NCLEX Exam Practice Question of the Week - 5/1/19
- Humidify the oxygen.
- Apply water-soluble lubricant to the nares.
- Instruct the client to breathe through the nose only.
- Instruct the client and family about the purpose of the oxygen.
- Increase the oxygen flow if the client complains of dryness in the nares
Rationale:
The nasal cannula provides for lower concentrations of oxygen and can even be used with mouth breathers because movement of air through the oropharynx pulls oxygen from the nasopharynx. The nurse should humidify the oxygen and apply water-soluble lubricant to the nares to prevent and treat dryness. The nurse should also instruct the client and family regarding the purpose of the oxygen. It is not necessary to instruct a client to breathe only through the nose. It is unnecessary and potentially harmful to increase the oxygen flow; this action requires a primary health care provider’s prescription. Additionally, increasing the flow of oxygen will contribute further to dryness of the nares.
Practice Question Sourced From: Silvestri: Saunders 2018-2019 Strategies for Test Success, 5th Edition (Fundamentals of Care Questions, Ch. 13, pg. 126, Question 9)
NCLEX Exam Practice Question of the Week - 4/24/19
- pH
- Po2
- Pco2
- HCO3
Rationale:
3 - The lower the Po2 and the higher the Pco2, the more rapidly oxygen dissociates from the oxyhemoglobin molecule.
1 - The pH will decrease with an increase in CO2 pressure.
2 - An increase in Po2 will not increase oxygen dissociation from hemoglobin.
4 - Oxygen dissociation will decrease with an increase in HCO3.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Pharmacology (Respiratory Drugs, Ch. 15, pg. 309, Question 3)
NCLEX Exam Practice Question of the Week - 4/17/19
- Cellular metabolism is unstable in young children.
- The proportion of water in the body is less than in adults.
- Renal function is immature in children until they reach school age.
- The extracellular fluid requirement per unit of body weight is greater than in adults.
Rationale:
4 - The extracellular body fluid represents 45% at birth, 25% at 2 years of age, and 20% at maturity. Another measurement is fluid’s percentage of total body weight, which is 80% at birth, 63% at 3 years, and approximately 60% at 12 years.
1 - Cellular metabolism in children is stable, but its rate is higher than that in adults.
2 - The proportion of total body water in children (up to 2 years) is greater than it is in adults.
3 - Renal function is immature through the second year of life, not until school age, which makes it more difficult to maintain fluid balance.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Pediatrics (Growth, Development, and Physical Assessment, Ch. 2, pg. 18, Question 2)
NCLEX Exam Practice Question of the Week - 4/10/19
- Hypoglycemia may be experienced before dinnertime.
- The insulin dose should be decreased if illness occurs.
- The insulin should be administered at room temperature.
- The insulin vial needs to be shaken vigorously to break up the precipitates.
- The NPH insulin should be drawn into the syringe first, then the regular insulin.
Rationale:
Humulin NPH is an intermediate-acting insulin. The onset of action is 60 to 120 minutes, it peaks in 6 to 14 hours, and its duration of action is 16 to 24 hours. Regular insulin is a short-acting insulin. Depending on the type, the onset of action is 30 to 60 minutes, it peaks in 1 to 5 hours, and its duration is 6 to 10 hours. Hypoglycemic reactions most likely occur during peak time. Insulin should be at room temperature when administered. Clients may need their insulin dosages increased during times of illness. Insulin vials should never be shaken vigorously. Regular insulin is always drawn up before NPH.
Practice Question Sourced From: Saunders Comprehensive Review for the NCLEX-RN Examination, 7e (Adult - Endocrine, Ch. 51, pg. 664, Question 575)
NCLEX Exam Practice Question of the Week - 4/3/19
- Lung maturity
- Type 1 diabetes
- Cardiac anomaly
- Neural tube defect
Rationale:
4 - Alpha-fetoprotein in amniotic fluid is elevated in the presence of a neural tube defect.
1 - Lung maturity cannot be determined until after 35 weeks’ gestation.
2 - Diabetes cannot be detected via an amniocentesis.
3 - Cardiac disorders cannot be detected via an amniocentesis.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Maternity (Assessment of High-Risk Pregnancy, Ch. 5, pg. 59, Question 5)
NCLEX Exam Practice Question of the Week - 3/27/19
- Evaluate her willingness to pursue adoption
- Encourage her to focus on her own recovery
- Emphasize that she does have two children already
- Ensure that other treatment options for her will be explored
Rationale:
Although a hysterectomy may be performed, conservative management may include cervical conization and laser treatment that do not preclude future pregnancies; clients have a right to be informed by their health care provider of all treatment options.
1 - Evaluating her willingness to pursue adoption currently is not the issue for the client.
2 - Encouraging her to focus on her own recovery negates the client’s feelings.
3 - Emphasizing that she has two children already negates the client’s feelings.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Mental Health (Legal and Ethical Issues, Ch. 4, pg. 54, Question 9)
NCLEX Exam Practice Question of the Week - 3/20/19
- Place the client in a high Fowler position.
- Help the client assume a left side-lying position.
- Measure the tube from the tip of the nose to the umbilicus.
- Instruct the client to swallow after the tube has passed the pharynx.
- Assist the client in extending the neck back so the tube may enter the larynx.
Rationale:
(A and D) are the correct steps to follow during nasogastric intubation. Only the unconscious or obtunded client should be placed in a left side-lying position (B). The tube should be measured from the tip of the nose to behind the ear and then from behind the ear to the xiphoid process (C). The neck should only be extended back prior to the tube passing the pharynx and then the client should be instructed to position the neck forward (E).
Practice Question Sourced From: HESI Comprehensive Review for the NCLEX-RN Examination, 5e (Evolve Resources - Fundamentals)
NCLEX Exam Practice Question of the Week - 3/13/19
- 100 mL
- 300 mL
- 500 mL
- 1000 mL
Rationale:
Cleansing enemas promote complete evacuation of feces from the colon. They act by stimulating peristalsis through the infusion of a large volume of solution or through local irritation of the colon’s mucosa. For an adult client, 750 to 1000 mL is used. Therefore, the maximum volume of solution for an adult is 1000 mL.
Practice Question Sourced From: Silvestri: Saunders 2018-2019 Strategies for Test Success, 5th Edition (Leadership/Management Questions, Ch. 20, pg. 224, Question 186)
NCLEX Exam Practice Question of the Week - 3/6/19
- Pathological fracture
- Urinalysis positive for nitrites
- Hemoglobin level of 15.5 g/dL (155 mmol/L)
- Calcium level of 8.6 mg/dL (2.15 mmol/L)
- Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)
Rationale:
Multiple myeloma is a B-cell neoplastic condition characterized by abnormal malignant proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow. The client with malignant melanoma may experience pathologic fractures, hypercalcemia, anemia, recurrent infections, and renal failure. A serum calcium level of 8.6 mg/dL (2.15 mmol/L) and a hemoglobin level of 15.5 g/dL (155 mmol/L) are normal values. Therefore, the correct answers are pathological fractures, positive urinalysis for nitrites, and a serum creatinine level of 2.0 mg/dL (176.6 mcmol/L).
Practice Question Sourced From: Saunders Comprehensive Review for the NCLEX-RN Examination, 7e (Adult - Oncological, Ch. 48, pg. 607, Question 516)
NCLEX Exam Practice Question of the Week - 2/27/19
- Depressive symptoms
- Manic symptoms
- Risk for suicide
- Anger and aggression
Rationale:
3 - Risk for suicide is the most important observation in clients with an adjustment disorder.
1 - Depressive symptoms, though common, are not the most important observation in clients with an adjustment disorder.
2 - Manic symptoms are not the most important observation in clients with an adjustment disorder.
4 - Anger and aggression, though important, are not the most important observation in clients with an adjustment disorder.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Mental Health (Trauma-Related and Stress-Related Disorders, Ch. 19, pg. 373, Question 8)
NCLEX Exam Practice Question of the Week - 2/20/19
- Supine with the knees flexed
- Orthopneic with pillows for support
- Side-lying with the upper body elevated
- Prone with the head supported by pillows
Rationale:
With the head and chest elevated, gravity promotes respiratory excursion; alternating side-lying positions allows for pulmonary drainage and expansion. Placing the infant in an infant seat helps to maintain these positions.
