Nurse will examine own feeling about something-so do not counter transfer

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Mark Klimek notes

How to guess

• Use knowledge
• Common sense
• Guessing strategy

Psych

 Nurse will examine own feeling about something-so do 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

• 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

2

 When in doubt-pick the older age  When in doubt-pick the easier task-more time to do the harder one

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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

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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

• rules to prioritization

• Acute beats (higher priority than) chronic

Example: COPD versus appendicitis--->appendicitis is the priority

• Fresh postop (<12 hrs) beats medical or other surgical

Example: 2 hr post op versus appendicitis--->2 hr post op is the priority

• 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 (1 st 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