PN 154 Nclex Review

PN 154
NCLEX Review
Spring 2010
Instructor: Lisa Lee Rohm, RN, BSN
Creator of this fabulous PowerPoint:
Amber Lee, RN, BSN!!
Concordes Process
A preliminary Candidate list is made and sent to
OSBN, who then sends the list to Pearson Vue

Applications (both for OSBN and Pearson Vue),
fingerprinting, & passport photo will be sent by
Concorde to the appropriate places
You may receive your Authorization to Test (ATT)
prior to OSBN receiving the official transcripts,
however if you take the exam before your transcripts
are received, you will not receive a nursing license
until after the entire process has been completed
On the graduation date, Concorde will send the
official Candidate List to OSBN
When all of the grades and SIGNED (by you and the
instructors) evaluation forms are turned in, the official
transcripts will be sent to OSBN
Application Hints
Do not change your name or you appearance
from the time you fill out the application and take
your passport picture until you receive your
license
Do not fill out the blue fingerprinting card until you
are in the presence of the fingerprinter
For the fingerprinting day:
Make sure you are well hydrated and your hands are
moisturized
If you have callouses, seriously consider a
(wo)manicure
Application Hints (Just say, Yes!)

If you have any yes answers on your BON app.
A short, one paragraph, explanation is sufficient
On the chemical substances question, say yes
even if you have a prescription.

The question reads Have you ever been
arrested, charged with, entered a plea of guilty,
no contest, convicted of or been sentenced
for ...
Answer yes even if the record has been

expunged (juvenile or adult)
If you say no and it somehow shows up on your
background check, this will delay your process
How to apply for an

Oregon Nursing License
(step by step process)
www.osbn.state.or.us/OSBN/new
graduates.shtml
How to apply for initial

licensure in another state
www.ncsbn.org
(Click on Boards of Nursing, then member
boards, then click on the state you want to be
licensed in)
How to register for the

NCLEX
https://www.ncsbn.org/2009_NCLEX_Cand
idate_Bulletin.pdf
or
www.ncsbn.org/Eight_steps_of_NCLEX.p
df
(for overview)
Scheduling Your Exam

Concorde will send OSBN a Candidate list who will
then send Pearson Vue a Candidate List

After your board of nursing declares you eligible, you
will receive your Authorization to Test (ATT)
Pearson Vue will mail each person their ATT.
After you receive your ATT, you may schedule your
test with any Pearson Vue Testing Center (200
locations)
Oregon testing centers: Beaverton, Salem, Medford

Average test date is 27 days from the date of scheduling
You must take the exam within 90 days of receiving
your ATT (but after graduation date 6/25/10)
Scheduling Your Exam

Each ATT is valid for the period of time specified
by the board of nursing (BON) (90 days).

Once the BON has declared you eligible to test
and your ATT is issued, you must test within the
validity dates of your ATT.
These validity dates cannot be extended for
any reason. If you do not test within these
dates, you will have to re-register and you
are responsible for the $200.00 payment.
Before the day of the test:

Expect and prepare for stress
Be prepared for others to leave the testing
center before or after you

Bring water and snack to keep in the locker
Plan alternate routes to the testing facility
You can take a virtual tour of your testing facility
by going to: www.pearsonvue.com/index
Do not carpool, do not make any other plans
Day of Test:
Bring to Testing Center
ATT letter You will not be admitted to the exam
without your ATT. You will be required to re-register

and re-pay to take the exam ($200.00).
2 forms of ID, one with photo, both with signature
First and Last name must exactly match the
name on your ATT letter
VALID Drivers License or State ID or Passport
(MUST NOT BE EXPIRED) and must include a
photograph and signature
A small storage space is provided
Day of Test
Plan to arrive 30 minutes before your
scheduled testing time. (If you arrive late

you may be required to forfeit your
appointment. Your failure to take the exam
will be reported to the BON!)
The test administrator (TA) will provide you
with an erasable note board that may be
placed
Day of Test: Do Not Bring

Any study materials!
Hats, Scarves, Coats, Phones, Watches, Pager
Paper/Pen/Pencil/Calculator (Dry Erase Board,
Marker, and Calculator are provided)

Do not take textbooks or notebooks containing
NCLEX study materials to the test center as
such items are considered prohibited testing
aids; doing so may result in dismissal or
cancellation of your testing results.
Day of Test
You will be fingerprinted, photo taken, and
asked to illustrate your signature.
Earplugs provided if needed.

Clock starts as soon as you are logged in.
You have 5 hours to complete the NCLEX-PN.
You will receive a tutorial before the exam to
familiarize you with the computer.
Day of Test
Optional Breaks provided at 2 hours, and at 3.5
hours
Breaks count against your testing time, when you
return from break, you will be fingerprinted again
You will be asked to complete a survey at the end
of the exam
Do not give any information about the exam to
anyone, including instructors!
Day of Test
The test administrator (TA) will provide you
with an erasable board that may be replaced

as needed during testing.
The TA will give you a short orientation and
then will escort you to a computer terminal.
You must remain in your seat during the
exam, except when authorized to leave by
test center staff.
You may not change your computer terminal
unless a TA directs you to do so.
Day of Test
Raise your hand to notify the TA if You:
Believe you have a problem with your computer

Need to change note boards
Need to take a break
Need the administrator for any reason
When you have finished the test and
questionnaire, raise your hand. The TA will

collect and inventory all note boards.
The TA will dismiss you when all requirements
are fulfilled.
~48 hours after the NCLEX

Results will not be released until the Board of
Nursing receives you official transcripts from

Concorde
Oregon License Verification (free):
www.oregon.gov/OSBN or call 971-673-0679
You may also obtain unofficial NCLEX exam
results two business days after taking the
exam by phone (1-900-776-2539) or on the
web at www.pearsonvue.com/nclex. The cost
is $7.95 via the website or $9.95 per phone
call.
If results are taking longer than 2 weeks,
contact the Board of Nursing
Common Questions and Myths About

the NCLEX
Passing Score depends on what the average
score of all people taking the test across the

nation
Theres lots of drug questions

Can you have a piece of scratch paper/pencil/
calculator?
Passing Score is 77%
If you think you failed, you passed
Common Questions and Myths

About the NCLEX
It is hard!
Can you take the NCLEX in another state?
How many times can you retake the exam?
Test-takers are selected randomly to take a
certain number of questions.
If you miss a question on a particular subject,
you will get more questions on that topic.
FYI
OSBN is now requiring that you notify them of
name changes, address changes, email changes,

employment changes, and lost card
You must work 960 hours/5 years (about 1
weekend a month) to maintain your license
May be any employment that is at a nurse level
May be volunteer work (if volunteer or selfemployment, you are responsible for keeping track
of your hours)
Your employer may narrow your scope of practice,
but may not broaden your scope of practice
Test Breakdown
85- 205 questions
(There are thousands of questions in
the test bank)
25 pre-test questions on every NCLEX-PN
exam (60 official plus 25 pre-test questions make up your first

