Weekly Actual Nclex Question Bank

Sunday, February 20, 2011

What To Do After You've Made A Mistake

Everyone makes mistakes. It's what you do afterward that makes you an honorable human being and a good nurse . . . or not.
Nursing school doesn’t really teach you how to be a nurse, it just gives you a glimpse into the world of nursing and the NCLEX gives you a license to learn. If you’re smart, you’ll learn something new every day of your career. If you’re very smart, you’ll learn how to handle those moments when you’re very, very stupid.

Everyone makes mistakes. Everyone. There are no perfect people, and anyone who would have you believe they ARE perfect is a damn liar. So know from the very first moment you put on that name badge that says “RN” or “LPN” or “CNA” that you, too will make a mistake. Mistakes are an inevitable part of life and an inevitable part of nursing. What matters isn’t that you’re perfect; what matters is what you do after you’ve made that mistake.

Recognize your mistakes. I’ve known a few people who were so convinced of their own perfection they couldn’t recognize their imperfections. If they did it, it must be right. If you’re not willing to admit the possibility that you might make a mistake, you’re unlikely to realize when you’ve made one. The very first thing to do when you’ve made a mistake is to recognize it. The second thing to do is to admit it -- to yourself, to your charge nurse, to the provider, to your manager and ultimately to the patient.

It’s amazing how few mistakes actually kill patients or even cause them permanent injury. Some do, we all know that. But if you recognize your mistake, admit it and immediately set about to minimize the damage, most mistakes are merely a bump in the road rather than a career ending or life ending catastrophe.

I worked with a nurse I’ll call Maria. Maria was a lovely person -- beautiful, funny and smart. She also lacked integrity. We worked in SICU together years ago, and one day I was in her room with her, helping her to turn her fresh-from-the-OR cardiac surgery patient. As we turned him, the monitor started to alarm and we looked up in horror to see his heart rate slowing down and passing 30 on the way south. The surgery resident was just outside the room and responded instantly to my involuntary utterance of “Oh, S%&#!” There were many interventions, but the one I’m talking about was the order to give “point one milligram of epinephrine.” Maria grabbed up the amp of epi I handed her and pushed the entire thing -- one milligram.

Suddenly we had the opposite problem. The patient’s heart rate picked up -- slowly at first, but rapidly gathering steam and the rate on the monitor was over 15o when I looked up from the code cart. From no blood pressure and a flat art line, we suddenly had a pressure of over 250 systolic. And climbing. “How much epi did you give?” shouted the resident.

“What you said,” replied Maria, hiding the empty syringe from view. “I gave what you said.”
“How much was that?” countered the resident.
“I have what you said,” Maria insisted, despite clear evidence to the contrary. And she never budged from her story. Never. The chest tubes were suddenly full of blood and the pleurevac overflowing. As we whisked the patient back to the OR, there was a trail of bright red blood in his path. Maria’s mistake didn’t kill the patient because of the quick thinking and quicker actions of that surgery resident, but I never trusted her again. Neither did the resident, who is now head of cardiac surgery at the hospital where Maria still works.

As soon as you recognize that you’ve made a mistake, tell the appropriate person. It’s not enough that you recognize your mistake, you have to do everything you can to prevent, minimize or mitigate the damage. If you’ve made a medication error, tell the physician. There may be -- usually is -- something that can be done. Narcan can reverse a narcotic overdose , protomine reverses a heparin overdose and if you’ve given too much insulin you can follow it with sugar whether it be a can of real Coke or an amp of D50. You’ll need a doctor’s input and a doctor’s order.

Once you’ve done what you can to help the patient, take a moment to think through the process that led to your error. Were you moving too quickly? Distracted by family members? Couldn’t read someone’s handwriting? Whatever it was, you need a firm understanding of how and why you made your error and an idea of what you’re going to do differently next time to keep it from happening again.

Then tell your manager. There are right ways and wrong ways to tell your manager, but whatever you do, tell her before she finds out from someone else, especially if it’s a big mistake. Call her at home, email her or whatever. There’s nothing worse from a manager’s perspective than being blindsided by the person who comes to confront her about some mistake made by a member of her staff.

As an example of the WRONG way to tell your boss about a mistake, David once defibrillated a patient in normal sinus rhythm because he mistook artifact for a lethal arrhythmia. He was new to ICU, and some artifact LOOKS like V tach, V fib or even asystole. David shocked his patient in full view of an entire team of doctors and a couple of nurses who were all yelling at him to stop. “Oops,” he said with a laugh. “I shouldn’t have done that.”

No one else was amused.

You want to make it abundantly clear to your boss that you realize you’ve made a mistake, that you understand the consequences were or could have been enormous and that you’re profoundly sorry. You also want her to know that you’ve thought about how it happened and how you’re going to make sure it doesn’t happen again. Few bosses would tolerate David’s responses to a mistake, but I can tell you from personal experience that you can survive the second with your job and your license intact.

Lastly, forgive yourself and move on. That’s often the most difficult part of the whole process. But not moving on condemns you to relive your mistake over and over and over again. It undermines your confidence, destroys your sleep and makes it more likely you’ll make more mistakes. That’s a vicious cycle.

I won’t say I’ve completely forgiven myself and moved on . . . yet . . . but I’m working on it.

