NCLEX Mark Klimek (Part 1) UPDATED
ACTUAL Exam Questions and CORRECT
Answers
"Decide Sickest v.s. Healthiest"
With prioritization, answers will always have these 4 parts: - CORRECT ANSWER - Age-
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". - CORRECT ANSWER - Prioritization
4 Rules to Prioritization - CORRECT ANSWER - acute 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 - CORRECT ANSWER - The 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 - CORRECT ANSWER - The 2 hour post
hysterectomy would be the priority because it's a fresh post op.
*Stable vs Unstable On notes - CORRECT ANSWER -
EX: "Severe colic pain with kidney stones" or "mild pain with chest x ray" is the priority? -
CORRECT ANSWER - The 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. - CORRECT
ANSWER - The 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: - CORRECT
ANSWER - Hemorrhage
High fevers above 105= seizures
Hypoglycemia= "Ex: 8"
Pulselessness or Breathlessness
When is pulselessness and breathlessness the lowest priority? - CORRECT ANSWER - AT
A SCENE OF AN UNWITNESSED ACCIDENT
, IF YOU WITNESS= HIGHEST PRIORITY!!!!
3 THINGS TO THAT RESULT IN A BLACK TAGE OF AN UNWITNESSED ACCIDENT: -
CORRECT ANSWER - Pulselessness
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? - CORRECT ANSWER - 1. 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. - CORRECT ANSWER - The 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 - CORRECT
ANSWER -!
You can NOT delegate the following to an LPN: - CORRECT ANSWER - 1. Starting an
IV
2. Hanging/mixing IV meds
3. Pushing IV push meds
"With IV's, they can maintain and document the flow"
ACTUAL Exam Questions and CORRECT
Answers
"Decide Sickest v.s. Healthiest"
With prioritization, answers will always have these 4 parts: - CORRECT ANSWER - Age-
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". - CORRECT ANSWER - Prioritization
4 Rules to Prioritization - CORRECT ANSWER - acute 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 - CORRECT ANSWER - The 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 - CORRECT ANSWER - The 2 hour post
hysterectomy would be the priority because it's a fresh post op.
*Stable vs Unstable On notes - CORRECT ANSWER -
EX: "Severe colic pain with kidney stones" or "mild pain with chest x ray" is the priority? -
CORRECT ANSWER - The 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. - CORRECT
ANSWER - The 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: - CORRECT
ANSWER - Hemorrhage
High fevers above 105= seizures
Hypoglycemia= "Ex: 8"
Pulselessness or Breathlessness
When is pulselessness and breathlessness the lowest priority? - CORRECT ANSWER - AT
A SCENE OF AN UNWITNESSED ACCIDENT
, IF YOU WITNESS= HIGHEST PRIORITY!!!!
3 THINGS TO THAT RESULT IN A BLACK TAGE OF AN UNWITNESSED ACCIDENT: -
CORRECT ANSWER - Pulselessness
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? - CORRECT ANSWER - 1. 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. - CORRECT ANSWER - The 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 - CORRECT
ANSWER -!
You can NOT delegate the following to an LPN: - CORRECT ANSWER - 1. Starting an
IV
2. Hanging/mixing IV meds
3. Pushing IV push meds
"With IV's, they can maintain and document the flow"