85 questions)
Pre-test questions are written by nurses

Questions are reviewed by Item Reviewers who
are nurses that are currently practicing nursing
Questions must be approved by a Panel of
Judges
Then the questions will be pre-test questions
You will not know which questions count towards
your exam
NCLEX Breakdown
Up to 5 hours to take the exam
(Speed per
question is not a factor in the final score, but figure approx. 1
minute per question)
Exam will end when:
At least the minimum number of questions

(85) questions are answered and there is a
95% certainty the test-taker will pass or fail
Maximum number of questions (205) have
been answered
Maximum time (5 hours) has passed
Pass or Fail?
It is impossible to take a test which will cover
every subject, it would be way too long and

take too much time.
Instead the computer decides based off your
answers to a minimum amount of questions
whether it is 95% certain you would pass or
fail if you answered every question on every
subject.
Passing with 95% Confidence
Failing with 95% Confidence
Pass or Fail?
After 85 questions the computer will begin

to determine the 95% confidence
If at 85 questions, the test taker is not
passing or failing, you will continue to
answer questions until there is 95%
confidence, on way or another.
OR
Pass or Fail?
If the maximum number of questions (205)
has been reached or 5 hours has passed,

and the computer can still not determine a
95% confidence:
The computer will look back at the last 60
questions.
If at any point the test taker falls below the
standard- the test taker fails.
If the test taker remains above the
standard for the last 60 questions, they
pass
Should you give up if you take more

than 85 questions?
NO!
Stay focused. Relax. You still have
plenty of opportunities to pass.

Test takers who took 205 questions
have passed
Questions About How CAT

works?
National Council of State Boards of

Nursing, Inc. (NCSBN)
www.ncsbn.org
Toll free: 1.866.293.9600
E-mail: nclexinfo@ncsbn.org
Pass Rates
2007
87% test takers
passed on the first
time
75% of all the test
takers in 2007
passed the NCLEX
2008
85% of test takers
have passed on the
first time
78% of test takers
have passed the
NCLEX so far
*Your best chance to pass is to take the exam sooner than later*
(<1month)
What If I Fail?
You will receive a
performance report
in the mail, which
will show you your
weak areas
You may retake the
exam after 45 days
as many times as it
takes for up to three
years
NCLEX REVIEW
NCLEX TEST
PLAN
www.ncsbn.org
Components of Test Plan

Each exam question addresses:
A level of cognitive ability
A client needs category
An integrated process
Levels of Cognitive Ability

Knowledge Recall
Comprehension
Application
Analysis

Knowledge: recall
A nurse reviews the laboratory results of a
clients blood glucose level. The nurse knows

that which of the following is a normal level?
1.) 40mg/dL
2.)100 mg/dL
3.) 180 mg/dL
4.) 220 mg/dL

Knowledge: recall
A nurse reviews the laboratory results of a
clients blood glucose level. The nurse knows

that which of the following is a normal level?
1.) 40mg/dL
*2.)100 mg/dL
3.) 180 mg/dL
4.) 220 mg/dL

Comprehension: understand information and
draw inferences based on that information

A hospitalized client with Type 1 diabetes
mellitus complains of hunger and
nervousness and the nurse notes that the
client is diaphoretic. The nurse understands
that the client is most likely experiencing:
1. anxiety related to the hospitalization
2. signs related to an infection
3. a hyperglycemic reaction
4. a hypoglycemic reaction

Comprehension: understand information and
draw inferences based on that information

A hospitalized client with Type 1 diabetes
mellitus complains of hunger and
nervousness and the nurse notes that the
client is diaphoretic. The nurse understands
that the client is most likely experiencing:
1. anxiety related to the hospitalization
2. signs related to an infection
3. a hyperglycemic reaction
*4. a hypoglycemic reaction

Application: Intervention, nursing action,
decision or problem that needs to be

addressed
A client is experiencing a hypoglycemic
reaction. The nurse administers which best
item to the client to treat the reaction?
1. water
2. diet soda
3. milk
4. one sugar-free cookie

Application: Intervention, nursing action,
decision or problem that needs to be

addressed
A client is experiencing a hypoglycemic
reaction. The nurse administers which best
item to the client to treat the reaction?
1. water
2. diet soda
*3. milk
4. one sugar-free cookie

Analysis: Consider/examine possibly several
concepts in order to answer the question

correctly
The nurse administers 10 units of Regular
insulin at 0700 to a client with Type 1
diabetes mellitus. The nurse monitors the
client most closely for a hypoglycemic
reaction during which hours?
1. 0900 to 1000
2. 1300 to 1900
3. 0900 to 1500
4. 1100 to 1200

Analysis: Consider/examine possibly several
concepts in order to answer the question

correctly
The nurse administers 10 units of Regular
insulin at 0700 to a client with Type 1
diabetes mellitus. The nurse monitors the
client most closely for a hypoglycemic
reaction during which hours?
*1. 0900 to 1000
2. 1300 to 1900
3. 0900 to 1500
4. 1100 to 1200
Client Needs
1 Safe, effective care environment
2. Health promotion and maintenance
3. Psychosocial integrity
4. Physiological integrity
Client Needs
Safe and Effective Care Environment
Coordinated Care
Safety and Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Integrity
Basic Care and Comfort
Pharmacologic Therapies
Reduction of Risk Potential
Physiological Adaptation
Clients are defined as individuals,

families and significant others.
Safe and Effective Care

The practical nurse provides nursing care that
contributes to the enhancement of the health

care delivery setting and protects clients and
health care personnel by:
Collaborating with health care team
members to facilitate effective client care.
Contributing to the protection of clients and
health care personnel from health and
environmental hazards.
Safe and Effective Care Environment:

Coordinated Care (12-18%)
Client Rights
Client includes individuals, families, and
significant others
Advance Directives
Advocacy
Client Care Assignments (delegation)
Ethical Practice
Informed Consent
Information Technology

Coordinated Care cont
Legal Responsibilities
Collaboration with the Interdisciplinary Team
Concepts of Management and Supervision
Confidentiality/Information Security
Continuity of Care
Establishing Priorities
Performance Improvement/Quality
Improvement
Referral Process
Resource Management
Staff Education

Safety and Infection Control (8-14%)
Accident/Error/Injury Prevention
Ergonomic Principles
Handling Hazardous and Infectious Materials
Home Safety (clients home)
Internal and External Disaster Plans
(Implementation)
Medical and Surgical Asepsis

