Mark Klimek notes How to guess 1. Use knowledge 2. Common sense 3. Guessing strategy Psych Nurse will examine own feeling about something-so do not counter transfer Establish trust rela... tionship Nutrition Pick chicken not fried chicken Fish but not shellfish Never pick casseroles for kids Never mix meds in food Toddlers-finger foods Preschool-one meal a day is OK. Leave them alone 3 expectations to have Do not expect 75 questions-think 265 Do not expect to know everything Do not expect everything will go right Pharm Most tested area is side effects Do not worry about route or dose If know what drug does but do not know side effect-pick a side effect in same body system the drug is working No idea what the drug is-look to see if it is PO-pick GI side effect Never tell kids that med is candy OB-check fetal HR Med Surg 1st thing assess-LOC 1st thing do-establish airway Peds All based on principle-give child more time to grow and develop When in doubt-call it normal When in doubt-pick the older age When in doubt-pick the easier task-more time to do the harder one2 General Rule out absolutes If 2 answers say same thing-neither is correct If 2 answers are opposite-one is probably right Umbrella strategy If questions has 4 right answers and ask for priority of needs of a patient-worse consequences game-worst outcome When stuck between two answers-read the question Sesame street rule-use only as last option Right answer tends to be different than the rest Wrong answers are usually all similar Right answer is most unique or different Answer based on what you know, not what you don’t know If you dont know something in a question-pull it out of the equation-use common sense Nclex also testing on common sense-do not overanalyze-do not think like a nurse Go with gut answer-only if other answer is superior3 Prioritization Decide who is sickest or healthiest--->based on question ABC does no work with prioritization questions Answers will have 4 parts Age Gender Diagnosis Modifying phrase 2 are irrelevant ---->age and gender In Peds pay attention to age but in prioritization age is not important Modifying phrase most important Ex: pt has angina pectoris vs MI ----> MI is high priority Pt has angina pectoris and unstable BP vs MI with stable VS ---->angina with unstable BP is now the priority 4 rules to prioritization 1. Acute beats (higher priority than) chronic Example: COPD versus appendicitis--->appendicitis is the priority 2. Fresh postop (<12 hrs) beats medical or other surgical Example: 2 hr post op versus appendicitis--->2 hr post op is the priority 3. Unstable beats stable Stable words Unstable words Stable Chronic illness Post op >12 hrs Local or regional anesthesia Lab abnormalities A or B level Unchanged assessments To be discharged Ready for discharge Admitted longer than 24 hrs ago Experiencing the typical expected S/S of disease with which they were diagnoses Unstable Acute illness Post op <12 hrs General anesthesia (1st 12 hrs) Lab abnormalities C or C level Changed/changing assessment Not ready for discharge Newly diagnosed Newly admitted Experiencing unexpected S/S Example: 16 yo w/ meningococcal meningitis who has had temp of 103.8 F since admission 3 days ago. 61 yo male w/IBS who spiked temp of 103 F this afternoon. Who is higher priority and why?--->2 nd option is priority-->have more high priorities than 1st Always unstable no matter what-even if expected [Show More]
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