9_24_2012 Nursing Study Sites http://www.campuscollusion.com/Default.aspx http://www.medcram.

com/

http://www.youtube.com/user/tomiwa007/videos?flow=grid&view=0

http://ftplectures.com/lecture-videos.html Flash Cards http://flashcarddb.com/Sparticuslives http://quizlet.com/sparticuslives http://www.studyblue.com/#flashcard/view/271624 http://www.flashcardexchange.com/mycards?view=saved http://www.flashcardexchange.com/profile

Sara Hawley http://www.studyblue.com/#flashcard/view/1623562 http://www.studyblue.com/#flashcard/view/1603588 http://www.studyblue.com/#flashcard/view/1605409

http://www.studyblue.com/#flashcard/view/2106661 http://www.studyblue.com/#flashcard/view/2171572

Jam Walker http://www.studyblue.com/#search/notes/AUTHOR:371855 http://www.studyblue.com/#flashcard/view/271637

http://www.studyblue.com/#flashcard/view/271631 http://www.studyblue.com/#flashcard/view/271623 http://www.studyblue.com/#flashcard/view/2460562 http://www.studyblue.com/#search/notes/ATI%20 http://www.studyblue.com/#flashcard/view/1978976 http://www.studyblue.com/#search/notes/AUTHOR:1747795 NCSBN http://www.studyblue.com/#search/notes/NCSBN HESI http://www.studyblue.com/#search/notes/HESI http://www.studyblue.com/#flashcard/view/862176 http://www.studyblue.com/#flashcard/view/3139685 http://www.studyblue.com/#search/notes/AUTHOR:544043 http://www.studyblue.com/#flashcard/view/1955775 http://www.studyblue.com/#flashcard/view/1026013 http://www.studyblue.com/#flashcard/view/3324303

Healthcare and Medicine Videos about medicine and the healthcare system
http://www.khanacademy.org/science/healthcare-and-medicine Human biology http://www.khanacademy.org/science/biology/human-biology The Kidney and Nephron http://www.khanacademy.org/science/biology/immunology/v/the-kidney-and-nephron Secondary Active Transport in the Nephron

http://www.khanacademy.org/science/biology/immunology/v/secondary-active-transport-in-thenephron

Inflammatory Response http://www.khanacademy.org/science/biology/immunology/v/inflammatory-response Cellular respiration http://www.khanacademy.org/science/biology/cellular-respiration

Video Talks about ALL Diseases http://www.uhs.net/video-education http://www.uhs.net/video-education#TB_inline?height=371&width=610&inlineId=atlasPopUp

http://www.learningnurse.com/ http://www.learningnurse.com/content/view/28/42/

Free CE Units http://ce.nurse.com/FreeCE.aspx Great Site http://www.nlm.nih.gov/medlineplus/tutorials/ http://www.umm.edu/media/video/mht_kidney_heartdisease_weir_1.htm http://www.umm.edu/media/channel/ http://videos.med.wisc.edu/learningthemes/ http://videos.med.wisc.edu/learningthemes/ http://studentnurseconnections.com/Links21.html Video Skills http://alfa.saddleback.edu/vid_index.aspx

http://alfa.saddleback.edu/ http://kidney.niddk.nih.gov/resources/HealthTools/healthtools.aspx http://www2.niddk.nih.gov/HealthEducation/InteractiveTools/

http://nursinglink.monster.com/education/articles/8280-comprehensive-nclex-study-guide---quizyourself http://nursinglink.monster.com/content/nclex-study-center Seniors http://nihseniorhealth.gov/videolist.html http://www.medbroadcast.com/humanatlas_info_list.asp?search_letter=A http://freenursetutor.com/

http://sjheducation.weebly.com/medical-surgical-nursing-education.html Miami Dade College http://itunes.apple.com/us/itunes-u/school-nursing-nclex-review/id381370337