Safety and Infection Control (8-14%) cont
Reporting of Incident/Event/Irregular
Occurrence or Variance
Restraints and Safety Devices (correct use)
Safe Use of Equipment
Security Plan (implementation)
Standard/Transmission Based/Other
Precautions
Coordinated Care
A client scheduled for surgery tells the nurse that he
signed an informed consent but was never told about the

risks of the surgery. The nurse serves as the clients
advocate by:
1. posting a note on the chart for the surgeon will see it
when the client arrives in the OR.
2. documenting in the chart that the client was not told
about the risks of the surgery.
3. notifying an RN and requesting that the surgeon to be
contacted and asked to explain the surgical risks to the
client.
4. reassuring the client that the risks are minimal and
unlikely to occur.
Coordinated Care
A client scheduled for surgery tells the nurse that he
signed an informed consent but was never told about the

risks of the surgery. The nurse serves as the clients
advocate by:
1. posting a note on the chart for the surgeon will see it
when the client arrives in the OR.
2. documenting in the chart that the client was not told
about the risks of the surgery.
3. notifying an RN and requesting that the surgeon to be
contacted and asked to explain the surgical risks to the
client.
4. reassuring the client that the risks are minimal and
unlikely to occur.
Health Promotion and Maintenance

The practical/vocational nurse provides
nursing care for clients that incorporates

knowledge of expected stages of growth and
development and prevention and/or early
detection of health problems.
Health Promotion and Maintenance (7-13%)

Aging Process
Ante/Intra/Postpartum and Newborn Care
Data Collection Techniques
Developmental/Growth Stages and
Transitions
Disease Prevention
Expected Body Image Changes
Health Promotion and Maintenance (7-13%)

Family Planning
Health Promotion and Screening Programs
High Risk Behaviors (Identification)
Human Sexuality
Immunizations (Identifies schedules)
Lifestyle Changes
Self Care
Health Promotion & Maintenance

A nurse is preparing to care for a hospitalized
teenager who is in skeletal traction. The

nurse plans care knowing that the most likely
primary concern of the teenager is:
1. Obtaining adequate nutrition
2. Body image
3. Keeping up with schoolwork
4. Obtaining adequate rest and sleep
Health Promotion & Maintenance

A nurse is preparing to care for a hospitalized
teenager who is in skeletal traction. The

nurse plans care knowing that the most likely
primary concern of the teenager is:
1. Obtaining adequate nutrition
2. Body image
3. Keeping up with schoolwork
4. Obtaining adequate rest and sleep
The practical/vocational nurse provides care
that assists with promotion and support of the

emotional, mental and social well-being of
clients
Psychosocial Integrity (8-14%)

Abuse or Neglect
Recognition and nursing responsibilities
Behavioral Management
Sensory/Perceptual Alterations
Situational Role Changes
Psychosocial Integrity cont

Coping Mechanisms (identifications)
Crisis Intervention
Cultural Awareness (considerations of care)
End of Life Concepts
Grief and Loss (assist with process)

Mental Health/Illness Concepts
Care of a client with a mental health disorder
Religious or Spiritual Influences on Health
Considerations of care
Stress Management (techniques)

Substance Related Disorders (identification)
Suicide/Violence Precautions
Support Systems
Therapeutic Communication
Therapeutic Environment
Unexpected Body Image Changes
A male child is brought to the school nurses office with c/o
1.
2.
3.
4.
abdominal pain. On data collection, the nurse notes the

presence of several bruises on the childs abdomen and back
and several cigarette burn marks. The nurse suspects child
abuse and plans for which priority action?
Calling the parents to ask them how the childs bruises and
burn marks occurred
Removing the child from the abusive situation to prevent
further injury
Documenting the bruises noted on the child
Asking the child how long his parents have been abusing him.
A male child is brought to the school nurses office with c/o
1.
2.
3.
4.
abdominal pain. On data collection, the nurse notes the

presence of several bruises on the childs abdomen and back
and several cigarette burn marks. The nurse suspects child
abuse and plans for which priority action?
Calling the parents to ask them how the childs bruises and
burn marks occurred
Removing the child from the abusive situation to prevent
further injury
Documenting the bruises noted on the child
Asking the child how long his parents have been abusing him
Physiologic Integrity
The practical nurse assists in the promotion
of physical health and well-being by providing

care and comfort, reducing risk potential for
clients and assisting them with the
management of health alterations by:
Physiologic Integrity cont

Providing comfort to clients and assistance in the
performance of their activities of daily living
Providing care related to the administration of
medications and monitors clients receiving
parenteral therapies
Reduces the potential for clients to develop
complications or health problems related to
treatments, procedures, or existing conditions
Provides care for clients with acute, chronic or
life threatening physical health conditions
Physiologic Integrity:
Basic Care and Comfort (11-17%)
Alternative and complementary therapy
Elimination (monitoring patterns)
Assistive Devices (canes, crutches, walkers, etc)
Mobility/Immobility (monitoring for complications)
Nonpharmacological Comfort Interventions
Nutrition and Oral Hydration (therapeutic diets)
Palliative/Comfort Care
Personal Hygiene (identifying issues)
Rest and Sleep

A nurse has provided information about the measures
that will promote normal urination patterns and

prevent urinary tract infections. Which statement by
the client indicates a need for further information?
1. I should eat foods that will make my urine acid.
2. I should try to hold my urine in as long as I can rather
than expelling it when I feel the urge.
3. I should drink plenty of fluids during the day.
4. I should take my furosemide (Lasix) in the morning.

A nurse has provided information about the measures
that will promote normal urination patterns and

prevent urinary tract infections. Which statement by
the client indicates a need for further information?
1. I should eat foods that will make my urine acid.
2. I should try to hold my urine in as long as I can rather
than expelling it when I feel the urge.
3. I should drink plenty of fluids during the day.
4. I should take my furosemide (Lasix) in the morning.
Physiologic Integrity:
Pharmacological Therapies (9-15%)
Adverse (or toxic) Effects

Contraindications and Compatibilities
Dosage Calculations
Expected Effects
Medication Administration (6 rights)
Pharmacological Actions
Pharmacological Agents
Side Effects
Client Teaching
Physiological Integrity:
Pharmacological Therapies cont
Blood transfusions (monitoring for complications)
Counting narcotics/controlled substances
Discontinuing an IV line
IV therapy
Monitoring IV sites/flow rates
Administering medication via various routes
including a gastrointestinal tube

Pharmacological pain management
Phoning in client prescriptions to the pharmacy
Pharmacological Therapies
Cyclosporine (Sandimmune) oral solution is
prescribed for a client who had a kidney

transplant. The nurse provides information to
the client about the medication and tells he
client that which of the following is most
important to monitor?
1. Apical heart rate
2. Peripheral Pulses
3. Platelet count
4. Temperature
Pharmacological Therapies
Cyclosporine (Sandimmune) oral solution is
prescribed for a client who had a kidney

transplant. The nurse provides information to
the client about the medication and tells he
client that which of the following is most
important to monitor?
1. Apical heart rate
2. Peripheral Pulses
3. Platelet count
4. Temperature
Reduction of Risk Potential (10-16%)
Diagnostic Tests (preparing the client)
Laboratory Values (monitoring results)
Potential for Alterations in Body Systems
(recognition of)
Therapeutic Procedures
Vital Signs
Potential for Complications of (pre and
post-procedure care)
Diagnostic Tests
Treatments
Procedures
Surgery
Health Alterations
A nurse assists a physician with performing a
liver biopsy on a client. Following the

procedure, the nurse assists the client to
which position?
1. Prone
2. On the right side
3. On the left side
4. Left Sims
A nurse assists a physician with performing a
liver biopsy on a client. Following the

procedure, the nurse assists the client to
which position?
1. Prone
2. On the right side
3. On the left side
4. Left Sims
Physiological Adaptation (11-17%)
Alterations in Body Systems
Wound care/dressing changes

