Here are some tips from notes I took along the way! Take some notes of your own. Highlight away and stay positive!
The most common risk factors for cancer of the breast are family history of breast cancer, age over 50, and nulliparity. When assessing for a mass, signature signs to look for include fixed, painless nodes usually in the upper outer quadrant or near the axilla. Now while all of these facts are great to know about breast cancer, I have found that most NCLEX type questions are derived from the post operative procedures. SO, let me share some tips with you!
Post OP Must Know’s
Position patient in semi fowlers on unaffected side.
Elevate the affected arm above the level of the heart to promote drainage and prevent lymphedema
No IV’s, injections BP measurements on affected side
No carrying heavy items in affected arm (Books, laptop, purse)
Following a mastectomy another biggie NCLEX likes you to assess is the patient’s attitude and self esteem. How they … Read More »
Metered dose inhalers (MDI) are commonly used for asthma treatment. An MDI should never be put in the mouth but held two fingerwidths in FRONT of the mouth. However, if the MDI has a spacer, it can be placed in between the lips.
Take a deep breath before use
Breathe for 5 seconds with the inhaler activated
Hold breath for 10-15 seconds before slowly breathing out
If second dose is needed, wait 1-2 minutes before repeating
MDI medications can include Albuterol, Theophylline, Salmeterol, Advair, Fluticasone, Montelukast. These are a few of the more commonly used medications, be sure to look up side effects and contraindications.
Theophylline: toxicity can occur when serum level is higher than 20 mcg/nl. Look for early signs such as restlessness, nervousness, tremors, palpitations, and tachycardia.
During kidney failure, peritoneal dialysis (PD) is used as a means to keep the body’s electrolyte levels in balance. A tube is entered through the stomach 3-5 cm BELOW the umbilicus. The three main steps to this type of dialysis for one infusion is fill, dwell, and drain.
Look for infection signs ( Number one complication for PD)
Abdominal Pain (Some irritation in first few infusions is normal)
leakage around the catheter site ( can indicate wrong placement)
Sample NCLEX Question
A patient newly diagnosed with renal failure has just been started on peritoneal dialysis. During the infusion of the dialysate, the client reports pain in the abdominal area. What action should the nurse take?
Stop the dialysis
Slow down the infusion rate
Immediately Report findings to the physician
Explain that the pain with subside after the first several infusions
The answer is 4. Note that the patient is … Read More »
Both cleft lip and cleft palate are congenital abnormalities that can occur in the womb. Repair surgery is usually done between 6-24 months of age. As far as nursing and NCLEX goes, prepare for assessment and interventions on caring for these types of patients.
Assessment: ability to suck, swallow, breathe, and manipulate secretions without distress.
Interventions: Hold infant in upright position to prevent aspiration. When feeding through bottle, position it into the side and back of the mouth and burp frequently.
After Repair: NO suctioning, thermometer, forks, spoons, pacifiers, straws in the mouth. A soft elbow restraint may be put on the child to prevent site being touched. (Removing the restraints every 2 hours)
I know it’s been a while since I’ve posted! I’ve been busy with moving and some traveling here and there for the military.
I was thinking about all you December graduates who might be taking the NCLEX shortly! I would love to know when you are taking the exam. Or if you have already and haven’t passed, maybe I can help you personally. If you have recently taken it, were my tips helpful?
Good luck everyone and Congrats to those of you who have already passed! How exciting! Go take a break you deserve it! Keep up the studying guys!
Quick tip for those preparing: Try to do as many practice questions you can a day. I would suggest 100, BUT if you do not have time to review all 100 questions, lessen the load a little bit. Reviewing the questions is … Read More »
When it comes to a kidney transplantation and the NCLEX, most of the questions are going to be focused on the nurse’s responsibilities.
Below are several highlighted key point duties for the nurse to be aware of before and after the transplantation. Remember these are just the main ones and are not limited to just these.
Administer immunosuppressive medications 2 days before transplantation
Verify hemodialysis of recipient was completed 24 hours before transplantation
Assess renal function studies
Maintain strict aseptic technique
WATCH for urine output and immediately report an output less than 100 ml/hr
Note that urine is pink and bloody initially but returns to normal within several days
Monitor fluid balance labs and IV fluids closely
Kidney transplant rejection signs: temp 100 F and higher, chills, edema, hypertension, hypertension, 2-3 lb weight gain, pain and tenderness over kidney.
When your exam decides to throw you a tricky question about which patient you assess first, always remember your ABC nemonic and try to stick to it as close as possible.
For example “After receiving report, which patient would you first assess?
