Mark Klimek notes
How to guess
1. Use knowledge
2. Common sense
3. Guessing strategy
Psych
Nurse will examine own feeling about something-so do
... [Show More] not counter transfer
Establish trust relationship
Nutrition
Pick chicken not fried chicken
Fish but not shellfish
Never pick casseroles for kids
Never mix meds in food
Toddlers-finger foods
Preschool-one meal a day is OK. Leave them alone
3 expectations to have
Do not expect 75 questions-think 265
Do not expect to know everything
Do not expect everything will go right
Pharm
Most tested area is side effects
Do not worry about route or dose
If know what drug does but do not know side effect-pick a side effect in same body system the drug is
working
No idea what the drug is-look to see if it is PO-pick GI side effect
Never tell kids that med is candy
OB-check fetal HR
Med Surg
1
st thing assess-LOC
1
st thing do-establish airway
Peds
All based on principle-give child more time to grow and develop
When in doubt-call it normal
When in doubt-pick the older age
When in doubt-pick the easier task-more time to do the harder one
2
General
Rule out absolutes
If 2 answers say same thing-neither is correct
If 2 answers are opposite-one is probably right
Umbrella strategy
If questions has 4 right answers and ask for priority of needs of a patient-worse consequences game-worst
outcome
When stuck between two answers-read the question
Sesame street rule-use only as last option
Right answer tends to be different than the rest
Wrong answers are usually all similar
Right answer is most unique or different
Answer based on what you know, not what you don’t know
If you dont know something in a question-pull it out of the equation-use common sense
Nclex also testing on common sense-do not overanalyze-do not think like a nurse
Go with gut answer-only if other answer is superior
3
Prioritization
Decide who is sickest or healthiest--->based on question
ABC does no work with prioritization questions
Answers will have 4 parts
Age
Gender
Diagnosis
Modifying phrase
2 are irrelevant ---->age and gender
In Peds pay attention to age but in prioritization age is not important
Modifying phrase most important
Ex: pt has angina pectoris vs MI ----> MI is high priority
Pt has angina pectoris and unstable BP vs MI with stable VS ---->angina with unstable BP is now the
priority
4 rules to prioritization
1. Acute beats (higher priority than) chronic
Example: COPD versus appendicitis--->appendicitis is the priority
2. Fresh postop (<12 hrs) beats medical or other surgical
Example: 2 hr post op versus appendicitis--->2 hr post op is the priority
3. Unstable beats stable
Stable words Unstable words
Stable
Chronic illness
Post op >12 hrs
Local or regional anesthesia
Lab abnormalities A or B level
Unchanged assessments
To be discharged
Ready for discharge
Admitted longer than 24 hrs ago
Experiencing the typical expected S/S of
disease with which they were diagnoses
Unstable
Acute illness
Post op <12 hrs
General anesthesia (1st 12 hrs)
Lab abnormalities C or C level
Changed/changing assessment
Not ready for discharge
Newly diagnosed
Newly admitted
Experiencing unexpected S/S
Example:
16 yo w/ meningococcal meningitis who has had temp of 103.8 F since admission 3 days ago.
61 yo male w/IBS who spiked temp of 103 F this afternoon.
Who is higher priority and why?--->2 nd option is priority-->have more high priorities than 1
st
Always unstable no matter what-even if expected [Show Less]