Care of supportive devices (trach/vent)
Identifying abnormalities on cardiac telemetry
Basic Pathophysiology
Fluid and Electrolyte Imbalances (interventions for)
Infectious Diseases (interventions for)
Medical Emergencies (responding to)
Radiation Therapies
Unexpected Response to Therapies
A nurse is reviewing the medical records of the
4 clients she will be caring for. The nurse

determines that which client is at risk for
deficient fluid volume?
1. A client on long-term corticosteroid therapy
2. A client with congestive heart failure
3. A client with syndrome of inappropriate antidiuretic hormone
4. A client with a nasogastric tube attached to
suction
A nurse is reviewing the medical records of the
4 clients she will be caring for. The nurse

determines that which client is at risk for
deficient fluid volume?
1. A client on long-term corticosteroid therapy
2. A client with congestive heart failure
3. A client with syndrome of inappropriate antidiuretic hormone
4. A client with a nasogastric tube attached to
suction
Integrated Processes
The following processes fundamental to the
practice of practical/vocational nursing are
integrated throughout the Client Needs
categories and subcategories:
1. Caring
2. Clinical problem-solving process
3. Communication and documentation
4. Teaching and learning
Caring
It is very easy to become involved with the
technological viewpoint when answering a

question; however, always think about the
process of caring when answering a question
Caring .. interaction of the
practical/vocational nurse and clients,
families, and significant others in an
atmosphere of mutual respect and trust. In
this collaborative environment, the
practical/vocational nurse provides support
and compassion to help achieve desired
therapeutic outcomes.
Integrated Processes - Caring

An infant is brought to the emergency department by
emergency medical services (EMS) with suspected

sudden infant death syndrome (SIDS). The infants
parents have accompanied EMS and are present when
the infant is pronounced dead. The most important aspect
of compassionate care for the parents is to:
1. Explain to the parents that the death was not their fault
2. Allow the parents to say goodbye to the infant.
3. Gather data about the events that occurred before the
infant was found
4. Encourage the parents to attend a support group.
Integrated Processes - Caring

An infant is brought to the emergency department by
emergency medical services (EMS) with suspected sudden

infant death syndrome (SIDS). The infants parents have
accompanied EMS and are present when the infant is
pronounced dead. The most important aspect of
compassionate care for the parents is to:
1. Explain to the parents that the death was not their fault.
2. Allow the parents to say goodbye to the infant.
3. Gather data about the events that occurred before the
infant was found
4. Encourage the parents to attend a support group.
Clinical Problem-Solving Process
(Nursing Process) a scientific approach
to client care that includes data collection,
planning, implementation and evaluation.
Clinical Problem Solving (Nursing Process)
1. Data collection
Subjective: information given by the client
Objective: observable, measurable
First step
If you are asked to identify the initial or first action;
follow the steps of the nursing process, if a data
collection action is one of the options, that option is
most likely correct
If the question addresses an emergency situation,
read carefully; an intervention may be the priority
Integrated Processes:
Data Collection
A postoperative asks the nurse for pain
medication. The nurse should take which action

first?
1. Ask the client how long it has been since the last
dose of pain medication was administered.
2. Gather data from the client about the pain
3. Prepare the prescribed dose of pain medication
4. Ask the client if the last dose of the medication
was effective.
Data Collection
A postoperative client asks the nurse for pain
medication. The nurse should take which action

first?
1. Ask the client how long it has been since the last
dose of pain medication was administered.
2. Gather data from the client about the pain
3. Prepare the prescribed dose of pain medication
4. Ask the client if the last dose of the medication
was effective.
Clinical Problem Solving
2. Planning
Setting priorities
Assisting in determining goals/outcome
criteria for goals of care
Assisting in developing plan of care
Collaborating with other health team members
Communicating the plan of care
Actual problems are usually more important
than Risk for
Integrated Processes: Planning

A nurse is reviewing the nursing diagnoses written in
a nursing care plan for a client with chronic

obstructive pulmonary disease. The nurse determines
that which nursing diagnosis is the priority?
1. Ineffective Role Performance r/t role loss
2. Disturbed Thought Processes r/t sleep deprivation
3. Anxiety r/t loss of control during dyspneic episodes
4. Imbalanced Nutrition: Less Than Body Requirements
r/t dyspnea and fatigue.
Integrated Processes: Planning

A nurse is reviewing the nursing diagnoses written in
a nursing care plan for a client with chronic

obstructive pulmonary disease. The nurse determines
that which nursing diagnosis is the priority?
1. Ineffective Role Performance r/t role loss
2. Disturbed Thought Processes r/t sleep deprivation
3. Anxiety r/t loss of control during dyspneic episodes
4. Imbalanced Nutrition: Less Than Body Requirements
r/t dyspnea and fatigue.
3. Implementation
Client in test question is your only assigned
client
Client in test question is only client you are
concerned about
Answer question from textbook/ideal
perspective, rather than reality one
Answer the question, remembering you have
all the time, resources and supplies needed
and readily available at the clients bedside
Implementation
A nurse is assisting in monitoring a client following a
1.
2.
3.
4.
cardiac catheterization procedure. The client suddenly

complains of a feeling of wetness at the injection site.
The nurse quickly checks the site and discovers that the
client is bleeding. The best initial nursing action is to:
Apply firm pressure to the site using a sterile gauze
pad.
Apply firm pressure to the site using a bath towel.
Ask the client to place pressure on the site.
Check the clients blood pressure
Implementation
A nurse is assisting in monitoring a client following a
1.
2.
3.
4.
cardiac catheterization procedure. The client suddenly

complains of a feeling of wetness at the injection site.
The nurse quickly checks the site and discovers that the
client is bleeding. The best initial nursing action is to:
Apply firm pressure to the site using a sterile gauze
pad.
Apply firm pressure to the site using a bath towel.
Ask the client to place pressure on the site.
Check the clients blood pressure
4. Evaluation
Ongoing, continual process of comparing
actual with expected outcomes
Provides means for determining need to
modify plan of care
Frequently written in false response format;
ie the question may ask for a client
statement that indicates inaccurate
information related to the issue of the
question
Integrated Processes: Evaluation

Ibuprofen (Motrin) has been prescribed for a
client. On a follow-up physicians visit, the

nurse determines that the medication is
effective if the client states relief of:
1. Abdominal bloating
2. Constipation.
3. Joint stiffness.
4. Heartburn.
Integrated Processes: Evaluation