NCLEX for RN - Leadership and Management (11-15)

NCLEX for RN about Leadership and Management

11. A nursing student is developing a plan of care for a client with a chest tube that is attached to a Pleur-Evac drainage system. The nurse intervenes if the student writes which incorrect intervention in the plan?

a) position the client in semi-fowler's position
b) add water to the suction chamber as it evaporates
c) tape the connection sites between the chest tube and the drainage system
d) instruct the client to avoid coughing and deep breathing

12. A nurse is caring for a client who has just had a plaster leg cast applied. The nurse would plan to prevent the development of compartment syndrome is instructing the licensed practical nurse assigned to care for the client to:

a) elevate the limb and apply ice to the affected leg
b) elevate the limb and cover the limb with bath blankets
c) place the leg in a slightly dependent  position and apply ice to the affected leg
d) keep the leg horizontal and apply ice to the affected leg

13. A registered nurse (RN) is supervising a licensed practical nurse (LPN) administering an intramuscular (IM) injection of iron to an assigned client. The RN would intervene if the LPN is observed to perform which of the following?

a) changing the needle after drawing up the dose and before injection
b) preparing an air lock when drawing up the medication
c) using a Z-track method for injection
d) massaging the injection site after injection

14. A nursing student develops a plan of care for a client with paraplegia who has a risk for injury related to spasticity of the leg muscles. On reviewing the plan, the co-assigned nurse identifies which of the following as an incorrect intervention.

a) use of padded restraints to immobilize the limb
b) performing range of motion to the affected limbs
c) removing potentially harmful objects near the spastic limbs
d) use of prescribed muscle relaxants as needed

15. A registered nurse (RN) is observing a licensed practical nurse (LPN) preparing a client for treatment with a continuous passive motion (CPM) machine. Which observation by the RN would indicate that the LPN is performing an incorrect action?

a) places the client's knee in a slightly externally rotated position
b) keeps the client's knee at the hinged joint of the machine
c) assesses the client for pressure areas at the knee and the groin
d) checks the degree of extension and flexion and the speed of the CPM machine per the physician's orders

Thursday, February 3, 2011

Nclex Review

Nclex is one of the most difficult examination - and that's a truth ! One needs adequate preparation prior to scheduling for the exam, otherwise it'll be a waste of money if failed. However, it is said that nclex is designed to pass the test takers since the questions are within the entry level of nursing. With these, high percentage of Americans pass nclex on the first try same as with international test takers in different testing center.

The question is how to make good for an nclex review? how many hours per day shall be needed to study? what will be the books to buy? and when is the right time to take it? These are some of the many questions to consider in taking nclex.

Nclex review is a must regardless of the span of time you need to learn the nursing concepts. It depends on how well you grasp information. If you are a fast learner then, that's a good job and if your a bit slow then, you need some effort.

What about the time to be alloted to review each day? Well, again it depends on your attention span. Some people can retain information in long period of time like 8 hours or more while some only need about 2-3 hours per day.  The key is, you have to upgrade your brain neurons ! Eat a good meal for your nutrition, do some exercise, meditate, do yoga ! it's good for both physical and mental health.

Furthermore, the choice of books would be something to consider, some would recommend the saunders book which is over rated. You can try ncsbn online  nclex review, or you local nclex review offered by the reputable review centers in your place. Well, it doesn't matter whatever book you choose since all are helpful and contain almost same information though of different authors.

When, shall i schedule for the exam? oooh no! I'm anxious ! I feel i'm not yet ready ! Hep hep!
Scheduling the exam is produces anxiety and that a truth. If you think you are ready, then go on ! choose the best date that you feel lucky and the time; morning or afternoon session. During your nclex review, examine if what time of the day you have the most energy and working neurons, is it in the morning or afternoon?
it's your choice !

Again, nclex is a difficult exam and remember that. Never underestimate and just do your best. Say a little prayer everyday in your nclex review. Prayer works !

How to Pass the RN Nclex Exam

  1. Pay attention in nursing school. This may seem oversimplified, but the better you do academically, the less stressed you'll be when the actual test comes around. That is, if you learn the material in the first place, you won't be trying to play catch-up in your senior year and beyond.
  2. Take a prep test while you are still in school, such as the Mosby Assess Test, which is a set of NCLEX-style practice questions. These pre-tests can really show both your weak and your strong points, and give you a point to focus studying from. Also, doing it while you're still in school allows you to get help from your teachers while they are still easily accessible.
  3. If you are unclear on a concept, be dogged about learning it. Whatever it takes, if you know your weaknesses, hone in on them and don't give up. Eventually, many of them will become clear to you if you come at them from a couple different angles. And 90% of learning is perseverance.
  4. Seek new opportunities in clinical. If you can learn concepts hands on, you will be a lot more likely to remember them later when you study. Look up your patients' labs and find out why they are the way they are. Look up your patients' meds and learn the side effects, proper dosages, etc, even if they are meds you've seen a hundred times. The key to learning pharmacology is (sadly) repetition.
  5. Get a good NCLEX-RN prep book early in your academic career. It is never too early to start reviewing and practicing answering NCLEX-RN style questions. Getting used to the way the questions are worded is one of the best prep tools there is.
  6. 6
    Take an NCLEX-RN prep class above and beyond what your school has to offer. Many independent institutions (such as Drexel University College of Nursing and Health Professions contract with nursing schools and/or student groups across the United States to provide 4-day review courses to prep for the test. Some even offer reimbursement of test fees if you fail. If your school does not have this opportunity, seek it out elsewhere.
  7. As soon as you graduate, set up your test. Your school should be able to help you out with this, but it's very important that you do it soon after graduating, while the knowledge is fresh in your head.
  8. Studystudystudy. Use more than one source for review information, and do as many questions as possible before your test. If you want to be confident going into the test, count on answering at least 5,000 test prep questions prior to the test itself. This takes a long time, so budget appropriately.
  9. At some point before your test, sit down and do 265 questions in a row. Answering that many questions in a row takes discipline and stamina, but bear in mind that you can answer 265 questions and pass the test, so make sure you can.
  10. Take computerized tests for prep if possible. Hopefully, your nursing school has already done this for you, but if not, get a review book with a CD-ROM in it, which will allow you to take the test on the computer, which is how you'll actually be taking it.
  11. Drive to the test site the day before, especially if it is far from your home (i.e., in unfamiliar territory). This will cut down on stress the day of as you will already know where the test site is.
  12. Try and relax and have fun the day before the test.
  13. Your brain needs glucose to operate properly, so have a decent breakfast with the major food groups represented on the day of the exam, even if you are not hungry.
  14. Make sure you use the bathroom before you take your test.
  15. Ask the proctor for earplugs. They really cut down on the distraction of ambient noise.
  16. Sit down and familiarize yourself with your computer station. Find the calculator. Complete the tutorial.
  17. Take a moment, close your eyes, clear your mind, and visualize very clearly what you are about to do. This is also a great time to pray.
  18. Calmly start the test, taking one question at a time and allowing each question to hold your attention completely. Remember that the test will shut off automatically. This can be quite jarring, but hey, you're done!
  19. Get in your car and go buy yourself a treat.
source: wikihow

