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NCLEX-RN Review Course

NCLEX-RN Review Course

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NCLEX-RN Review Course

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  1. NCLEX-RN Review Course Test-Taking Workshop

  2. Test taking Workshop

  3. Testtaking Workshop NCLEX-RN Measures Nursing Knowledge • Normal Growth and Development (Integrated throughout your nursing education) • Basic Human Needs • Coping Mechanisms of Individuals • Actual Potential for Health Problems • Effects on Health Needs of Age, Sex, Culture, Ethnicity and Religion • Ways to Assist Clients by Teaching Them to: Maintain Health Cope with Health Problems

  4. Testtaking Workshop

  5. Testtaking Workshop Integrated Process 1. Nursing Process 2. Caring 3. Communication and Documentation 4. Teaching/Learning

  6. Testtaking Workshop

  7. Testtaking Workshop 1. Assessment 2. Analysis 3. Planning 4. Intervention 5. Evaluation

  8. 1. Identify the signs and symptoms most indicative of a deterioration of the client’s respiratory status. • Increased restlessness and changes in level of consciousness • Bradycardia and increases in blood pressure • Complaints of chest pain and shortness of breath • Rapidly dropping PCO2 and pH

  9. 1. Identify the signs and symptoms most indicative of a deterioration of the client’s respiratory status. • Increased restlessness and changes in level of consciousness • Bradycardia and increases in blood pressure • Complaints of chest pain and shortness of breath • Rapidly dropping PCO2 and pH A. The brain is one of the first organs to be affected by a decrease in oxygenation. Restlessness and changes in the level of consciousness indicate this decrease. All the other choices are assessments for other conditions.

  10. Testtaking Workshop 1. Assessment 2. Analysis 3. Planning 4. Intervention 5. Evaluation

  11. 2. A client is admitted to the unit with a diagnosis of bronchitis, heart failure and fever. The nurse assesses the client to be very nervous, have a temperature of 101.1oF (38.4oC), peripheral edema, dyspnea, and rhonchi. Which nursing diagnosis has the highest priority? • Anxiety related to fear of hospitalization • Ineffective airway clearance related to retained secretions • Fluid volume excess related to third spacing of fluid (edema) • Ineffective thermoregulation related to fever

  12. 2. A client is admitted to the unit with a diagnosis of bronchitis, heart failure and fever. The nurse assesses the client to be very nervous, have a temperature of 101.1oF (38.4oC), peripheral edema, dyspnea, and rhonchi. Which nursing diagnosis has the highest priority? • Anxiety related to fear of hospitalization • Ineffective airway clearance related to retained secretions • Fluid volume excess related to third spacing of fluid (edema) • Ineffective thermoregulation related to fever B. Nursing diagnoses that deal with the airway always have highest priority.

  13. Testtaking Workshop 1. Assessment 2. Analysis 3. Planning 4. Intervention 5. Evaluation

  14. 3. A client is diagnosed with respiratory failure and is placed on oxygen. Select the highest priority goal for this client. • Ambulate the client twice per shift down the length of the hall • Complete a bath and morning care before breakfast • Maintain an oxygen saturation of 90% throughout the shift • Keep the head of the bed elevated to promote proper ventilation

  15. 3. A client is diagnosed with respiratory failure and is placed on oxygen. Select the highest priority goal for this client. • Ambulate the client twice per shift down the length of the hall • Complete a bath and morning care before breakfast • Maintain an oxygen saturation of 90% throughout the shift • Keep the head of the bed elevated to promote proper ventilation C. Choice A is unrealistic for this client. Choice B is not client centered, and choice D is a nursing intervention, not a goal. Maintaining an oxygen saturation of 90% is realistic and within normal limits.

