Introduction 1
About This Book 1
Foolish Assumptions 2
Icons Used in This Book 2
Beyond the Book 3
Where to Go from Here 3
Part 1: Demystifying the Complexity of the NCLEX-RN 5
Chapter 1: Meet the NCLEX-RN: Your Ticket to Getting a License 7
The Big Deal behind the Big Exam 7
You Must Remember This: Nursing Basics to Know by Heart 8
The NCLEX-RN — Not Your Average CAT Scan! 9
Thinking the NCLEX-RN Way 10
Getting to the root of the question 10
Navigating the grand inquisition, or the integrated exam 11
Avoiding test-taking missteps 12
Finding the real question behind the long scenario 13
Keeping your cool when answering select-all-that-apply questions 13
When All Is Said and Done 14
Hey, nurse? Yeah, you! 14
So, you failed — it’s not the end of the world 14
Chapter 2: Preparing for T-Day: Paperwork and Whatnot 17
How Long Should I Wait after I Graduate? Deciding When to Test 17
Applying to Take the NCLEX-RN 18
Completing the application process 18
Paying your dues 19
Hitting a bump: Potential problems with the licensure application 19
Scheduling the Time and Place 21
Planning Ahead for the Big Day 22
Help, My Car Won’t Start! Rescheduling the Test 24
Chapter 3: The NCLEX-RN Blueprint 25
Considering the Four Main Categories of Client Needs 25
Client need #1: Safe and effective care environment 26
Client need #2: Health promotion and maintenance 28
Client need #3: Psychosocial integrity 28
Client need #4: Physiological integrity 30
Queuing Up Question Types 32
Putting knowledge into action: Application questions 33
Becoming an assessor: Evaluation questions 34
Slipping into Sherlock’s shoes: Analysis questions 34
Getting creative: Synthesizing and creating questions 35
Exercising individuality: Alternate test questions 35
Chapter 4: Buffing Up: Study Tips and Test-Taking Strategies 43
Setting Up an NCLEX-RN Study Schedule 44
Identifying Your Weak Points and Hitting the Books 45
Remembering Dear Maslow and His Needs 47
Applying the Nursing Process in Test Questions 48
Assessing the situation 49
Analyzing the situation 51
Planning your actions 52
Implementing care 54
Evaluating your actions 55
Dissecting the Questions and Finding Keywords 57
Pinpointing the keywords 58
Putting the keywords in context 59
Developing Critical-Thinking Strategies 60
Knowing the expected outcomes 60
Finding the elusive question topic 61
Making an educated guess 62
Picking the best answer when you’re completely clueless 62
Knowing how to prioritize when all the answers are right 64
Avoiding Test Question Pitfalls 67
Don’t read into the question 67
Read the whole question and reword it 68
Eliminate wrong answers 68
Try not to predict answers 69
Part 2: Testing Your Knowledge of Client Needs 71
Chapter 5: Management of Care 73
First Things First: Knowing Your Patient’s Rights 73
You must heed prearranged treatment options 74
All lips must remain sealed 75
Information and technology changes 76
Nothing happens without informed consent 76
Ethical decisions don’t require your opinion 77
Rallying the Troops: Managing Care 78
Assuring the quality of patient care 78
Prioritizing when your hands are full: Group care 79
Tailoring care for each patient: Case management 80
Collaborating with other medical team members 81
Getting others to lend a hand: Delegation 82
Recognizing Legal Rights and Nursing Responsibilities 84
Knowing Where to Get the Support You Need 86
Keeping up with education and training 86
Expecting adequate supervision 87
Making referrals 88
Chapter 6: Safety and Infection Control 89
Preventing Accidents and Injuries 89
Using electrical equipment safely 90
Keeping clients from falling 91
Disaster Planning and Emergency Response 92
Sounding the alarm: When fires break out 93
Responding to terrorism or bioterrorism 95