My NCLEX Experience

I had been dreaming dreading the NCLEX exam ever since I heard about it. I knew I had to take it but deep down inside I was wishing that I didn’t. I started saving for the Hong Kong trip since this was the most practical destination for NCLEX test takers from the Philippines. I even tried to rationalize that I didn’t have the funds to go to Hong Kong just so I could get out of taking the darned exam. Unfortunately/fortunately a testing center opened up in Makati and I knew then that I had no choice.

I took a 3 month leave of absence from my school and began to study. At first it was fun and challenging but as the days went by I began to feel bored. I had internet access 24/7 so I spent most of my time surfing and blogging when I knew that I should have been studying. The first month passed and I realized that I hadn’t even read 20 pages of my review book. Two months, 3 months and then the big day came.

It was like a bad dream but there I was, in front of Trident Towers in downtown Makati. There were about 30 other nervous wrecks. There was no turning back. The elevator ride seemed like forever and then there we were on the 27th floor. By that time I was freaking out inside, smiling to mask my emotions. I told myself to calm down, breathe deeply.

As I sat in front of the computer I thought it wasn’t that bad. The first couple of questions were easy and then the torture began. “Select all that apply” questions came flying at me and I had no clue whatsoever. Medications which I had never encountered in my life were being asked. Lab values which I didn’t memorize came out one after the other. I knew then that I was in deep shit. However, I was hoping that the torture would be over in 75 questions.

The 74th question came and when I answered it I told myself that I had one more to go. When I pressed the next button at question 75 I expected a blue screen but what I got was another question. And another. And another. By this time I was losing hope, questioning my knowledge, my capability, my brain. All around me, test takers were leaving, apparently finished at question 75.

I had no choice but to go on and so I did, numbly reading each question. Before I knew it I was at the 200th mark but it still kept going. My stomach was growling and my eyes were beginning to fail me but I knew I had no choice. 210, 220, 230, 240,250,260. Man, was it even possible? 261,262,263,264 and then came 265. I clicked the next button, answered the questionnaire and then raised my hand. I smiled weakly at the proctor and walked out of the room.
Alone in the elevator I tried to hold back my tears. I was sure I’d failed. Definite. Certain. On the bus ride home, the rains began. How timely, I thought to myself, since my eyes were pouring buckets too.

The wait wasn’t that brutal for me, after all, I was sure I’d failed. But then 3 weeks and 2 days later I got a small envelope stating that I’d passed the exam. Was it even possible? Disbelief. Realization. Relief. Thank God, I passed!


1. Understand the test. Read about the CAT.
2. Don’t over study. Learn the basics like common meds, lab values, special diets, treatments.
3. Familiarize yourself with the exam. Do the Kaplan question trainer since it’s similar to the real thing albeit a bit harder.
4. Get the yellow Gapuz reviewer.
5. Do the NCSBN online review. It’ll give you confidence.
6. Sleep early the night before the exam.
7. Be confident, believe you will pass.
8. Do something while waiting for the results. Doing nothing will drive you crazy.
9. Learn to pray. And pray. And then pray some more. God listens.

by: y-d-a blogspot

Wednesday, February 2, 2011

The Importance of Critical Thinking in Nclex

The NCLEX is the test to know if a student who has learned nursing is fit for the challenge. It is administered at defending the masses from hoax practitioners by setting standards for the profession. It is not a new one therefore that the NCLEX is a strenous exam to succeed. But with the right behavior and ample critical thinking skills during the tests, it is certainly not impossible by any stretch of the imagination.

Critical thinking comes into play on the day that you take the NCLEX.

Nclex Practice Test

It enables you to answer very stressful questions by showing the principles of critical thinking.

But don't get me wrong here, preparing for the Nclex-RN is more than a routine in studying, for learning without critical thinking amounts to another empty reading. You would have to understand the question and determine the answer to it as rapidly as possible. Always keep in mind, the NCLEX is a 6 hrs activity and giving too much time on one answer will take a big, enormous end toll on your score.

Here are the best 4 tips on how to sharpen your critical thinking:

You would answer the questions correctly. This will allow you to weed out negligent information that may tend to harden the setting more than it already is. You must be able to distinguish what is important and what is negligible. This way, the questions will be easier to determine.

