Mark Klimek Nclexgold - Lecture notes 1-12
L L L L L L
Nursing Of Adults (Clemson University)
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StuDocu is not sponsored or endorsed by any college or university
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Downloaded by Jenna Ventrice ()
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,GOLD 1
Nothing is impossible- the word itself says “I’m L L L L L L L L
Possible”
NCLEX TIPS L
1) Do not read into the question- never assume anything that has not
L L L L L L L L L L L L
been specifically mentioned (in the question) and do not add extra
L L L L L L L L L L L
meaning or history to the question—do not make up a story to validate
L L L L L L L L L L L L L
choosing an answer L L
2) NCLEX land is set at Utopia General Hospital- you have all the time, all
L L L L L L L L L L L L L L
the resources, and all the staff you need!
L L L L L L L
3) Least invasive to most invasive – least restrictive to most restrictive
L L L L L L L L L L L
(restraints are rarely a good choice) L L L L L
4) Avoid using absolutes- always, never, must, etc.
L L L L L L
5) Assess the client first before implementing a treatment or action—if there’s
L L L L L L L L L L L
a choice that pertains to assessment of the patient—it is usually the
L L L L L L L L L L L L
answer – assess unless in distress L L L L L
6) Priority goes to assessments and answers that deal with the patient
L L L L L L L L L L L
(patient-focused) directly and not with machines/monitors/equipment L L L L L L
(unless the question is specifically asking about them)
L L L L L L L
a. Ex: Auscultate fetal heart rate before checking the monitorL L L L L L L L
7) If it is the FIRST time doing something for or with the patient (such as
L L L L L L L L L L L L L L L
vital signs upon admission to the floor/unit, or when a transfer is
L L L L L L L L L L L L
involved), the NURSE must complete the assessment- including vital L L L L L L L L L
signs
8) If patient is an adult, answers with family options can be ruled out (unless
L L L L L L L L L L L L L L
patient is not competent to make own decisions)L L L L L L L
9) In emergency situations (mass casualty), patients with greater chance to
L L L L L L L L L L
live are treated first
L L L
10) If you are asked about the FIRST action you would take in a
L L L L L L L L L L L L L
prioritization/discrimination question think: “If I can only do one L L L L L L L L L
action, and then I must go home, what will the outcome be?”
L L L L L L L L L L L
11) Therapeutic communication- reflect feelings and provide correct L L L L L L L
information
12) Do not ask “why” questions (or yes/no) and do not say “I understand”
L L L L L L L L L L L L
13) An answer that delays care or treatment is usually wrong (Ex: reassess in
L L L L L L L L L L L L L
15 minutes, monitor the patient for a continuation of symptoms)
L L L L L L L L L
14) When determining interventions to enhance a client’s wellness, consider
L L L L L L L L L
options that promote healthy nutrition, regular exercise, proper weight
L L L L L L L L L
maintenance, proper rest, and avoidance of harmful chemicals (nicotine) L L L L L L L L L
and risk-taking behaviors (not wearing a seat belt)
L L L L L L L
15) If two of the answer choices are the exact opposite, one is probably the
L L L L L L L L L L L L L L
answer (ie. bradycardia, tachycardia) L L L
Downloaded by Jenna Ventrice () L L L L
,16) If two or three answers are similar, none are correct (*be
L L L L L L L L L L L
careful—sometimes answers may seem similar but in fact are saying L L L L L L L L L L
something different) L
17) Always look for the UMBRELLA option—one that is a broad universal
L L L L L L L L L L L
statement and usually contains the concepts of the other options with
L L L L L L L L L L L
it—often the correct answer L L L
18) If you have never heard of an answer—do not eliminate it—work around
L L L L L L L L L L L L
it…if you can safely eliminate all other answers, that is your answer—if you
L L L L L L L L L L L L L
are down to two answers and you know one answer is right, go with what
L L L L L L L L L L L L L L L
you know L
19) Prioritize actual problems over potential problems L L L L L
20) DO NOT leave the patient – think safety
L L L L L L L
21) DO NOT “do nothing”- you always have to do something
L L L L L L L L L
22) If the question is about endorsement—always report anything new or
L L L L L L L L L L
different to the next shift L L L L
23) Only select “document” if the assessment is normal
L L L L L L L
24) Put patients with the same or similar diagnoses in the same room-clean vs.