  16. Testtaking Workshop 1. Assessment 2. Analysis 3. Planning 4. Intervention 5. Evaluation

  17. 4. When the nurse ambulates a client who has been on bedrest for three days, the client suddenly becomes very restless, displays extreme dyspnea and complains of chest pain. Which is the appropriate immediate nursing action? • Call the physician about the change in the client’s condition • Continue to ambulate the client, but at a slower rate • Give the client an injection of ordered pain medication • Return the client to bed, and evaluate vital signs and lung sounds

  18. 4. When the nurse ambulates a client who has been on bedrest for three days, the client suddenly becomes very restless, displays extreme dyspnea and complains of chest pain. Which is the appropriate immediate nursing action? • Call the physician about the change in the client’s condition • Continue to ambulate the client, but at a slower rate • Give the client an injection of ordered pain medication • Return the client to bed, and evaluate vital signs and lung sounds D. These are symptoms of a pulmonary embolism which is a common complication of prolonged bedrest.

  19. Testtaking Workshop 1. Assessment 2. Analysis 3. Planning 4. Intervention 5. Evaluation

  20. 5. A client is being prepared for discharge and is to take a theophylline medication by mouth at home for his lung disease. Which client statement indicated that teaching concerning theophylline medications has been effective? • “I can stop taking this medication when I feel better.” • “If I have difficulty swallowing the time-released capsules, I can crush or chew them.” • “If I have a lot of nausea and vomiting or become restless and can’t sleep, I need to call my physician.” • “I need to drink more coffee and soft drinks while I am on this medication.”

  21. 5. A client is being prepared for discharge and is to take a theophylline medication by mouth at home for his lung disease. Which client statement indicated that teaching concerning theophylline medications has been effective? • “I can stop taking this medication when I feel better.” • “If I have difficulty swallowing the time-released capsules, I can crush or chew them.” • “If I have a lot of nausea and vomiting or become restless and can’t sleep, I need to call my physician.” • “I need to drink more coffee and soft drinks while I am on this medication.” C. Choice C lists some adverse effects of theophylline medications that may indicate the onset of toxicity. The physician needs to know about these so that the theophylline level can be determined and the dosage adjusted accordingly. Other factors that the client could be taught about theophylline medications include avoiding excessive amounts of caffeine, never suddenly stop taking the medication, take it with a full glass of water and a small amount of food, and watch for interactions with OTC medications.

  22. Testtaking Workshop Caring

  23. Testtaking Workshop Communication And Documentation

  24. Testtaking Workshop Teaching/ Learning

  25. Testtaking Workshop

  26. Testtaking Workshop Client Needs I. Safe,Effective Care Environment II. Health Promotion and Maintenance III. Psychosocial Integrity IV. Physiological Integrity

  27. Testtaking Workshop Client Needs Safe, Effective Care Environment Management of Care Safety & Infection Control Health Promotion and Maintenance Psychosocial Integrity Physiological Integrity Basic Care and Comfort Pharmacological & Parenteral Therapy Reduction of Risk Potential Physiological Adaptation 13-19% 8-14% 6-12% 6-12% 6-12% 13-19% 13-19% 11-17%

  28. Testtaking Workshop Client Needs I.Safe, Effective Care Environment

  29. Testtaking Workshop Client Needs II. Health Promotion and Maintenance

  30. Testtaking Workshop Client Needs III. Psychosocial Integrity

  31. Testtaking Workshop Client Needs IV. Physiological Integrity

  32. Testtaking Workshop

  33. Testtaking Workshop

  34. 6. A client is admitted to the medical unit with respiratory failure. What is the normal range for PO2? • 10-30 mm Hg • 35-55 mm Hg • 10-20 cm H2O • 80-100 mm Hg

  35. 6. A client is admitted to the medical unit with respiratory failure. What is the normal range for PO2? • 10-30 mm Hg • 35-55 mm Hg • 10-20 cm H2O • 80-100 mm Hg D. You either have or do not have the knowledge for this particular laboratory test.