Determine the info for relevance. One of the key factors in answering an item is learning the relevant facts necessary in order to get it correctly. The information provided should be shown for specific measures of compatibility and then you should try to ascertain, from the given choices, which one it corresponds to the most.

Trace implications and results. One of the most difficult parts of critical thinking is trying to get the implications of the lessons provided in the questions. But through repeated tests, you will be able to determine with relative easeness the items of the facts provided in NCLEX exams.

Keep focused and diligent. you may not have time to check and review your answers in the Nursing Exam, it is useful to stay focused on the situation at hand, which is to excel the Nclex-RN exam. Diligence is the weapon to any difficult exam session. Any distracting situation will tend to take valuable hours away from you, showing you with less chance to actually pass the Nclex-RN Exam.

Prayer Before Taking Nclex

I thankfully turn to You, God, for guidance. I listen in the stillness to Your wisdom already in my heart, and I know what to do.

Dear God, Your love fills my heart and your light guides my steps. In all I do I acknowledge You and give thanks for Your wisdom, strength, and peace within.

In the awareness of Your constant presence within me, God, I listen for the direction that guides me and makes my way sure.

You, dear God, are the light that shines on my path. Your light gives me insight and understanding that help me make wise decisions.

God, You are my source of wisdom. Your spirit guides me, Your love enfolds me, and Your light inspires me. Please be with all of us on our testing day. Guide us with your strength, courage and glory. Let us enter those doors to the testing center with all of our burdens handed to you. We ask that you take away all our fears and anxieties. Help to guide us with the knowledge that you have given to us. In you all things are possible. Thank you Lord for all that we have and all we have accomplished. In Jesus name we pray, Amen.

Tuesday, February 1, 2011

How I passed the NCLEX on the first and second try!

written by kellysbeans

Well, you all know that’s not really possible. You either pass on the first time, or you don’t. But I sure feel like that’s how it was.

My boyfriend and me met 4 years ago, through my brother. What are the chances that we were both busy doing nursing pre-reqs? He finished his, and applied at the local Community College. They lost his application. He waited 6 more months and applied again. He didn’t get in. Finally the following January he was accepted for the LPN program. Seeing his frustration, I finished my pre-requisites and applied directly to a private school. We both started at separate schools at the same time. He considered the content challenging, the instructors unmotivated and their enthusiasm underwhelming. Nevertheless, he still managed to get straight A’s. I had a program that felt like home; a close-knit group of students and instructors, hands on and flexible clinicals and even field trips. I managed A’s and B’s as well. He graduated in December and got his Authorization to Test in February. We were both confident in his abilities. I mean, Straight-A’s… he had this in the bag. We studied here and there but assumed that his year of hard work would be all he needed. The day came, we held hands in the car and talked about how this was finally all going to pay off for him. I sat in the car trying not to worry while he tested. I had heard through the grapevine that 85 questions is a good indication of passing, so when he walked out with a smile on his face and said “I stopped at 85!” I was thrilled. We went to get something to eat and he then hung out with his friends. The next day he came over and we saw Quick-Results were available! Awesome! We paid the $7 and clicked the button:

“Status: Fail”

He put his head in his hands and didn’t budge for nearly an hour. He didn’t want to talk about it, and I could tell he was crushed. He said he didn’t want to take it again, he wasn’t meant to be a nurse, he was stupid, you name it. I felt like I failed too. I talked about the test like it was going to be a piece of cake and how he didn’t need to worry too much about studying. It took until the next day for me to be able to talk sense into him. He agreed that he hadn’t studied like he should have and that the format of the questions was kind of confusing to him.

I graduated from school the next week.

My school paid for the NCLEX and filed the paperwork for us, so my ATT was there before I knew it. His re-take application was approved also. The plan was to focus on him and I would take mine after his re-take. But that wasn’t meant to be. The only afternoon openings were both on the same day, a month away. We made the decision to just take it on the same day. I thought of this as setting ourselves up for heartbreak. Unless we BOTH pass, there wont be a celebration. So I decided to turn drill-sergeant and get serious. 100 NCLEX questions a day, as well as 6 chapters in the book. We took turns reading to each other. We argued over the questions and rationales. Once we got closer to the date, we did some software my school supplied me and made pharmacology flashcards. By the time the test date came up, we had gone through a 70 chapter-nursing book, did 3,000+ questions and memorized endings of drugs. And I was about to see how he felt when he sat in that testing center.

It felt as though none of these questions made sense, and I felt like I didn’t know any of it. How could I have read ALL THE WRONG things!? I rested my head on the desk at one point because I just couldn’t believe it. My test stopped at 85. I was so unsure of myself. I sat outside the testing center for three unbearable hours waiting. My boyfriend finally walked out, grimacing. “I got all 205 questions,” he said. My stomach dropped. I had read that chances are you failed if you got all 205 questions. I hid my anxiety and told him “I’m sure you did fine!” I felt that he had failed, again. I knew he would not try a third time-- he would be too upset. It was going to be a long night. We went to Applebee’s and got margaritas. That helped for about an hour. We stayed up all night talking.

The next day I looked at the Board of Nursing site. He was napping so I paid and got my results without telling him. OMG! I passed! I was thrilled. However, who cares if I passed if he didn’t?! I really wanted to check his results behind his back, but the form required a Social Security number. I leaned down next to him and whispered “What’s your Social Security number?” he said, “Oh god Kelly, not now, please” I said “I checked mine, I passed” He sat up and said “Okay, lets get it over with” I thought this was the walk of doom. But I smiled and said, “Whatever happens, happens”. He put in his information and I told him to turn around. I clicked enter.