The School of Nursing - NCLEX Review

by MDC

http://www.freelecturevideos.com/browse-medicine_and_healthcare-videos-1date.html#axzz27SXrMtge

http://wps.prenhall.com/chet_kozier_fundamentals_7/11/2980/763096.cw/index.html

http://www.acid-base.com/

Pharmacology http://www.mediglyphics.com/public/Pharmacology/ http://nursinglink.monster.com/education/articles/2347-nursinglink-videos-nclex-review http://www.brooksidepress.org/Products/OperationalMedicine/DATA/operationalmed/Manuals/Standa rd1stAid/toc.htm http://www.martindalecenter.com/Nursing_2_Inter.html http://www.martindalecenter.com/Nursing_3_NPra.html http://www.martindalecenter.com/Nursing_1_Jour.html#JO-GER

http://www.campuscollusion.com/med%20surg%20questions.aspx http://www.campuscollusion.com/med%20surg%20questions.aspx

http://nursinglectures.blogspot.com/ http://emedicine.medscape.com/emergency_medicine http://libguides.adelaide.edu.au/content.php?pid=227947&sid=1886268#general http://www.uihealthcare.org/Adam/?/HIE Multimedia/0/diseidxa http://www.uihealthcare.org/Adam/?/HIE Multimedia/0/diseidxa http://www.muschealth.com/gs/healthatoz.aspx http://emedicine.medscape.com/ http://www.examsfornursing.com/cardio-vascular/86-hypertension http://examsfornursing.com/ http://examsfornursing.com/shock-and-death/68-shock http://www.campuscollusion.com/Default.aspx

Nurse Scripts http://nurseleadershipbuilders.com/wordpress/?p=103 http://www.healthleadersmedia.com/content/NRS-270551/10-Ways-to-Help-Nurses-Improve-PatientSatisfaction

http://caring4you.net/answer.html

http://rnlaurie.nfshost.com/nursing_resources.htm

Some of my favorite web sites are listed below:

Learning tools and games

http://freenursetutor.com/ (Learning Games) my favorite games are: http://www.freenursetutor.com/endocrine/games-endocrine-rags-to-riches-millionaire-typegame--2.html http://www.freenursetutor.com/cardiac/flashcards-matching-hypertension-and-cardiacmedications-3.html http://www.rale.ca/Recordings.htm http://www.or-live.com/ (operations see live via pod cast) http://evolve.elsevier.com/staticPages/s_index.html http://www.gwc.maricopa.edu/class/bio201/cn/cranial.htm cranial nerve matching

Cardiac Resources
http://www.wilkes.med.ucla.edu/inex.htm http://www.bioscience.org/atlases/heart/ http://www.chfpatients.com/ http://www.blaufuss.org/tutonline.html http://www.cardiologysite.com/auscultation/html/severe_as.html http://www.anesoft.com/ click on "free stuff" then under the heading educational resources - training aides choose either Rhythm for the web or Rhythm 2000 http://www.campaignfornursing.com/events/WINNERS/pennsylvania/ EKG tap dance http://www.icufaqs.org/ ICU information with many additional links http://www.pacep.org/ pulmonary artery catheter education http://medinfo.ufl.edu/~ekg/index.html "EKG Web" adapted from text

Nursing Associations
http://www.nurseportal.net/ (many useful inks- as well as a link to state board's of nursing)

http://www.nsna.org/ (National Student Nurses' Association - NSNA) http://www.nursingworld.org/ (American Nurses Association) http://www.wsna.org/ (Washington State Nurses Association) http://www.oregonrn.org/ (Oregon Nurses Association) http://www.nursingcertification.org (Advanced Certifications for Nurses) http://www.aacn.org (American Association of Critical Care Nurses)

Health Specific Associations

http://www.lungusa.org/ (American Lung Association) http://www.cancer.org/ (American Cancer Society) http://www.diabetes.org/main/application/commercewf (American Diabetes Association) http://www.aap.org/ (American Academy of Pediatrics) http://www.amhrt.org/ (American Heart Association) http://www.ama-assn.org/ (American Medical Association) http://www.acnm.org/ (American College of Nurse-Midwives) http://www.acog.org/ (American College of Obstetricians and Gynecologists) http://www.obgyn.net/ (OB/GYN Net) http://www.awhonn.org/ (Association of Womens Health, Obstetric, and Neonatal Nurses) http://www.aaaai.org/ (American Academy of Allergy, Asthma and Immunology)

Informative and Resource websites

http://www.lib.uiowa.edu/hardin/md/index.html (Hardin Meta Directory) http://www.aahn.org (History of Nursing) http://www.vh.org/ (Virtual Hospital) http://www.cdc.gov/ (Center for Disease Control and Prevention) http://www.nih.gov/ (National Institutes of Health) http://www.nlm.nih.gov/ (Medline) http://www.os.dhhs.gov/ (Office on Womens Health, U.S. Public Health Service, Dept of Health and Human Services) http://www.4woman.gov/ (The National Womens Health Information Center) http://www.discovernursing.com/http://www.ultimatenurse.com/component/option,com_mtree/ta sk,listcats/cat_id,93/Itemid,59/ (Ultimate Nurse) http://www.nursingnet.org/ (Nursing Net) http://www.healthopedia.com/ http://www.nejm.org/ (New England Journal of Medicine) http://i.nursegroups.com/nursing-article/guide-nursing-resources.html (Resource guide)

