This is the new popup if you passed. They no longer want you to call your Board Of Nursing.
ONLY IF YOU GET THE CC PAGE, CALL 1-856-777.0840 OR EMAIL INFO@CARING4YOU.NET. BEFORE CALLING VISIT THE UPDATED PAGE, YOUR ANSWER MAY BE HERE. [ CLICK HERE ]
PLEASE VISIT THE LINK ABOVE FOR RECENT INFORMATION
FOR YOUR CONVENIENCE, HERE IS A LIST OF THE STATE BOARDS OF NURSING [ HERE ] [ CLICK HERE ] for free updated NCLEX free resources.
10. PRIORITIZE!! Remember to look for words that establish priority (most, first, best, & initial). These words will help you weed out info that you really don’t need!! Keep in mind Maslow’s hierarachy of needs, the nursing process, and patient safety. "Which patient should you see first?" is a popular question….understand the rules of management.
9. Know your NORMALS!! Normal lab and test values are good to know. They will help you decide when there is a problem or if it has already been fixed!
I put together a very helpful list for you in my NCLEX yahoo group.
Please go to yahoo group http://health.groups.yahoo.com/group/annelieseRN/ LOOK FOR LabValues.pdf UNDER FILES.
8. Stay CALM!! You will get questions that you will have little confidence on how to answer, but staying calm and using key words to pick the best answer will never lead you wrong.
There is an extended version if anxiety is a real problem for you in the Delegation and Prioritization seminar
7. Always ASSESS before you IMPLEMENT. It is easy to get tripped up by implementing a nursing action before they assess the patient.
6. Assume you have an MD ORDER. There are no trick questions out there and the NCLEX wants to know if you know what to do as a nurse….not what the doc knows! So, your first response is probably not going to be "calling the doc".
5. Think PATIENT SAFETY at all times. Start remembering this mantra now because you will hear it over and over in practice.
4. The REAL WORLD is a different place from the NCLEX WORLD. Answer the questions by what you know from a textbook…..not what you remember about taking care of Mrs. X in your clinical rotation.
3. Remember the FIVE RIGHTS of MEDICATION administration. Know these frontwards, backwards, and sideways….you will use this on NCLEX and daily in the real world!
2. CONSIDER "THERAPEUTIC COMMUNICATION" WITH THE PATIENT. The wrong answers usually are ones that include you being a drill sergeant, asking closed-ended questions, or "why do you feel this way?" questions. Also be wary of any answers to patient questions that involve "don’t worry" or "that happened to me once".
1. REVIEW, STUDY, REVIEW, STUDY, REVIEW, STUDY!!!!!! Do not take the NCLEX until you have taken time to review what you learned in nursing school. One thing you did not learn in nursing school in an adequate amount was infection control. To fill this need, I have put together an infection control seminar.
When attending the live seminar, please wear a headset if possible. The cuts down on the echo and makes for better interacting between teacher and attendee. Thank You.
Now that I know how to attend, how do I participate?
Caring 4 You . Net Live Interactive Seminars
How To Choose The Right Answer On The NCLEX
Test Taking Tips and Stategies Have you taken the nclex over and over and just don't know what you are doing wrong? Upon doing some practice questions, people usual have 3-5 weaknesses in the way they answer questions. I will explain this and much more as to what you can do to help you study more effectively and time efficently. [ Register for class now ]
Infection Control and the NCLEX
This is a ONE HOUR ADAPTATION of my full Infection Control Seminar. A quick overview of whom should room with whom according to the Center For Disease Control. Also included is information about Standard Precautions, Airborne Precautions, Droplet Precautions, Contact Precautions and Tuberculosis. [ Register for class now ]
Unleash The Power Of The Internet For The NCLEX
Did you know that there are thousands of dollars of Nursing Review material on the web but you have to know how to access it as it comes in all kinds of different files and downloads that you may not be aware of how to handle. My online seminar "Unleash The Power Of The Internet" will show you 1). WHERE TO ACCESS IT and 2). HOW TO USE IT. Set aside one and a half to three hours time when attending this seminar. [ Register for class now ]
Triage In A Disaster
This seminar is one hour in length. Teaches you how to prioritize and delegate in the mist of an emergency. This is new information on the NCLEX in light of recent events such as 9/11 and Homeland Security Guidelines. [ Register for class now ]
Help With The NCLEX. You may listen live or download for later use. Every Monday Night is open mic night at 7:00pm EST. Call in or post your questions you may need help with or just listen to others: http://www.talkshoe.com/tc/22608
Here are different ways to use the service:
Call in using your phone: Dial (724) 444-7444 Call ID for this show is 22608 Follow the voice prompts.
