Navigating the NCLEX: Strategies and Tips for Success

 

The National Council Licensure Examination (NCLEX) is a critical step in the journey of becoming a licensed nurse in USA. This standardized exam is designed to assess the knowledge and skills of nurses, ensuring they meet the minimum competency required for safe and effective practice. Success on the NCLEX requires not only a solid foundation of nursing knowledge but also effective test-taking strategies. Lets explore some key tips and tricks to help navigate the NCLEX and increase the chances of success.

1. Understand the Format: Before diving into preparation, it's crucial to familiarize oneself with the format of the NCLEX. The exam is computerized and adaptive, meaning the difficulty of the questions adjusts based on the performance. Understanding the format will help alleviate anxiety and allow to focus on the content.

2. Comprehensive Content Review: The NCLEX covers a wide range of nursing topics, including medical-surgical, pediatric, psychiatric, and maternal-newborn nursing. A thorough content review is essential. Utilize reputable review materials, textbooks, and practice questions to reinforce understanding of key concepts.

3. Develop a Study Plan: Creating a structured study plan is imperative for effective preparation. Break down study sessions into manageable chunks, covering different content areas each day. Allocate time for both content review and practice questions. Consistency is key to reinforcing knowledge.

4. Practice, Practice, Practice: Practice questions are invaluable for NCLEX preparation. They not only help apply knowledge but also familiarize with the question format. Use reputable NCLEX review books, online question banks, and simulated exams to gauge readiness and identify weak areas.

5. Prioritize High-Yield Topics: While all nursing content is important, focus on high-yield topics that are more likely to appear on the exam. This includes fundamental nursing concepts, pharmacology, prioritization, and delegation. Understanding the core principles will enhance ability to tackle a variety of questions.

6. Master Test-Taking Strategies: The NCLEX is not just a test of nursing knowledge; it's also a test of ability to think critically and make sound clinical judgments. Learn and practice test-taking strategies such as process of elimination, answering the question asked, and not overanalyzing. Remember that safety and prioritization are key components of nursing practice.

7. Time Management: Time is a critical factor in the NCLEX. Practice answering questions within the allotted time frames to ensure pace effectively during the actual exam. If  challenging question is encountered make an educated guess and move on to prevent spending too much time on a single item.

8. Stay Healthy and Manage Stress: Adequate rest, proper nutrition, and stress management are often overlooked aspects of exam preparation. Ensure you are taking care of your physical and mental well-being to optimize your cognitive function during the exam.

9. Utilize Available Resources: Take advantage of review courses, study groups, and online forums where you can exchange information and strategies with fellow test-takers. Learning from others' experiences and insights can provide valuable perspectives.

10. Simulate Exam Conditions: Familiarize with the exam environment by simulating test conditions during practice sessions. This includes using a computer for practice questions, timing and minimizing distractions. Building confidence in the exam setting can contribute to better performance on test day.

Success on the NCLEX is a culmination of thorough preparation, effective study strategies, and a confident mindset. By understanding the exam format, reviewing content comprehensively, practicing with a variety of questions, and mastering test-taking strategies, aspiring nurses can increase their likelihood of passing this critical milestone in their professional journey. The NCLEX is not just a measure of knowledge; it is a gateway to a rewarding career in nursing, and with the right approach, aspiring nurses can confidently navigate this challenging exam.

Elevating Patient Care: The Crucial Role of Critical Thinking in Nursing Practice

In the dynamic and complex world of healthcare, critical thinking stands as a cornerstone of nursing practice, distinguishing adept nurses and shaping the quality of patient care. The ability to think critically enables nurses to navigate intricate situations, make informed decisions, and adapt to the ever-evolving landscape of healthcare. Critical thinking is the lifeblood of nursing practice, empowering nurses to provide safe, effective, and patient-centered care. Beyond its theoretical underpinnings, critical thinking is a dynamic and evolving skill that nurses must hone throughout their careers. As healthcare landscapes evolve and patient needs become more intricate, the cultivation of critical thinking skills remains paramount. Nurses equipped with strong critical thinking abilities not only navigate the complexities of healthcare with finesse but also contribute significantly to elevating the quality of patient care and outcomes.

