NCLEX Simplified

The holidays make it harder than ever to get in a solid amount of studying. Some of you may be traveling or hosting family. Others may simply need the extra holiday dollars at work and have bitten off more shifts than they can chew. I myself have fallen behind on updating this blog due to traveling! The solution is simple: when time is not easy to find, you have to make it. How can you make time around the holidays? Here's a few tips. 1. Don't sleep or play games on the plane- study! An airplane is one of my favorite places to get work done. You have a nice constant drone in the background, access to a bathroom or beverages should you need it, and nothing better to do. If your seatmates distract you, put some headphones in and get to work. No excuse. This same advice can be applied to a car as well. If you get sick while reading or looking down in a car, change your study source to something that's pure audio. 2. At a relatives' house, get up early. You are most...

The nurse has administered aminophylline to a client with emphysema. The medication is effective when there is: ❍ A. Relief from spasms of the diaphragm ❍ B. Relaxation of smooth muscles in the bronchioles ❍ C. Efficient pulmonary circulation ❍ D. Stimulation of the medullary respiratory center Don't panic because this is a medication you don't know.  For this question, you do NOT need to know how the medication works. Crazy, right? But you don't. Question interpretation: How can I tell that the medication I gave to treat emphysema worked? Pretty much the only thing you have to know is what on earth emphysema is. Emphysema is a lung disorder characterized by overinflated alveoli and being unable to get enough oxygen in through the airway. It also involves retaining CO2. Correct answer: B Let's look at our answer choices. Answer A  talks about relief from spasms of the diaphragm, but this is not a disease that has to do with the diaphragm. That won't...

Pressure ulcers are wounds that develop in a patient's skin, mostly where weight is distributed on a surface. There are a large number of factors that can make a patient vulnerable to pressure ulcers: Immobility, such as that related to bedrest Poor nutrition, because patients who don't eat, don't heal Confusion or an uncooperative patient Incontinence Excessively moist or excessively dry skin Age Smoking Diabetes or other circulatory diseases All pressure ulcers begin as non-blanchable erythema. This means that the area is reddened and, when pressed, does not lose its color. Healthy skin will blanch, meaning it temporarily turns pale or even white. The fact that skin does not perform this color change means that it is a Stage 1 ulcer. Note the following stage descriptions: Stage 1:  Non-blanchable, no open skin Stage 2:  Open skin blister, no depth, may be drainage Stage 3:  Full-thickness tissue loss, some depth and possible tunneling ...

The NCLEX is a test that will destroy the confidence of any test-taker. Apart from its targeted questioning varying in number, select-all-that-apply questions that never seem to end, and the wide-open prairies of information you have to know, you'll pass it no problem. Unless you don't. By the time you pay for another ATT to reschedule, your confidence is most likely in the toilet. Not only did you attempt this beast of a test, but you failed. You failed . Losers fail. People who should be attempting other careers fail. Stupid people fail. Wrong! Not with this test. Let's curb your self-pity in its tracks. 1. For a test that's supposed to be an evaluation of minimum competency of nurses, the NCLEX is a crappy predictor of who will make a good nurse and who won't.  I cannot even begin to name the names of all the LPNs and RNs I know who failed the NCLEX at least once if not multiple times. Some of them are my mentors, some of them are my colleagues, but my ...

Yep, it happens. Don't listen to anyone who would tell you otherwise or say "Oh, well sometimes patients joke," because it absolutely happens. Because nursing is a traditionally female-occupied profession (not to say it is anymore!), sexual harassment of nurses has a long and dirty history that roots all the way back to medieval battlefields where healers with herbal concoctions pressed onto wounds were being told "You have beautiful eyes. Would you like to have your evening meal with me?" Then there are all of the incredibly unhelpful media images as nurses as something sexy (insert Halloween costume here) or that all nurses want to marry doctors or at least do them in on-call sleeping areas. Damn you, Grey's Anatomy! The only positive thing is that we now generally wear scrubs instead of the cute little dress, hat, and stockings ensemble. But even for those that still do, fear of sexual harassment should not be stopping them from wearing what t...

One of the most important issues in nursing is falls. Now I realize that, as nurses, we all hate doing fall assessments, post-fall notes, and post-fall neuro checks. And we don't hate them for the sake of patient safety (of course we realize they're important and need to be done!). We hate them because they add more work onto our already substantial workload. When completing an assessment on any patient, look for reasons that they would fall. This can include advanced age, altered gait, and disease processes that affect balance and coordination such as Parkinson's disease and Multiple Sclerosis. Not all patients who fall are high risk... but many are! One of my favorite bloggers Marijike (self described "nurse writer") found a study conducted by researchers that involved having patients wear sensors that analyzed different gait variables. The study found that just a reduction in gait speed of 5cm/second was associated with an 86.3 percent probability of falling...