1 - The supine position with the knees flexed causes the abdominal viscera to put pressure on the diaphragm, thereby impeding lung expansion.
2 - It is difficult to maintain a 5-week-old infant in orthopneic position with pillows for support; in addition, this position will not promote rest.
4 - The prone position with the head supported by pillows will make it difficult for the lungs to expand, causing difficulty in breathing. The prone position is contraindicated for all infants because of its relationship to sudden infant death syndrome (SIDS).
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Pediatrics (Care of the Child with Cardiac Problems, Ch. 13, pg. 220, Question 24)
NCLEX Exam Practice Question of the Week - 2/13/19
- Eye
- Skin
- Hearing
- Hematologic
- Gastrointestinal
Rationale:
Iminostilbene therapy increases the client’s risk for the development of eye related problems like diplopia, blurred vision, photosensitivity, and the exacerbation of glaucoma. Iminostilbene therapy also raises the risk for rashes and urticaria making a skin assessment a priority. Finally, the client is at risk for thrombocytopenia, leukopenia, leukocytosis, eosinophilia, agranulocytosis, and anemia.
3 - Iminostilbene therapy is not known to pose a significant risk to hearing.
5 - Although vomiting (GI related) may occur, generally all clients have a gastrointestinal assessment.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Pharmacology (Antiepileptic Drugs, Ch. 4, pg. 67, Question 17)
NCLEX Exam Practice Question of the Week - 2/6/19
- Obtaining an informed consent for a surgical procedure
- Providing information necessary for a client to make informed decisions
- Providing assistance in asserting the client’s human and legal rights if the need arises
- Including the client’s religious or cultural beliefs when assisting the client in making an informed decision
- Defending the client’s rights by speaking out against policies or actions that might endanger the client’s well-being
Rationale:
In the role of client advocate, the nurse protects the client’s human and legal rights and provides assistance in asserting those rights if the need arises. The nurse advocates for the client by providing information needed so that the client can make an informed decision. The nurse needs to consider the client’s religion and culture when functioning as an advocate and when providing care. The nurse would include the client’s religious or cultural beliefs in discussions about treatment plans so that an informed decision can be made. The nurse also defends clients’ rights in a general way by speaking out against policies or actions that might endanger the client’s well-being or conflict with his or her rights. Informed consent is part of the primary health care provider–client relationship; in most situations, obtaining the client’s informed consent does not fall within the nursing duty. Even though the nurse assumes the responsibility for witnessing the client’s signature on the consent form, the nurse does not legally assume the duty of obtaining informed consent.
Practice Question Sourced From: Saunders Q&A Review for the NCLEX-RN Examination, 7e (Safe amd Effective Care Environment, Test 2, Question 401, Page 189)
NCLEX Exam Practice Question of the Week - 1/30/19
- Anger
- Denial
- Bargaining
- Depression
- Acceptance
Rationale:
2 - The initial response is shock, disbelief, and denial, and the client seeks additional opinions to negate the diagnosis.
1 - When negating the diagnosis is unsuccessful, the client becomes angry and negative.
3 - Bargaining for wellness follows in an attempt to prolong life.
4 - As the reality of the situation becomes more apparent, depression sets in and the client may become withdrawn.
5 - Acceptance is the final stage of grieving; this stage may never be achieved.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Maternity (Perinatal Loss, Bereavement, and Grief, Ch. 20, pg. 329, Question 4)
Preparing for the Exit Exam
Written by Rashana Mahamane.
When it’s time to take the exit exam, many of us begin to feel overwhelmed. No matter which exit exam you’re taking, it’s a lot of material to cover and somehow remember for the exam. But, don’t stress!
A good study plan and study materials are all you need. The best thing you can do is identify your weak areas, meaning the information you remember the least. It’s also important to know your strong areas. How do you accomplish this? Take a practice exam. If you have the NCLEX Saunders book for RN or LPN/LVN, then you’re in luck because the online portion of the book comes with a pre- and post-test for the NCLEX. After taking the pre-test, you get results that pinpoint the subjects in which you’re strong and weak. The analysis of the exam is pretty detailed and creates a personalized, 6-week study guide that puts the different subjects in the order of your weaknesses (what you should concentrate on first, next, etc.). If you follow this schedule, a lot of the stress that comes with preparing for the exam will hopefully subside.
If you don’t have the book, that’s okay. Take an online practice test and review the material you got right and wrong. Pay attention to the areas where you missed the most questions. For example, maybe maternity, pediatrics, or cardiology. Based on the number of questions you missed, arrange the content in priority order from the subject where you missed the most questions to the subject where you missed the fewest questions. This organization will allow you to strengthen your weak areas and increase your chances of passing the test on the next try.
In addition to the pre- and post-tests, there are many practice questions available online. Those questions allow you to quiz yourself on the information as you study, enabling you to see how well you grasp the material. Once again, if you don’t have the book with access to the online practice questions, you can use any nursing quizzing program you may have purchased during your nursing program.
If you follow these tips on preparing for the exam, I have faith that you can ace it. Remember to challenge yourself, but don’t compare yourself to others. Wishing you all the success in the world!
NCLEX Exam Practice Question of the Week - 1/23/19
- A client on strict bed rest
- A client scheduled for discharge to home
- A client scheduled for a cardiac catheterization
- A postoperative client who had an emergency appendectomy
Rationale:
The nurse is legally responsible for client assignments and must assign tasks based on the guidelines of nurse practice acts and the job descriptions of the employing agency. A client scheduled for discharge to home, a client scheduled for a cardiac catheterization, or a postoperative client who had an emergency appendectomy has both physiological and psychosocial needs that require care by a licensed nurse. The UAP has been trained to care for a client on bed rest. The nurse provides instruction to the UAP, but the tasks required are within the role descriptions of a UAP.
Practice Question Sourced From: Silvestri: Saunders 2018-2019 Strategies for Test Success, 5th Edition (Delegating/Prioritizing Questions, Ch. 19, pg. 213, Question 168)
NCLEX Exam Practice Question of the Week - 1/16/19
- Restrict fluids.
- Assess for airway patency.
- Administer oxygen as prescribed.
- Place a cooling blanket on the client.
- Elevate extremities if no fractures are present.
- Prepare to give oral pain medication as prescribed.
Rationale:
The primary goal for a burn injury is to maintain a patent airway, administer intravenous (IV) fluids to prevent hypovolemic shock, and preserve vital organ functioning. Therefore, the priority actions are to assess for airway patency and maintain a patent airway. The nurse then prepares to administer oxygen. Oxygen is necessary to perfuse vital tissues and organs. An IV line should be obtained and fluid resuscitation started. The extremities are elevated to assist in preventing shock and decrease fluid moving to the extremities, especially in the burn-injured upper extremities. The client is kept warm since the loss of skin integrity causes heat loss. The client is placed on NPO (nothing by mouth) status because of the altered gastrointestinal function that occurs as a result of a burn injury.
Practice Question Sourced From: Saunders Comprehensive Review for the NCLEX-RN Examination, 7e (Adult - Integumentary, Ch. 46, pg. 563, Question 486)
Staying Stress-Free in Nursing School
Written by Joy Clark.
Now this may seem like a laughing matter for some, but I think it's something that can be (at least in part) attained.
My last blog piece was on living a balanced life, managing time wisely and making time for the things you enjoy. Those things may assist me in being stress free but there is more that goes into living stress free.
I actually wrote a research paper last year on the effects of stress in nursing school. Qualitatively, we assessed the positive and negative behaviors that developed due to stress. Surprisingly, exercise and healthy eating seemed to remain unchanged. However, a troubling change in sleep patterns emerged. The most distressing example of this, came from a student who reported that each night before an exam they would wake up every fifteen minutes to check the clock, despite setting six alarms.
