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