“Status: Pass”

I could not believe it. I told him and we jumped up hugged. His face lit up like a kid on Christmas morning. Hard work does pay off. We earned it, and now we could really celebrate.

I just think it’s funny how things work out. We joke now about how he failed when most people pass, and passed when most people fail. I can’t think of anything that felt as gratifying as May 17th, 2010

Monday, January 31, 2011

Neonatal Disorders: Nclex Select All That Applies Questions (SATA)

1. What information should the nurse include when teaching postcircumcision care to parents of a neonate before discharge from the hospital?

Select all that apply:

1. The infant must void before being discharged home.
2. Petroleum jelly should be applied to the glans of the penis with each diaper change.
3. The infant can take tub baths while the circumcision heals.
4. Any blood noted on the front of the diaper should be reported.
5. The circumcision will require care for 2 to 4 days after discharge.

2. A 28-year-old client is admitted with inflammatory bowel syndrome (Crohn's disease). Which therapies should the nurse expect to be part of the care plan?

Select all that apply:

1. Lactulose therapy
2. High-fiber diet
3. High-protein milkshakes
4. Corticosteroid therapy
5. Antidiarrheal medications

3. The nurse is assisting in the discharge planning for a client with alcoholism. Which of the following should be included in the discharge plan?

Select all that apply:

1. Strongly encourage participation in Alcoholics Anonymous (AA).
2. Provide nutritional information and counseling.
3. Establish an exercise program.
4. Discuss relapse prevention.
5. Have the client introduce himself slowly to people from his former lifestyle.

4. The nurse receives a change-of-shift report for a 76-year-old client who had a total hip replacement. The client is not oriented to time, place, or person and is attempting to get out of bed and pull out an I.V. line that's supplying hydration and antibiotics. The client has a vest restraint and bilateral soft wrist restraints. Which action by the nurse would be appropriate?

Select all that apply:

1. Assess and document the behavior that requires continued use of restraints.
2. Tie the restraints in quick-release knots.
3. Tie the restraints to the side rails of the bed.
4. Ask the client if he needs to go to the bathroom and provide range-of-motion exercises every 2 hours.
5. Position the vest restraints so that the straps are crossed in the back.

5. The nurse is performing a Denver Developmental Screening Test II on a 4 1/2-year-old child. What behaviors should the nurse expect the child to demonstrate?

Select all that apply:

1. He balances on each foot for at least 6 seconds.
2. He copies a square using straight lines and square corners.
3. He prepares his own cereal without help.
4. He copies a circle that's closed or very nearly closed.
5. He speaks clearly.
6. He draws a person with at least three body parts.

6. The nurse is caring for a 45-year-old married woman who has undergone hemicolectomy for colon cancer. The woman has two children. Which concepts about families should the nurse keep in mind when providing care for this client?

Select all that apply:

1. Illness in one family member can affect all members.
2. Family roles don't change because of illness.
3. A family member may have more than one role at a time in a family.
4. Children typically aren't affected by adult illness.
5. The effects of an illness on a family depend on the stage of the family's life cycle.
6. Changes in sleeping and eating patterns may be signs of stress in a family.

Neonatal Disorders: Nclex Select All That Applies Questions (SATA) Answer Key:

1. 1, 2, 5
2. 4, 5
3. 1, 2, 3, 4
4. 1, 2, 4
5. 3, 4, 5, 6
6. 1, 3, 5, 6

Nclex Select All That Apply Review !

1. The nurse is monitoring a client who is receiving oxytocin (Pitocin) to induce labor. The nurse should be prepared for which maternal adverse reactions?

Select all that apply:

1. Hypertension
2. Jaundice
3. Dehydration
4. Fluid overload
5. Uterine tetany
6. Bradycardia

2. A client who is 29 weeks pregnant comes to the labor and delivery unit. She states that she's having contractions every 8 minutes. The client is also 3 cm dilated. Which medications can the nurse expect to administer?
Select all that apply:

1. Folic acid (Folvite)
2. Terbutaline (Brethine)
3. Betamethasone
4. Rho (D) immune globulin (Rhogam)
5. I.V. fluids
6. Meperidine (Demerol)

3. The nurse is evaluating a client who is 34 weeks pregnant for premature rupture of the membranes (PROM). Which findings indicate that PROM has occurred?

Select all that apply:

1. Fernlike pattern when vaginal fluid is placed on a glass slide and allowed to dry
2. Acidic pH of fluid when tested with nitrazine paper
3. Presence of amniotic fluid in the vagina
4. Cervical dilation of 6 cm
5. Alkaline pH of fluid when tested with nitrazine paper
6. Contractions occurring every 5 minutes

Maternal & Child Nursing: Intrapartum Disorders Sata Questions For Nclex Answer Key:

1. 1, 4, 5
2. 2, 3, 5
3. 1, 3, 5

Nclex is now asking about some herbs! A must review!

 Nclex is now asking some questions about herbs. A must review!


Uses: Chamomile is often used in the form of a tea as a sedative.

Reactions: Allergic reactions can occur, particularly in persons allergic to ragweed. Reported reactions include abdominal cramps, tongue thickness, tightness in the throat, swelling of the lips, throat and eyes, itching all over the body, hives, and blockage of the breathing passages. Close monitoring is recommended for patients who are taking medications to prevent blood clotting (anticoagulants) such as warfarin.


Uses: Largely because white blood cells in the laboratory can be stimulated to eat particles, Echinacea has been touted to be able to boost the body's ability to fight off infection.
Reactions: The most common side effect is an unpleasant taste. Echinacea can cause liver toxicity. It should be avoided in combination with other medications that can affect the liver (such as ketaconazole, leflunomide (Arava), methotrexate (Rheumatrex), isoniazide (Nizoral).

