NCLEX Simplified

The Next Generation NCLEX (NGN) project has been going on for quite a while now. It's sought to determine if its questions really test what new nurses need to know when they enter their practice for the first time. Currently, only 20% of employers felt that new nurses are empowered with the knowledge to make critical clinical decisions - and that can account for some of the high error rate of new nurses (50% in the first year of practice!), low confidence to advocate for patients, and high turnover in hospital staffing. In an effort to do better, NCLEX is considering some drastic changes, and I don't mean to be inflammatory here, but you should be afraid. You should be very afraid. As technology has improved and the price of it has fallen, the NCSBN has considered using it to greatly enhance questions. And I don't just mean new drag-and-drop scenarios. I'm talking playing through clinical scenarios like a video game where you need to make the right choices . Or els...

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...