Essence of Critical Thinking: Critical thinking in nursing involves the systematic evaluation of information, the consideration of multiple perspectives, and the ability to make sound decisions based on evidence and reasoning. It goes beyond rote memorization and routine procedures, demanding a deeper level of cognitive engagement. Nurses equipped with critical thinking skills not only possess a solid understanding of medical knowledge but also demonstrate the capacity to analyze, synthesize, and apply information in real-time situations.

Application of Critical Thinking in Patient Care: In the clinical setting, critical thinking is the linchpin that transforms theoretical knowledge into effective, patient-centered care. Nurses regularly encounter complex scenarios requiring swift and accurate decision-making. For instance, in assessing a patient's deteriorating condition, a nurse with strong critical thinking skills will not only recognize the signs but also prioritize interventions based on the severity of the situation. This ability to quickly and accurately analyze situations enhances patient safety and contributes to positive outcomes.

Moreover, critical thinking plays a pivotal role in the formulation and execution of nursing care plans. Nurses must consider a myriad of factors, including the patient's medical history, current symptoms, and potential risk factors. Through critical thinking, nurses can tailor interventions to meet the unique needs of each patient, ensuring a personalized and effective approach to care. This adaptability is particularly crucial in the face of unexpected challenges or changes in a patient's condition.

Problem Solving and Critical Thinking: One of the key facets of critical thinking in nursing is the adeptness at problem-solving. Nurses encounter a spectrum of challenges, from medication errors to unexpected changes in patient status. Critical thinkers approach these challenges systematically, identifying the root causes, considering alternative solutions, and implementing interventions with a focus on both immediate and long-term goals. The ability to solve problems efficiently not only enhances patient safety but also contributes to a culture of continuous improvement within the healthcare setting.

Continuous Learning and Professional Development: Critical thinking is not static; it is a skill that evolves with experience, ongoing education, and reflective practice. Nurses committed to cultivating their critical thinking abilities engage in continuous learning, staying abreast of advancements in medical knowledge, technology, and evidence-based practices. This commitment to professional development ensures that nurses remain agile and well-equipped to provide the highest standard of care to their patients.

Marshmallow Test

We are well aware of the psychologists performing different tests to explore human behavior and their future consequences.  LIkely this marshmallow test is one test psychologists performed to test about the delayed gratification and consequences.  The test was done by Walter Mischel in 1972 for the first time to find out delayed gratification among children of ages 3.5 years and 5.5 years.  Walter Mischel is a professor at Stanford University.

Marshmallow is kind of sweet which children are crazy for.  It's really difficult to resist eating it when it is in front of them. So Walter has wisely chosen the marshmallow as a test material to find the real delayed gratification.

Procedure:  30 children of ages 3.5 and 4.5 were chosen for this test.  They were bought to the experimental room by the experimenter.  They were given a marshmallow and explained to them that if they did not eat it for 15 minutes till the experimenter comes back, they will be given another one to eat.  They can eat it instantly as well but they will not be given another one. Almost all the children said they would wait for 15 minutes till the experimenter comes back.  Then the experimenter leaves the place and left marshmallow and child alone in the room.

For a few minutes, children avoided the marshmallow.  But as time pass by, their temptation to eat the marshmallow is growing bigger and they have very hard time avoiding it.  Finally, lots of children had very difficult emotional times, some picked up marshmallow licked it, some ate it and some controlled it with great difficulty.

After 15 minutes the experimenter found there were very few students who had controlled gratification, i.e, who did not eat the marshmallow.   Those students who abstained to eat marshmallow were awarded the next marshmallow as promised before.

After 10 to 15 years, those students were studied about their achievement.  It was found that those students with delayed gratification were found to be more successful in their life, have good SAT scores, good jobs, good health, and good education ailment and have a better life.

So it was found that children with control over their gratification tend to be successful.

Proper use of In,at,on preposition

Prepositions "On," "At," and "In"

 

When we talk about preposition, it has always been a problem to choose a right one as there is not hard and fast rule about it's usage.  Preposition changes as per the situation so, it is always a nuisance.  Anyway, some rules are there to help us out.

A preposition is a word that links a noun, pronoun, or noun phrase to some other part of the sentence.

Prepositions can be tricky for English learners. There is no definite rule or formula for choosing a preposition. In the beginning stage of learning the language, you should try to identify a preposition when reading or listening in English and recognize its usage.

