Introduction to Testing and the NCLEX-RN Exam: Hints NUR 328

IntroductIntroduction to Testing and the NCLEX-RN Exam Most questions are written in a positive style. Negative style questions will contain key words that denote the negative style. Examples: 1. “Which response indicates to the nurse a need to re-teach the client about…?” (Which information/understanding by the client is incorrect?) 2. “Which prescription (order) should the nurse question?” (Which prescription is unsafe, not beneficial, inappropriate to this client situation, etc…?) The council want to make sure that the exam measures current entry-level nursing behavior. For this reason, job analysis studies are conducted every 3 years. These studies determine how frequently various type of nursing activities are performed, how often they are delegated, and how critical they are to client safety with criticality given more value than frequency. A nursing diagnosis is not a medical diagnosis. It must be subject to oversight by nursing management. The cause may or may not arise from medical diagnosis. Answering NCLEX-RN questions correctly often depends on setting priorities properly, on making judgments about priorities, and on analyzing the case and formulating a decision about care (or the correct response) based on priorities. Using Maslow’s Hierarchy of Needs can help you to set priorities. One or more of the choices are likely to be very wrong. You will usually be able to rule out two of the four choices rather quickly. Reread the question choices again if necessary. Ask yourself which choice answers the question being asked. Even if you have absolutely no idea what the answer is you have a 50/50 chance of getting the right answer if you follow this process. Your first response will provide an educated guess and will usually be the correct answer. Go with your gut response! Pace yourself from the beginning of the test. Allow yourself 1.5 minutes per question. The night before taking the NCLEX-RN , allow only 30 minutes of study time. This 30- minute period should be designated for review of test-taking strategies only. Practice these strategies with various practice test items if you wish (for 30 minutes only; do not take an entire test).Spend the night before the exam doing something you enjoy, something that promotes stress reduction, something that does not involve alcohol or other mind-altering drugs. Only you can identify the special something that will work for you. Remember, you can be successful. Leadership and Management Often an NCLEX-RN question asks who should explain a surgical procedure to the client. The answer is the provider. This is probably the only question in which you refer to the healthcare provider. Remember, nurses are proud people; nurses wrote the test items, and they expect nurses to handle most client situations. Also remember that it is the nurse’s responsibility to be sure that the operative permit is signed and is on the chart. It is not the nurse’s responsibility to explain the procedure to the client. Often questions are asked regarding the Good Samaritan Act, which is the means of protecting the nurse when he or she is performing emergency care. If the nurse carries out a health care provider’s or a physician’s prescription for which he or she is not prepared and does not inform the healthcare provider or physician of his or her lack of preparation, the nurse is solely liable for any damages. If the nurse informs the healthcare provider or physician of his or her lack of preparation in carrying out a prescription and carries out the prescription anyway, the nurse and the healthcare provider or physician are liable for any damages. Assignments are often tested on the NCLEX-RN. The Nurse Practice Acts of each state governs policies related to making assignments. Usually, when determining who should be assigned to do a sterile dressing change, for example, a licensed nurse should be chosen; that is an RN or licensed practical nurse (LPN) who has been checked off on this procedure. Restraints of any kind may constitute false imprisonment. Freedom from unlawful restraint is a basic human right and is protected by the law. Assertive communication starts with “I need” rather than “You must.” Motivation comes from within an individual. A nurse leader can provide an environment that will promote motivation through positive feedback, respect and seeking input. Look for responses that demonstrate these behaviors. Delegating to the right person requires that the nurse be aware of the qualifications of the delegatee: appropriate education, training, skills, experience and demonstrated and documented competence. (18) Remember the nursing process: assessments, analysis, diagnosis, planning and evaluation (any activity requiring nursing judgment) may not be delegated to UAP. Delegated activities fall within the implementation phase of the nursing process. (18) UAPs generally do not perform invasive or sterile procedures. (18) The RN is responsible for adhering to the three basic aspects of supervision when delegating to other healthcare personnel such as LPNs, graduate nurses, inexperienced nurses, students nurses and UAPs. (18) ,,,..............................................CONTINUED...............................