Nursing NCLEX RN Review Video: Strategies for Test Taking on the NCLEX exam

Nursing NCLEX RN Review Video: Strategies for Test Taking on the NCLEX exam

 

In this video I am going to talk about a few test taking strategies that enable you to have a systematic approach to answering very common types of questions on the NCLEX exam. Visit my website www.simplefiturse.com for more NCLEX content review and a free E-BOOK where I shared my study schedule for passing the NCLEX exam.  

 

The NCLEX exam has various testing patterns which require different strategies for answering them. In this section I hope to share with you strategies on identifying these question types and how to best answer them. Once you identify these patterns and trends, you are better able to answer questions and ultimately pass. These strategies work almost every single time and you will improve your test taking skills by continuously doing practice questions with these concepts in mind.

 

Before I begin I want to mention that in my previous videos I talked about how the exam is going to get more difficult over time due to the inherent structure of the exam. As a result it is important to remember that when you are writing the exam you will constantly feel like you are not doing well and this is quite scary. However, now that you know that this exam is designed in a way that constantly challenges you, causing you to think that you are doing horribly or failing, you know to control your emotions and focus on trying your best in answering each question. I want you to just remember that this exam was designed to continuously challenge you and this often causes a feeling that people are “failing” or doing “poorly” because they aren’t confident in their answers. This gets to people’s heads and makes them panic and deviate from the strategies that I am about to discuss. OK, so now that I have mentioned this, let’s move onto talking about the nursing process.

 

I am sure you are familiar with the nursing process at this point. You have to remember the acronym ADPIE and always ask yourself, is the question asking me to recall ADPIE? The  best way to know if it is, is by looking at the key terms from the question itself or the answers. For example the exam will frame ADPIE questions by usually asking if “this” happens, what should the nurse do first or what is the first thing the nurse should do.

 

So what is ADPIE? ADPIE stands for Assessment, Diagnosis, Plan, Implementation and Evaluation. I recommend looking at a list of common nursing diagnoses to get a hang of what they exactly are. Here are a few examples and if you would like more there is a link in the description to my blog post with a list of them.

 

Risk for urinary tract injury …. Related to [etiology/related factor] as evidenced by [signs and symptoms]

Risk for impaired skin integrity … Related to [etiology/related factor] as evidenced by [signs and symptoms]

Ineffective airway clearance … Related to [etiology/related factor] as evidenced by [signs and symptoms]

 

Readiness for enhanced health literacy

Ineffective adolescent eating dynamics

Ineffective child eating dynamics

Ineffective infant eating dynamics

Risk for metabolic imbalance syndrome

Imbalanced energy field

Risk for unstable blood pressure

Risk for complicated immigration transition

Neonatal abstinence syndrome

Acute substance withdrawal syndrome

Risk for acute substance withdrawal syndrome

Risk for surgical site infection

Risk for dry mouth

Risk for venous thromboembolism

Risk for female genital mutilation

Risk for occupational injury

Risk for ineffective thermoregulation

Imbalanced nutrition: less than body requirements (Nursing care Plan)

Readiness for enhanced nutrition

Insufficient breast milk production

Ineffective breastfeeding (Nursing care Plan)

Interrupted breastfeeding (Nursing care Plan)

Readiness for enhanced breastfeeding

Ineffective adolescent eating dynamics

Ineffective child eating dynamics

Ineffective infant feeding dynamics

Ineffective infant feeding pattern (Nursing care Plan)

 

Sometimes the exam will be tricky and give you the nursing diagnosis, and there will be questions that ask about the next step but they will put “assessment” in one of the options to choose from. In that case you have to recall the ADPIE acronym and remember that the next step is “plan” not “assessment” if that makes sense. They want to know that you follow the steps chronologically. This is important as they do try to trick you by doing this. . So make sure you identify which PART of the ADPIE you are in and see if the answers RELATE to the ADPIE

 

Before I go onto speaking about strategies for prioritization questions I would appreciate it if you would rate this video! These videos take a long time to make and if you would like to see more videos like this give me feedback by either giving it a thumbs up or thumbs down. This will help me decide whether I should make more videos like this. Thank you.

 

Prioritization Questions:

You will get a “priority” question on your NCLEX exam. It is imperative that you have a strategy that you utilize when answering these types of questions. There are two concepts that are important for you to remember for answering these questions:

1. Maslow’s Hierarchy of Needs
2. Primary Assessment Survey

 

Think of the Maslow’s hierarchy of needs as a pyramid in which the most important needs are at the base of the pyramid and need to be met before the next category of needs can be achieved. For example basic needs of food, water, warmth, rest and safety need to be met before the safety needs are met. This picture is a great summary of what the maslows hierarchy of needs are, starting from bottom to top in relation to most important to least important. If you want to be successful at priority questions you need to recall this diagram in your head and utilize it systematically remove possible answers from the question you are answering.