The results of the study, aside from the change in sleep patterns, were fairly positive. We concluded that everyone found a way to manage their stress somehow but that no two-people managed it the same. I acknowledge that some level of stress is good. It enables us to push through for those all-nighters or make important, quick decisions. Yet living with constant stress is unhealthy, and leaves us feeling drained.
Let me briefly describe my own struggles with stress and share a few tips that I have found to be life-saving.
I’ll begin by stating I have never failed to turn an assignment in on time…yet. However, this past September I was more disorganized than I had ever been. Due dates loomed over my head and I felt unprepared for every one of them. I was not prioritizing my education and I felt like I was finishing my senior year strictly out of obligation. I was continuously fatigued. Finally, after complaining about the mountains of work I had and consistent stress, a good friend reminded me who I was.
I am an organizer. She encouraged me to make my lists and fill my calendars. Previously, I assumed I had so little time that I couldn't take time to plan. However, taking ten minutes to spend with my syllabi and daily planner so I could organize my assignments brought immediate peace.
I like to say that my house depicts my mind; when it is in a disarray, so am I. Yet, when it is clean and tidy I feel calm and organized. I lie to myself constantly saying that I don't have time to put my clothes away. Inevitably, it doesn't take long for piles of laundry to collect on my floor. Somehow, it only takes five minutes to actually put them away and I always feel so relieved when I’m finished.
There are many more things that can reduce your stress. Planning a girl’s night out, a night in, date night, studying ahead of time, getting assignments/group projects done ahead of time, even positive thinking can make a major difference in our week, and the list goes on and on. Every person is unique. If being an uptight planner doesn't work for you, that is ok! While nothing is going to take away pre-exam jitters, organization is what has made a big difference for me. I advise you to explore different techniques and find what works for you.
Wishing you a happy, less stressful, New Year!
NCLEX Exam Practice Question of the Week - 1/9/19
- Pain on expiration, deep rapid respirations
- Pain on inspiration, deep rapid respirations
- Pain on expiration, shallow guarded respirations
- Pain on inspiration, shallow guarded respirations
Rationale:
The client with fractured ribs typically has pain over the fracture site with inspiration and to palpation. Respirations are shallow, and guarding of the area is often noted. Bruising may or may not be present. Therefore, the remaining options are incorrect.
Practice Question Sourced From: Silvestri: Saunders Q&A Review for the NCLEX-RN Examination, 7e (Comprehensive Test, Test 6, Question 1328 Page 588)
NCLEX Exam Practice Question of the Week - 1/2/19
- Reassure her that her blindness is temporary and will resolve with time
- Gently point out that she seems to be able to see well enough to function independently
- Encourage expression of feelings and link emotional trauma to the blindness
- Teach ways to cope with blindness, such as methodically arranging personal items
Rationale:
Patients with conversion disorders are experiencing symptoms, even though there is no identifiable organic cause; therefore, the patient should be assisted in learning ways to cope and live with the disability. Encouraging the expression of feelings is okay, but it is premature to expect the patient to link the fight to her blindness. It is likely that the sudden onset of blindness will quickly resolved. The patient may physically be able to see, but presenting facts would not be helpful at this time.
Practice Question Sourced From: LaCharity: Prioritization, Delegation, and Assignment, 4e (Chapter 22, Question 4, Page 196)
NCLEX Exam Practice Question of the Week - 12/26/18
- Nausea
- Hypotension
- Blurred vision
- Excessive drooling
Rationale:
Adverse effects of antipsychotic medications such as haloperidol include marked drowsiness and lethargy; extrapyramidal symptoms, including parkinsonism effects (drooling); dystonias; akathisia; and tardive dyskinesia. The correct option is a parkinsonism effect of this medication, excessive drooling. Nausea, hypotension, and blurred vision are occasional side effects of the medication.
Practice Question Sourced From: Selvestri: Saunders Q&A Review for the NCLEX-RN Examination, 7e (Comprehensive Test, Test 6, Question 1265 Page 566)
NCLEX Exam Practice Question of the Week - 12/19/18
- Chest pain that is dull and feels like heartburn
- Leg pain that is sharp and occurs with exercise
- Chest pain that is sudden and occurs with exertion
- Leg pain that is achy and gets worse as the day progresses
Rationale:
Intermittent claudication is a symptom characterized by a sudden onset of leg pain that occurs with exercise and is relieved by rest. It is the classic symptom of peripheral arterial insufficiency. Chest pain can occur for a variety of reasons, including indigestion or angina pectoris. Venous insufficiency is characterized by an achy type of leg pain that intensifies as the day progresses.
Practice Question Sourced From: Silvestri: Saunders Q&A Review for the NCLEX-RN Examination, 7e (Comprehensive Test, Test 6, Question 1315 Page 584)
NCLEX Exam Practice Question of the Week - 12/12/18
- Restrict the patient to bed rest for at least 12 hours
- Recheck the patient's vital signs every 4 to 8 hours
- Ensure that the patient's call light is within easy reach
- Keep the patient's bed in a supine position with all side rails up
- Remind the patient to rise slowly from the bed and sit before standing
- Assist the patient to get out of bed and use the bathroom
- Assess the patient for signs of dizziness
Rationale:
After the first dose of most antihypertensive drugs, dizziness is a common side effect. The patient should call for help when getting out of bed, and the call light should be within easy reach. The patient should rise slowly, sitting on the side of the bed before standing, and then can be assisted to the bathroom. The UAP's scope of practice includes these actions. Patients are not restricted to bed rest or kept in a supine (flat) position, and side rails are not all kept up for safety of the patient. Assessment is not within the scope of practice for a UAP. However, the RN could instruct the UAP to ask the patient about dizziness before and during ambulation and then report any dizziness immediately to the RN.
Practice Question Sourced From: LaCharity: Prioritization, Delegation, and Assignment, 4e (Chapter 20, Question 11, Page 179)
NCLEX Exam Practice Question of the Week - 12/5/18
- Pinpoint petechiae noted on both legs
- Whitish vesicles located across the chest
- Petechiae spots that are reddish and pinpoint on the soft palate
- Small, blue-white spots with a red base found on the buccal mucosa
Rationale:
In rubeola (measles), Koplik's spots appear approximately 2 days before the appearance of the rash. These are small, blue-white spots with a red base that are found on the buccal mucosa. The spots last approximately 3 days, after which time they slough off. Based on this information, the remaining options are all incorrect.
Practice Question Sourced From: Silvestri: Saunders Q&A Review for the NCLEX-RN Examination, 7e (Chapter 6, Test 5, Question 1089 Page 498)
NCLEX Exam Practice Question of the Week - 11/28/18
- Reinforcing the client's need to check his temperature daily
- Teaching the client how to care for his retention catheter
- Documenting a discharge assessment in the client's chart
- Instructing the client about the prescribed narcotic analgesic
Rationale:
Reinforcement of previous teaching is an expected role of the LPN/LVN. Planning and implementing client initial teaching and documentation of a client's discharge assessment should be performed by experienced RN staff members.
Practice Question Sourced From: LaCharity: Prioritization, Delegation, and Assignment, 4e (Chapter 17, Question 11, Page 147)
NCLEX Exam Practice Question of the Week - 11/21/18
- “Prune juice needs to be included in my diet.”
- “I need to avoid strenuous activity for 4 to 6 weeks.”
- “My intake of water needs to be at least 6 to 8 glasses daily.”
- “I can't lift or push objects that weigh more than 30 pounds.”
Rationale:
The client needs to be advised to avoid strenuous activity for 4 to 6 weeks and avoid lifting items that weigh more than 20 pounds. Straining during defecation is avoided to prevent bleeding. Prune juice is a satisfactory bowel stimulant. The client needs to consume a daily intake of at least 6 to 8 glasses of nonalcoholic fluids to minimize clot formation.
Practice Question Sourced From: Silvestri: Saunders Q&A Review for the NCLEX-RN Examination, 7e (Chapter 6, Test 5, Question 1066, Page 489)
Embracing the Work/Life/School Balance
Written by Meagan MacDonald.