  36. Testtaking Workshop

  37. 7. A client is becoming progressively short of breath and the ABGs are: pH-7.13; PO2-48; PCO2-53; HCO3-26. What is indicated by these values? • Uncompensated metabolic acidosis with moderate hypoxia • Respiratory alkalosis with hypoxia • Uncompensated respiratory acidosis with severe hypoxia • Compensated respiratory acidosis with normal oxygen

  38. 7. A client is becoming progressively short of breath and the ABGs are: pH-7.13; PO2-48; PCO2-53; HCO3-26. What is indicated by these values? • Uncompensated metabolic acidosis with moderate hypoxia • Respiratory alkalosis with hypoxia • Uncompensated respiratory acidosis with severe hypoxia • Compensated respiratory acidosis with normal oxygen C. Not only do you have to know the normal values for each of the blood gas components given, you also have to be able to use that information in determining the underlying condition.

  39. 8. A client has become cyanotic and is having Cheyne-Stokes respirations. What is the best action for the nurse to take at this time? • Call a code blue and begin CPR • Call the physician and report the condition • Make sure the client’s airway is open and begin supplemental oxygen • Give the ordered dose of 200 mg aminophylline IVPB now

  40. 8. A client has become cyanotic and is having Cheyne-Stokes respirations. What is the best action for the nurse to take at this time? • Call a code blue and begin CPR • Call the physician and report the condition • Make sure the client’s airway is open and begin supplemental oxygen • Give the ordered dose of 200 mg aminophylline IVPB now C. Answers B and D are also actions that should be carried out, but at this time, opening the airway and oxygenating the client must receive highest priority. Not only does this question require that the nurse know some specific facts (definitions of “cyanotic” and “Cheyne-Stokes respirations), but also requires a decision be made about the seriousness of the condition (analysis) and a selection of the care to be given from several correct options (judgment).

  41. Testtaking Workshop

  42. Testtaking Workshop Multiple Choice Items

  43. Testtaking Workshop

  44. Testtaking Workshop CAT changes difficulty level for next question based on response to previous question.

  45. 9. The nurse is instructing a client on how to obtain a 24-hour urine sample for creatinine clearance. Which measure is appropriate for the nurse to include in the teaching plan? • Keep the urine in a glass container only • Drink extra fluid to increase the amount • Save all the urine for a full 24 hours • Save only enough urine to fill the container

  46. 9. The nurse is instructing a client on how to obtain a 24-hour urine sample for creatinine clearance. Which measure is appropriate for the nurse to include in the teaching plan? • Keep the urine in a glass container only • Drink extra fluid to increase the amount • Save all the urine for a full 24 hours • Save only enough urine to fill the container C. All urine needs to be saved, or the results would be inaccurate. This material should be covered in one of the introductory courses and is considered to have a low difficulty level.

  47. 10. A client has been diagnosed as having Wolff-Parkinson-White (WPW) syndrome, Type A. In evaluating the electrocardiogram, the nurse notes which characteristics for this condition? • PR interval less than 0.12 second and wide QRS complex • PR interval greater than 0.20 second and normal QRS complex • Delta wave present in a positively deflected QRS complex in lead V1 and PR interval less than 0.12 second • Delta wave present in a positively deflected QRS complex in lead V6 and PR interval greater than 0.20 second

  48. 10. A client has been diagnosed as having Wolff-Parkinson-White (WPW) syndrome, Type A. In evaluating the electrocardiogram, the nurse notes which characteristics for this condition? • PR interval less than 0.12 second and wide QRS complex • PR interval greater than 0.20 second and normal QRS complex • Delta wave present in a positively deflected QRS complex in lead V1 and PR interval less than 0.12 second • Delta wave present in a positively deflected QRS complex in lead V6 and PR interval greater than 0.20 second C. These are the criteria for WPW. This material is much more difficult and usually covered, if at all, toward the end of the educational program.

  49. Testtaking Workshop Alternate Format Items 1. Fill-in-the-blank 2. Select more than one option 3. Identification of an Area/Location within an Image or Graphic 4. Ranking or Ordered response 5. Charts and Tables

  50. Fill-in-the-Blank For breakfast, a client consumed the following food and fluids. 1 cup of milk 10 oz. of water 4 oz. of gelatin 1 scrambled egg 1 crisp piece of bacon 2 biscuits with jelly How many milliliters should the nurse document for the breakfast intake? Answer:______________mL.