St. John's Wort

Uses: St. John's Wort is popularly used as an herbal treatment for depression, anxiety, and sleep disorders. It is technically known as Hypericum perforatum. Chemically, it is composed of at least 10 different substances that may produce its effects. The ratios of these different substances varies from plant to plant (and manufacturer). Studies of its effectiveness by the National Institutes of Health are in progress.
Reactions: The most common side effect has been sun sensitivity which causes burning of the skin. It is recommended that fair- skinned persons be particularly careful while in the sun. St. John's wort may also leave nerve changes in sunburned areas. This herb should be avoided in combination with other medications that can affect sun sensitivity (such as tetracycline/Achromycin, sulfa- containing medications, piroxicam (Feldend). St. John's wort can also cause headaches, dizziness, sweating, and agitation when used in combination with serotonin reuptake inhibitor medications such as fluoxetine (Prozac) and paroxetine (Paxil).


Uses: Garlic has been used to lower blood pressure and cholesterol (Dr. Lucinda Miller notes that there is "...still insufficient evidence to recommend its routine use in clinical practice.")
Reactions: Allergic reactions, skin inflammation, and stomach upset have been reported. Bad breath is a notorious accompaniment. Studies in rats have shown decreases in male rats' ability to make sperm cells. Garlic may decrease normal blood clotting and should be used with caution in patients taking medications to prevent blood clotting (anticoagulants) such as warfarin /Coumadin.


Uses: Most commonly used for migraine headaches.
Reactions: Feverfew can cause allergic reactions, especially in persons who are allergic to chamomile, ragweed, or yarrow. Nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen (Advil), naproxen (Aleve) or Motrin) can reduce the effect of feverfew. A condition called "postfeverfew syndrome" features symptoms including headaches, nervousness, stiffness, joint pain, tiredness, and nervousness. Feverfew can impair the action of the normal blood clotting element (platelets). It should be avoided in patients taking medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin).

Ginko Biloba

Uses: This herb is very popular as a treatment for dementia (a progressive brain dysfunction) and to improve thinking.
Reactions: Mild stomach upset and headache have been reported. Ginko seems to have blood thinning properties. Therefore, it is not recommended to be taken with aspirin, nonsteroidal anti-inflammatory drugs (Advil), naproxen (Aleve) or Motrin), or medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin). Ginko should be avoided in patients with epilepsy taking seizure medicines, such as phenytoin (Dilantin), carbamazepine (Tegretol), and phenobarbital.


Uses: Ginseng has been used to stimulate the adrenal gland, and thereby increase energy. It also may have some beneficial effect on reducing blood sugar .in patients with diabetes mellitus. (Dr. Miller emphasized that there is substantial variation in the chemical components of substances branded as "Ginseng.")
Reactions: Ginseng can cause elevation in blood pressure, headache, vomiting, insomnia, and nose bleeding. Ginseng can also cause falsely abnormal blood tests for digoxin level. It is unclear whether ginseng may affect female hormones. Its use in pregnancy is not recommended. Ginseng may affect the action of the normal blood clotting element (platelets). It should be avoided in patients taking aspirin, nonsteroidal antiinflammatory drugs (such as ibuprofen (Advil), naproxen (Aleve) or Motrin), or medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin). Ginseng may also cause headaches, tremors, nervousness, and sleeplessness. It should be avoided in persons with manic disorder and psychosis.


Uses: Ginger has been used as a treatment for nausea and bowel spasms.
Reactions: Ginger may lead to blood thinning. It is not recommended to be taken with medications that prevent blood clotting (anticoagulants) such as warfarin (Coumadin).

Saw Palmetto

Uses: Saw palmetto has been most commonly used for enlargement of the prostate gland. (Dr. Miller emphasized that studies verifying this assertion are necessary.) Saw palmetto has also been touted as a diuretic and urinary antiseptic to prevent bladder infections.
Reactions: This herb may affect the action of the sex hormone testosterone, thereby reducing sexual drive or performance. Dr. Miller states that "While no drug-herb interactions have been documented to date, it would be prudent to avoid concomitant use with other hormonal therapies (e.g., estrogen replacement therapy and oral contraceptives...")
This listing represents only a small portion of herbal treatments. Nevertheless, the popularity of herbal therapies is unquestionable. Doctors routinely confront the unknown with their patients who are using herbs. Doctors simply do not have any way of helping you to decide whether these herbs are helpful or harmful for you, or whether they are interacting with your current medications. There are no data.

Black Cohosh

Claims, Benefits: A natural way to treat menopausal symptoms.
Bottom Line: Little is known about its benefits and its risks. If you try it, tell your physician, since it might interact with other medications you are taking.