Call in using your computer - use a microphone attached to your computer to speak, and use the computer speakers to listen. A headset works best. It will cut down on the echo.
Call in using your computer - a telephone to speak. If you are using a ViOP such as Gizmo, Skype or X-lite, instead of dialing the number type Sip:123:talkshoe@66.212.134.192 in place of the telephone number and follow the same prompts as above.
You do not need to join Talkshoe to use the service, but if you join (free), then you can log in. Once you log in, we will be able to tell your name. This is helpful if you want to speak because you don't come in as a "Guest." See this tutorial for futher information: Talkshoe and You: How To Participate, Join, and download podcasts.
Not all States require the CGFNS exam. [ Click here ] to see the latest news regarding this information.
What is the CGNFS CGFNS uses an objective multiple-choice exam. The exam is still administered in a paper & pencil format. This exam is a one-day exam with 2 Nursing parts –one in morning & other in noon, which includes 150 questions in the morning & 110 questions in the afternoon (total 260 questions). You’ll get only one minute for each question. Credit is given for each correct answer & one of the advantages is that there is no penalty for wrong answer, so it is best to guess than leaving blank. Score of 50% is considered as pass that means you have to get 400 for pass.
Both of the Nursing part involves questions from medical, surgical, maternity, pediatric, psychiatric, & community nursing. Your understanding of the phases of Nursing Process & Client needs is tested in the exam.
PHASES OF NURSING PROCESS:
Assessment (17-23%),
Analysis (17-23%),
Planning (17-23%),
Implementation (17-23%),
Evaluation (17-23%).
CLIENT NEEDS:
Safe, effective care environment (15-21%)
· Coordinated care
· Environmental safety
· Safe & effective treatment & procedures.
Physiological integrity (46-54%)
· Physiological adaptation
· Reduction of risk potential
· Provision of basic care
Psychosocial integrity (8-16%)
· Psychosocial adaptation
· Need for coping
Health promotion & maintenance (17-23%)
· Growth & development
· Self-care & support systems
· Prevention & early treatment of disease
How Do You Study for the CGFNS Exam?
Study the same way you would the nclex. Here, we have put together some questions for you to practice. As you practice, take notes on the areas you are weak in for study references later.
First, you have to be aware that the nclex changes every 4 years {or less}. So, the advice you will be getting from nurses that you have recently talk to may be inaccurate. If you do talk to a nurse that has taken his/her NCLEX, the important question for you to ask, "When did you sit for the EXAM?" If it was within the year, then yes, you can take their advice. Okay, so you have now talked to a few nurses. Still not knowing what to do, you turn to the internet.
The internet offers a wealth of information but is that information accurate? What do you look for when you surf the web?
Sites that really care about your well being and your success in life will offer material and resources for FREE. Please don't misunderstand me. Of course they will be trying to sell you something. Afterall, it takes countless of hours to put a site together and it costs money to run the site. But I would suggest looking for FREE material first. But before you buy any product you have heard was great or that you feel you may be interest in, email the webmaster. Are they easy to reach? Do they email you back? Can you ask questions easily, do you feel comfortable? If you do, then it is a good sign that you can do business with this person.
Since the nclex changes, be sure the site is fresh and up to date. How will you know? Does that site have an interactive forum? If so, look at the date on the posts. A good site is updated often. Don't bother with a site that has not been updated within the year or that has a bunch of broken links or graphics that do not work. If there are broken links, email the webmaster. If the links are fixed within 2 weeks and no more than a month, then the site is good. The more interactive the site is the better the chance is that it will be a good resource for you and the NCLEX.
Inevitably you will have to buy something there is no doubt about that but first look for FREE resources There is a wealth of free information on the internet gather everything FREE. Practice, post on forums, ask questions and then decide what you need to work on and what you have to buy. I have a tried and true formula so I always recommend my resource material in conjunction with others as you will see.
