Académique Documents
Professionnel Documents
Culture Documents
LeeAnn Danner-Wilson
Pass or Fail
All of the examination questions are categorized by test plan area and
level of difficulty.
Test Plan
Each Examination Question will address:
Levels of Cognitive Ability
Client needs category
Integrated Process
Client Needs
Categories/Subcategories
Safe, Effective Care Environment
Management of Care
Safety and Infection Control
Integrated Processes
Caring
Communication & Documentation
Nursing Process
Teaching/Learning
Preparation
Developing a Study Plan
Good Time Management
Calendar
Study Sessions
Quality vs. Quantity
Materials needed
Computer
Questions & Answers
Special Notebook
HESI
Minimum of 100 Questions a day
NCLEX-RN
Minimum of 200 Questions a day
MEMORY DUMP
Answer your
questions as if the situation were ideal, and
you had ALL the resources and time needed.
The only client you need to be concerned
with is the one in the question
Components of a
Question
Case Scenario
Stem
Four Answers
My New Routine
After reading the Question ask:
First
What is the question telling me?
What is the question asking me?
Look at the stem!!!!
Second
The Client
Who is the focus of the question?
You must identify the client in the question
because the answer MUST relate to the client.
The client is NOT always the patient, it
sometimes is a family member.
Example
A nurse will be going on vacation. To involve the
patient in the excitement, what is the best thing the
nurse should say ?
Third
Key Words (Circle These)
The important phrases or words in a question
Early
Late
Immediately
Most likely, least likely
Initial
After several days
Last
What is the issue in the question?
The specific problem or subject which the
question is ASKING
Drug
Problem
Toxic Effect
Behavior
Disorder Procedure
Pitfalls
Reading into the
question
Asking well what
if.
Answers
1. Your father needs opportunities to be
independent. This will help him become
self-sufficient.
2. Your father is capable of taking care of
himself. Try allowing him more
independence.
3. Stress is not good for your father at this
time. Perhaps you could call your
children.
4. You are feeling concern for both your
father and your children. Let me know
when you are leaving, and Ill stay with
him.
Helpful Tips
To avoid reading into the question
Restate in your own words
Eliminate options that includes new
information
Eliminate options that require you to make
assumptions
Problem
oMy problem is I get
narrowed down to 2
answers and I always
pick the wrong one!
Guidelines
If you are left with two questions
marks and cant make a decision
go with your gut instinct!
Using a selection procedure allows
you to make educated guesses.
When you narrow to 2, you have a
50% chance of guessing correctly!
Response
Similar Distractors
Similar words or phrases
Remember
Global Response
A global response is one that is a general
statement and may include the ideas of
other options within it.
This option is often the correct answer
when 2 or 3 more specific options appear
equally correct.
1.
2.
3.
4.
Answer
4- This is an APPROPRIATE
Similar Distracters
Always remember there is only 1 correct
answer.
If 2 options say the same thing or include
the same idea, they cant be correct.
Answer is the option that is different.
Answers
1.
2.
3.
4.
Answer
Similar Words
Answers
1.
2.
3.
4.
Answer
!. When caring for a client with
a newly applied cast, it is
IMPORTANT to keep the
affected extremity above the
level of the heart to reduce
swelling.
Key words are leg and cast
Knowledge Questions
Knowledge questions require you
to recall or remember
information. To answer a question
you need to commit facts to
memory.
Knowledge Question
The first step of the procedure for
making unoccupied bed is
Answer
B- because you need to know the
sequence of steps in the procedure
of making an unoccupied bed or
the basic principles that your
hands must be washed before ALL
procedures.
Comprehension Questions
Require you to understand
information. To answer a
comprehension question, you must
commit facts to memory as well as
translate, interpret, and determine
the implications of that information.
Comprehension Question
To evaluate the therapeutic effect of
a cathartic, the nurse should asses
the patient for:
A. Increased urinary output
B. A decrease un anxiety
C. A bowel movement
D. Pain Relief
Answer
C- to answer this question you have
to know not only that a cathartic is a
potent laxative that stimulates the
bowel but also that the increase in
peristalsis will result in bowel
movement.
