NCLEX - Simple Nursing Lecture Review Main Points

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NCLEX EXAM PREVIEW

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SATA questions: Rememberdo NOT overselect

look at key words what is the key problem what is the question asking safety = principle worsening, new, sudden changes are MOST important Priority questions: Rememberwhat will you do RIGHT NOW to save the client from dying "Best" questions: Rememberdo ONE thing and nothing else, fix the prob in ONE step

Ex: best thing for client rn

Key words that show worsening condition and need

intervention NOW:

new sudden abrupt rapid worsening

Test-Taking Strategies:- no absolutes "always, never, must, cure"

• only use what youre given
• least invasive to most
• assess then intervene "assess unless in distress"
• always assess the client first before monitor/tech
• an answer that delays care/tx, prob is not right
• if two answer choices are the EXACT opposite, one is prob right
• if two answer choices are similar/say the same thing, neither are right
• if one part of the answer is wrong, the whole thing is

- w/ therapeutic com: open ended Q ab feelings, state fact

Group Prioritization Questions: Remember- unstable client with changes/acute first (new, sudden, worsening, rapid, returning to the floor postop, new admission)

• stable clients are chronically ill with no changes (if all are chronically ill go

based on brain - lungs - heart)

• two days post--- with no changes = stable
• what kills the client the fastest

Single Client Priority Question: Remember-low glucose, creat over 1.3 = dead kidne, toxic lab levels (dig, lithium, phenytoin) A = #1 - throat swell, noisy/squeaky breathing, stridor, wheezing, postop neck surgery B = #2 - high co2, hypoxia (1st sign is mental status change like agitated/confused) C = #3 - unpalpable pulses/only w doppler, low bp, high bp, internal bleed (hard board like rigid abd), plt under 150, high ptt or inr Delegation Questions: RememberNEVER delegate what U EAT (U = unstable pt), (E = eval, trending), (A = assess, initial, 1st or primary), (T = teach, initial, 1st or primary) UAP can do: ADL, vitals, ambu, bath, eat/feed, I/O, remind, nothing with unstable clients even ambulating, CAN tell you about changes in pt status

LPN can do: secondary and follow up assessments, cont monitoring after RN

looks, no IV push or blood, no central line drugs or tpn, no initiating new iv line, no titrating, can maintain IV NEVER delegate to fam Intervene immediately if someone is doing something wrong If it is illegal, report to the supervisor 1st Follow up and reassess is on the RN

Ethics/Legal Questions: RememberGo safe > sorry

You can tell visitors about precautions, just not specifics Log your coworker off Negligence = "n" for "not" caring the way another would (ex: not using sterile or withholding diagnoses)

Malpractice = provable medical error leading to damage (ex: not checking med

dose)

Abandonment = (ex: leaving without giving report)

Assault vs BatteryAssault = ASS w assault - verbal threat

Battery = physical contact that causes harm (ex: surgery without consent)

False imprisonment vs LiableFalse imprisonment = unneeded sedatives or restraints Liable = written defamation Slander vs DefamationSlander = spoken defamation Defamation = rude/insulting remarks

For mandatory reporting questions: Rememberassess 1st

report 2nd and protect the pt you do NOT need proof Autonomy =always in control with autonomy the client is given the right to make decisions

Ex: can refuse treatment

Advocacy =advocating for client health, safety and rights Beneficience =benefits the client, do what you say

ex: say that you will get a med for them and do it, calling to talk to familu

Justice =treating people fair and equal Nonmaleficence =avoid causing harm no "mal" = no bad

ex: double checking med doses

Verosity =Very honest, telling the truth

ex: incident report

For informed consent:the client gets risks/benefits

required before any invasive procedure need a med trained interpretor (not fam member) must be by a competent adult including: hc surrogate (power of attorney, proxy), parent or guardian if under 18, preg/married/emancipated/substance abuse/STD pts under 18 can make own decisions do NOT educate on the procedure or give specifics, this is the surgeons job the nurses job is to witness not obtain and doc consent and competency of the patient "you need to talk to the doc about implications, risks, specifics" if they change their mind about surgery, tell the doctor and nothing else you CAN educate on general post-op education Refusal of Care / AMApts have the right only if they are deemed competent

ex: can refuse blood products

respect rights but give risks and educate any altered mental status is NOT competent notify the provider if leaving Advance directives/Living willlegal doc with plan of care if patient cannot verbalize

ex: DNI, DNR, comfort measures only

tattoo of DNR is not legal durable power of attorney or surrogate can make the decision if the patient cannot encourage copies to be given out if pt is cog declining, advocate to make decisions now