So now that you have surfed the web it is time to get serious. You are financially strapped. You spent all your money on nursing school and now you have to buy some study material. But what? You have to pass this time.
Everyone needs Lippincott's Review for the NCLEX-RN or Lippincott's Review for the NCLEX-PN whether you just graduated or you have been out of school for years. This is a great book. When purchasing, make sure you get the most recent edition and you can buy it used from www.amazon.com or off of your friend. It is great because it is full of questions front to back and they are complete with rationale and are broken down into sub categories based on which part of the body systems a section relates to.
Do you need to refresh your memory with the 9 System Review? If you find that you are weak in any area of nursing, resources regarding this subject is bountiful on the internet. www.caring4you.net does offer this resource and if you want more information, you can email me. No matter where you get this material, you do not have to worry about the date of this product so you can buy it used from your friend or amazon.com. For example, our Endocrine System is the same today as it was 20 years ago. The function of the human body has not changed. Remember, this is a refresher for you. Before you spend a ton of money, see where you can buy it for less.
The NCLEX is now focusing on Delegation and Prioritization. This change came about due to the events of 9/11/08 and the nursing shortage. There are not a lot of resources on the web pertaining to this subject matter and resource books seem to just touch on this. www.caring4you.net is the best resource for this. You will find that studying this for the RN and LPN are just about the same except, the RN questions deal with a higher level of critical thinking and delegation across the mutispectrum. With the LPN, it relates to delegating to nursing assistants and other LPN's but the prioritization questions are the same.
The NCLEX is now focusing on Infection Control situations. You have got to understand when a patient can room with someone else and with what type of illness that patient can be in a room with and you have got to understand when a patient needs to be alone. You also need to understand when to gown up and when you do not need to. Surf the web and find the FREE resources. www.caring4you.net has great resources available on this topic.
The NCLEX now has new format questions. It use to be in the days of old, prespective nurses were coraled into a giant room and took their exam with paper and pen multiple choice style. And as time went by with the advent of computers, we now met at predetermined testing sites and sit at a computer multiple choice style. One question building on the other with no way to go back and look at the previous question. And now today, the powers that be said to themselves, "Hmmm, we know there is a huge nursing shortage but let's throw a monkey wrench into the whole process anyway. Hey! Let's have the questions still be nultiple choice but you can pick more than one answer and you have to pick 'all that apply'. Yeah, that should make it harder." Just when one thinks they have conquered this thing called the NCLEX, They have to deal with now format questions. Everyone needs to buy NCLEX-RN 250 New-Format Questions: Preparing for the Revised NCLEX-RN or NCLEX-PN 250 New-Format Questions: Preparing for the Revised NCLEX-PN. You can buy this used from amazon.com or from your friend just make sure you have the latest edition.
Caring 4 You . Net is now offering a Live Online Seminars. I have been helping nursing students pass their NCLEX since 1997 I first started out by putting what I knew about the NCLEX on the internet because I kept answering the same emails over and over again. Hence, Caring 4 You . Net was born. "Healing the community by caring 4 you". This logo was chosen for two reasons, 1). Helping nurses pass the nclex helped my community and 2). I knew the pain of failing and I eventually passed but at the time, I had no one to turn to for help. I wanted to help students heal and achieve their dream. As time went on, I developed a live seminar that I did in person. Delegation and Prioritization: http://caring4you.net/Shop. This was developed because the NCLEX changed and books did not meet this need per the changes on the NCLEX. As time went on the NCLEX changed again and I met the changes by developing my seminar, Infection Control and the NCLEX: http://caring4you.net/IC. and now, due to your interest along with many others, recently, I have started LIVE ONLINE SEMINARS. Right now, I have two available that are about one hour no more than two hours long depending on your participation and questions: http://caring4you.net/liveseminar.html.
How does this seminar work? At a time decided upon between me and you, you will be sent a link. Click on the link and push the 'launch session' button. Once you do this, you will be able to interact with me via a web cam. You also may ask questions via your mic during my seminar or you may write in in the 'chat box' in the seminar. I use the same power point, pdf or word documents in the online seminar that I do in my live seminars at colleges in person. You can also browse through the material I place on the white board or you can participate in answering the questions via your mouse. It is a very new and interesting way to learn via the comfort of your own home!
