Exam (elaborations) RN Med Surg 242 Galen

Med Surg 242

Exam 1 Study Guide & Test Taking Strategies

S.T.A.T Education

When answering nursing exam questions, especially NCLEX-style questions, use ADPIE and
Patient Safety as your decision-making framework. This helps you eliminate wrong answers and
choose the safest nursing action.

ADPIE

A – Assess

 Collect data before acting.
 Look for assessment cues.
 If you don't have enough information, assessment is often the first action. .

D – Diagnose

 Identify the patient's problem based on assessment findings.
 Usually not an answer choice on nursing exams, but it guides your thinking.

P – Plan

 Determine priorities and expected outcomes.
 Think about what needs to happen next.

I – Implement

 Perform nursing interventions.
 Administer medications.
 Educate the patient.
 Carry out provider orders.

E – Evaluate

 Determine if the intervention worked.
 Reassess after medications or treatments.




Patient Safety Always Comes First

,Ask yourself:

"Which patient is the least safe right now?"

Prioritize:

1. Airway
2. Breathing
3. Circulation
4. Neurological status
5. Safety

Use ABCs

A = Airway

 Obstruction
 Choking
 Swelling
 Stridor

B = Breathing

 Shortness of breath
 Low oxygen saturation
 Respiratory distress
 Cyanosis

C = Circulation

 Bleeding
 Hypotension
 Shock
 Chest pain





Maslow's Hierarchy

,Address needs in this order:

1. Oxygen
2. Circulation
3. Food and fluids
4. Elimination
5. Temperature
6. Safety
7. Love and belonging
8. Self-esteem
9. Self-actualization



Stable vs. Unstable

See the unstable patient first.

Unstable:

 New onset chest pain
 Difficulty breathing
 Change in mental status
 Active bleeding
 Hypotension
 High fever with confusion

Stable:

 Chronic pain
 Routine medications
 Discharge teaching
 Stable postoperative patient




Acute Before Chronic

,Treat new problems before long-standing conditions.

Example:

 New shortness of breath takes priority over chronic COPD teaching.

Unexpected Before Expected

Expected findings usually don't require immediate intervention.

Example:

 Mild pain after surgery = expected.
 Sudden absent pedal pulse = unexpected and urgent.

Least Restrictive First

Always choose the least invasive intervention.

Example:

1. Reorient patient.
2. Use a bed alarm.
3. Move patient closer to the nurses' station.
4. Apply restraints (last resort).

Nursing Before Provider

If a nursing intervention can solve the problem safely, do it before calling the provider.

Example:

 Reposition a patient with low oxygen saturation before notifying the provider.




When to Assess First

,Choose assessment first if:

 You don't know what's wrong.
 Data is missing.
 The patient has changed condition.
 You need more information before acting.

Don't assess first if:

 The patient is crashing.
 There is an obvious life-threatening emergency.
 Immediate action is required.

NCLEX Priority Questions

Ask these questions in order:

1. Is the patient safe?
2. Is there an airway problem?
3. Is the patient breathing?
4. Is circulation compromised?
5. Is this patient unstable?
6. Do I need more assessment?
7. Can I fix this with a nursing intervention?
8. Should I evaluate the outcome?



Easy Test Strategy

For every question, mentally walk through this sequence:

Safety → ABCs → ADPIE → Acute vs. Chronic → Stable vs. Unstable → Least Restrictive

This systematic approach works well for prioritization, SATA, and next-action questions because
it keeps your focus on protecting the patient while following the nursing process.




Basic Needs for Health & Safety

 Freedom from trauma, violence, addiction and crime

,  Fresh air
 Nutritious food
 Safe drinking water
 Routine care for physical and mental health
 Routine physical activity
 Safe, satisfying sexuality and reproduction
 Sufficient sleep



Primary Prevention - preventive measures before onset of illness

 Physical fitness – nutrition
 Immunizations
 Smoking cessation
 Limited alcohol use
 Family planning - genetics
 Violence control
 Seat belts & helmets
 Weight
 Sun exposure

Secondary Prevention - preventive measures that lead to early dx/ tx

 Self-breast examination
 Self-testicular examination
 TB screening
 Eyes tested for glaucoma
 Papanicolaou smear
 CVA - skin care - mobility



Tertiary Prevention -preventive measures for rehabilitation after illness

 CVA (stroke) -Speech therapy
 MI (heart attack)- Participate in cardiac rehabilitation
 Chemotherapy - Blood counts taken prior to new chemo

Exam 1
50 Questions
Unit Content # of Items
 Introduction and Orientation
 Health and Wellness
Unit 1  Safety 16-20