PDA Software sites

http://books.mcgraw-hill.com/medical/diagnosaurus/index.html Diagnosaurus (freeware) http://www.beiks.com/palmzonebg/Free_dictionaries.htm BDicty (freeware) http://www.epocrates.com/ Drug Guide (freeware) http://www.immunizationed.org/anypage.aspx?pagename=shotshome Immunization Shots 20062007 http://www.merckmedicus.com/pp/us/hcp/hcp_mobile_merckmanual.jsp Merck Manual, 17th Edition http://www.pdacortex.com/ PDA Cortex http://www.skyscape.com/estore/store.aspx?category=35 Skyscape (freeware)

University sites

http://ublib.buffalo.edu/libraries/units/hsl/internet/nsgsites.html (University at Buffalo New York) http://www.medweb.emory.edu/MedWeb/ (Emory University) http://www.ethnomed.org/ (Harborview and University of Washington website for multicultural information)

Inspirational stories
http://include.nurse.com/apps/pbcs.dll/article?AID=/CM/20070507/HL02/705070332&SearchID =73295766838851 http://www.boston.com/news/special/nursing/top/ The Making of an ICU Nurse- written in the Boston Globe

Sites specific to Genetics and Breast cancer:

http://www.facingourrisk.org/ http://www.ornl.gov/hgmis/project/about.html http://www.faseb.org/genetics/acmg/pol-24.htm http://www.bcrfcure.org/rese_meet_king.html http://www.ovariancancer.com/default.asp http://www.myriad.com/ http://www.ornl.gov/ http://www.ocrf.org/ http://www.komen.org http://www.susanlovemd.com
Yesterday is history, tomorrow is a mystery and today is a gift....that is why it is called the present. ~Unknown
Laurie Home | NCLEX Home My Interests | Technology and Power Point Shows | Nursing Resources | Nursing Philosophy | Nursing Education

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.

Perhaps thats why it can be tough for some people to filter out extraneous information in order to answer NCLEX-style, multiple choice or multiple select questions. (And some of you come to the NCLEX with an existing habit of overthinking.pretty much everything!) So here are some strategies to help you to be more successful when answering NCLEX-style questionswithout over-thinking. Strategy One: Think about the question First, read the question carefully, looking for key words (such as first, priority, best, etc.) Be sure to relate the question to the context of the situation (such as disease process). Before you look at the answer choices, briefly think about the concept the question is relating to and organize your thoughts about that topic. For example: A nurse is caring for a client with an acute attack of inflammatory bowel disease (IBD). Which of the following findings indicates a potential complication? (Select all that apply). To answer this question, you need to know the anticipated findings of IBD, which are typically changes in bowel movements (either diarrhea and/or constipation), abdominal pain, and cramping. You are being asked to identify findings that would suggest a complication something you wouldnt normally expect from a diagnosis of IBD. Strategy Two: Eliminate the obviously incorrect responses Next, you will want to eliminate answers that you know are not correct (please note - this will work on many, but not all questions on NCLEX). Usually you can eliminate two options on most multiple-choice questions, but that still leaves you with a decision to make about how best to answer the question. In the above example, you would eliminate the options that you would normally expect the diarrhea and associated blood and mucus in the stool, as well as abdominal pain. Strategy Three: Pick the best remaining answer If you still need help, you can eliminate wrong choices by adding each alternative to the stem (the statement that asks the question) and treating this new sentence as a TRUE-FALSE statement. If the added alternative makes the new sentence false, disregard this distractor and move to the next option. When the new sentence becomes true AND answers the question, you have found the best alternative and, most likely, the correct answer. For instance, the options you wouldnt expect in a typical case of IBD would include fever or abdominal distension. So when you add this alternative (fever or abdominal distension) to the

stem (Which of the following findings indicates a potential complication?), you end up with: Fever or abdominal distension indicates a possible complication. Since these statements are true, you know you have your correct answers! Strategy Four: Dont dwell Answering NCLEX-style questions takes skill and practice. And although you can take your time when you are answering questions in the review course, dont forget that you will only have a few minutes per question on NCLEX. Sometimes the best critical thinkers are the ones who tend to over-analyze the question and the options. So thats where I can help. If you get stuck or cant work things out on your own (as to why a certain response is the correct one), please write to me and tell me what you are thinking. I can usually help you to re-focus on the question and help determine why the correct response is the best response. So instead of over-thinking why you over-think use our course (and me!) to help you find a balance between analyzing and over-analyzing questions and responses. The result will be an increased confidence and ease in taking (and passing) NCLEX