Balancing a family, nursing school, and trying to have some sort of social life is not easy. Nursing school on its own requires so much time and dedication, plus having a family to take care of sometimes makes me wonder how I can get everything done.
When I feel completely overwhelmed I’ve found it’s best to leave the house, and either go to school or the public library. This separation between school and home makes assignments easier to complete since there’s less distractions. To be honest, most of my studying at home is done after everyone is asleep. For example, I have a 12-hour clinical, I get home, cook dinner, get the baby fed and ready for bed, then do some homework and get to bed at some point. Talk about a busy day? What is important for you to realize is that it’s all manageable.
After a long day in clinical, it’s nice to come home, take a breath, and hang out with my boys. This time stands as a reminder as to why I work so hard and do what I do. My husband works until 6 at night and leaves for work around 5:30 in the morning, so we both have very long days. After everyone is settled, and I finally do get to sit down to study, the house is quiet, and it’s time for me to accomplish what I need to for school.
My recommendation to anyone beginning nursing school would be to find that time slot, whether its early in the morning or after everyone goes to bed, to give yourself time to get your school work done and prepare for what you need. Also, don’t forget to give yourself some “me” time. Whether it’s watching your favorite tv show or getting your nails done, find time to do things that you enjoy and make time to relax.
I know balancing nursing school with the day-to-day sounds tough (and believe me it is), but it is totally possible and completely worth it.
NCLEX Exam Practice Question of the Week - 11/14/18
- Presence of glucose in the nasal drainage
- Presence of nasal packing in the nares
- Urine output of 40 to 50 mL/hr
- Patient reports of thirst
Rationale:
The presence of glucose in nasal drainage indicates that the fluid is cerebrospinal fluid (CSF) and suggests a CSF leak. Packing is normally inserted in the nares after the surgical incision is closed. Urine output of 40 to 50 mL/hr is adequate, and patients may experience thirst postoperatively. When patients are thirsty, nursing staff should encourage fluid intake.
Practice Question Sourced From: LaCharity: Prioritization, Delegation, and Assignment, 4e (Chapter 14, Question 13, Page 125)
NCLEX Exam Practice Question of the Week - 11/7/18
- Nutrition
- Communication
- Insurance coverage
- High-risk behaviors
- Health care practices
- Family roles and organization
Rationale:
When performing a cultural and spiritual assessment, the nurse should focus on the following factors: nutrition, communication, high-risk behaviors, health care practices, family roles and organizations, workforce issues, biocultural ecology, overview (e.g., heritage), pregnancy and childbirth practices, death rituals, spirituality preferences, and health care practitioners. Asking the client about insurance coverage is not specifically related to culture or spiritual practices.
Practice Question Sourced From: Silvestri: Saunders Q&A Review for the NCLEX-RN Examination, 7e (Chapter 6, Test 5, Question 1052, Page 483)
NCLEX Exam Practice Question of the Week - 10/31/18
- Administering 600 mg of ibuprofen to the patient
- Encouraging the patient to perform exercises recommended by a physical therapist
- Applying ice and gentle massage to the patient's lower extremities
- Reminding the patient to drink milk and eat cottage cheese
Rationale:
Applying heat, not ice, is the appropriate measure to help reduce the patient's pain. Ibuprofen is useful to manage mild to moderate pain. Exercise prescribed by a physical therapist would be nonimpact in nature and provide strengthening for the patient. A diet rich in calcium promotes bone health.
Practice Question Sourced From: LaCharity: Prioritization, Delegation, and Assignment, 4e (Chapter 11, Question 6, Page 99)
NCLEX Exam Practice Question of the Week - 10/24/18
- “No. That is not why you are hospitalized.”
- “No, but there could be some minimal damage to your heart.”
- “No, not this time and we will do our best to prevent a future heart attack.”
- “No, but it's necessary to monitor you and control or eliminate your pain.”
Rationale:
Angina pectoris occurs as a result of an inadequate blood supply to the myocardium causing pain; managing the condition will help address the client's pain. The nurse will want to correct the client's misconception regarding a heart attack while addressing the client's concerns. Option 1 does not address the client's concerns. Option 2 is not correct because angina involves interrupted blood supply but does not result in cardiac tissue damage. Neither the nurse nor the primary health care provider can guarantee that a heart attack will not occur as option 3 seems to indicate.
Practice Question Sourced From: Saunders Q&A Review for the NCLEX-RN Examination, 7e (Chapter 6, Test 5, Question 1039, Page 476)
Life Hacks: Nursing Student Edition
Written by Ari Anderson.
There is no question that life as a nursing student is nothing short of busy; somedays there is barely enough time in the day to eat and sleep! We can probably all agree that if we could stretch our day more than 24 hours or freeze time for a bit to accomplish all our tasks with ease, we absolutely would. Since this is not a possibility.... yet, here are some ‘nursing student life-hacks’ that I have picked up along the way that have really helped me with time management during my schooling.
- Buy A Planner- A planner can help you to write out everything that needs to be done for the day, so you can decide how and when to tackle each task.
- Print Out A ‘Semester Calendar’- Visualizing what you are responsible for completing throughout the semester such as exams, projects, papers, practical, and anything else is helpful when trying to plan your schedule. It can make coming up with work and social calendars easier when you know what can’t be changed or moved around, to prevent scheduling conflicts from occurring.
- Pack Your Bag the Night Before- Before you go to bed for the night, make sure your school bag, gym bag, work bag, or any other bags you may need are packed and ready to go, so you don’t spend time searching for things in the morning when you have limited time. It also lowers the chance that you will forget something...like your Stethoscope!
- Meal Prep All Your Meals for The Week- It really cuts down on the time it takes to cook or prepare a few meals a day when you prepare all your meals at one time and store them in the fridge. You can just ‘grab-and-go’ during the week, instead of spending time doing one meal at a time, three times a day. For our Supermoms (and Superdads) out there who are cooking for more than one/ two, casserole dishes or a rotisserie chicken is a great option that can feed your whole family for a few days.
- Ask for Help- Don’t be afraid to ask a spouse, older children, family members, or roommates to pitch in a little more when you’re extra busy during the school year, before an exam, or whenever you feel overwhelmed! Family members are there to support you and help you out when they can; communicate with them so you have some relief from chores, cooking, or other responsibilities when you need it.
- Study Efficiently- Don’t try to pull an all-nighter before the exam or just start studying the material a day or two before the exam. Try to set daily, uninterrupted study time aside for a few hours a day, starting after the respective lecture. Turning the phone off for a couple hours a day and dedicating yourself to your lecture material before you’re pressed for time is so much more effective that spending an entire day cramming before the exam.
- Don’t Over-Commit- Sometimes, you have to just say no. Unfortunately, that leisurely event or get together with friends might need to wait for when your schedule has opened up or during time off from school.
- Work Smart- Have your school schedule on hand when planning your work schedule. If possible, try to decrease your work schedule during the school year, especially during exams. If this is not an option, try not to schedule a shift before an exam, on the same day as a mandatory nursing event, or practical assessment. Collaborate with people on your unit or at your job so you can switch if necessary.
- Study While You Work Out- If you are doing cardio, such as walking on the treadmill or using an elliptical, this is a great time to drag your notes along with you and review while getting exercise!
- Follow a Routine- Following a similar daily routine helps to condition yourself to getting certain tasks done at a certain time because you will become used to it. Knowing that you have certain responsibilities to complete by a certain time each day can help you to stay on task.
- Take Time for Mindfulness- A few minutes a day to sit aside and meditate, relax, and de-stress can really help you stay focused and not get overwhelmed. I personally like to meditate for 30 minutes at the end of my day to make sure I am tending to my mental/spiritual needs as well.
Each student has certain things they do to help them achieve their necessary tasks daily. Some things work and some don’t for certain types of people and their way of accomplishing them. What are some things you’ve learned in nursing school that help you? Share them with us!
NCLEX Exam Practice Question of the Week - 10/17/18
- Evaluating the patient's response to normal activities of daily living
- Obtaining the patient's blood pressure and pulse with position changes
- Determining which self-care activities the patient can do independently
- Assisting the patient in choosing a diet that will improve strength
Rationale:
UAP education covers routine nursing skills such as assessment of vital signs. Evaluation, baseline assessment of patient abilities, and nutrition planning are activities appropriate to RN practice.