As the NCLEX keeps evolving, so too, will Caring 4 You . Net. This site is the best on the 'net because of your participation.
There you have it. Take all you have learned in nursing school and combine it with this information and you have the formula for success! Good luck on your exam and God bless .....
To ensure public protection, the United States and its territories require entry into the practice of nursing to be regulated by licensing authorities within each jurisdiction. Each jurisdiction requires all candidates for licensure as entry-level nurses to pass an examination which assesses the knowledge required to perform safely and effectively. NCLEX stands for The National Council Licensure Examination which is a standardized exam used by each state board of nursing to determine if RN or LPN/LVN candidates are competent for entry-level nursing practice.
There are two NCLEX tests offered by the National Council of State Boards of Nursing (NCSBN): the National Council Licensure Examination for Registered Nurses - NCLEX-RN ? and the National Council Licensure Examination for Practical Nurses - NCLEX-PN ? . The NCLEX-RN is for registered nurse candidates while the NCLEX-PN is for practical and vocational nurses. The main difference between the two tests is the number and difficulty of correctly answered questions required to pass the exam. The States and territorial boards of nursing use these exams in making licensure decisions.
The NCLEX-RN has 265 questions and the minimum number you need to answer is 75. The NCLEX-PN has 205 questions and the minimum number you need to answer is 85. The NCLEX exams are administered using Computerized Adaptive Testing ? CAT. There is a six hour limit for NCLEX-RN and a five hour time limit for NCLEX-PN which includes time for the computer tutorial and breaks. Both tests require an understanding of nursing practice and cover the following categories of client needs:
Safe, Effective Care Environment
Management of Care
Safety and Infection Control
Health Promotion and Maintenance
Growth and Development Through the Life Span
Prevention and Early Detection of Disease
Psychosocial Integrity
Coping and Adaptation
Psychosocial Adaptation
Physiological Integrity
Basic Care and Comfort
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Using this method (CAT) each exam is unique and the questions are retrieved from a database as the exam progresses. The computer measures the ability of the candidate using the answers provided previously and changes the difficulty and topic of the new questions accordingly - if you answer correctly the computer will select harder questions and if you are answer incorrectly it will choose easier questions. The software estimates your ability every time you provide the answer to a question and with each new answer you provide the estimate of your ability gets more precise.
The exam software selects questions that it believes you will have a close to 50% chance of answering correctly ? not too hard or too easy for the ability it believes you have. This is done so that a well prepared candidate will be asked more difficult questions thus having a good chance of passing the exam by answering the minimum number of questions while less prepared candidates are not forced to guess the answers to questions too difficult for them. The expected number of correct answers is half the total number of questions you are presented with because of the adaptive nature of the test.
After you answer the minimum number of questions for the exam the software will analyze your performance and it may shut-down the computer. This means that you either passed or failed the exam. The computer will shut-down only when the program running the test has determined with 95% certainty that your ability is either above or below the passing standard.
The only way to get additional questions is if you are very close to the passing score ? either 2.5% above or 2.5% below it. If this is the case you should not worry about failing but instead should concentrate on answering correctly the next set of questions. You must understand that you are very close to passing the exam if you answer most questions correctly from this point on. You must answer the maximum number of questions on the exam only if at the end of each set of questions you are within the 2.5% above or below the passing score. The time you spend on each question is not an important factor with regard to passing but you should answer the required number of questions in the allotted time.
If you are required to answer the maximum number of questions and the computer still isn't 95% sure you can pass, the 95% confidence requirement is dropped. If at this point you have a score higher than the minimum required you pass the exam otherwise you fail. If you run out of time and did not answer the minimum number of questions required you fail automatically. If you run out of time but you answered the minimum number of questions required and for the last 60 questions your score was never below the passing standard you pass otherwise you fail the exam. This does not mean that you have to answer the last 60 questions correctly but only that at any point during the last 60 questions your score was above the minimum required to pass the exam. You can think about it this way: for each correct answer add one to your score while for each incorrect answer subtract one. Adding your scores one at a time for each question answered should never result in a negative score in order for you to pass if you run out of time but you have answered the minimum number of questions required.