Ibuprofen (Motrin) has been prescribed for a
client. On a follow-up physicians visit, the

nurse determines that the medication is
effective if the client states relief of:
1. Abdominal bloating.
2. Constipation.
3. Joint stiffness.
4. Heartburn.
Communication and Documentation
verbal and nonverbal interactions between

the practical/vocational nurse and clients,
families, significant others and members of
the health care team. Events and activities
associated with client care are validated in
written and/or electronic records that reflect
standards of practice and accountability in the
provision of care.
Communication
Therapeutic communication techniques
indicate a correct option
Nontherapeutic communication techniques
indicate an incorrect response
If an option reflects a clients feelings,
anxieties, or concerns, select that option
Communication
A client says to a nurse, Im scared about my
surgery that I am having tomorrow. The nurse

makes which appropriate response to the client?
1. There is no reason to be scared.
2. You have plenty of reasons to be scared.
Surgery is a scary thing.
3. Scared?
4. Most people who have to have surgery are
scared.
Communication
A client says to a nurse, Im scared about my
surgery that I am having tomorrow. The nurse

makes which appropriate response to the client?
1. There is no reason to be scared.
2. You have plenty of reasons to be scared.
Surgery is a scary thing.
3. Scared?
4. Most people who have to have surgery are
scared.
Documentation
Review documentation guidelines-legal and ethical
Sample question:
A nurse discovers that she needs to make a correction to
a written entry in a clients chart. The nurse would
appropriately:
1) Contact the nursing supervisor to cosign the
correction
2) Remove the page, recopy the data to a new page,
and add the correct entry
3) Draw a single line through the entry that needs
correction followed by his/her (the nurses) initials
4) Erase the entry that needs correction and add the
correct entry
Sample question:
A nurse discovers that she needs to make a
correction to a written entry in a clients chart. The
nurse would appropriately:
1) Contact the nursing supervisor to cosign the
correction
2) Remove the page, recopy the data to a new
page, and add the correct entry
3) Draw a single line through the entry that needs
correction followed by his/her (the nurses) initials
4) Erase the entry that needs correction and add
the correct entry
Teaching and Learning .. facilitation of
the acquisition of knowledge, skills and

attitudes to assist in promoting positive
changes in behavior
Teaching and Learning
If a test question addresses client teaching,

remember that client motivation and
readiness to learn is the FIRST priority
See handout
Teaching & Learning
A nurse has reinforced teaching with a clients spouse about
how to change the clients colostomy bag. The nurse best

determines that the spouse understands the procedure by:
1. Asking the spouse if she has any questions about the
procedure.
2. Asking the spouse is she understands what items are
needed to perform the procedure.
3. Asking the spouse to perform the procedure and observe
her performing it.
4. Asking the spouse is she feels comfortable performing the
procedure.
Teaching & Learning
A nurse has reinforced teaching with a clients
spouse about how to change the clients colostomy

bag. The nurse best determines that the spouse
understands the procedure by:
1. Asking the spouse if she has any questions about
the procedure.
2. Asking the spouse is she understands what items
are needed to perform the procedure.
3. Asking the spouse to perform the procedure and
observe her performing it.
4. Asking the spouse is she feels comfortable
performing the procedure.
Types of Test Questions

Multiple Choice (majority ~85-90%)
Only one correct answer

Fill in the blank
Numerical response (question will tell you how to
round your answer and what units)
Multiple response (must have all correct answers to
receive credit)
~ 5-6 potential answer choices
Prioritizing (Ordered response)
Figure or illustration (hot spot)
Chart/exhibit
Fill in the Blank

The nurse is preparing to administer digoxin
(Lanoxin) 0.25mg orally. The label on the

medication bottle reads digoxin (Lanoxin)
0.125 mg per tablet. How many tablet(s) does
the nurse plan to administer to the client?
(round to the nearest 0.5)
_____________ tablet(s)
Multiple Response
Select all nursing interventions that apply in the care
of an infant following a cleft lip repair (cheiloplasty)

__Position the child on the abdomen
__Cleanse the suture line gently after feeding the infant
__Keep elbow restraints on the infant at all times
__Institute measures that will prevent vigorous and
sustained crying
__Observe for bleeding at the operative site
__Assist the mother with breastfeeding if this is the
feeding method of choice
Using a Figure or Illustration

The nurse is performing CPR on a 6 month
old infant. Using the computer mouse, click

on the anatomical area that the nurse would
palpate to assess circulation.
www.atitesting.com
http://www.studygs.net/schedule/index.htm
Prioritizing
List in order of priority the interventions that
the nurse would take in the care of a client

who develops acute pulmonary edema.
(Number 1 indicates the first action and
number 4 indicated the last action.)
__Place the client on pulse oximetry
__Place the client in high-Fowlers position
__Prepare the client for endotracheal intubation
and mechanical ventilation
__Prepare for the administration of oxygen
Using a Chart or Exhibition

The nurse reviews the
1.
2.
3.
4.
clients laboratory
results for electrolyte
levels. The nurse
reports which
abnormal result?
Sodium
Potassium
Chloride
Bicarbonate
Clients Chart
Labs Meds Notes
Sodium
150mEq/L
Potassium
4mEq/L
Chloride 102
mEq/L
Bicarbonate 26
mEq/L
Avoid Reading into the Question:

Multiple Choice
Identify parts of the question
Read carefully
Look for key words or phrases
Identify the issue
Use the process of elimination
Avoid asking yourself What if?
Parts of the Question

1. Case situation- The heart of the question;
provides with information needed to answer

2. Question stem- Statement that generally
follows the situation and asks something very

specific about the info in the case situation
3. Options- All answers presented with the
question (usually 4)
Key Words/Phrases
Focus your attention on critical and specific
points
May indicate there is only one option
May indicate you may need to prioritize
May indicate a true response question
May indicate a false response question
Key Words or Phrases That

Indicate there is only
one correct option
Early sign
Late sign
Understands
Goal has been
achieved
Adequately tolerating
Avoid
Needs reinforcement
of the instructions
Lack of
understanding
Goals have not yet
been fully met
Has not met the
outcome criteria
Ineffective
Inadequate
Unable to tolerate

Indicate the need to
prioritize
Best
First
Initial
Immediately
Most or least likely
Most or least
appropriate
Highest or lowest
priority
Order of priority
At highest risk
At lowest risk
Best understanding

Indicate a true
response
Early sign
Late sign
Best
First
Last
Initial
Immediately
Most likely
Most appropriate
Highest priority
Order of priority
All nursing
interventions that
apply
Goal has been
achieved
Adequately
tolerating

Indicate a false
response
Least likely
Least appropriate
Least priority
Least helpful
At lowest risk
Avoid
Needs
reinforcement of the
instructions
Needs additional
teaching
Lack of
understanding
Goals have not yet
been fully met
Has not met the
outcome criteria
Ineffective
Inadequate
Unable to tolerate
The Issue of the Question