Practice Question Sourced From: LaCharity: Prioritization, Delegation, and Assignment, 4e (Chapter 8, Question 20, Page 77)
NCLEX Exam Practice Question of the Week - 10/10/18
- Dehydration
- A normal finding
- Increased intracranial pressure
- Decreased intracranial pressure
Rationale:
The anterior fontanel is normally 2 to 3 cm in width, 3 to 4 cm in length, and diamond-like in shape. It can be described as soft, which is normal, or full and bulging, which could indicate increased intracranial pressure. Conversely a depressed fontanel could mean that the infant is dehydrated.
Practice Question Sourced From: Silvestri: Saunders Q&A Review for the NCLEX-RN Examination, 7e (Chapter 5, Test 1, Question 16, Page 40)
5 Ways to Keep from Procrastinating
Written by Alannah Davis.
Nursing school can be very overwhelming at times, and sometimes you would rather go shopping or watch a movie instead of studying for an exam. When this happens later that night or the next day you are frantically trying to get everything you need to do finished in order to feel semi-prepared for your exam or to turn your homework in on time. Generally, everyone is guilty of this, including myself. This creates copious amounts of unnecessary stress, and in my case, a lack of sleep when I already don’t get enough. I have finally learned my lesson about procrastinating after countless nights of barely sleeping. Below I have included 5 steps to help you keep from procrastinating:
- GET A PLANNER! My planner is my life-saver. It is my best friend and is one of my most prized possessions. I write everything down in my planner so I never forget about a test or an assignment. My planner is color coated to help me keep up with what lecture I went over in class, what I have for homework, and anything I have to do outside of school.
- Review the material you learn in class that night before you go to bed. This may sound silly, but I find this very helpful. I usually review my notes or the PowerPoint presentation that I had in lecture that day before I go to bed. This helps me learn the material and saves me a bunch of time when I go back to study for the test.
- Create a routine. This helps me a ton because once I finally get in the habit of doing something it doesn’t seem as difficult. I try to balance my homework and social life, so I have a routine of finishing all of my nursing homework assignments on Sunday night. This way the rest of my week is clear for studying or doing clinical paperwork. For example, I know that on Tuesdays I do all my work for my non-nursing classes and on Thursdays and Fridays I complete all of my clinical paperwork. This keeps me from feeling overwhelmed if I have an extra assignment, or if I have other obligations for the week outside of school.
- Study for the test AT LEAST two nights before. Before nursing school, I had always been able to study the night before a test and do perfectly fine but nursing school tests can be difficult. The more time you have to study, the better. I like to give myself two nights to read over the PowerPoints and my notes, and then I study a lot the day and night before the test. This method is how I retain the most information.
- Have time to relax. Relaxing is important to keep yourself from feeling stressed and from shutting down mentally. It is important to give yourself a break. That way when you are doing your work or studying, you give it your full attention. I give myself a little time each night to relax. It could be going out to eat with my friends, taking a bubble bath, or even watching my favorite show on Netflix.
NCLEX Exam Practice Question of the Week - 10/3/18
- Weigh the client every morning
- Maintain accurate intake and output records
- Restrict fluids to 1500 mL/day
- Administer furosemide 40 mg IV push
Rationale:
Bilateral moist crackles indicate fluid-filled alveoli, which interferes with gas exchanges. Furosemide is a potent loop diuretic that will help mobilize the fluid in the lungs. The other orders are important but not urgent.
Practice Question Sourced From: LaCharity: Prioritization, Delegation, and Assignment, 4e (Chapter 4, Question 6, Page 39)
NCLEX Exam Practice Question of the Week - 9/26/18
- Allows the right foot to only touch the floor
- Does not bear any weight on the right leg/foot
- Puts 30% to 50% of the weight on the right leg/foot
- Puts 60% to 80% of the weight on the right leg/foot
Rationale:
The client who has partial weight-bearing status is allowed to place 30% to 50% of the body weight on the affected limb. Touchdown weight-bearing allows the client to let the limb touch the floor but not to bear weight. Non–weight-bearing status does not allow the client to let the limb touch the floor. There is no classification for 60% to 80% weight-bearing status. Full weight-bearing status involves placing full weight on the limb.
Practice Question Sourced From: Silvestri: Saunders Q&A Review for the NCLEX-RN Examination, 7e (Chapter 5, Test 3, Question 604, Page 281)
Making Yourself Marketable to Future Employers
Written by Kate Dookie.
As nursing students, we are constantly busy. We have virtual calendars, paper agendas, and to-do lists to keep track of our slightly chaotic lives. Towards the end of nursing school, we have the privilege of adding “study for the NCLEX” and “land my dream job” to the ever-growing list of tasks. After years of studying, we will begin to pursue careers as nurses. So, as soon-to-be-grads, how can we make ourselves marketable to potential employers?
First, begin to network while still in school. There are many professional organizations that will allow students to attend, such as the American Association of Critical Care Nurses or the Society of Pediatric Nurses. Many of these meetings offer education regarding their specific specialty, so you can add to your education as you network.
Second, evaluate your previous work experience. Even if you have not worked in healthcare, many job skills will ease your transition into nursing. Have you served in a restaurant? You’ve mastered time management. Have you worked in customer service? You have good people skills and can connect with guests (and patients). Have you worked in retail? Your organizational skills are sought after. These job skills are important to broadcast when you begin to write your resume.
Next, assess your clinical experience. Did you have a unit you loved learning on? Did you connect with a nurse or a nurse manager on that unit? When you are learning in a hospital setting, introduce yourself to the nurse manager and ask what they look for in new hires. Ask your preceptor questions and learn as much as you can about the unit’s procedures. When units hire a new graduate nurse, they want to make sure you are teachable.
Above everything else, don’t give up! Decide on your dream job, develop your resume, collect a few letters of recommendation, and remember that you have put in years of hard work and studying to land this job!
NCLEX Exam Practice Question of the Week - 9/19/18
- Hot, flushed feeling
- Sudden chills and fever
- Chest pain that occurs suddenly
- Dyspnea when deep breaths are taken
Rationale:
The most common initial symptom in pulmonary embolism is chest pain that is sudden in onset. The next most commonly reported symptom is dyspnea, which is accompanied by an increased respiratory rate. Other typical symptoms of pulmonary embolism include apprehension and restlessness, tachycardia, cough, and cyanosis.
Test-Taking Strategy: Note the strategic word, most. Because pulmonary embolism does not result from an infectious process or an allergic reaction, eliminate options 1 and 2 first. To select between the correct option and option 4, look at them closely. Option 4 states dyspnea when deep breaths are taken. Although dyspnea commonly occurs with pulmonary embolism, dyspnea is not associated only with deep breathing. Therefore, eliminate option 4.
Practice Question Sourced From: Silvestri: Saunders Comprehensive Review for the NCLEX-RN Examination, 7e (Respiratory System, Ch. 54, pg. 731, Question 639)
NCLEX Exam Practice Question of the Week - 9/12/18
- Anxiety level of the client and family
- Presence of a MedicAlert card for the client to carry
- Knowledge of restrictions on postdischarge physical activity
- Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver
Rationale:
The nurse who is caring for the client after insertion of an automatic internal cardioverter-defibrillator needs to assess device settings, similar to after insertion of a permanent pacemaker. Specifically, the nurse needs to know whether the device is activated, the heart rate cutoff above which it will fire, and the number of shocks it is programmed to deliver. The remaining options are also nursing interventions but are not the priority.
Practice Question Sourced From: Saunders Comprehensive Review for the NCLEX-RN Examination, 7th Edition (Cardiovascular System, Ch. 56, pg. 791, Question 683)
Why Should You Get Involved?
Written by Justina Dreschler.
Getting involved in something takes time, effort and often times a financial commitment. Nursing school is a huge commitment in and of itself, so it’s easy to ask this question when it comes to leadership opportunities during nursing school.