The NCLEX-RN and NCLEX-PN questions are mostly multiple-choice questions with four answers. In some cases the NCLEX exam uses more difficult question formats such as multiple-choice questions that require you to select one or more correct answers, fill-in-the-blank questions or questions that require you to identify an area on a picture. Both exams cover mostly the same topics but the NCLEX-RN is more difficult.?
You must apply to your state board of nursing in order to take the NCLEX examination. That board of nursing will decide whether or not you are eligible for the NCLEX examination. If you are eligible you must register to take the exam using the Authorization to Take the Test (ATT) provided by the board of nursing in your state. They will also provide you with a list of testing centers and instructions for how to schedule and take the licensure examination.
Here are a couple of things you might want to consider if you are taking the NCLEX exam:
attend an NCLEX review class to refresh your knowledge
always read and understand the entire question before answering it
answer and understand 3000 - 4000 practice questions
you can't change an answer once you moved to another question so forget about it ? good or bad what it is done is done so it is better to concentrate on the current question instead of pondering if you were right or wrong
always pick the answer you believe is best ? the test is not designed to trick you but good reading and comprehension skill are required
always think about the safety of the patient when answering the NCLEX questions
After you take the test you will have to wait for the results. The time you need to wait depends on how the results are reported in your state: mail, online, phone or email. If you fail the test you will receive a summary of your test performance indicating topics where you did well and topics that you need to study further. You will be able to take the test again after a mandatory waiting period (usually 45 days) which may vary from state to state. If you are interested in becoming a registered or practical nurse you may want to visit this nursing site.
Good luck!
This article is free for republishing Source: http://www.articlealley.com/article_13015_22.html
Panic attack natural treatments are preferred by the health-conscious communities worldwide. Studies in America shows that more than 2 percent of the adult population suffers from panic and anxiety attacks. That is more than 2 million Americans struggle with this problem. How do you know if you are suffering from a panic attack and what are the panic attack natural treatments available to help you?
Look out for the following symptoms if you suspect you could be having a panic and anxiety attack: 1. Overwhelming Sense of Fear Especially of Death 2. Profuse Sweating 3. Shaking and Trembling in Body and Speech 4. Shortness in Breath 5. Heart Palpitation 6. Dizziness 7. Abdominal Cramps
These are just some of the signs. If you are experiencing one of these, it does not necessarily mean that you are suffering from a panic and anxiety attack. However, a combination of a few symptoms could be a tell tale sign of a panic attack. Panic attack natural treatments can be in the form of home remedies meant to calm your nerves or simple lifestyle and dietary changes. Do not underestimate the influence and impact some of these panic attack natural treatments can make in your life. It has been known that several age old methods have saved celebrities and public figures at the crucial moments of their careers.
1. Lifestyle and Diet Changes a. Exercises Regular exercises thrice a week is helpful for stress relief and keeps our bodies healthy and fit. Depression-induced anxiety patients have seen improvement in their mental health and panic attack condition when they get into shape with regular exercises.
b. Foods, Medicines and Beverages to Avoid Alcohol, caffeinated drinks like coffee and tea, and some over-the- counter and prescribed medicines could actually increase heart palpitation and lead to panic attacks. Drug abuse has been reportedly associated with increased anxiety.
c. Rest People are too engrossed with their work and leisure. There are many distractions in our lives that rob us of our sleep. Without proper sleep, our bodies face mounting pressures in coping with daily stresses from work, studies, relationship etc. Make sure you get enough sleep about 7 - 8 hours each day. 2. Home Remedies as Panic Attack Natural Treatments Herbal remedies are making inroads into many American homes due to their effectiveness and increasing acceptance of herbal cures as panic attack natural treatments. Here is a list of herbs that can calm your nerves and relieve stress and anxiety. a. Ashwaganda b. Bugleweed c. Borage Juice d. Chamomile e. Ginkgo Biloba (Maidenhair Tree) f. Kava Kava (Piper Methysticum) g. Lemon Balm h. Lavender i. Peppermint j. Passion Flower k. Valerian Root Kava Kava and valerian root can be ground into powder and mixed with water for consumption. Both are excellent anti-anxiety herbs. If you find the taste too bitter, add some honey for sweetness and flavor.