Specific subject content that the question is
asking about
Look back at the Client Needs
The Issue of the Question

Sample Question
1.
2.
3.
4.
A client with metastatic cancer is receiving

morphine sulfate to alleviate pain. The
nurse monitors the client for which adverse
or toxic effect of the medication?
Dizziness
Sedation
Skeletal muscle flaccidity
Nausea
Random Strategies
Process of elimination
Likely to eliminate two of the options; you
have two remaining

With those two remaining:
Read the question again
Identify the case situation
Look for key words/phrases
Ask again What is the question asking?
Read options again
What if?
Sample question
A nurse is caring for a hospitalized client with a
diagnosis of congestive heart failure who
suddenly complains of shortness of breath and
dyspnea. The nurse takes which immediate
action?
1) Prepares to administer furosemide (lasix)
2) Calls a respiratory therapist
3) Prepares to administer oxygen
4) Elevates the head of the clients bed
Prioritizing Questions
General Guidelines
Note key words/phrases

The ABCs
Maslows Hierarchy of Needs
The steps of the nursing process
Prioritizing Key Words
Best
Essential
First
Highest priority
Immediately
Initial
Most appropriate
Most effective
Most important
Most likely
Nest
Order of priority
Priority
Primary
Vital
Maslows Hierarchy
Maslows Hierarchy of Needs Theory

A nurse is assisting with the admission of a
1.
2.
3.
4.
client to the mental health unit with a

diagnosis of post-traumatic stress disorder.
The client is confused and disoriented.
During the data collection, the nurses
primary goal for this client is to:
Stabilize the clients psychiatric needs
Orient the client to the unit
Explain the unit rules
Make the client feel safe
Maslows
A nurse has helped develop a plan of care
1.
2.
3.
4.
for a client diagnosed with anorexia nervosa.

Which nursing diagnosis would the nurse
select as the priority in the plan of care?
Disturbed Body Image
Defensive Coping
Deficient Knowledge
Imbalanced Nutrition: Less Than Body
Requirements
Maslows
A nurse is preparing to reinforce instructions with a
client about using crutches. Before reinforcing
the instructions, the nurse collects which
priority information from the client?
1. The clients fear related to the use of crutches
2. The clients understanding of the need for
increased mobility
3. The clients muscle strength and previous
activity level
4. The clients feelings about the restricted activity
Prioritizing Questions
Highest Priority: A client need that is life-
threatening or if untreated could result in

harm to the client
Intermediate Priority: Non-emergency or
non life-threatening client need that does not
require immediate attention
Low Priority: Client need that is not directly
related to the clients illness or prognosis, is
not urgent or does not require immediate
attention
Prioritizing
A nurse is caring for a client with angina
1.
2.
3.
4.
pectoris who begins to experience chest

pain. The nurse administers a sublingual
nitroglycerin (Nitrostat) tablet as prescribed,
but the pain is unrelieved. What action
should the nurse take next?
Call a Code Blue
Call the clients family
Administer another nitroglycerin tablet
Reposition the client
Prioritizing
An infant with tetralogy of Fallot experiences
a hypercyanotic spell during a blood draw.

List in order of priority the actions that the
nurse would take (number one is the first
priority and number four is the lowest priority).
__Administer morphine sulfate subcutaneously
as prescribed
__Administer 100% oxygen by face mask as
prescribed
__Place the infant in a knee-chest position
__Administer intravenous fluids as prescribed
The ABCs
The client with a diagnosis of cancer is
1.
2.
3.
4.
receiving morphine sulfate 10 mg

subcutaneously every 3 to 4 hours for pain.
When preparing a plan of care for the client,
the nurse includes which priority action?
Monitor stools
Monitor the urine output
Encourage the client to cough and deep
breathe
Encourage fluid intake
The ABCs
A nurse is monitoring a clients condition
1.
2.
3.
4.
after cardioversion. Which of the following

observations is the highest priority to the
nurse?
Status of airway
Oxygen flow rate
Level of consciousness
Blood pressure
The ABCs
A nurse is reinforcing preoperative
1.
2.
3.
4.
instructions to a client scheduled for a

cholecystectomy. Which intervention is of
the highest priority in the preoperative
teaching plan?
Teaching coughing and deep breathing
exercises
Teaching leg exercises
Instructing regarding fluid restrictions
Determining the clients understanding of the
surgical procedure
When to Select Notify an RN

If the question DOES NOT describe a life-
threatening client situation or one that indicates a

change in the clients condition AND there is an
option that directly relates to a nursing action
relevant to the situation, then it best to select that
option and NOT the option that reads Notify the
RN
If the question DOES describe a life threatening
client situation or one that indicates a change in

clients condition, then select the option that reads
Notify the RN
Notify RN?
A nurse is caring for a postoperative client
who becomes restless. The nurse should

take which initial action?
1.
2.
3.
4.
Check the clients vital signs

Notify a registered nurse
Medicate the client for pain
Talk to the client in a calm voice
Notify RN?
A nurse is caring for a client who just returned
from the recovery room following a
tonsillectomy and adnoidectomy. The client is
restless and the pulse rate is elevated. The
nurse prepares to collect additional data on
the client but the client begins to vomit large
amounts of bright red blood. The immediate
nursing action is to:
1. Notify an RN
2. Continue with data collection
3. Check the clients blood pressure
4. Obtain a flashlight and gauze
Key Words That Indicate

Data Collection
Check
Collect
Determine
Find out
Gather
Identify
Monitor
Observe
Obtain Information
Data Collection
A nurse is teaching a client with coronary
1.
2.
3.
4.
artery disease about dietary measures to

follow. During the session, the client
expresses frustration in learning the dietary
regimen. The nurse should initially:
Identify the cause of frustration
Continue with the dietary teaching
Notify a registered nurse
Tell the client that the diet needs to be
followed
Planning
A nurse is reviewing the plan of care for a
1.
2.
3.
4.
pregnant client with a diagnosis of sickle cell

anemia. Which nursing diagnosis, if stated
on the plan of care, should the nurse select
as receiving the highest priority?
Anxiety
Ineffective coping
Disturbed body image
Deficient fluid volume
Implementation
ANSWER THE QUESTION FROM AN IDEAL
TEXTBOOK PERSPECTIVE, YOU HAVE