CGFNS Makes changes in CES Report

New CGFNS-CES Reports introduced

CGFNS Credentials Evaluation Services (CES) announced the creation of two new CES reports designed to address specific needs, starting on February 1, 2011.CES application
These two new reports was named CES Professional Report and CES Academic Report, replacing CES Healthcare Profession and Science Report and CES Full Report, respectively.
The new CES Professional Report was designed to meet the specific requirements of individual state boards of nursing to provide a more comprehensive credentials evaluation of applicants educated outside the United States. This would also be helpful to employers, immigration attorneys and recruiters.
It also allows state boards of nursing to integrate their own requirements template, which includes a statement of comparability of an applicant’s education when measured against U.S. standards.
On the other hand, the new CES Academic Report was aimed to meet the needs of applicants pursuing further education in U.S. institutions of higher learning.
“We are genuinely grateful for the input that U.S. state boards of nursing have provided regarding their current and future assessment needs,” said Barbara L. Nichols, CEO, CGFNS International. “Technology enables us to continue to provide customized reports to meet the specific needs of recipient boards while keeping the cost affordable to the applicants.”
CES Academic and Professional Reports Application will only be accepted thru online application starting February 1, 2011. Also from that date on, CES applications for the discontinued Full Course-by-Course and Healthcare & Science reports will no longer be accepted. CES Professional Report costs $335 while CES Academic Report is $385.
Source: CGFNS website

Sunday, January 30, 2011

Nclex Tips & Tricks

How to Choose the Right Answer

Decide What the Question is Dealing With:
  • Which part of the Nursing Process: Assessment; Analysis; Planning; Implementation or Evaluation?
  • Next, Decide the Order of Priority
First you must decide what part of the nursing process the question is connected with:

  • ANALYSIS--is the process of identifying potential and actual health problems. Most identify pertinent assessment information and assimilate it into the nursing diagnosis. Prioritize the needs that have been identified during analysis.

  • Some common words that are associated with ANALYSIS questions:
  • diagnose; contrast; compare; analyze; order; prioritize; define; classify; catagorize; synthesize; sort; arrange;

  • ASSESSMENT--consists of a collection of data. Baseline information for pre and post procedures is included. Also included the recognition of pertinent signs and symptoms of health problems both present and potential. Verification of data and confirmation of findings are also included. Assess a situation before doing an intervention.

  • Some common words that are associated with ASSESSMENT questions:
  • observe; gather; collect; differentiate; assess; recognize; detect; distinguish; identify; display; indicate; describe;

  • PLANNING--Involves formulating goals and outcomes. It also involves various members of the health care team and the patient's family. All outcome criteria must be able to be evaluated with a specific time frame. Be sure to establish priorities and modify according to question.

  • Some common words that are associated with PLANNING questions:
  • rearrange; reconstruct; determine; outcomes; formulate; include; expected; designate; plan; generate; short/long term goal; develop;

  • IMPLEMENTATION--Addresses the actual/direct care of a patient. Direct care entails pre, intra and postoperative management, preforming procedures, treatments, activities of daily living. Also includes the coordination of care and referral on discharge. It involves documentation and therapeutic response to intervention and patient teaching for health promotion and helping the patient maintain proper health.

  • Some common words that are associated with IMPLEMENTATION questions:
  • document; explain; give; inform; administer; implement; encourage; advise; provide; perform;

  • EVALUATION--Determines if the interventions were effective. Were goals met? Was the care delivered properly? Are modification plans needed. Addresses the effectiveness of patient teaching and understands and determines in proper care was offered. Evaluation can involve documentation, reporting issues, evaluates care given and determine the appropriateness of delegating to others. Most significantly, it finds out the response of the patient to care and the extent to which the goals we met.

  • Some common words that are associated with EVALUATION questions:
  • monitor; expand; evaluate; synthesize; determine; consider; question; repeat; outcomes; demonstrate; reestablish;

  • After determining what part of the nursing process the question is concerned with, next focus your attention on determining the category of priority: Safe and effective care environment is always first. Patient safety is related to the proper preparation and delivery of nursing techniques and procedures as part of the nursing practice. It relates to every aspect of the delivery of care. Physiologic integrity is the ability to provide competent care Information that may be described as traditionally medical- surgical and pediatric nursing falls into this category. Specific questions in this area can be related to many direct-care aspects of nursing practice. The importance of this area is highlighted because it is one in which planning, implementation and evaluation of care needs can easily be identified and tested. Physiologic integrity is always a slight lower priority than safety unless it involves airway, breathing and circulation. "ABC's" always comes first! Psychosocial integrity tests the knowledge about a patients response to a disease or disorder. An understanding of stress, anxiety and ways to cope are essential. This is a lower priority the physiological integrity. Health maintenance deals with health promotion, health teaching, disease prevention and assessment of risk factors for health problems. Normal growth and development is a major theme in this category. This however, is a low priority. In Summary, when choosing the right answer for you NCLEX exam question 1) ask yourself, "what part of the nursing process is this question dealing with: analysis, assessment, planning, implantation or evaluation? and 2) Remember to prioritize your choices: safety always being first, 2)physiological integrity, 3)psychosocial integrity and health maintenance always has the lowest priority when choosing an answer. Other tidbits:
  • avoid choices with the answers "all" "always" "never" or "none". Nothing is ever a definite in Science.

  • look for answers that are different. If three answers say the same thing but in different words, choose the answer that is different.

  • when given choices that are pharmacologically based or non pharmacologically based, choose the non pharmacological intervention. It is more often then not, the correct answer.

  • Saturday, January 29, 2011

    Nclex latest update from test taker

    Actual nclex subjects/questions from a recent nclex taker at Pearson Vue Manila.

    According to her, questions have strong resemblance from kaplan trainer. Bulk of questions about prioritization, delegation, infection control and medications.

    1. Vardenafil - the effect is  just like sildenafil (viagra). It is contraindicated with the use of nitroglycerine.

    2. What to expect in cvosteks?  - the correct choice is abnormal spasm of the facial muscles elicited by tapping the jaw.