Vitamins likewise make great panic attack natural treatments. Vitamin B group are known calming and soothing agents that bring stability to our body's lactate levels. Our lactate levels are directly related to anxiety. Niacin also produces a calming effect on our nerves. Daily intake of calcium and magnesium also helps to improve sleep and relieves our nervous system. Discover through my blog how you can quickly treat your panic attacks with some of the best panic attack natural treatments ever known. This article may be freely reprinted or distributed in its entirety in any ezine, newsletter, blog or website. The author's name, bio and website links must remain intact and be included with every reproduction.
I have completed an update on my infection control seminar. See if you can answer these questions.
If you want all the entire infection control quiz Click here.
6. The proper sequence of precautions for taking care of a pt on Infection Control Precautions are as follows :
1) Wash hands upon completion 2). Care for pt 3). Don mask/gown/gloves 4). Enter Room 5). Remove mask/gown/gloves
7. What type of precaution is used with persons that have Cytomegalovirus infection?
A. Standard precautions B. Contact precautions C. Droplet precautions D. Airborne precautions
8. What illness/disease process requires the use of disposable dishware according to the center for disease control guidelines? Choose all that apply:
A. Tuberculosis B. MRSA (methicillin-resistant Staphylococcus aureus). C. Meningitis D. Chicken pox
9. What are the symptoms of Acinetobacter infection caused by pneumonia? Check all that apply:
A. Fever B. Chills C. Sneezing D. Congestion E. Cough F. Runny Nose
10. When caring for someone on “Contact Isolation”. The following is true. 2 part answers must be entirely correct. Check all that apply:
1. Wear gloves for all contact with the patient, the patient's bedside equipment, and the patient's environment. a. Change gloves between distinctive tasks (e.g. wound care, perineal care, suctioning). b. Gloves must always be removed before leaving the room.
2. Wear a disposable gown for direct contact with the patient or the environment if the patient is incontinent, or has diarrhea or a draining wound. a. Gowns are removed and placed in a special container for next use. b. Cloth gowns may be substituted if there is no risk of splash
3. As per Standard Precautions, wear a mask and protective eyewear when performing procedures that generate aerosols (Standard Precautions)
I was incorrect when I said 7). was wrong the answer is A. Cytomegalovirus (CMV) (from the Greek cyto-, "cell", and -megalo-, "large") is a viral genus of the Herpesviruses group: in humans it is commonly known as HCMV or
Human Herpesvirus 5 (HHVTransmission of HCMV occurs from person to person through bodily fluids. Infection requires close, intimate contact with a person excreting the virus in their saliva, urine, or other bodily fluids. CMV can be sexually transmitted and can also be transmitted via breast milk, transplanted organs, and rarelyfrom blood transfusions. Standards precautions are recommended by the CDC.
8). Is half correct. There is one other.
9). Correct if you dropped D. It should not be in the answer.
1. Your patient is considering participating in a multi-site trial of a new cancer medication. According to the " Patient's Bill of Rights," it is important for the patient to know that:
all costs of research are paid by the patient.
he has the right to refuse to participate in research without fear of loss of care.
the physicians will no longer be caring for him if he does not participate in the research.
the research study is his only hope of treatment.
2. At 8:30 a.m. on a Thursday morning, several small canisters exploded in a bus station. Later in the day, many of the people who were present at the time of the explosion developed shortness of breath and muscle and chest pain. The hazardous materials (Hazmat) team has determined the canisters contained Ricin. All of the following statements about Ricin are correct except:
inhaled Ricin attacks the respiratory system, causing pneumonia and pulmonary edema.
ingested Ricin causes gastrointestinal bleeding, which can lead to death.
Ricin can be produced in an aerosolized form and solid form.
symptoms of Ricin toxicity begin 48 to 72 hours after exposure.
3. While attending closed medical case rounds, you are giving as a part of the teaching-learning process a detailed written case that is to be further discussed. In the course of the discussion, the identity of the patient becomes known to the group. You should:
dispose of any class notes in the regular trash.
stop the discussion immediately after the identity of the patient is known.
participate in the discussion while in class, but dispose of the case information in the shredded trash after the presentation.
respect the patient's confidentiality by leaving the presentation at the point at which the identity of the patient becomes known.