Question Two: Therapeutic lab values and how are they different from normal lab values? As I wrote in part one of this 3-part series, Im tackling some of the most frequently asked student questions. Last time I wrote about isolation protocol. This time Im tackling therapeutic lab values - specifically therapeutic lab values for blood thinners. (Stay tuned for Question Three about triage for disaster victims.)

Therapeutic Lab Values: Used to look for the presence/effectiveness of specific drugs in the blood. Normal Lab Values: The range of results expected from lab tests without influence from a therapeutic drug.

Back to the basics! When it comes to preparing for NCLEX, I often suggest that students have a basic understanding of normal PT (and INR) and APTT lab values and how these are different from therapeutic lab values (used with anticoagulant therapy). Usually this prompts a question like, how are they different? Before I talk about therapeutic lab values, lets start with the basics. But before I do that, let me emphasize that lab values vary slightly from lab to lab. When students write and ask which lab values they should memorize, I usually suggest they go with what they learned in school why get confused with all these other numbers? Labs for bleeding and clotting times Lets look at the three tests used to determine bleeding or clotting times:

Prothrombin Time (PT) this blood test measures how long it takes blood to clot and can be used to check for bleeding problems. An abnormal PT/INR can be caused by liver disease; injury; lack of vitamin K; or treatment with blood thinners. QUIZ YOURSELF: Which blood thinner are we talking about here? (answer below). 2. International Normalized Ratio (INR) is a standardized way to report results of bleeding time. It is used in place of PT; in fact, some labs will only report INR. 3. Activated Partial Thromboplastin Time (APTT)* this blood test also measure the time it takes your blood to clot and to help diagnose bleeding problems. An abnormal APTT can be caused by bleeding disorders (such as hemophila); liver or kidney disease; or treatment with blood thinners. QUIZ YOURSELF: Which blood thinner are we talking about here? (answer below)
1.

Therapeutic Lab Values Lets look at these same lab tests once again.

PT & INR If you answered warfarin (Coumadin) to the first question above, you were correct! How much warfarin the person is prescribed depends on the prothrombin time (or INR). The therapeutic value of PT is about 1.5 to 2.5 times the normal value; the therapeutic value of INR is 2 to 3 times the normal value.
Normal lab value 11 13 seconds 0.8 1.1 Therapeutic lab value 15.5 35 seconds 23

Test Prothrombin time (PT) International normalized ratio (INR)

APTT If you answered heparin for this test, you were correct! As with the PT/INR test, the heparin dose is changed so that the APTT result is about 1.5 to 2.5 times the normal value.

How can you remember if APTT is used for heparin or warfarin? I always remember APTT has 2 sticks (the Ts), and there are 2 sticks in the H in HEPARIN its stuck with me all these years.
Test Activated Partial thromboplastin time (aPTT) Normal lab value 30 40 seconds Therapeutic lab value 45 100 seconds

Applying this information So, lets say you are caring for a client taking warfarin (for example, following total hip replacement surgery). This means that when you look at the labs for this client, you want to see longer bleeding times or, essentially abnormal values. The idea here is to prevent blood clots from forming. For heparin therapy, you are caring for a client who is on IV heparin (admission diagnosis is deep vein thrombosis). When you look at the labs for this client, you also want to see longer bleeding times. Keep in mind that if the number is too high for either client, you should start watching for signs of spontaneous bleeding and the dosage should be decreased. Another key point to remember, these tests should be done at the same time of day every day while the client is hospitalized.

QUIZ YOURSELF: What are the antidotes for reversing the effects of heparin? And for warfarin? (Watch for the answer below.)** Now its your turn Are there any other topics you would like me to discuss in an upcoming blog? *Are you wondering if it's PTT or APTT? PTT was first used in the early 1950s and was replaced by APTT in the 1970s. ** The antidote for reversing the effects of heparin is... protamine sulfate. The antidote for reversing the effects of warfarin is... vitamin K. Did you come up with the correct response without looking?

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