• to the office
• at the desk
• on the table
• in an hour
• about myself

A preposition is used to show direction, location, or time, or to introduce an object.

Here are a few common prepositions and examples.

Let's Check how many you can get correct:

1)I want to lose 5 kilogram                      (on, at, in) one month.
2)Could you get me this pants                      (on, at, in) a larger size?
3)She seems to be interested                      (on, at, in) Psychology.
4)I will come to pick you up                      (on, at, in) 2 pm tomorrow.
5)This class will be held                      (on, at, in) Mondays. 

Answers are given at the bottom.

Let's explore the rules first then,

On

To express a surface of something:

• I put a book on the study table.
• The pen is on my bed.

To specify dates and days:

• The garbage truck comes on Wednesdays.
• I was born on the 14th day of June in 1988.

To indicate a device or machine, such as a phone or computer:

• He is on the phone right now.
• She has been on the computer since this morning.
• My favorite movie will be on TV tonight.

To indicate a part of the body:

• The stick hit me on my shoulder.
• He kissed me on my cheek.
• I wear a ring on my finger.

To indicate the state of something:

• Everything in this store is on sale.
• The building is on fire.

At

Used to point out specific time:

• I will meet you at 12 p.m.
• The bus will stop here at 5:45 p.m.

Used to indicate a place:

• There is a party at the club house.
• There were hundreds of people at the park.
• We saw a baseball game at the stadium.

Used to indicate an email address:

• Please email me at abc@defg.com.

Used to indicate an activity:

• He laughed at my acting.
• I am good at drawing a portrait.

In

Used for unspecific times during a day, month, season, year:

• She always reads newspapers in the morning.
• In the summer, we have a rainy season for three weeks.
• The new semester will start in March.

Used to indicate a location or place:

• She looked me directly in the eyes.
• I am currently staying in a hotel.
• My hometown is Los Angeles, which is in California.

Used to indicate a shape, color, or size:

• This painting is mostly in blue.
• The students stood in a circle.
• This jacket comes in four different sizes.

Used to express while doing something:

• In preparing for the final report, we revised the tone three times.
• A catch phrase needs to be impressive in marketing a product.

Used to indicate a belief, opinion, interest, or feeling:

• I believe in the next life.
• We are not interested in gambling.

Answers for the question above
1 In (Unspecific time, one month)
2In (size)
3 In (interest)
4 At (specific time)
5 On (specific day)

Hope you got it all right.  Comment, if you have some suggestions.

Mutato, cure for cancer

Do you know the fact that an estimation that 18.1 million new cancer cases are diagnosed worldwide each year and 16% of total deaths are due to cancer making it second leading cause of death as per reports by the International Agency for Research on Cancer.  There are very few people who return back to normal life once they have been diagnosed with cancer.  So lots of people lose their hope when they hear about a cancer patient.  Now to a relief, a promising small group of Israeli scientist came up with some good news in a name of “MuTaTo (multi-target toxin).

Israeli scientists, working in Accelerated Evolution Biotechnologies Ltd formed in 2000, think they might have found the complete cure for cancer. They said they will come up with this complete cure by a year’s time. It is reported that cancer cure will be effective from day one, will last a duration of a few weeks and will have no or minimal side-effects at a much lower cost than most other treatments in the market.

MuTaTo  is essentially on the scale of a cancer antibiotic – a disruption technology of the highest order. The potentially game-changing anti-cancer drug involves the introduction of DNA coding for a protein, such as an antibody, into a bacteriophage — a virus that infects bacteria. That protein is then displayed on the surface of the phage. Researchers can use these protein-displaying phages to screen for interactions with other proteins, DNA sequences and small molecules.

Don’t abstain from treatment just because you are poor

Don’t abstain from treatment just because you are poor

The government of Nepal has launched the “Disadvantaged Citizens Medical Treatment Fund Directive” for the establishment of a separate fund to provided financial aid to need citizens for their disease treatment. Any citizen shall be entitled to grant amount of up to Rs 4 million for the treatment of prescribed disease within Nepal.

Nepalese suffering from heart disease, cancer, Parkinson’s disease, Alzheimer’s disease, spinal injury, head injury, renal disease and sickle cell anemia may submit an application, along with a recommendation letter of the local level, to the committee.  The committee will then recommend a government hospital for providing necessary treatment to the concerned patient.  The concerned hospital may refer the patient to any other government health facility to utilize the treatment grant.

