Tips on answering nclex-rn questions

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, second physiological integrity, third,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.
Good ol' Maslow:
1st Physiologic needs
2 Security and safety
3 Love and belonging
4 Self actualization
NCLEX TRAPS
In some questions validation is required in order to answer the question
corectly...meaning the question may ask you to assess or evaluate as opposed to
implement (do some action, for example, call the doctor, start CPR, reposition the
patient or give oxygen to the patient, etc.) Remember the intent of the question will be
hidden to you.

read the stem question for determining whether you should assess or implement
and within that context eliminate the answers which do not fit to with what you
must do, that will lead you to the right response.

If all the anwers fit in to implementation, then move on to use Maslow Hierarchy of
Human Needs
--Physical needs take priority over other needs-Pain is not a physical need--it is considered psychosocial, so it goes higher up on
Maslow scheme
If all answers fit in to the physical needs apply ABC (air/blood/circulation) scheme

do not automatically select respiratory answers--remember to thow out wrong

answers first

If all answers are psychosocial do not choose the answer that "sounds right": determine
the outcome of each answer, throw out first the answers with negative outcome. Ask
yourself "is this answer choice has a desired outcome?"
Examples of Undesirable Answers you are Looking for to Throw Out First:
a) pass the buck
b) judgmental
c) bad nursing
d) off topic
e) take the buck
f) encourage dependency
g) asking why
h) do not persuade
i) leave patient alone
J) non therapeutic
k) gives false reasurance
l) blame
m) do nothing answers
n) answers which by pass the nursing process such as implementing a particular tx before
assessing the situation
o) by pass proper delegation qualifications
p) by pass priority of care
q) do not involve the patient in their own healing process
r) do not listen to the patient in a respectful manner
s) violate patient's rights
t) do not show cooperation with the health team
u) answers that contain absolute worlds such as only, always--watch for those
If Manslow and ABC does not apply: Evaluate ask yourself why, as I did in the example
above, the answers presented are wrong by comparing them against the normal values,
throw out first wrong ones for that will lead you to the one you are looking for: the right
answer. Best wishes to all of you who are taking the NCLEX in February. feliz3
Here are my five for today: NCLEX answers 1) If you have never heard of it, nobody else probably had, so don't choose that answer.
2) If your pt. is unstable don't choose reassess in 15 min. He might be dead in 15 min don't delay treatment. find first question that will kill or harm pt., secondly that will delay
treatment and eliminate those. if there is something you can do before calling doctor, do it
( pick that question ). sometimes to call the doctor may be the only right option.
3)Maslow's hierarchy : Physiologic needs A) Maintaining airways and respiration
B) Maintaining circulation
C) Nutrition and elimination
D) Sleep
Safety needs - when no physiological needs exist, safety takes priority - mainatining safe
and secure enviroment for pt. and nurse

4) Communication - focus on pt. feelings first

5) Teaching and learning - motivation and readiness - assess if pt. had previous
experiences or any information first
How to Determine Whether to Delegate or Not
Task that which are the responsibility of the RN only:
a) unstable patients with the least predictable medical outcomes
b) central line care
c) any tasks involving teaching, observation, discharge of a patient, assessment and
critical thinking based decisions
d) blood transfusions
e) parenteral nutrition
f) patient controlled analgesia
g) development of a plan of care
h) taking a medical history
i) taking phone doctor's orders for prescription and treatment
j) doing an admission assessment
K) initiate a Care Plan
Task that can be delegated to LPN/LVN only
a) patients who are stable and with predictable outcomes and common, well-defined
health problems
b) give meds, oral, topical and inhalants, can administer treatments such as sterile wound
care, blood sugar testing, nasogastric tube insertion, tube feedings and charting
c) LPN/LVN can start an IV of saline and superimpose IV fluids with vitamins, nutrients
and electrolytes by primary or secondary infusion lines, infuse blood and blood products
with IV Certification
d) give injections
e) monitor running IV
f) give enemas
g) monitor a urinary catheter
h) do simple wound dressing change
i) any task which does not require nursing judgment or complex observation, nurse can
delegate to the LPN. RN must inform the parameters of what to report as abnormal
j) use sterile technique procedures such as putting a urinary catheter
K) can give intra muscular injections, subcutaneous, intradermal
l) cannot give IV Push, infuse antibiotics or other medications via secondary IV line
m) can initiate teaching and a care plan
n) cannot infuse IV fluids such as TPN or other fluids via a central line and cannot do
blood withdrawal via central line
o) can do blood withdrawal via venipuncture or peripheral line with blood withdrawal

UAP
a) bathing patient
b) ambulation
c) making beds
d) routine vital signs feeding patients
e) transferring patients
Nclex tips
If answers are mixture of assessment and implementation. Assess
first( check the question to see if the assessment has been done) Determine
whether assessment is appropriate.
Take care of the patient first, the machines and documentation later
Always choose the most complete answer with the least opportunity for error
In Priority question, look for acute and unstable pt to see first
Always remember your ABCs
Maslow's will usually work and pain is seen as a psychosocial need---Not a
physical need
Delegation--If you are assigning pt care to LPN/NA, rank order the pt as to
the ones who have the least acute problems/changes to the most
Anytime a question comes up about a procedure or diagnostic test, consider
the possible complications

The rules of Management:

Do not delegate assessment teaching or evaluation
Delegate care for stable pt's with expected outcomes
Delegate tasks that involve standard unchanging proceedures

Most appropriate Indicates a priority

First indicate a priority
Most concerns the nurse indicate a complication