4. Family members had a variety of negative reactions to the restraining of their relative in acute care settings. These reactions were:
"She didn't do anything and she's tied up."
"My mother was overjoyed over the restraint as it felt secure. "
"The restraints are a good thing for older people."
"Collaboration is always excellent here concerning restraints."
5. The goal of delegation is:
staff satisfaction.
workload distribution.
effective management.
prioritizing patient care needs.
6. Which activity is part of the termination phase of the therapeutic relationship?
Selecting behaviors that will terminate the relationship.
Discussing the expectations of the nurse and client.
Relating feelings generated by separation to former losses.
Selecting alternative responses to situations.
7. Priority setting occurs during which step of the nursing process ?
Assessment.
Planning.
Intervention.
Evaluation.
8. A client and nurse contracted to meet for 10 weeks. Beginning at the seventh week, the client starts arriving late to the meetings and engages mostly in superficial talk. The nurse recognizes this behavior is:
because the client has other responsibilities.
due to the client's anger over the upcoming termination.
the client oversleeping due to increased depression.
a relapse of the progress made earlier in the relationship.
9. The teaching plan for a comprehensive sex education program should include all of the following goals except:
teach appropriate values, beliefs, and attitudes about sexuality.
communicate accurate information about sexuality.
help students develop relationships and interpersonal skills.
encourage the exercise of responsibility in sexual relationships.
10. Potential quality indicators that may be the focus of unit-based quality improvement (CQI) activity on a med-surg unit are all of the following except:
medication errors.
incisional wound infections.
incidence of pneumonias post-operatively.
number of readmissions with primary diagnosis of CHF.
11. All of the following are true as a nurse designates a task as high priority except:
priorities are physiological.
priorities are psychological.
if untreated could result in harm to the client.
involve a quick response to needs as determined by the nurse independently from the client involved.
12. At 11:00 a.m., Mr. P. is brought to the unit from the emergency room for admission. Lying on the transport cart, he is complaining of severe nausea and is dry heaving into an emesis basin. His wife and son are with him. What would be the most appropriate action for the nurse to take at this time?
Help get Mr. P. into bed and orient him to the bed controls.
Help get Mr. P. into bed and begin to fill out the detailed admission assessment form.
Ask him whether he has valuables for the safe.
Help get Mr. P. into bed, properly positioned for comfort, and begin focused abdominal assessment targeting his nausea.
13. Which cranial nerve is responsible for chewing movement?
Facial.
Abducens.
Trigeminal.
Hypoglossal.
14. Which of the following signs or symptoms would alert a nurse to increasing intracranial pressure in a client with acute head trauma?
Widening pulse pressure.
Narrowing pulse pressure.
Tachycardia.
Regular respirations.
15. Which of the following terms describe a complication of rheumatoid arthritis where the fingers become bent outward?
Hallux valgus
Wwan-neck deformity.
Boutonniere deformity.
Ulnar drift.
16. Which of the following statements by a client indicates a need for further teaching by the nurse regarding prevention and treatment of Lyme disease?
"I will spray insect repellant on myself."
"I will tell my doctor about a bull's eye rash."
"If I see a tick, I will twist it out of my skin."
"I will avoid walking in tall grass."
17. A client who is an intravenous drug abuser had an appendectomy. He requests morphine sulfate for pain relief every hour, and it is only ordered every four hours. What is the appropriate response of the nurse?
Tell him it is only ordered every four hours.
Let him know his addiction may get worse.
Notify the physician of his request.
Instruct him on possible side effects.
18. Where should a nurse administer eye drops?
Inner corner of the eye.
Outer corner of the eye.
Directly over the cornea.
Center of conjunctival sac.
19. If a patient is deemed "incompetent," this means that:
he/she can't afford to pay the hospital bill.
he/she won't follow medical direction.
a court proceeding has declared him/her unable to make his/her own decisions.
as a nurse you have assessed that he/she is not making good choices or decisions.