According to directive, at least 1.5 per cent of a total annual budget of the Department of Health Services (DoHS) shall be appropriated for the programme.  A total of 80 hospitals or health institutions have been assigned for the treatment of disadvantaged citizen.  A person with renal disease will get up to 4 million and heart disease will get up to Rs 1 million as per the severity of the case.

Source: Himalayan times

NCLEX, what and why?

NCLEX:

The National Council Licensure Examination (NCLEX-RN^® exam) is taken in order to determine if it's safe for you to begin practice as an entry-level nurse.  It is different from any test that you took in nursing school as they are knowledge based and while other one tests application and analysis using the nursing knowledge you learned in school. It even analyses how you can use critical thinking skills to make nursing judgments.

After a hard time in nursing education and earing a nursing degree, one should get a title of registered nurse offical by passing the NCLEX exam to get license in state.  This will allow you to practice as a nurse in the hospitals.

The exam is organized according to the framework, "Meeting Client Needs." There are four major categories and eight subcategories.  Safe and effective care environment (Management of care 17-23%, safety and infection control 9-15%), Health promotion and maintenance 6-12%, Psychosocial integrity 6-12% and Physiological integrity (Basic care and comfort 6-12%, Pharmacological and parenteral therapies 12-18%, Reduction of risk potential 9-15%, physiological adaptation 11-17%).

Most of the questions are primarily multiple-choice with four possible answer choices; except some are alternate question types including multiple-response, fill-in-the-blank, hot spots, chart/exhibit and drag-and-drop.

In an exam there will be a minimum of 75 questions to a maximum of 265 questions. Regardless of how many you answer, you will be given 15 experimental questions that do not count for or against you. The exam administrators use them to test for future questions on the exam.

A time of 6 hours will be given to complete the exam including a tutorial in the beginning and there is no time limit for each individual question. There are no mandatory breaks. However, there's an optional break after 2 hours of testing, and another optional break after 3.5 hours of testing.  The exam will end in follwoing conditions:

• we demonstrated minimum competency and answered the minimum number of questions (75).
• we demonstrated a lack of minimum competency and answered the minimum number of questions (75).
• we answered the maximum number of questions (265).
• we used the maximum time allowed (6 hours).

There is no numerical score in exam but will be said pass or fail only. A determination will be made at the conclusion of the exam as to whether you have passed or failed.  If you fail, you'll receive a diagnostic profile that evaluates your test performance.  You'll see how many questions you answered on the exam.  The only way you continue to get questions after the first 75 is if you are answering questions close to the level of difficulty needed to pass.  Re-testing for the exan is permitted 45 days after the initial administration

NCLEX some questions to practice with explanation

1.When evaluating the arterial blood gases (ABGs) of a patient with a 20 year history of chronic bronchitis, which of these would the healthcare provider expect?

a. Metabolic acidosis, uncompensated

b. Respiratory acidosis, compensated

c. Respiratory alkalosis, uncompensated

d. Metabolic alkalosis, compensated

2. During an assessment of a patient experiencing acute hemorrhage , the healthcare provider would most likely expect to find

a. Jaundice

b. Hypotension

c. Tachycardia

d. Nausea

3. A patient presents to the emergency department with a blood pressure of 180/130 mmHg, headache, and confusion. Which additional finding is consistent with a diagnosis of hypertensive emergency?

a. Bradycardia

b. Jaundice

c. Retinopathy

d. Urinary retention

4. Before administering two units of whole blood, what type of intravenous (IV) device should be used?

          a. The smallest possible catheter to prevent pain on insertion

b.      b. The same IV device as previously used.  Consult the patient’s chart.

c.       c. Whatever the doctor has ordered. consult the patient’s chart.

d.      d. A large bore catheter to allow blood cells to pass easily into the patient 

5. A patient diagnosed with ulcerative colitis is admitted to the medical unit. When assessing the patient, which of these findings would be of the most concern?

a. Blood diarrhea

b. Borborygmi

c: Oral temperatture of 99.0F (37.2 C)

d. Rebound tenderness

6. The safest method of changing a patient's tracheotomy ties is to

a. Never attempt to change ties alone.

b. Apply the new ties before removing the old ones.

