
Step 2 – Are the answers assessment (get data) or implementation (to effect change)?
Step 3 – Apply Maslow: Are the answers physical or psychosocial? (Physical trumps psychosocial)
Step 4 – Are the answer choices related to ABCs?
Step 5 – What is the outcome of each of the remaining answers?
Rules for Delegation
RN ASSIGNMENT
● Cannot delegate assessment, teaching, or nursing judgement EAT, or planning
LPN/LVN ASSIGNMENT
● Assign stable with expected outcomes
UAP ASSIGNMENT
● Delegate standard, unchanging procedures
Five Rights of Delegation
RIGHT TASK – scope of practice, stable client
RIGHT CIRCUMSTANCES – workload
RIGHT PERSON – scope of practice
RIGHT COMMUNICATION – specific task to be performed, expected results, follow-up communication
RIGHT SUPERVISION – clear directions, intervene if necessary
Therapeutic Communication Tips
DO: DO NOT:
P a g e 2 | 63
, 3
● Do respond to feeling tone ● Do not ask ‘why’ questions
● Do provide information ● Do not ask ‘yes/no’ questions, except in the case of possible self-harm
● Do focus on the client ● Do not focus on the nurse
● Do use silence ● Do not explore
● Do use presence ● Do not say, “Don’t worry!”
P a g e 3 | 63
, 4
Who Do You See First?
Consider:
∙ Unstable vs. Stable ∙ Acute vs. Chronic
∙ Unexpected vs. Expected ∙ Actual vs. Potential
∙ ABCs
Common NCLEX Traps
∙ Do not ask “Why?” ∙ Do not ‘do nothing.’
∙ Do not leave the client. ∙ Do not read into the question
∙ Do not persuade the client. ∙ Do not pass the assignments to someone else
∙ Do not say, “Don’t worry!”
Strategies
● Only use textbook nursing – textbook knowledge
● Pain is psychosocial, unless, it’s severe, acute, & unrelenting
● If it’s a position question, is it going to prevent or promote something – position, prevent, promote
● Teaching/learning – use T/F on each answer
● Risk Questions – use Risk Factors
● If the answers have an absolute in them, do not pick them
● Question that have the phrase ‘And Then’ – did they miss something
Important Lab Values
WBC 4K – 11K
RBC 4–6
Hgb 12 – 16, 0r 12-18
Hct 36 – 48, or 37-52
Platelet 150K – 400K
BUN 6 – 20, or 7-22
Creatintine/ 0.6 – 1.2
Lithium
Urine 85 – 135,
Clearance (GFR)=maintain above
60
Uric Acid 250 – 750 mg
Na 135 – 145
Cl 95 – 105
Ca 8.5 – 10.5
K 3.5 – 5.0
PO 2.5 – 4.5g
Mag 1.6 – 2.6, 4-7 if pregnant
and receiving Tocolytics
Warfarin INR 2.0 – 3.5
Heparin PT 10 – 13 Seconds
PTT 25 – 35 Seconds
P a g e 4 | 63