ALL THE TIME AVAILABLE TO CARE FOR
THE CLIENT AND ALL THE RESOURCES
AT THE CLIENTS BEDSIDE!
Implementation
1.
2.
3.
4.
A nurse is caring for a preoperative male client who

verbalizes a great deal of anxiety about the surgical
procedure scheduled in two hours. Which action by the
nurse would best alleviate the clients anxiety?
Tell the client that you will spend some time answering
question as soon as you get your other tasks completed
Talk to the client for 15 minutes and return shortly
thereafter to check on him
Call the clients wife and ask her to visit the client before
surgery
Stay with the client until he is taken to the operating room
Implementation
1.
2.
3.
4.
A nurse is caring for a client following a cardiac

catheterization. The client suddenly complains of a
feeling of wetness in the groin at the catheter
insertion site. The nurse checks the site, notes that
the client is actively bleeding, and takes which best
action?
Don a clean glove and places pressure on the
insertion site with the gloved hand
Dons a sterile glove and places pressure on the
insertion site using sterile gauze
Checks the clients blood pressure
Checks the clients peripheral pulse in the affected
extremity
Evaluation
A client recovering from an exacerbation of left-sided heart
failure has a nursing diagnosis of Activity Intolerance.
The nurse determines that the client best tolerates mild
exercise if the client exhibits which of the following
changes in vital signs during activity?
1. Pulse rate increased from 80 beats/minute to 104
beats/minute
2. Respiratory rate increased from 16 breaths per minute
to 19 breaths per minute
3. Oxygen saturation decreased from 96% to 91%
4. Blood pressure decreased from 140/86 mm Hg to
112/72 mm Hg
Delegation/Assignment Making
Questions
Always ensure client safety
Match tasks based on Nurse Practice Act
Think about individual variations in work
abilities
Always provide clear direction to the
delegatee
General Guidelines: Who Can Do

What
UAP
Ambulation
Bathing
Grooming
Hygiene measures
Positioning
ROM exercises
Skin care
Some specimen collection (urine, stool)
Transporting a client

What
LPN
All that UAP can do AND
Administering PO meds
Administering IM meds
Administering SQ meds
Dressing changes
Irrigating wounds

What
LPN (continued)
Monitoring IV flow rate
Performing urinary catheterization
Suctioning
Teaching about basic hygiene/nutritional
measures
Using nursing process: data collection,
planning, implementing, evaluating

What
RN can do
ALL that UAP and LPN can do AND

Administer IV medications
Leading others and managing client care
environment
Teaching
Using nursing process: assessment,
analyzing data, planning client care,
implementing and evaluating care
Delegation/Assignments
A licensed practical nurse is planning client assignments for
the day and has another licensed practical nurse and a
nursing assistant on the nursing team. The nurse most
appropriately assigns which client to the licensed
practical nurse?
1. An older client recovering from pneumonia who requires
ambulation every 3 hours
2. A client with a tracheostomy who requires frequent
suctioning
3. An older client who requires turning and repositioning
every 2 hours and range of motion exercises every 4
hours
4. A client who requires the collection of urine for a 24-hour
period
Delegation/Assignments
A licensed practical nurse employed in a long term
1.
2.
3.
4.
care facility is assigning client care activities to a

nursing assistant. The nursing assistant is a firstsemester senior nursing student and works at the
facility as a nursing assistant part-time on weekends. The facility position description for a nursing
student who is employed as a nursing assistant
indicates that he or she may perform procedures
learned in nursing school if supervised by a licensed
nurse. Based on the facilitys position description,
the nurse assigns which most appropriate activity to
the nursing assistant?
Hang an IV solution of 0.9% normal saline
Insert an IV catheter
Change a sterile abdominal dressing
Administer digoxin (Lanoxin)
Time Management
Must do
Should do
Nice to do
Focus on beginning the daily tasks, working
on the most important first while keeping

goals in mind
Think
Organize
Plan
Prioritize
Time management
A nurse on the day shift is assigned to care for the four
clients. Following report from the night shift, the nurse
plans to perform client rounds and collect data from each
client. Number in order of priority how the nurse will plan
the client rounds. (Number 1 is the first client that the
nurse will check and collect data from and number 4 is
the last client that the nurse will check and collect data
from.)
__Client scheduled for a cardiac catheterization at 11 am
__Client diagnosed with diabetes mellitus who is scheduled
for discharge to home at 12 noon
__Client with emphysema who is receiving oxygen therapy
__Client scheduled to have an electrocardiogram (ECG) at
2:00 pm
Communication Questions
May be in any clinical setting and in any
patient care area!

Focus on clients feelings, concerns, anxieties
or fears
Consider cultural differences: communication
styles, use of eye contact, meaning of touch
Nontherapeutic techniques impede or block
the flow of communication; shut down or shut
off conversation
Pharmacological Questions
Medication Rights
Always :
Check for allergies hypersensitivities

Ask the client about existing medical disorders that are
contraindicated with the administration of a prescribed
med
Check for potential interactions related to the med
Check pertinent lab values
Check vital signs, particularly if
antihypertensive/cardiac meds
Monitor for intended, side, adverse, toxic effects of
meds
Monitor clients response
Intended effect: desired effect
Side effect: Not a desired effect
Not usually life-threatening

Can usually be alleviated with specific measures
Adverse effect: more severe than a side effect
Always an undesirable effect
Always reported to an RN and MD
Toxic effect: Medication level in the body exceeds
the therapeutic level
Tylenol, Tegretol. Lanoxin, Gentamycin, Lithium,
Magnesium sulfate, Dilantin, Salicylate,
Theophylline
Refer to FON Appendix C pg 1281
Look to the trade name /generic
name/medical terminology for help in

determining use of medication example:
Brethine; Lopressor
See handouts
The nurse notes that a physician has
prescribed cotrimoxazole (Bactrim) for a

client with a urinary tract infection. Which
priority action will the nurse take before
administering this medication?
1.
2.
3.
4.
Call the pharmacy to order the medication

Ask the client about an allergy to
sulfonamides
Check the medication supply room to find out
if the medication needs to be ordered
Inform the client about the need to increase
fluid intake
Pharmacology
A client taking amitriptyline hydrochloride
1.
2.
3.
4.
(Elavil) calls the nurse at the physicians

office and reports that he develops an upset
stomach whenever he takes the medication.
The nurse appropriately tells the client to:
Take the medication with an antacid
Stop the medication for 2 days and then
resume the prescribed medication schedule
Take the medication on an empty stomach
Take the medication with food
Dosage Calculations
Total Volume X gtt Factor
Time in minutes
= gtt/ minute
Available mg
Desired mg
=
Available mL*
Desired mL*
mL/hr
60 minutes
volume in mL
minutes to give
* mL may be substituted with capsules/tablets
Dosage Calculation Tips

Use the on-screen calculator
Convert the unit of measure is necessary
Follow the formula
Place the decimal points in the correct places
Place a zero before a decimal point if the
value lacks a number before the decimal
point (0.5 not .5)
Avoid placing a decimal point and a zero after
a whole number (5 not 5.0)
Recheck the accuracy of the calculation!!
Dosage Calculations
A physicians order reads phenytoin
(Dilantin) 0.2 g orally twice daily. The

medication label states 100 mg capsules. A
nurse prepares how many capsule(s) to
administer one dose?
1.
2.
3.
4.
1 capsule
2 capsules
3 capsules
4 capsules
Dosage Calculations
A physician orders 1000mL of one-half
normal saline to infuse over 8 hours. The

drop factor is 15 drops (gtt) per 1 mL. The
nurse sets the flow rate at how many drops
per minute? (round to the nearest whole
number)
1.
2.
3.
4.
18 drops per minute