c. Change ties as soon as possible after the patient has eaten.

d. Ask the doctor to suture the tracheostomy in place

7. During an arteriogram (angiogram), the patient suddenly says, “I’m feeling really hot.” Which is the best response?

a. "The heat indicates that the clots in the coronary vessels are dissolving."

b. "You are having an allergic reaction to the dye. I will get an order for Benadryl."

c. "That feeling of warmth is normal when the dye is injected. It will last up to 20 seconds."

d, "Let me get your doctor to explain this sensation to you

8. The healthcare provider is caring for a patient on a ventilator with an endotracheal tube in place. What assessment data indicate the tube has migrated too far down the trachea?

a. Low pressure alarm sounds

b. Increased crackles auscultation bilaterally

c. A high pressure alarm sounds

d. Decreased breath sounds on the left side of the chest

9. A patient with chronic hepatitis C is scheduled for a liver biopsy. Before the procedure, the nurse checks the most recent lab results. Which of the following laboratory tests does NOT assess coagulation?

a. Hematocrit

b. Platelet count

c. Partial thromboplastin time

d. Prothrombin time

10. When caring for a patient with a cardiac dysrhythmia, which laboratory value is a priority for the healthcare provider to monitor?

PT and INR

Hemoglobin and hematocrit

Sodium, potassium, and calcium

BUN and creatinine

Answers with Explanation:

1. b: Chronic bronchitis diminishes airflow during expiration, trapping carbon dioxide (CO2) in the lungs. The increased CO2 lowers the arterial pH, causing respiratory acidosis. The kidneys compensate for the chronic acidosis by conserving bicarbonate. This keeps the pH in a low-normal range, resulting in compensated respiratory acidosis.

2. c: The heart rate will increase in an attempt to deliver more oxygen to the brain and body. Tachycardia is a pulse rate > 100bpm.

3. c: A hypertensive emergency is a sudden rise in blood pressure, with a reading of 180/120mmHg or higher. Immediate intervention is necessary. It may cause hypertensive retinopathy, resulting in hemorrhages, exudates, and/or papilledema. Other consequences of a hypertensive emergency include stroke, heart attack, aortic dissection, kidney damage, and pulmonary edema.

4. d: Large bore catheters are necessary to prevent damage to blood cells. This also decreases development of clots from hemolysis. An 18 gauge needle is often the standard for blood administration.

5. d: Rebound tenderness is a sign of peritonitis that could be the result of rupture of the colon. It is a clinical sign that occurs during physical examination, referring to pain upon removal of pressure, not during application of pressure. Bloody diarrhea is a common finding because of bleeding lesions and anal excoriation. A temperature of 99.0 F (37.2 C) is within normal range, and chronic inflammation may keep temperatures within the high normal range or above. Borborygmi are the sounds made by air or fluids moving through the intestines.

6. b. The best way to change tracheotomy ties is to apply the new ones before removing the old ones. This keeps the tracheostomy in place during the process. With this method, a second person is not necessary; besides, a helper might not prevent the patient from coughing out the tracheotomy. Wait two hours after eating to change the ties, to avoid vomiting from stimulating the gag reflex. Asking the doctor to suture the tracheotomy in place is not appropriate.

7. c, Patients should be instructed that it is normal to experience a warm sensation when IV contrast is injected. The feeling lasts 5-20 seconds.

8. d: If the endotracheal tube is inserted too far, it often goes into the right main stem bronchus. Air will then be delivered to the right lung and not the left. A low pressure alarm indicates a disconnection or a leak in the circuit. A high pressure alarm can mean an obstruction, such as a kink in the tubing or a need for suctioning.

9. a, Prothrombin time, partial thromboplastin time, and platelet count are all included in coagulation studies. The hematocrit does not assess coagulation; it reports the percentage of red blood cells (RBCs) in the blood.

10. c, Because abnormalities in sodium, potassium and calcium levels are likely to affect depolarization and repolarization of cardiac cells, it is most important for the healthcare provider to monitor these laboratory values. BUN and creatinine levels are always important to monitor when giving any drug, not only anti-dysrhythmia drugs. The PT and INR will be important for patients who are on warfarin (Coumadin).

Should you have any comment, please drop it and i will surely address them as soon as possible.  More of the questions will be added in near future.