Keeping Infectious Bugs at Bay 95
Maintaining medical and surgical purity 95
Differentiating among the types of infection precautions 97
Handling hazardous and infectious materials 100
Keeping Clients Down in a Way That Lifts Them Up 101
Accidents Happen: Knowing the Next Steps and Preparing an Incident Report 103
Code Pink: Understanding the Protocol for Infant Abduction 104
Chapter 7: Health Promotion and Maintenance 107
Surveying the Stages of Growth and Development 107
For children 108
For normal pregnancy and the birth of newborns 110
For older adults 111
To Your Clients’ Health! Promoting Well-Being 111
Creating and Implementing Care Plans 112
Assessing your patient’s physical condition 112
Teaching patients from the moment of introduction 114
Understanding and explaining screening tests 116
Handling High-Risk Behavior and Alternate Lifestyle Choices 117
Preparing Patients to Leave Your Care 118
Helping patients take care of themselves 118
Embracing the family system 118
Chapter 8: Psychosocial Integrity 121
Looking beyond the Surface: Factors That Influence Behavior 121
Behavioral basics: Important development theories 122
The spice of life: Cultural and family diversity 123
Coping, Counseling, and Crisis Intervention 124
Dealing with defense mechanisms 125
Talking through troubles 126
Teaching stress management 128
Helping Patients through Grief and Loss 129
Caring for Patients with Abuse Issues 130
Recognizing different types of abuse 130
Identifying stages of substance abuse 131
Chapter 9: Basic Care and Comfort 133
Giving Patients First What They Need Most 133
Ensuring Adequate Nutrition and Hydration 134
Identifying the building blocks of nutrition 135
Modifying your patient’s diet 135
Recognizing malnutrition 136
Administering tube feedings 138
Hydrating your patient 138
Resting Easy, Sleeping Soundly 139
Keeping ’em Clean: Personal Hygiene 140
Understanding the Process of Elimination 142
Measuring your patient’s urinary health 142
Keeping bowels healthy 144
Wading through Irrigations 145
Providing Holistic Care with Alternative and Complementary Medicine 147
Decreasing Pain without Pills 148
Helping Patients Get Around (and What to Do if They Can’t) 149
Training patients to use crutches, walkers, and canes 149
Avoiding complications from immobility 150
Chapter 10: Meditating on Meds: Pharmacological and Parenteral Therapies 153
Remembering the Factors You Must Verify before Giving Meds 153
Medicating Patients Safely 155
Assessing before medicating 155
Calculating dosages 156
Recognizing the effects of meds 159
Answering questions about unfamiliar meds 161
Using Medicine to Manage Pain 162
Giving Meds and More with a Stick and a Poke: Parenteral Therapy 165
Solving the puzzle of solutions 165
Providing med therapy all in vein 168
Hanging blood and blood products 169
Chapter 11: Reduction of Risk 173
Interpreting Lab Results without a Hitch 173
Separating the oozing red stuff 174
Looking closely at immunity defenders 178
Examining pee (ha-ha) 179
Recognizing the Main Diagnostic Assessments 180
The daily routine: Checking vital signs 180
Respiratory tests 181
Cardiovascular tests 183
Gastrointestinal tests 184
Musculoskeletal tests 184
Neurological tests 184
Being Ready for the Bumps: Complications with Testing and Treating 185
Taking stock of diagnostic risks 186
Preventing postsurgical complications 186
Taking a Load Off: Therapeutic Procedures and Diagnostic Tests 190
Administering Conscious Sedation Safely 193
Chapter 12: Physiological Adaptation 195
Understanding What’s Normal So You Know What Isn’t 195
The water of life: Accounting for fluid 196
Getting the right pH: The key to acid-base balance 198
Keeping an eye on respiratory health — the sum of water and pH 199