31 drops per minute
44 drops per minute
100 drops per minute
Additional General Strategies:

Absolute Words
Absolute
All
Always
Cant
Every
Must
Never
None
Not
Only
Wont
Not-So-Absolute Words
Generally
May
Possibly
Usually
In general, if an
option contains an
absolute word, it is
incorrect
Absolute Words
A nurse is providing dietary instructions to a
client about a low-fat diet. The nurse tells

the client to:
1.
2.
3.
4.
Never use butter in their cooking

Read the labels on food items to determine
their fat content
Eat only foods that have less than 1% fat
content
Drink fluids only if they are fat free
Not-So-Absolute Words
A client scheduled for a computed
tomography (CT) scan of the abdomen asks

the nurse when the results of the test will be
available. The nurse make which appropriate
response to the client?
1.
2.
3.
4.
The results wont be available for at least

one week
You must ask the CT technician for that
information
Your physician may have the results in about
3 days
Every scan is read by a radiologist and this
process always takes 1 week
Additional General Strategies: Medical

vs Nursing Interventions
Select the option that is a nursing intervention
and not a medical one

The only situation in which you may need to
select a medical intervention is if the question
indicates to do so, i.e. Which intervention
does the nurse anticipate the physician will
prescribe?
Eliminating Options That Contain Medical

Rather Than Nursing Interventions
A nurse is caring for a client with a diagnosis
of congestive heart failure who suddenly

experiences severe dyspnea, and the nurse
suspects that the client developed
pulmonary edema. The nurse immediately:
1.
2.
3.
4.
Obtains a vial of furosemide (Lasix) and a

syringe
Places the client in the high-Fowlers position
Obtains a dose of morphine sulfate from the
narcotic medication drawer
Inserts a foley catheter

Eliminating Similar Options
Note options that are similar in regards to
their content or context; if they are present,

they are both wrongmultiple choice
questions have only ONE right answer
Additional General Guidelines:

All Parts of an Option are Correct
2 part answers: connected by and or
Both must be correct
The nurse expects to collect the following data

on a client with a cataract of the right eye:
1. Complaints of blurred vision AND excessive

tearing of the eye
2. A cloudy white pupil AND complaints of eye
pain
3. Complaints of a gradual loss of vision AND
photophobia
4. Complaints of a frontal headache AND
photophobia
Additional General Guidelines

Select the Umbrella Option
General statement that may incorporate the
content of the other options with it

When you are answering a question and note
that more than one option appears to be
correct, LOOK FOR THE UMBRELLA
OPTION
Umbrella Option
Sample question
A nurse in the emergency department receives a

phone call from EMS and is told that several victims
who survived a plane crash and are suffering from
cold exposure will be transported to the hospital. The
initial nursing action is which of the following?
1)
Supply the trauma rooms with bottles of sterile water
and normal saline
2)
Call the laundry department and ask to send as
many warm blankets as possible to the emergency
department
3)
Call the nursing supervisor to activate the agency
disaster plan
4)
Call the ICU to request that nurses be sent to the
emergency department
Additional General Guidelines:

Visualize the Information
Form a mental image of the situation and place
yourself into the situation
Visualizing
Sample question
A nurse prepares to perform a sterile
dressing change on a PICC line. The nurse
explains the procedure to the client, washes
her hands, and sets up the sterile field. The
nurse would take which action next?
1)
2)
3)
4)
Don sterile gloves

Don clean gloves and remove the old dressing
Clean the site with Chloraprep
Inspect the integrity of the skin around the
insertion site

Similar Concepts
Look for similar concepts in the question and
in one of the options

Sample question
A client is admitted to the hospital with a

diagnosis of pericarditis. A nurse monitors
the client for which manifestation that
differentiates pericarditis from other
cardiopulmonary problems?
1)
2)
3)
4)
Chest pain that worsens on inspiration

Pericardial friction rub
Anterior chest pain
Weakness and irritability
Laboratory Values
Identify whether the laboratory value is
normal or abnormal
Note the disorder presented in the question
Identify the associated body organ that is
affected as a result of the disorder
Laboratory Values
A client with a diagnosis of sepsis is
receiving antibiotics by the intravenous

route. The nurse monitors for nephrotoxicity
by checking the results of which laboratory
value most closely?
1.
2.
3.
4.
Blood urea nitrogen

White blood cell count
Platelet count
Lipase level

Client Positioning
Always review physician orders
Focus on clients diagnosis
Identify the anatomical location of the clients
diagnosis
Consider the pathophysiology of the disorder
and the goals of care
Think about what complications you want to
prevent
See handout
Client Positioning
A nurse assists a physician in performing a
liver biopsy. After the biopsy, the nurse plans

to place the client in which of the following
positions?
1.
2.
3.
4.
Supine
Prone
A left side-lying position with a small pillow or
or folded towel under the puncture site
A right side-lying position with a small pillow
or folded towel under the puncture site

PN 154 Nclex Review

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PN 154

OSBN, who then sends the list to Pearson Vue

Application Hints (Just say, Yes!)

even if you have a prescription.

Answer yes even if the record has been

How to apply for an

How to apply for initial

How to register for the

Scheduling Your Exam

then send Pearson Vue a Candidate List

Oregon testing centers: Beaverton, Salem, Medford

You must take the exam within 90 days of receiving

your ATT (but after graduation date 6/25/10)

Scheduling Your Exam

by the board of nursing (BON) (90 days).

Before the day of the test:

center before or after you

without your ATT. You will be required to re-register

scheduled testing time. (If you arrive late

Day of Test: Do Not Bring

Marker, and Calculator are provided)

asked to illustrate your signature.

Earplugs provided if needed.

familiarize you with the computer.

Breaks count against your testing time, when you

return from break, you will be fingerprinted again

You will be asked to complete a survey at the end

Do not give any information about the exam to

anyone, including instructors!

with an erasable board that may be replaced

Believe you have a problem with your computer

When you have finished the test and

questionnaire, raise your hand. The TA will

~48 hours after the NCLEX

Nursing receives you official transcripts from

Common Questions and Myths About

score of all people taking the test across the

Theres lots of drug questions

Common Questions and Myths

certain number of questions.

If you miss a question on a particular subject,

you will get more questions on that topic.

name changes, address changes, email changes,

Your employer may narrow your scope of practice,

but may not broaden your scope of practice

(There are thousands of questions in

the test bank)

25 pre-test questions on every NCLEX-PN

exam (60 official plus 25 pre-test questions make up your first

Pre-test questions are written by nurses

Exam will end when:

At least the minimum number of questions

every subject, it would be way too long and

Passing with 95% Confidence

Failing with 95% Confidence

After 85 questions the computer will begin

has been reached or 5 hours has passed,

Should you give up if you take more