Secondly, using a primary assessment survey is a way of ensuring the safety and stability of a patient’s condition. It is the initial assessment that needs to be done when seeing a patient and there are certain assessments that are prioritized than others.

1. Airway
2. Breathing
3. Circulation

This is key for you to remember the “ABC’s”. This will guide you in choosing the correct answer. If there are answers where it talks about an airway being obstructed, then you need to focus on opening the airway.

 

Common assessments indicating problems in ABC’s:

Airway:

• NPO, gag reflex, breathing, water after surgery, dysphagia after stroke, airway

 

Breathing:

• Breath sounds, O2 administration, O2 status, pulse ox, raise HoB, spirometry

 

Circulation

• HR, BP, CPR, fluid status (fluid deficit or overload), IV fluids, TPN, central lines, bleeding hemorrhage

 

The only exception to this is if they have uncontrolled bleeding that takes priority over anything and typically you want to “control the bleeding” whether that is putting pressure or tying a tourniquet. 

 

Provider Questions:

A common question type on the NCLEX exam are provider questions. These are going to test your ability to communicate to the provider. To answer these questions you need to think of life threatening conditions and situations, whether those lab values or clinical presentations indicate severe complications that need to be reported to the healthcare provider or not. Unfortunately these are among the most challenging questions as they often require a high amount of memorization on generally everything. This is where they test your ability to remember lab values and a few life-threatening conditions. This is the strategy I used to answer these types of questions, apart from memorizing common lab values. Be sure to subscribe for my lab values NCLEX video.

 

The first question I ask myself is:

1. Does the patient have any of these life threatening conditions, using a head to toe method?

Neurology

• Stroke?
• Overdose?
• Drug interaction? (think of the mental health drugs)

Throat:

• Esophageal Varices?

Respiratory:

• Tension pneumothorax?
• Asthma exacerbation?
• Pleural Effusion?

 

Cardiac:

• Abdominal Aortic Aneurysm?
• Myocardial Infarction?
• Cardiac Tamponade?

 

Gastrointestinal?

• Profusely bleeding – GI Bleed?
• Perforated organs, appendix, pancreas, spleen etc..?

 

Metabolic?

• Diabetes
  • DKA?
  • HHNS?
  • Hypoglycemia?

 

Impact injury?

• Spine injury?
  • Loss of rectal tone?

 

Pregnant?

• Ectopic pregnancy?
• Hemorrhage?

 

2. Is there anything I need to do BEFORE informing the provider – think ADPIE?

 

This has helped me organize my thoughts in a systematic way and tackle these provider questions more effectively. Let’s move onto talking about the dreaded SATA or select all that apply questions. 

 

SATA – select all that apply:

These questions are the most challenging questions on the NCLEX. They require a serious amount of knowledge and unfortunately the better you do on the NCLEX the more of these questions they are going to give you. Therefore having a strategy to utilize can help guide you on how to answer each question. There is no trick that will get you results, these require you to know a lot but there are a few tips I can share which help answering these questions.

 

Number one go through each answer and ask yourself if it is a true statement. Use the process of elimination to determine if that answer can be correct. If any part of the answer makes it false,then cross it off.

 

Number two compare the answer options with each other. If there are very strong opinions such as ALWAYS, NEVER, NONE you want to avoid those. These can be correct but rarely are.

 

As mentioned there aren’t great strategies other than doing tons of practice questions that are going to help you with those. Now let’s move onto prefixes and suffixes. 

Prefixes and Suffixes

These are incredibly helpful for you to know when answering questions as there are certain conditions that you may not remember. However knowing the prefix and suffix can help you get an idea of what the condition/situation of the patient is. Here is a video I made to provide better guidance on what to do.

Duplicating Statements:

Duplicating statements are huge hints on the exam. They are actually more common than what you might think. If the answers have two that mean the same thing they can’t be correct. You will get some questions that have the same meaning but are worded a bit differently. If it is a single choice question and answer then it can’t be correct.

 

That is going to be the end of this video. Be sure to check out the links in the description for various resources and check out my blog at www.simplefitnurse.com where I have various free content to help make nursing simple for you! Here is a preview of my website.