Monitoring hemodynamics 201
Anticipating the Results of Imbalance 202
Knowing what to do when the body systems are out of whack 202
Looking down the road to infection 204
Pathophysiology: Recognizing and Managing Illness and Disease 205
Houston, we have a problem: Focusing on microsystems 206
Doing damage control of the medical kind 208
Taking a Patient for Tests and Therapy 208
Facing an MRI, the hot potato of medical tests 209
Handling therapies, from dialysis to radiation 209
Part 3: Just What You Were Looking For: A Full-Length Practice Test 213
Chapter 13: A Story of Blood, Chills, and Pain: A Practice NCLEX-RN 215
Chapter 14: The Answers to All Your Questions (and Explanations to Boot) 257
Answers and Explanations 258
Answer Key 284
Part 4: The Part of Tens 287
Chapter 15: Ten Myths about the NCLEX-RN 289
Length Matters 289
Every Question Counts 290
Computer Savvy Is Essential 290
You Can’t Stop ’til You’re Done 290
The Test Plays Off Your Weakness 290
You Have to Wait Eons to Retake a Failed Test 291
Your First Instinct Is Probably Wrong 291
The Same Question Popped Up Twice 292
Your Test Schedule Chooses You 292
Choice (3) Is the Magic Answer, and Other Multiple-Choice Fails 292
Chapter 16: Ten Common Phrases Found in NCLEX-RN Questions 293
Assessment and Priority 293
Diagnosis 294
Planning and Assigning Care 295
The Teaching Plan 296
Outcomes and Goals 296
Best Response 297
Priority Action 298
Interventions 298
Further Teaching 299
Chapter 17: Ten Rules to Remember When Prepping for the NCLEX-RN 301
Read Each Question in Its Entirety 301
Don’t Read into the Question 302
Answer Questions with the Ideal Situation in Mind 302
Avoid Changing Your Answers 302
Don’t Call the Doctor until You’re Sure You Need To 303
Avoid Answers That Make You Choose All or Nothing 303
Don’t Memorize Facts, Questions, or Other Useless Trivia 303
Don’t Think You Can Be Ready without Hard Work 304
Know Your Strengths and Weaknesses 304
Be Kind to Yourself 305
Part 5: Appendixes 307
Appendix A: Additional Info about Exam and Licensing Logistics 309
Identifying Individual State and Territory Licensing Requirements 310
Testing and Licensing Information Arranged by State and U.S Territory 310
Alabama 311
Alaska 311
American Samoa 312
Arizona 312
Arkansas 312
California 313
Colorado 313
Connecticut 314
Delaware 314
District of Columbia 315
Florida 315
Georgia 316
Guam 316
Hawaii 316
Idaho 317
Illinois 317
Indiana 318
Iowa 318
Kansas 319
Kentucky 319
Louisiana 320
Maine 320
Maryland 321
Massachusetts 321
Michigan 322
Minnesota 322
Mississippi 322
Missouri 323
Montana 323
Nebraska 324
Nevada 324
New Hampshire 325
New Jersey 325
New Mexico 326
New York 326
North Carolina 327
North Dakota 327
Northern Mariana Islands 328
Ohio 328
Oklahoma 328
Oregon 329
Pennsylvania 329
Puerto Rico 330
Rhode Island 330
South Carolina 330
South Dakota 331
Tennessee 331
Texas 332
U.S Virgin Islands 333
Utah 333
Vermont 333
Virginia 334
Washington 334
West Virginia 335
Wisconsin 335
Wyoming 336
Appendix B: Information for International Nurses Moving to the United States 337
Following the Two-Step Process for Becoming Eligible to Take the NCLEX-RN 338
Getting a VisaScreen certificate 338
Securing a CGFNS certificate 338
Getting the NCLEX-RN go-ahead without a certificate 340
Taking the NCLEX-RN Abroad 340
Navigating Nursing Roles in the U.S 342
Forming partnerships with clients 342
Teaching and instructing 342
Providing care 343
Working with other professionals 343
Getting Accustomed to U.S Cultural Values 343
Communicating Therapeutically 344
Practicing therapeutic communication 344
Steering clear of nontherapeutic techniques 345
Applying U.S Nursing Know-How to the NCLEX-RN 347
Appendix C: Glossary of Nursing Terms 351
Index 371