Why should you get involved? Well, I can tell you from personal experience that it is worth the time, effort and energy! During my first semester of nursing school I was actively involved in my SNA chapter at my university. Before I knew it, I was approached by the previous President of the club and she encouraged me to run for a position and currently I am the President. I was not too sure about it at first because I was involved in other things and nursing school is already a big commitment. However, I am so glad that I chose to run because now I look back on all the opportunities that have come up because of my willingness to take a risk.
Some of the amazing benefits of being involved may include connections with local hospitals, professors, other staff at your university’s nursing school knowing who you are and willing to write recommendations, and the opportunity to attend conventions. In my time of being in a leadership position, I have been able to grow in my personal and professional skills as I interact with several different people to help coordinate events. I also have grown in public speaking as I have lead several meetings of up to 100 students, and spoke at different events in which hospital representatives attended. I have made a name for myself in the College of Nursing at my university and most professors know who I am and can see my work ethic by the amount of effort I put into the club. I have attended several conventions both on the state and national level and have been a delegate at both. I’ve been a part of national level change we make as the National Student Nurses’ Association when we vote on resolutions and join movements that are influential to give our patients the best quality of care we can.
Overall, I completely recommend getting involved because this blog post only scratches the surface of what I have gained from my time leading the SNA chapter at my university. I feel more qualified to take on the world of applying to several different hospitals as I have all this valuable experience under my belt. It may take some time and effort but it will pay off in the end!
NCLEX Exam Practice Question of the Week - 9/5/18
- Try to reduce the fracture manually.
- Assist the victim to get up and walk to the sidewalk.
- Leave the victim for a few moments to call an ambulance.
- Stay with the victim and encourage him or her to remain still.
Rationale:
With a suspected fracture, the victim is not moved unless it is dangerous to remain in that spot. The nurse should remain with the victim and have someone else call for emergency help. A fracture is not reduced at the scene. Before the victim is moved, the site of fracture is immobilized to prevent further injury.
Practice Question Sourced From: Saunders Comprehensive Review for the NCLEX-RN Examination, 7th Edition (Musculoskeletal System, Ch. 64, pg. 952, Question 802)
NCLEX Exam Practice Question of the Week - 8/29/18
- Witnessing a murder
- The death of a loved one
- A fire that destroyed the client's home
- A recent rape episode experienced by the client
Rationale:
A situational crisis arises from external rather than internal sources. External situations that could precipitate a crisis include loss or change of a job, the death of a loved one, abortion, change in financial status, divorce, addition of new family members, pregnancy, and severe illness. Options 1, 3, and 4 identify adventitious crises. An adventitious crisis refers to a crisis of disaster, is not a part of everyday life, and is unplanned and accidental. Adventitious crises may result from a natural disaster (e.g., floods, fires, tornadoes, earthquakes), a national disaster (e.g., war, riots, airplane crashes), or a crime of violence (e.g., rape, assault, murder in the workplace or school, bombings, or spousal or child abuse).
Practice Question Sourced From: Saunders Comprehensive Review for the NCLEX-RN Examination, 7th Edition (Crisis Theory and Intervention, Ch. 71, pg. 1038, Question 894)
NCLEX Exam Practice Question of the Week - 8/22/18
- Face tent
- Venturi mask
- Aerosol mask
- Tracheostomy collar
Rationale:
The Venturi mask delivers the most accurate oxygen concentration. It is the best oxygen delivery system for the client with chronic airflow limitation such as chronic obstructive pulmonary disease, because it delivers a precise oxygen concentration. The face tent, aerosol mask, and tracheostomy collar are also high-flow oxygen delivery systems but most often are used to administer high humidity.
Practice Question Sourced From: Saunders Comprehensive Review for the NCLEX-RN Examination, 7th Edition (Respiratory System, Ch. 54, pg. 731, Question 644)
NCLEX Exam Practice Question of the Week - 8/15/18
- “You seem concerned about time. Let's talk about it.”
- “That's up to you because you have to do what works for you.”
- “Holding the baby when feeding is important for development.”
- “It is not safe to prop a bottle. The baby could aspirate the fluid.”
Rationale:
The nurse should suggest talking about the client's concern regarding the time. This opens up an area of communication to determine what really is troubling the mother about feeding her baby.
- The nurse is aware that propping the baby during feedings is not the bet method when using a bottle to feed an infant; the problem of time should be explored with the mother.
- Holding can be accomplished at times other than feeding periods; talking about the importance to development does not explore the client's feelings.
- ““It is not safe to prop a bottle.”” The baby could aspirate the fluid"" is true, but the mother should not be challenged so directly; a more gentle explanation should be offered.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Maternity (Nursing Care of the Family During the Postpartum Period, Ch. 14, pg. 227, Question 18)
NCLEX Exam Practice Question of the Week - 8/8/18
- Assault
- Battery
- Slander
- Invasion of privacy
Rationale:
Assault occurs when a person puts another person in fear of harmful or offensive contact and the victim fears and believes that harm will result as a result of the threat. In this situation, the nurse could be accused of the tort of assault. Battery is the intentional touching of another's body without the person's consent. Slander is verbal communication that is false and harms the reputation of another. Invasion of privacy is committed when the nurse intrudes into the client's personal affairs or violates confidentiality.
Practice Question Sourced From: Silvestri: Saunders Comprehensive Review for the NCLEX-RN Examination, 7e (Comprehensive Test, pg. 1060, Question 961)
NCLEX Exam Practice Question of the Week - 8/1/18
- “You need to try to be realistic. The rape did not just occur.”
- “It will take some time to get over these feelings about your rape.”
- “Tell me more about the incident that causes you to feel like the rape just occurred.”
- “What do you think that you can do to alleviate some of your fears about being raped again?”
Rationale:
The correct option allows the client to express her ideas and feelings more fully and portrays a nonhurried, nonjudgmental, supportive attitude on the part of the nurse. Clients need to be reassured that their feelings are normal and that they may express their concerns freely in a safe, caring environment. Option 1 immediately blocks communication. Option 2 places the client's feelings on hold. Option 4 places the problem solving totally on the client.
Practice Question Sourced From: Silvestri: Saunders Comprehensive Review for the NCLEX-RN Examination, 7e (Crisis Theory and Intervention, Ch. 71, pg. 1039, Question 905)
NCLEX Exam Practice Question of the Week - 7/25/18
- Reestablishes kidney function
- Cleans the peritoneal membrane
- Provides fluid for intracellular spaces
- Removes toxins in addition to other metabolic wastes
Rationale:
Peritoneal dialysis uses the peritoneum as a selectively permeable membrane for diffusion of toxins and wastes from the blood into the dialyzing solution.
- Peritoneal dialysis acts as a substitute for kidney functions; it does not reestablish kidney function.
- The dialysate does not clean the peritoneal membrane; the semipermeable membrane allows toxins and wastes to pass into the dialysate within the abdominal cavity.
- Fluid in the abdominal cavity does not enter the intracellular compartment.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Pediatrics (Care of the Child with Genitourinary and Reproductive Problems, Ch. 15, pg. 289, Question 18)
NCLEX Exam Practice Question of the Week - 7/18/18
- “I should not use someone else's crutches.”
- “I need to remove any scatter rugs at home.”
- “I can use crutch tips even when they are wet.”
- “I need to have spare crutches and tips available.”
- “When I'm using the crutches, my arms need to be completely straight.”
Rationale:
The client should use only crutches measured for the client. When assessing for home safety, the nurse ensures that the client knows to remove any scatter rugs and does not walk on highly waxed floors. The tips should be inspected for wear, and spare crutches and tips should be available if needed. Crutch tips should remain dry. If crutch tips get wet, the client should dry them with a cloth or paper towel. When walking with crutches, both elbows need to be flexed not more than 30 degrees when the palms are on the handle.
Practice Question Sourced From: Silvestri: Saunders Comprehensive Review for the NCLEX-RN Examination, 7e (Musculoskeletal System, Ch. 64, pg. 953, Question 810)
NCLEX Exam Practice Question of the Week - 7/11/18
- Giving client full control over care decisions and restricting visitors
- Providing positive feedback and encouraging active range of motion
- Providing information, giving positive feedback, and encouraging relaxation
- Providing intravenously administered sedatives, reducing distractions, and limiting visitors.