    3. Diverticulosis, what to asses?  - Answer is high fiber diet.

    4. Patient with SLE, nsg health teaching?   Ans is photosensitivity

    5. How to administer nitroglycerin spray?  - spray under the tongue

    6. Manifestation of cushings?  - decrease serum calcium (hypocalcemia)

    7.  What reflex is still present at 9 months old?  -  babinski reflex

    8. Manifestation of lithium toxicity?  - nausea and vomiting

    9. What is the use of st. john's wort?  -  for alzheimers disease

    10. About fosamax..    -  taken on an empty stomach

    This may come out in actual nclex.

    High Precision Actual Nclex Questions : Secret to pass

    High Precision Nclex Questions

    High Precision Actual Nclex Question

    comprehensive nclex exam answer key

    Friday, January 28, 2011

    Vermont Nurse NCLEX License Renewal

    Vermont NCLEX License Renewal is due this March 31, 2011 and a lot of nurses are asking me how to do it. Well, the Vermont License renewal is not that hard, really. Here’s what you should do:NCLEX Application in Vermont

    Vermont NCLEX Renewal Steps

    Download Vermont License Renewal form and fill it up. The renewal form is not yet available online, Vermont Board of Nursing is still updating it for 2011 -2013 cycle. I’ll post it here once it is ready.

    Attach payment of $95 in bank draft, check (US currency, withdrawable from banks with US affiliate) payable to ‘Office of the Secretary of State‘.

    For international nurses, attach a copy of passport in lieu of SSN.

    Notes on Vermont RN License renewal:

    The renewal application fee is non-refundable. If the renewal

    application is postmarked after the current expiration date you will be required to pay a late renewal penalty. The penalty is $25.00 for renewals submitted less than 30 days late. Thereafter, the penalty increases by $5.00 for every additional month or fraction of a month, not to exceed $100.00.

    If you have had a name change please attach a copy of the marriage license, civil union license or section of divorce degree granting you the authority to change your name.

    Vermont NCLEX License Renewal is easy!

    Thursday, January 27, 2011

    HAAD Exam for Nurses

    If you intend to work for a nursing job in UAE, one of the requirements is passing the HAAD exam for nurses. HAAD or Health Authority-Abu Dhabi is the regulatory body for all healthcare related professions, including Nursing, in UAE.Haad exam for nurses

    Just like NCLEX, HAAD exam is administered by Pearsonvue, and HAAD candidates can take it in any Pearsonvue Testing Centers around the world. If you’re a Filipino nurse, the you can take it in Pearson Test Center in Trident Tower, Makati.

    Registration and Scheduling of HAAD exam

    1. Go to http://www.pearsonvue.com/haad/capva/ and create a web account.

    2. You are required to meet all of the eligibility criteria for nurses in order for your application to be accepted.

    3. Wait for your username and password to be emailed to you within the next 48 hours. Be sure to check your junk/spam folders as Pearson mails could go to these folders.

    4. Schedule your HAAD exam. You can do it online using the web account you created or via phone by calling Pearsonvue hotlines for HAAD exam.

    5. Print your booking confirmation and bring it with you to the testing center. Candidates will receive a booking confirmation by email within 48 hours for the date and location that you will take the exam. If you do not receive the booking confirmation within 48 hours or if any of the information is erroneous, please contact Pearson VUE immediately thru phone or by email.

    As I’ve mentioned at the outset, HAAD exam is just one of the requirements for licensure in Abu Dhabi, UAE. Check this Nursing Job in UAE posts for additional info on licensure requirements and job opportunity in UAE.

    Nursing Jobs in UAE

    Verdant Manpower Mobilization Center, a recruitment agency licensed by POEA, is in need of nurses for deployment in Al Ain, United Arab Emirates (UAE).Nursing Jobs Abu Dhabi

    Benefits Package for Nursing Jobs in UAE includes:

    • Nurse Salary:
    • Staff Nurse-AED 5,025-AED 8,040 (depending on experience)

    Charge Nurse – AED 9,000 – 11,100 (depending on experience)

    1 AED(arab emirate Dirhams ) = P11.75- P12.20,depends on current exchange rate

    • Housing benefit:

    Staff Nurse-AED 35,000-45,000/yr (depends on salary grade)

    OR Housing allowance of AED 2000-3000/month if housing benefit not availed

    Charge Nurse – AED 90,000/yr

    • Free hotel accommodation for the 1st 2 months
    • Free transportation OR transportation allowance if transpo not availed
    • Utilities allowance
    • Yearly airfare for the staff
    • Annual leave of 30 days/year


    • Educational Allowance
    • SN – AED 8,000/ child ( not more than 2 children)
    • CN – AED 20,000/yr
    • Furniture Allowance of AED 20,000 (once family is in UAE)- one time only


    Qualifications for UAE Nursing Jobs:

    These are Personal Qualification Requirements for staff nurses.

    • BSN degree
    • Current National License(PRC)
    • Preferrably with BLS, ACLS, PALS training relevant to area of specialty
    • NLT 4 years post graduate experience in appropriate and relevant health care settings i.e. primary health care, community, acute care, tertiary care, to include NLT 2 years experience in specialty area.

    If you are interested in this nursing job in UAE, contact Verdant Manpower Mobilization Center at the following means:

    Head Office:

    Unit B, 2/F Criselda II Bldg,107 Scout De Guia Street, Brgy. Sacred Heart, Diliman,Quezon City 1103

    Telephone Nos.:

    +63 2 9297448 and +63 2 4158750

    Branch Office:

    Unit 206 Luz J Henson Bldg,

    A Mabini St. Ermita Manila

    Tel. Nos. (632)5218916, (632)4501738

    Fax. No. (632)5275796

    E-mail: verdantcenter@hotmail.com

    Verdant Manpower Nursing Jobs

    If you are qualified, apply in this nursing job openings in UAE now!