1. A 2 year old with decreased pedal pulses with a coarctation of the aorta
2. A 4 year old with rheumatic fever who is complaining of severe knee pain.
3. A 5 year old with endocarditis who has crackles audible throughout both lungs
4. A 12 month old with a strawberry tongue and an increase in temperature.
What did you answer? Carefully go through and ask yourself if any of the answers have to do with the airway of the patient first. If your answer was no, then check Breathing and circulation next. Luckily we got to stop at letter … Read More »
Monamine Oxidase Inhibitors (MAOI’s) are antidepressant drugs and work great for treating patients. However, they have many side effects and the food list is limited when on the drug.
The three major MAOI’s are:
I think of “Panama” to help remember. Take the two first letters of each drug.
The DO NOT eat food list
Avacado, soybeans, figs, cheese, wine, bananas, raisins, sauerkraut
Most commonly seen side effects: Dry mouth, nausea, insomnia, dizziness, headache.
The perfect mnemonic for cranial nerves has arrived! It always helps to memorize something you can go back to during the exam so your not rattled if they ask you what the function of cranial nerve number 6 is and you can’t remember which one that is. Something to keep in your nursing notes while you study!
Oh – olfactory
To – trochlear
Feel – facial
Vintage- vestibulocochlear (auditory)
Velvet, – vagus
Ah – Accessory
This is a NEED to know insulin chart.
Rapid (Humalog ) Acts within 15 Min. Peaks in 1 hour.
Short acting (Humulin R) Acts within 30-60 min. Peaks in 2-4 hours.
Intermediate (NPH) Acts within 1-3 hours. Peaks in 6-12 hours.
Long acting (glargine, Lantus) Acts in 1 hour. NO PEAK
Remind patient’s to change insulin injection sites daily because over time, the same location will not absorb the insulin as correctly.
Also usually a good idea to choose an assessing the patient’s blood glucose answer before an implementation answer choice on the NCLEX.
Walking with canes or assisting someone to walk and knowing where to stand is of course on the NCELX!
Remember the acronym C.O.A.L
So if assisting someone without a cane, you will stand in place of the cane. It is the same procedures.
Remember when going up and down stairs. Good leg to heaven and bad leg goes to hell. So when going up the stairs, the good leg with always go first. When descending stairs, the bad leg will always go first .
There are two similar disease processes in females that can trip you up quite easily on the NCELX. The symptoms are key to know by heart.
Placenta Previa: Painless (Think the three P’s) bright red bleeding.
Abruptio Placentae: Uterine irritability, tenderness, abdominal pain, painful vaginal bleeding.
A strategy to use in knowing what to do first between assessment or implementation answers with a mom in labor is pretty difficult. Here is what I found to be true.
If a mom comes into the unit saying she is in active labor, the first action here would be to listen to the fetal heart sounds or observe the perineum for progress in dilation.
Once the patient’s water breaks, first check the fetal heart rate.
If there is cord prolapse, IMPLEMENT first. Place the patient in trendelenburg position.
When your patient is on radiation therapy such as having a cervical implant, here are a couple rules that have to be in place when you are caring for them.
visitors stand 6 Ft away
Only care for patient 30 min at a time
flush toilet 2x after use
wash laundry separately ( Keep linens in room)
Drink extra fluids
Separate eating utensils
Quick Fact: Once a cervical implant is placed for radiation, the patient must be on bed rest for 3 days to ensure the implant does not fall out. If it does, it must only be picked up with metal forceps, not your hand.
Therapeutic diets can be tricky questions on the NCLEX a lot of times coming in forms of Select All That Apply type of questions.
Cystic Fibrosis Diet
Restrict Fluid intake
No poultry (cold chicken)
Jewish Diet (Kosher Diet)
Hooved animals are ok to eat
Some quick and easy memorization facts to help you with your studying!
1. Morphine masks Increasing Intracranial pressure. Therefore if you have a patient come in with head trauma or any suspected neuro issues, do NOT give them morphine.
2. Prednisone is a steroid and has a hyperglycemic side effect. The second most significant side effect is Immune Deficiency. For example, if a patient taking Prednisone is placed with another patient who is febrile, that would be bad nursing judgement.
ACE Inhibitors ( ends in pril) have two key side effects to look out for.
Also Does not work on African Americans.
So if you have a question about a patient taking Captopril, make sure they are not eating leafy green vegetables because it will increase their potassium lab value.
After struggling for six months after graduation trying to pass NCLEX, I made it my goal to help as many aspiring nurses as possible to pass their boards. I hope to encourage you as you begin your journey with rigorous studying and pass along invaluable wisdom that I learned along the way.