L L L L L L L L L L L L L
dirty patients L
25) Never increase a patient’s fluids to “catch up”
L L L L L L L
26) Answer SATA questions as true or false for each answer option
L L L L L L L L L L
27) Rephrase the question in your own words—this ensures you understand
L L L L L L L L L L
what the question is asking—if you cannot rephrase the question, you do
L L L L L L L L L L L L
not know what the topic is
L L L L L
28) If you cannot determine the topic of the question, read all answer choices
L L L L L L L L L L L L L
to help you understand the problem (look for patterns)
L L L L L L L L
29) Try not to determine the answer before reading the answer
L L L L L L L L L L
choices—NCLEX uses traps and answers that scream “pick me” but are L L L L L L L L L L L
wrong
30) More often than not, pain will not be your answer -- pain is considered
L L L L L L L L L L L L L L
psychosocial—exception to this rule are signs and symptoms of L L L L L L L L L
compartment syndrome L
31) Try to focus on the here and now as much as possible
L L L L L L L L L L L
32) With positioning questions- you are trying to prevent or promote
L L L L L L L L L L
something—evaluate the outcome of each option L L L L L
33) When the question asks what is ESSENTIAL—think SAFETY
L L L L L L L
34) If you do not know what a word means, try to break it down using medical
L L L L L L L L L L L L L L L L
terminology
a. Ex: Rhabdomyosarcoma – muscle (myo), tumor (sarcoma) → L L L L L L L
tumor of the muscle tissue L L L L
b. Same idea applies to medications- use suffixes and prefixes to L L L L L L L L L L
recognize classifications L
35) Make an educated guess—if you can’t make the best answer for a question
L L L L L L L L L L L L L
after carefully reading it, choose the answer with the most information
L L L L L L L L L L
36) When in doubt, SAFETY L L L
2
Downloaded by Jenna Ventrice () L L L L
, “Keep them breathing, keep them safe”
L L L L L
Prioritization Techniques L
● Prioritize systemic vs. local (life before limb) L L L L L L
● Prioritize acute before chronic L L L
● Prioritize actual before potential future problems
L L L L L
● Prioritize according to Maslow’s- physiological needs before psychosocial
L L L L L L L L
(acute safety can take priority- ATI)
L L L L L
● Recognize and respond to trends vs. transient findings (recognizing a
L L L L L L L L L L
gradual deterioration) L
● Recognize signs of emergencies and complications vs. “expected client
L L L L L L L L L
findings”
● Apply clinical knowledge to procedural standards to determine the priority
L L L L L L L L L L
action- recognizing that the timing of administration of antidiabetic and
L L L L L L L L L L
antimicrobial medications is more important than administration of some L L L L L L L L L
other medications L
How to tackle- WHO DO YOU SEE FIRST- questions:
L L L L L L L L
● Who is your most stable patient? ELIMINATE ANSWER
L L L L L L L
● Who is your most stable patient (of the 3 remaining)? ELIMINATE
L L L L L L L L L L L
ANSWER
● Who is your most unstable patient (of the 2 remaining)? Airway?