Between your nursing degree graduation and the passing of your NCLEX, there is a weird in-between stage no one tells you about until you get there. This stage is known as being a graduate nurse. Graduate nurses are students who have graduated their nursing program and have not yet taken their NCLEX. These nurses, in most states, are able to hold positions in hospitals and other medical facilities with most of, if not all, the responsibilities of an actual nurse. The catch is that the graduate nurse needs to have been offered a graduate nurse or "nursing assistantship" position. In Delaware (for example), once the job offer is verified, the graduate nurse may receive a temporary permit to work for up to six months. After that, it expires and the graduate nurse is no longer allowed to practice until they have passed their NCLEX and been awarded their true license. Graduate nurses are usually paid more than a nursing assistant or certified nurse's aide but less than a ...

The nurse is caring for the client following a laryngectomy when suddenly the client becomes unresponsive and pale, with a BP of 90/40. The initial nurse’s action should be to:  ❍ A. Place the client in Trendelenburg position. ❍ B. Increase the infusion of normal saline. ❍ C. Administer atropine intravenously. ❍ D. Move the emergency cart to the bedside. Tough question. In an emergency (even an emergency question ), it can be tempting to rush and skip thinking it through because it's an emergency question. It's important to remember that this is a theoretical patient and that we can take all the time we need! First, let's analyze what this question is asking. Question interpretation: What is the most important thing the nurse can do for a client who is going into shock? How did we know it's shock? They stated that the patient has just had a procedure done that puts him or her at risk for blood loss (the laryngectomy) and the blood pressure suddenly plummeted...

One of the most undervalued and overlooked aspects of taking the NCLEX is preparing for the test day itself. Note that I said the day- not the test! You've been preparing for the test and studying for weeks, maybe months. That part is all taken care of. It's the day itself that can take any student by surprise. No matter how nervous you expect to be, you need to be prepared for a level beyond even that. Here's how to make sure you're prepared for the big day. 1. Exercise the day before. You are going to be just a little nervous. Admit it! Admit it, then conquer it. Anxiety could keep you up the night before the test, and the last thing you need is to try to sort through a SATA (select-all-that-apply) question on two hours of sleep. One of the best ways to defeat insomnia due to nervousness is to get physically tired. Depending on your exercise level, push it a little. If you don't exercise normally, an hour-long walk should be all you need. If you're a run...

1 week old. First minute in the Pavlik harness. Above is my daughter Elena, pictured at the age of 1 week of age. She is wearing what is known as a Pavlik harness, a cruel-looking device that can be confusing to understand. I certainly never thought I would have to understand it beyond the basic nursing questions. I was more than a little wrong. Elena in her harness, meeting her great-grandmother for the first time. Note how her hips could fold in but that she could not stretch her legs out, nor kick to the side. As it turns out, Elena was doomed. She and I literally had all the risk factors. Let's count them together! 1. Firstborn child. Check! 2. Female child. Check! 3. Breech position. Check! 4. Low amniotic fluid. Check! 5. Family history of hip dysplasia. Check check check! When she was first born, I remember craning my neck around from where I was positioned on the table to look at her as she was taken to the isolette. The entire NICU team was...

Ah, yes. Everyone's favorite type of question. "Select All That Apply" Questions, also known as SATAs, are a great clue that you're getting close to passing your NCLEX. They are what's referred to as a higher level question. In other words, you won't even see them unless you've answered quite a few questions in a row correctly. SATAs may have anywhere from five to seven answers. Any answer from one selection to all of them could be correct. (Don't ever leave a SATA blank. After all, that's guaranteed to be the wrong answer.) So where do you begin? The double-thinking and second-guessing is enough to drive someone insane. Here are some basic principles to help you keep your cool: 1. Read the question and get to the crux of it. Sometimes, they can be long and filled with information you don't need anyway. Sometimes they are! Either way, figure out what the question is really asking. 2. Once you read the question, come up with your own an...

The NCLEX stands for the National Council Licensure Examination and it is the only test that, once passed, allows the practice of a nurse. There are two versions of the NCLEX: PN, for associate-degree nurses (though this becomes rarer and rarer) and the RN, for bachelor-degree nurses. Either one is the most difficult test of any nurse's life. The test ranges anywhere from 75 to 265 questions. The length is based on how well the student answers the questions. If she gets a question right, she will be presented with a similar or more difficult question. If she gets a question wrong, she will be presented with a similar or easier question. Somewhere in between is a pass-fail line that the student must stay above in order to pass the exam. Important things to note about the NCLEX: There is a total time limit of six hours in order to complete the exam. Out of the first 75 questions, 15 of them do not count. These are considered trial questions that the exam writers are con...