1.Nclex Exam

8/10/2019 1.Nclex Exam

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NCLEX

What is it? How should I study?

How do I pass??


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What is the NCLEX?

National Council LicensureExamination

Administered by the boards of nursingof all 50 states

Mandate to protect the public from

unsafe and ineffective nursing care


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Why must you take the

NCLEX? Each state requires you to pass the

NCLEX to get a license

Once you get a license, you will get atitle of Registered Nurse (RN)


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CATComputer Adaptive

Testing Each test is assembled interactively based on the

accuracy of the candidates response to thequestions.

First question will be relatively easy, below the levelof minimum competency.

If you answer that question correctly, the computerselects a slightly more difficult question.

If you answer it incorrectly, the computer selects aslightly easier question

By continuing to do this, the computer can calculateyour level of competence.


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Taking the Exam

No time limit for each individual question Maximum of 6 hours to complete the exam.

Optional 10 min break after the first 2hours. Optional break after additional 90min of testing

Minimum 75 questions, maximum 265questions

15 experimental questions,indistinguishable, do not count for oragainst you


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Test ends when:

You have demonstrated competency andanswered the minimum number ofquestions (75)

You have demonstrated a lack of minimumcompetency and answered the minimumnumber of questions (75)

You have answered the maximum number

of questions (265) You have used the maximum time allowed

(six hours)


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Length of test

Try not to be concerned with thelength of the test

Plan on testing for 6 hours and seeing265 questions

No warm-up time so it is important to

be ready to answer every questionfrom the beginning

Concentration is key!!!


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Content

Management of Care 13-19%

Safety and Infection Control 8-14%

Health Promotion and Maintenance 6-12%

Psychosocial Integrity 6-12%

Basic Care and Comfort 6-12%

Pharmacological and Parenteral Therapies 13-19%

Reduction of Risk Potential 13-19%

Physiological Adaptation11-17%


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Management of Care 13-19%

A client arrives at the emergency departmentcomplaining of acute right lower quadrantabdominal pain. Laboratory tests are performedand the nurse notes that the clients white bloodcell (WBC) count is elevated. The nurse reviewsthe physicians orders and contacts the physicianto question which order, if noted, in the clientsrecord?1. Maintain an NPO status

2. Apply a cold pack to the abdomen3. Administer 30 mL of Milk of Magnesia (MOM)4. Initiate an intravenous (IV) line for the administration of

IV fluids


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Safety and Infection

Control 8-14% A hospitalized client is diagnosed with

urethritis caused by a chlamydial infection.

The nurse instructs the nursing assistantabout which measure to preventcontracting the infection during care?

1. Contact isolation

2. Enteric precautions3. Standard precautions

4. Use of gloves and mask


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Psychosocial Integrity 6-12%

A client with ovarian cancer says to thenurse, If I can just live long enough toattend my daughters graduation, Ill beready to die. The nurse determines thatthe client is experiencing which phase ofcoping?

1. Isolation

2. Bargaining

3. Depression

4. Acceptance


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Basic Care and Comfort 6-12%

A nurse provides instructions to a client about theuse of a cane and watches as the client uses it.Which observation by the nurse indicates the

need to provide additional instructions to theclient?1. The client holds the cane on the strong side.

2. The client holds the cane about 6 inches to the side ofthe foot.

3. The client flexes the elbow at a 15- to 30-degree anglewhen holding the cane in place.

4. The client moves the cane and the stronger leg forwardfirst and then moves the weaker leg forward.


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Pharmacological and ParenteralTherapies 13-19%

A nurse caring for a client with hypertensionreceiving torsemide (Demadex) 5 mg orally daily.Which laboratory finding indicates to the nurse

that the client might be experiencing an adversereaction related to the medication?1. A chloride level of 98 mEq/L

2. A sodium level of 135 mEq/L

3. A potassium level of 3.1 mEq/L

4. A blood urea nitrogen level (BUN) of 15 mg/dL

Torsemide (Demadex) is a loop diuretic. It can produce water lossand electrolyte depletion. Normal K+ level 3.5-5.0 mEq/L.


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Reduction of Risk Potential 13-19%

A magnetic resonance imaging (MRI) procedureis prescribed for a client with a suspected brain

tumor. The nurse implements which action toprepare the client for this test?