L L L L L L L L L L L
Breathing? Circulation? SELECT ANSWER L L L
Transmission-Based Precautions L L
AIRBORNE
MTV
M- measles
L L
T- TB
L
V- Varicella (chicken pox), varicella zoster (disseminated shingles)
L L L L L L L
*Private room- negative pressure with 6-12 air exchanges/hr, mask, N95
L L L L L L L L L
Chicken pox can be rapidly transmitted to other clients—should be isolated
L L L L L L L L L L L
quickly and placed in negative pressure room
L L L L L L
3
Downloaded by Jenna Ventrice ()
L L L L
L L L L L L
Nursing Of Adults (Clemson University)
L L L L
StuDocu is not sponsored or endorsed by any college or university
L L L L L L L L L L
Downloaded by Jenna Ventrice ()
L L L L
,GOLD 1
Nothing is impossible- the word itself says “I’m L L L L L L L L
Possible”
NCLEX TIPS L
1) Do not read into the question- never assume anything that has not
L L L L L L L L L L L L
been specifically mentioned (in the question) and do not add extra
L L L L L L L L L L L
meaning or history to the question—do not make up a story to validate
L L L L L L L L L L L L L
choosing an answer L L
2) NCLEX land is set at Utopia General Hospital- you have all the time, all
L L L L L L L L L L L L L L
the resources, and all the staff you need!
L L L L L L L
3) Least invasive to most invasive – least restrictive to most restrictive
L L L L L L L L L L L
(restraints are rarely a good choice) L L L L L
4) Avoid using absolutes- always, never, must, etc.
L L L L L L
5) Assess the client first before implementing a treatment or action—if there’s
L L L L L L L L L L L
a choice that pertains to assessment of the patient—it is usually the
L L L L L L L L L L L L
answer – assess unless in distress L L L L L
6) Priority goes to assessments and answers that deal with the patient
L L L L L L L L L L L
(patient-focused) directly and not with machines/monitors/equipment L L L L L L
(unless the question is specifically asking about them)
L L L L L L L
a. Ex: Auscultate fetal heart rate before checking the monitorL L L L L L L L
7) If it is the FIRST time doing something for or with the patient (such as
L L L L L L L L L L L L L L L
vital signs upon admission to the floor/unit, or when a transfer is
L L L L L L L L L L L L
involved), the NURSE must complete the assessment- including vital L L L L L L L L L
signs
8) If patient is an adult, answers with family options can be ruled out (unless
L L L L L L L L L L L L L L
patient is not competent to make own decisions)L L L L L L L
9) In emergency situations (mass casualty), patients with greater chance to
L L L L L L L L L L
live are treated first
L L L
10) If you are asked about the FIRST action you would take in a
L L L L L L L L L L L L L
prioritization/discrimination question think: “If I can only do one L L L L L L L L L
action, and then I must go home, what will the outcome be?”
L L L L L L L L L L L
11) Therapeutic communication- reflect feelings and provide correct L L L L L L L
information
12) Do not ask “why” questions (or yes/no) and do not say “I understand”
L L L L L L L L L L L L
13) An answer that delays care or treatment is usually wrong (Ex: reassess in
L L L L L L L L L L L L L
15 minutes, monitor the patient for a continuation of symptoms)
L L L L L L L L L
14) When determining interventions to enhance a client’s wellness, consider
L L L L L L L L L
options that promote healthy nutrition, regular exercise, proper weight
L L L L L L L L L
maintenance, proper rest, and avoidance of harmful chemicals (nicotine) L L L L L L L L L
and risk-taking behaviors (not wearing a seat belt)
L L L L L L L
15) If two of the answer choices are the exact opposite, one is probably the
L L L L L L L L L L L L L L
answer (ie. bradycardia, tachycardia) L L L
Downloaded by Jenna Ventrice () L L L L
,16) If two or three answers are similar, none are correct (*be
L L L L L L L L L L L
careful—sometimes answers may seem similar but in fact are saying L L L L L L L L L L
something different) L
17) Always look for the UMBRELLA option—one that is a broad universal
L L L L L L L L L L L
statement and usually contains the concepts of the other options with
L L L L L L L L L L L
it—often the correct answer L L L
18) If you have never heard of an answer—do not eliminate it—work around
L L L L L L L L L L L L
it…if you can safely eliminate all other answers, that is your answer—if you
L L L L L L L L L L L L L
are down to two answers and you know one answer is right, go with what
L L L L L L L L L L L L L L L
you know L
19) Prioritize actual problems over potential problems L L L L L
20) DO NOT leave the patient – think safety
L L L L L L L
21) DO NOT “do nothing”- you always have to do something
L L L L L L L L L
22) If the question is about endorsement—always report anything new or
L L L L L L L L L L
different to the next shift L L L L
23) Only select “document” if the assessment is normal
L L L L L L L
24) Put patients with the same or similar diagnoses in the same room-clean vs.