Difference
The difference between knowledge
questions and comprehension
questions is: to answer knowledge
questions you must know facts. To
answer comprehension questions you
must understand the significance of
the facts.
Application Questions
Application questions require the
learner to show solve, modify,
change, use, or manipulate
information in a real situation or
presented scenario. To answer,
you must apply concept you
learned previously to concrete
situations.
Application Question
1.
2.
3.
4.
A client is experiencing a
hypoglycemic reaction. The
nurse should administer which
of the following items to best
treat the reaction?
Water
Diet soda
Milk
One sugar-free cookie
Answer
3- In intervention questions you are
asked about an intervention, a nursing
action, a decision, or a problem that
needs to be solved. Here you are asked
to select the best item for treating a
hypoglycemic reaction. Remember, if
a hypoglycemic reaction occurs, the
client should be given an item that
contains 10 to 15 g carbohydrate.
Analysis Questions
Require you to interpret a
variety of data and recognize
the commonalities,
differences, and
interrelationships among
presented ideas. Make the
assumption that you know,
understand, and can apply
information.
Analysis Question
1.
2.
3.
4.
Answer
1- For analysis you are required to
consider and examine possibly
several concepts in the question to
answer it correctly. In this
question, it is necessary to know
that Regular insulin is short acting
insulin (i.e. it peaks in 2 to 3
hours) and that a hypoglycemic
reaction is most likely to occur
during peak time.
Differences
Analysis questions require an
ability to examine information,
which is a higher thought
process than knowing,
understanding, or applying
information.
Example
Studying Blood Pressure
First memorize the parameters of a normal
blood pressure (Knowledge)
Then develop an understanding of what factors
influence and produce a normal blood pressure
(Comprehension)
Identify a particular patient situation that
would necessitate obtaining a BP (Application)
Differentiate among a variety of situations and
determine which has the highest priority for
assessing the BP (Analysis)
Categories/Subcategories
Management of Care
Safety and Infection Control
Answer
Answer
2- If the ED nurse is notified that several victims
of a disaster will be arriving to the ED, the nurse
would immediately activate the emergency
response plan by notifying the supervisor and by
following the directions in the plan.
Test Taking hint- Option 2 is the global
response- once this action is taken the others
will follow
Answer
2- note keyword primary. Focus
on the client who is a teenager.
Thinking about psychosocial
development of a teenager, will
direct you to option 2.
Psychosocial Integrity
Answer
2- Maslows hierarchy of needs.
Physiological needs are the priority,
and if a physiological need does not
exist, then safety is priority.
Physiological Integrity
Basic Care & Comfort
3.
4.
Answer
Physiological Integrity
Pharmacological & Parental Therapies
Cyclosporine (Sandimmune) oral solution
is prescribed for a client who had a kidney
transplant. The nurse provides information
to the client about the medication and tells
the client that which of the following is most
important to monitor?
1. Apical heart rate
2. Peripheral pulses
3. Platelet count
4. Temperature
Answer
4- Use the process of elimination.
Eliminate options 1 and 2 first
because they are similar. From the
remaining options, note the
keywords most important. Recalling
that infection is an adverse effect will
direct you to option 4.
Physiological Integrity
Reduction of Risk Potential
The nurse assists a physician in
Prone
On the right side
On the left side
Left Sims position
Answer
2- Use knowledge regarding anatomy and
Physiological Integrity
Physiological Adaptation
A nurse is reviewing the medical records of the four
Answer
4- Focus on the issue! The client at risk for
Integrated Processes
Caring
Communication &
Documentation
Nursing Process
Teaching/Learning
Integrated Processes
Caring
An infant is brought to the ED by EMS with
Answer
2-Focuse on the issuecompassionate care. This
directs you to option 2,
because it is the only option
that addresses this issue. The
other answers are not
specifically related to
compassionate care.