1. Keeps the client NPO for 6 hours prior to the test

2. Shaves the groin for insertion of a femoral catheter

3. Removes all metal-containing objects from the client4. Instructs the client in inhalation techniques for the

administration of the radioisotope


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Physiological Adaptation 11-17%

A nurse reviews the blood gas results of aclient with pneumonia and determines that

the client is experiencing respiratoryacidosis. Which of the following validatesthe nurses findings?

1. pH 7.45, PCO2 52 mm Hg

2. pH 7.35, PCO2 40 mm Hg3. pH 7.25, PCO2 50 mm Hg

4. pH 7.50, PCO2 30 mm Hg


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The Nursing Process

Assessment

Analysis

Nursing Diagnosis

Planning

Implementation Evaluation


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The following is an example of aknowledge based question you mighthave seen in school. This question is at

the knowledge level.

Which of the following is acomplication that occurs during the

first 24 hours after a percutaneousliver biopsy?

1. Nausea and vomiting

2. Constipation3. Hemorrhage

4. Pain at the biopsy site


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Questions at the comprehension level requireyou to understand the meaning of the material.Lets look at the same question written at the

comprehension level.

The nurse understands that hemorrhage isa complication of a liver biopsy because:

1. There are several large blood vessels near theliver

2. The liver cells are bathed with a mixture ofvenous and arterial blood

3. The test is performed on clients with elevated

enzymes4. The procedure requires a large piece of tissue

to be removed


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Minimum competency NCLEX questions arewritten at the application or analysis level. Yourability to solve problems is not tested withrecall/recognition or comprehension levelquestions.

Which of the following symptoms, ifobserved by the nurse during the first 24hours after a percutaneous liver biopsy,would indicate a complication from aprocedure?

1. Anorexia, nausea, and vomiting

2. Abdominal distention and discomfort

3. Pulse 112, blood pressure 100/60, respirations20

4. Pain at the biopsy site


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The question is: What is a complicationof a liver biopsy?

In order to begin to analyze thisquestion, you must know that

hemorrhage is the major complication. But its not listed as an answer


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So lets look at the choices

Anorexia, nausea, and vomiting. Does this indicate thatthe client is hemorrhaging? No, these are notsymptoms of hemorrhage.

Abdominal distention and discomfort. Does this indicatethat the client is hemorrhaging? Perhaps. Abdominaldistention could indicate abdominal bleeding.

Pulse 112, blood pressure 100/60, respirations 20. Doesthis indicate the client is hemorrhaging? Yes. Anincreased pulse, decreased BP, and increasedrespirations indicate shock. Shock is the result ofhemorrhage

Pain at the biopsy site. Does this indicate the client ishemorrhaging? No, pain is expected with thisprocedure.


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How about an analysis level question

The nurse is caring for a 56-year old manreceiving Haldol 2 mg PO BID. The nurse assiststhe client to choose which of the following

menus?1. 3 oz. roast beef, baked potato, salad with dressing, dill

pickle, baked apple pie, and milk

2. 3 oz. baked chicken, green peas, steamed rice, 1 slice ofbread, banana, and milk

3. Cheeseburger on a bun, french fries with catsup,chocolate chip cookies, apple, milk

4. 3 oz. baked fish, 1 slice of bread, broccoli, ice cream,and pineapple drink taken - 1 hour after the meal


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Dont panic!!!

What type of diet do you chose for apatient taking Haldol?

Haldol is antipsychotic med There are no diet restrictions for

Haldol

This question is really a diet question Which of the choices is the most

balanced regular diet??


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Answers

1. 3 oz. roast beef, baked potato, salad with dressing, dill pickle,baked apple pie, and milk. Is this a balanced diet? Yes, its possible

2. 3 oz. baked chicken, green peas, steamed rice, 1 slice of bread,banana, and milk. Yes, it is also a good answer because it contains

food from each of the food groups.3. Cheeseburger on a bun, french fries with catsucp, chocolate chip

cookies, apple, milk. No, this diet is high in fat and does notcontain food groups. Eliminate.

4. 3 oz. baked fish, 1 slice of bread, broccoli, ice cream, and

pineapple drink taken - 1 hour after the meal. The choice isntbad, but why would the intake of fluids be delayed? Eliminate

Which is the better answer? 1 or 2? Dill pickles are

high in sodium, so the correct answer is 2.


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To be successful on the

NCLEX, you must Read the question

Decide what the question is asking

Evaluate the answer choices

Select the correct answer

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