L L L L L L L L L L L L L
dirty patients L
25) Never increase a patient’s fluids to “catch up”
L L L L L L L
26) Answer SATA questions as true or false for each answer option
L L L L L L L L L L
27) Rephrase the question in your own words—this ensures you understand
L L L L L L L L L L
what the question is asking—if you cannot rephrase the question, you do
L L L L L L L L L L L L
not know what the topic is
L L L L L
28) If you cannot determine the topic of the question, read all answer choices
L L L L L L L L L L L L L
to help you understand the problem (look for patterns)
L L L L L L L L
29) Try not to determine the answer before reading the answer
L L L L L L L L L L
choices—NCLEX uses traps and answers that scream “pick me” but are L L L L L L L L L L L
wrong
30) More often than not, pain will not be your answer -- pain is considered
L L L L L L L L L L L L L L
psychosocial—exception to this rule are signs and symptoms of L L L L L L L L L
compartment syndrome L
31) Try to focus on the here and now as much as possible
L L L L L L L L L L L
32) With positioning questions- you are trying to prevent or promote
L L L L L L L L L L
something—evaluate the outcome of each option L L L L L
33) When the question asks what is ESSENTIAL—think SAFETY
L L L L L L L
34) If you do not know what a word means, try to break it down using medical
L L L L L L L L L L L L L L L L
terminology
a. Ex: Rhabdomyosarcoma – muscle (myo), tumor (sarcoma) → L L L L L L L
tumor of the muscle tissue L L L L
b. Same idea applies to medications- use suffixes and prefixes to L L L L L L L L L L
recognize classifications L
35) Make an educated guess—if you can’t make the best answer for a question
L L L L L L L L L L L L L
after carefully reading it, choose the answer with the most information
L L L L L L L L L L
36) When in doubt, SAFETY L L L
2
Downloaded by Jenna Ventrice () L L L L
, “Keep them breathing, keep them safe”
L L L L L
Prioritization Techniques L
● Prioritize systemic vs. local (life before limb) L L L L L L
● Prioritize acute before chronic L L L
● Prioritize actual before potential future problems
L L L L L
● Prioritize according to Maslow’s- physiological needs before psychosocial
L L L L L L L L
(acute safety can take priority- ATI)
L L L L L
● Recognize and respond to trends vs. transient findings (recognizing a
L L L L L L L L L L
gradual deterioration) L
● Recognize signs of emergencies and complications vs. “expected client
L L L L L L L L L
findings”
● Apply clinical knowledge to procedural standards to determine the priority
L L L L L L L L L L
action- recognizing that the timing of administration of antidiabetic and
L L L L L L L L L L
antimicrobial medications is more important than administration of some L L L L L L L L L
other medications L
How to tackle- WHO DO YOU SEE FIRST- questions:
L L L L L L L L
● Who is your most stable patient? ELIMINATE ANSWER
L L L L L L L
● Who is your most stable patient (of the 3 remaining)? ELIMINATE
L L L L L L L L L L L
ANSWER
● Who is your most unstable patient (of the 2 remaining)? Airway?
L L L L L L L L L L L
Breathing? Circulation? SELECT ANSWER L L L
Transmission-Based Precautions L L
AIRBORNE
MTV
M- measles
L L
T- TB
L
V- Varicella (chicken pox), varicella zoster (disseminated shingles)
L L L L L L L
*Private room- negative pressure with 6-12 air exchanges/hr, mask, N95
L L L L L L L L L
Chicken pox can be rapidly transmitted to other clients—should be isolated
L L L L L L L L L L L
quickly and placed in negative pressure room
L L L L L L
3
Downloaded by Jenna Ventrice ()
L L L L