Integrated Processes
Communication Questions
Thought is If you cannot communicate
therapeutically, it is difficult to practice
safely.
Identify the Client in the Question
Identify the issue
Use the Communication Tools and Blocks
Tools (enhance)
Blocks (interfere)
Communication Tools
Being Silent
Sitting quietly
Offering Self
Let me sit with you.
Showing Empathy
You are upset.
Focusing
You say that..
Restatement
You feel anxious?
Validation/clarification
What you are saying is
Giving information
Your room is 423.
Communication Blocks
Giving advice
If I were you, I would
Showing approval/disapproval
You did the right thing
Requesting an explanation
Why did you do that?
Being Defensive
Every nurse on this unit is
exceptional.
Focusing on Inappropriate
issues or person
Have I said something wrong
Cheating on Communication
Questions
NEVER answer I
Always focus on feelings, thoughts, and
behaviors.
Usually the answer with you feel is
correct.
Always remember it is about the client
Integrated Processes
Communication
Answers
1.
2.
3.
4.
There is no reason to be
scared.
You have plenty of reasons to be
scared. Surgery is a scary thing.
Scared?
Most people who have to have
surgery are scared.
Answer
3- Therapeutic
communication
techniques. In option 3,
you are using reflection.
Options 1,2, & 4 are
nontherapeutic.
Integrated Process
Documentation
Answers
1.
2.
3.
4.
Answer
Integrated Process
Assessment
A client is eight hours
postoperative after a
transurethral resection of the
prostate gland (TURP). Which
nursing assessment would be
an early indication of a
postoperative complication?
Answer
D- A temperature of 101.8F
eight hours post-op is
considered an early
indication of a post-op
complication.
C- is a possibility, but
bloody urine is expected
post TURP.
Interpreting data
Validating data
Organizing related data
Identifying a nursing diagnosis
MOST DIFFICULT to answer
Require an understanding of the
principles of pathophysiology,
pharmacokinetics, and psychopathology,
as well as growth and development.
Be sure you have the correctly identified
the issue in the question
Integrated Process
Analysis/Diagnose
The nurse is performing a
developmental evaluation of a twoyear-old child. Which observation
would the nurse consider a good
indicator of normal development?
Answers
A. Having command of a
vocabulary of six words.
B. The ability to walk up and
down stairs without help.
C. The ability to dress and
undress.
D. The ability to point at
something that is wanted.
Answer
B- This is a good indicator of
normal psychomotor
development.
Integrated Process
Planning
Answers
Answer
Integrated Process
Implementation
Answers
A. The RN should implement the
Integrated Process
Evaluation
A patient returns to the clinic
after taking a 7-day course of
antibiotic therapy and is still
exhibiting signs of a urinary
tract infection. What should be
the nurses initial action?
Answers
A. Arrange for the MD to order a
different antibiotic.
B. Obtain another urine specimen
for a culture and sensitivity.
C. Determine if the patient took
the medication as prescribed.
D. Make an appointment for the
patient to be seen by the MD.
Answer
C- This item is designed to teat
your ability to recognize that the
nurse must analyze the factors
that influence outcomes of care.
Options 1,2,4 can be eliminated
because these actions immediately
move to an intervention before
collecting more information.
Integrated Process
Teaching/Learning
Teaching/Learning
Answer
Pharmacology Questions
Utilize the Five Medications Rights and your
knowledge on appropriate ways to give
medication.
Utilize the following assessment guidelines
Always assess
Pharmacology Question
The nurse notes that a physician has prescribed
cotrimoxazole (Bactrim) for a client with a urinary
tract infection. Which priority action will the nurse
take before administering this medication?
1. Call the pharmacy to order the med.
2. Ask the client about an allergy to
sulfonamides.
3. Check the medication supply room to find out
whether the medication needs to be ordered.
4. Inform the client about the need to increase
fluid intake.
Answer
2- Note the issue: the action that the nurse
will take
Note the keyword: priority
The steps of the nursing process help you
here, option 2 is the only option that
addresses client assesment.