Rationale:
The client with Guillain-Barr e syndrome experiences fear and anxiety from the ascending paralysis and sudden onset of the disorder. The nurse can alleviate these fears by providing accurate information about the client's condition, giving expert care and positive feedback to the client, and encouraging relaxation and distraction. The family can become involved with selected care activities and provide diversion for the client as well.
Practice Question Sourced From: Silvestri: Saunders Comprehensive Review for the NCLEX-RN Examination, 7e (Neurological System, Ch. 62, pg. 918, Question 783)
NCLEX Exam Practice Question of the Week - 7/4/18
- 18%
- 24%
- 36%
- 48%
Rationale:
According to the rule of nines, with the initial burn, the anterior half of the head equals 4.5%, the upper half of the anterior torso equals 9%, and the lower half of both arms equals 9%. The subsequent burn included the posterior half of head, equaling 4.5%, and the upper half of the posterior torso, equaling 9%. This totals 36%.
Practice Question Sourced From: Silvestri: Saunders Comprehensive Review for the NCLEX-RN Examination, 7e (Integumentary System: Chapter 46, Question 483, Page 566)
NCLEX Exam Practice Question of the Week - 6/27/18
- Anger
- Denial
- Bargaining
- Depression
- Acceptance
Rationale:
- The initial response is shock, disbelief, and denial, and the client seeks additional opinions to negate the diagnosis.
- When negating the diagnosis is unsuccessful, the client becomes angry and negative.
- Bargaining for wellness follows in an attempt to prolong life.
- As the reality of the situation becomes more apparent, depression sets in and the client may become withdrawn.
- Acceptance is the final stage of grieving; this stage may never be achieved.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Maternity (Perinatal Loss, Bereavement, and Grief, Ch. 20, pg. 329, Question 4)
How To Land A New Grad Nursing Job
Written by Ari Anderson.
“Begin with the end in mind” as said by Steven Covey, is one of my favorite quotes. In nursing school, we often get so wrapped up in focusing on the present and just “getting through” it all, that we tend to forget to also start preparing for the next step—getting a nursing job! Although the job outlook for nursing is positive, with the field expected to grow about 15% from 2016-2026 (Bureau of Labor Statistics, 2018), this doesn't necessarily make things any easier for ‘new grad' nurses. Applying for new grad nurse positions is a competitive process and should be approached with strategy and extra care. There are many aspects of the application process that the student nurse should try their best to excel in and positively set themselves apart from the other applicants. Here is some advice directly from a nursing supervisor, an experienced charge nurse, and an experienced staff nurse who have all participated in the hiring of new grad nurses
The Application
The application is the first thing seen by the hiring managers before they even consider bringing you in to interview you for a position. Having a strong resume that sets you apart from the average applicant will help you better your chances of making it further in the application process. Here is some advice on how to construct your resume and a few things that hiring managers look for that makes your resume stand out.
- A new grad resume should be about one page; most new grads have little to no experience, so a lengthy resume is unnecessary and most likely won't be read because there is just not enough time. The resume should be professional and formatted correctly; most schools have a resource center where someone can read over the resume and help them edit it for free!
- Relevant Experience- new grad nurses who have worked as techs/ student nurses before have a better chance of getting hired because they have experience in the field that will benefit their transition. Make sure you try to get a tech or student nurse job as soon as possible while in nursing school.
- GPA- although GPA isn't the only factor, it is important when it comes to certain units and hospitals.
- School and Level of education- Some hiring managers look for certain schools because they know them well and have had success with those students in the past. Furthering your education is exponentially important; especially at a Magnet Status hospital BSNs are strongly preferred. You should continue to gather certifications and increase your education throughout your career.
- Leadership and Membership- Memberships to organizations (such as student nurse association and/or student memberships to specialty related fields) really stand out to hiring managers because it shows your dedication and involvement in the nursing field.
- Apply as soon as possible! Don't wait until the last minute to apply to posted jobs; be proactive.
- Apply to the place you work at first- internal applicants are often preferred because they know you and the lateral transfer process is easier.
The Interviewing Process
First impressions are extremely important and can make or break how the rest of the interview progresses. Here are a few things you should keep in mind before and during an interview, to make your interview the best it can be.
- When you show up, show up early; if you are on time, you are already late.
- Dress appropriately-Business casual (from head-to-toe) is the way to go at the initial interview; leave the low-cut shirts, tight pants, flip-flops, jeans, acrylic nails, colorful hair, and exercise attire (ie: Yoga Pants) at home that day. Wear something modest, appropriate, and professional.
- Shake the manager's hand and make eye contact; these are professional behaviors that are looked for during an interview.
- Do your homework- Know about the hospital or facility you are applying to work at; it is great when you are knowledgeable about the place, it shows your level of interest.
- Be prepared- Bring any supplemental material, licenses, or anything else you may need or be asked for during the interview.
- Silence isn't always a bad thing! If the manager asks you a question, take some time to really think about a strong answer, if you need a minute say so, don't just answer just to answer.
- Be confident but have humility when appropriate. We all have room to grow; acknowledge that and grow build on it.
- Be flexible! As a nurse (especially the new nurse) you will absolutely have to work weekends and holidays, and most likely even night shifts. Know that this won't necessarily be permanent, but you will need to work where you are needed; a manager will be more likely to hire you if there are less “demands” to your schedule.
- Ask questions! The interview isn't just for you; it's also you are interviewing the place in a way. The only way to know the answer to if you would be a good fit for a place is if you find out all the information you can.
The Final Steps
After it is all said and done, then comes the worst part: the waiting game! Although in a perfect world, it would be amazing to be offered the job ‘on the spot', often times the hiring manager would prefer to meet and interview all of their options and then compare everyone so they can pick the new grad nurse(s) that they feel is the best fit. After an interview, it is always a good practice to send a follow up “Thank you” email. About a day after the interview, follow up with the hiring manager and thank them for their time and express how much you enjoyed the opportunity to speak with them. Finally, if there is a follow up call asking for further information, respond politely and promptly. These are all things that will positively affect the outcome.
Hopefully following these tips will help you get the nursing job of your dreams! Good luck to those in the application process and those who are approaching it. I want to give a special thanks to Barbara McGuinness, RN, MS, the Nursing Supervisor on the Heart and Vascular Unit at AAMC, Laura Kistler, RN, BSN, B-C, Charge Nurse on the Heart and Vascular Unit, and Diana Cole RN, BSN, an experienced staff nurse on the Heart and Vascular Unit for their help and feedback with this post.
NCLEX Exam Practice Question of the Week - 6/20/18
- “Call your parents immediately.”
- “Buy a soda and hamburger to eat.”
- “Administer insulin as soon as possible.”
- “Leave the arena and rest until the symptoms subside.”
Rationale:
The adolescent needs immediate and easily absorbable glucose, such as soda, and long-lasting complex carbohydrates and protein, which are supplied by the bun and hamburger.
- Calling the parents can be done after some glucose has been ingested; otherwise, the adolescent's hypoglycemia can become severe.
- Extra insulin will further aggravate the problem.
- Leaving is unsafe; appropriate intervention is necessary.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Pediatrics (Family-Centered Care of the School-Age and Adolescent Child, Ch. 11, pg. 183, Question 21) Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Pediatrics (Family-Centered Care of the School-Age and Adolescent Child, Ch. 11, pg. 183, Question 21)
Finding Balance
Written by Joy Clark.
We have all heard that nursing students have no lives, seen the t-shirts that state "I can't I'm in nursing school", or heard people say "I'll sleep when school is over". However, I want to give you hope that this chaotic lifestyle isn't always the reality. I was not willing to simply stop living when I started nursing school.
I have always lead a pretty jam packed life. From working part time in high school, participating in sports, and taking AP classes. Then into college with 18 units, joining clubs and playing on intramural sports teams. My life has been full, but never overwhelming. Neither was my transition from my exhaustive prerequisites into nursing school. Time management has always been an area of my life I had to stay on top of.