Pharmacology Question
1.
2.
3.
4.
Answer
4- Issue- upset stomach! Recall antacids
are not usually administered with
medication. Options 1 & 2, a nurse would
not tell a patient to stop taking a
medication.
Pharmacology Questions
Have to know the differences between
Intended effects: a desirable effect
Side effects: no desired, not usually lifethreatening, alleviated with specific measures
Adverse effects: more severe than a side
effect, always undesirable, always reports to
the health care provider
Toxic effects: medication level in the body
exceeds the therapeutic level.
Question
1.
2.
3.
4.
Answer
2- Issue- side effect. Eliminate options 1 &
4 first because they are similar and both
indicate the presence of hepatitis, and
adverse side effect of the medication.
Eliminate option 3 because of the word
severe, which indicates an adverse
effect.
Question
1.
2.
3.
4.
Answer
4- Issue- adverse effect. Eliminate 1 & 3
because they are similar and both relate to
the GI System. Eliminate option 2 because
it is an intended effect of the med.
Pharmacology Questions
Break the name down to help you
1.
2.
3.
4.
Answer
3- Keyword suspects the presence
Issue- nurses findings
Remember that many antiviral medication
names contain the letters vir will direct
you to option 3.
Note the similarity in options 1,2, & 4
Delegation
The Rules
1. Do not delegate functions of assessment,
evaluation, and nursing judgment.
2. This is not the read world
3. Delegate activities for stable patients with
predictable outcomes
4. Delegate activities that involved standard,
unchanging procedures.
5. Remember priorities!
Review your Nurse Practice Act
Ambulate
Bathe
Transport
Groom
Hygiene measures
Position
ROM
Skin care
Some specimen
collections, such as urine
or stool
LPN
Administer
Oral meds
IMs
Sub Qs
Change Dressings
Irrigate wounds
Monitor IV flow rates
Suction
Teach basic hygiene and
nutritional measures
Urinary cath
Use nursing process: data
collection, plan, implement,
evaluate
The RN
Administer IV meds
Leader others and manage client care
environment
Teach
Use nursing process: assess, analyze
data, plan, implement evaluate
Practice
1.
2.
3.
4.
Answer
4- Keywords are most appropriate and RN
assignment
1- the LPN can do
2- CNA
3- CNA
Answers
1.
2.
3.
4.
Answer
4- Issue- focus on continuity of care
Important are client needs and safe
environment
Options 1, 2, & 3 present a risk to the
healthcare provider
Option 4 is psychosocial needs that can be
met with continuity of care!
Practice
1.
2.
3.
4.
Answer
1- Keyword: most appropriate
Option 3- nothing tells us the patient is in
pain
Option 4- pyschosocial issue
Down to 1 and 2.
First step in nursing process
Practice
1.
2.
3.
4.
Answer
1- Keywords- restless, pulse rate increased,
large amounts bright red blood,
immediate.
Options 2,3,4 would delay necessary
interventions needed in this life
threatening situation!
Practice
1.
2.
3.
4.
Practice
1.
2.
3.
4.
Practice
1.
2.
3.
4.
Answer
2- Options 1,3, & 4 all require MD orders!
1.
2.
3.
4.
Lab Values
How do I ever remember them all?
Identify whether the lab value is normal or
abnormal.
Note the disorder presented in the
question
Identify the body organ that is affected as
a result of the disorder
Practice
1.
2.
3.
4.
Answer
1- Keyword most closely
Issue nephrotoxicity
Option 1 is the only one that relates to renal!
2- immune
3- hematological
4- panreatic
Resources
Websites
www.nscbn.org
http://caring4you.ne
t/tests.html
http://www.nclexinf
o.com/
www.learningext.c
om
http://www.testpre
preview.com/nclex_
practice.htm
Books
Kaplan (2005).
NCLEX-RN Exam
2005-2006 Edition.
Silvestri, L. (2005).
Strategies for
Success for the
NCLEX-RN
Examination