Nursing school did change a few things. I no longer looked at assignments and did them in the order they were due. Instead, I learned to work as far ahead as possible. If I found myself with a free afternoon I would write a paper even if it was not due for another month. The syllabus usually does a great job outlining assignments and utilizing it to get as many projects done ahead of time really relieves a lot of stress. I also learned I needed more than just one day to study for an exam. On days I had extra time in the morning I would review PowerPoints from that week to keep the information fresh.
The most important part of balance is making sure you allow time for things you enjoy so you don't get burned out. Saturday's were my day off. I would sleep in, play ultimate frisbee, go out for lunch, volunteer at my church and then go out in the evening. I made sure that I saw friends outside my nursing world by getting lunch/dinner with them throughout the week. I strategized my study habits to ensured that if there was an event I wanted to go to, even one that was the night before an exam, I had studied sufficiently ahead of time.
Now you might be thinking this girl must never have slept. I usually managed 6 hours of sleep a night.
I pray that this gives you hope and relieves some of your fears if you are an incoming nursing student. Plan out your days, use your time wisely, and schedule in fun things! Spend an hour at lunch with a friend. Take a nap when you need one. Say yes to going to the movies on Friday. Just ensure that you are aware of your time spent and that you are focused when you are studying. Bring balance into your life.
“Wherever you are be all there” Jim Elliot
NCLEX Exam Practice Question of the Week - 6/13/18
- “A balance of rest and exercise is important.”
- “I can apply lotion or powder to the incision if it is itchy.”
- “Activities in which my child could fall need to be avoided for 2 to 4 weeks.”
- “Large crowds of people need to be avoided for at least 2 weeks after surgery.”
Rationale:
The mother should be instructed that lotions and powders should not be applied to the incision site after cardiac surgery. Lotions and powders can irritate the surrounding skin, which could lead to skin breakdown and subsequent infection of the incision site. Options 1, 3, and 4 are accurate instructions regarding home care after cardiac surgery.
Practice Question Sourced From: Silvestri: Saunders Comprehensive Review for the NCLEX-RN Examination, 7e (Cardiovascular Disorders, Ch. 40, pg. 488, Question 418)
It's Okay to Have Bad Days
Written by Kate Dookie.
Nursing school is one of the most intense and stressful programs for students. Many hear how time-consuming and difficult it may be, but you never understand it until you have jumped off the diving board, head first, into your nursing school curriculum. Nurses have their own language, including nursing diagnosis, medical terminology, and the many abbreviations for all the above. It is important to remember, that it is difficult just to begin nursing school. If you are in your first semester, give yourself a pat on the back; you made it through all the prerequisites and entrance exams.
As you continue through your program, you will experience many accomplishments, a little anxiety, and possibly, a few bad days. It's important to remember that we all have bad days. There is not a single person going through nursing school right now that will not have a bad day. Bad days are okay. You might have a bad day because you didn't score as well on a test as you would have liked. Or, you did not pass your checkoff or dreaded simulation on your first try. Maybe, you had a tough patient during clinicals and it pulled at your heartstrings. No matter the reason, you have bad days because you care about your education and most of all, your future career. You care because you know how important your education is, because you desire to be the best nurse you can to provide exceptional care to your patients. So, when you have that awful day, tears are streaming down your face, and you consider giving up, just know that you are right where you are supposed to be.
On these bad days, give yourself a break. Find a way to relieve some of your stress, like going to the gym, taking a yoga class, cooking some comfort food, spending time with your family or friends, or escaping into a good (non-nursing) book. Have a friend that you call to vent to or go out to dinner with a group of your friends, they are there to celebrate the good times and support you during the rough days. Take the night off and remember the next day will be a new day, full of opportunity.
When you awake the next day (hopefully refreshed) take a minute to evaluate the previous day. What made it so bad? Did you not do well on that dreaded nursing school test? (Don't worry, those Select All That Apply Questions make us all cringe.) Evaluate how you studied and change what didn't work. This is trial and error. For me, using Elsevier Adaptive Quizzing helped ensure I really knew the information. After I mastered the concepts, I began my practice questions to prepare for the test.
If you didn't pass your checkoff/simulation, know you are not alone! Many don't pass the first time, and that's okay. The reason you have simulations are to prepare you for “real life” when you have graduated, and you have that beautiful license number that makes you a Registered Nurse. These can be difficult because they want to make sure you are prepared to assess and care for your patients in the field. If you didn't pass the first time, go practice! Remember that you are still learning, and you are preparing yourself to be a safe, exceptional nurse.
When you have a bad day because a patient really tugged at your heartstrings, know that this is because you truly care. Compassion and caring is something they cannot teach you in nursing school but are qualities that will make you a great nurse. Find a stress relief outlet like we discussed before and continue to use this as you graduate and become a nurse.
Bad days are okay! With the bad days, you will have many good days. Keep your eye on your long-term goals and know that you are one day further than you were yesterday. Keep pushing forward and be proud of your accomplishments, there are more to come!
How to Survive the First Year of Nursing School
Written by Alannah Davis.
Nursing school is a roller coaster of emotions, and to be completely honest the first year feels like you are going on the scary upside-down ride at the carnival for the very first time. You feel terrified during orientation and oh boy the first day of clinicals might be one of the hardest things you have ever done, but if you just keep pushing through you will realize that it is filled with experiences that will make it all worth it.
Nursing school coursework and clinicals are hard don't get me wrong but learning the tricks to keep yourself calm and focused are some of the most important parts.
Step One: Do NOT Procrastinate!!!!
This was the toughest thing that I had to learn. I was used to being able to complete a homework assignment or a project the night before it was due and not even bat an eye. Saving 100 practice questions for OB that were due the same day of the test was not the smartest move of my nursing school career, and my grade on the first exam definitely could vouch for me. If you know that you have an assignment due in a week and have a little extra time, make sure to do it then and skip the shopping trip.
Step Two: Actually Study.
I was never a good studier before this past year, but when my grades were not all A's like I was used to I decided I needed to change my study habits. I practiced studying the same day as I learned the material in class and not the night before the test. I am still guilty of not studying as much as I should until the last minute, but I have gotten a lot better. This takes a lot of practice and dedication, but in the end your grades will improve.
Step Three: Don't Be Afraid to Ask for Help.
This is something that is very important that you must learn in order to succeed throughout nursing school. You have to realize that your professors are there to help you and not hurt you, as well as your peers in the classes above you. If you don't understand something or are even confused on assignment it is always better to ask someone who can point you in the right direction. Ultimately one day you will be in charge of saving someone's life so now is the time to get clarification on whether something is correct or not.
Step Four: Get Sleep and Take Care of Yourself.
This is the most important step that I have given to survive nursing school. Sleep is an amazing thing and you really don't retain anymore information after 2:00 a.m. On test day make sure you get plenty of sleep. Also make sure that you are taking care of yourself mentally and physically. You can't drink coffee and energy drinks or eat chicken nuggets for every single meal, even though I personally wish I could. You also need to have some fun. I like to go shopping, running, or mostly come home and visit my puppy.
If you just take a deep breath and realize that nursing school isn't impossible your life will be so much easier your first year! I hope this article helps.
NCLEX Exam Practice Question of the Week - 6/6/18
- Hemorrhage
- Brain damage
- Respiratory distress
- Aspiration of mucus
Rationale:
Immaturity of the respiratory tract in preterm infants is evidenced by a lack of functional alveoli, smaller lumina with increased possibility of collapse of the respiratory passages, weakness of respiratory musculature, and insufficient calcification of the bony thorax, leading to respiratory distress.
- Hemorrhage is not a common occurrence at the time of birth unless trauma has occurred.
- Brain damage is not a primary concern unless severe hypoxia occurred during labor; it is difficult to diagnose at this time.
- Aspiration of mucus may be a problem, but generally the air passageway is suctioned as needed.
Practice Question Sourced From: Elsevier: Nursing Key Topics Review: Maternity (Newborn Complications, Ch. 19, Pg. 286, Question 3)