20. A "DNRCC" code means that:
the patient should not have their symptoms actively treated.
the patient's care is less priority than another patient whose code status is full code.
therapies and treatments have been limited to those that promote comfort.
it's no longer necessary to take the patient's vital signs.
This information is official and will be the new changes in the NCLEX-PN as pf April 2008
2008 NCLEX-PN® Test Plan
Test Plan for the National Council Licensure Examination for Practical/Vocational Nurses (NCLEX-PN® Examination)
Distribution of Content The percentage of test items assigned to each Client Needs category and subcategory in the 2008 NCLEX-PN® Test Plan is based on the results of the study entitled Report of Findings from the 2006 LPN/VN Practice Analysis: Linking the NCLEX-PN® Examination to Practice (NCSBN, 2006), and expert judgment provided by members of the NCSBN Examination Committee.
Client Needs Percentage of Items from Each Category/Subcategory Safe and Effective Care Environment Coordinated Care 12-18% Safety and Infection Control 8-14%
Health Promotion and Maintenance 7-13%
Psychosocial Integrity 8-14%
Physiological Integrity Basic Care and Comfort 11-17% Pharmacological Therapies 9-15% Reduction of Risk Potential 10-16% Physiological Adaptation 11-17%
The NCSBN Board of Directors Voted to Raise the Passing Standard for the NCLEX-PN Examination
12/7/2007 The NCSBN Board of Directors voted to raise the passing standard for the NCLEX-PN examination at its meeting on Dec. 5-7, 2007.
Contact: Dawn M. Kappel Director, Marketing and Communications 312.525.3667 direct 312.279.1034 fax dkappel@ncsbn.org
FOR IMMEDIATE RELEASE
CHICAGO - The National Council of State Boards of Nursing, Inc. (NCSBN) voted at its Dec. 5-7, 2007, meeting to raise the passing standard for the NCLEX-PN examination (the National Council Licensure Examination for Practical Nurses). The new passing standard is -0.37 logits on the NCLEX-PN logistic scale, 0.05 logits higher than the previous standard of -0.42. The new passing standard will take effect on April 1, 2008, in conjunction with the 2008 NCLEX-PN Test Plan.
After consideration of all available information, the NCSBN Board of Directors determined that safe and effective entry-level LPN/VN practice requires a greater level of knowledge, skills, and abilities than was required in 2005, when NCSBN established the current standard. The passing standard was increased in response to changes in U.S. health care delivery and nursing practice that have resulted in entry-level LPN/VNs caring for clients with multiple, complex health problems.
The Board of Directors used various sources of information to guide its evaluation and discussion regarding the change in passing standard. As part of this process, NCSBN convened an expert panel of 10 nurses to perform a criterion-referenced standard setting procedure. The panel's findings supported the creation of a higher passing standard. NCSBN also considered the results of a national survey of nursing professionals including nursing educators, directors of nursing in acute care settings and administrators of long-term care facilities.
In accordance with a motion adopted by the 1989 NCSBN Delegate Assembly, the NCSBN Board of Directors evaluates the passing standard for the NCLEX-PN examination every three years to protect the public by ensuring minimal competence for entry-level LPN/VNs. NCSBN coordinates the passing standard analysis with the three-year cycle of test plan evaluation. This three-year cycle was developed to keep the test plan and passing standard current. A PDF of the 2008 NCLEX-PN Test Plan is available free of charge from the NCSBN Web site https://www.ncsbn.org/1287.htm.
The National Council of State Boards of Nursing, Inc. (NCSBN) is a not-for-profit organization whose membership comprises the boards of nursing in the 50 states, the District of Columbia and four U.S. territories.
Mission: The National Council of State Boards of Nursing (NCSBN), composed of Member Boards, provides leadership to advance regulatory excellence for public protection. Media inquiries may be directed to the contact listed above. Technical inquiries about the NCLEX examination may be directed to the NCLEX information line at 1.866.293.9600 or nclexinfo@ncsbn.org.
The definition of a logit may be found on NCSBN’s Web site at https://www.ncsbn.org/02_18_05_brief.pdf.
I received this information from a good friend of mine. I always get asked this question in my emails. “Do you have to take the CGFNS in ________ (Name of State)?” This a the best way to explain it.
Each state has unique laws and regulations for Registered Nurses (RNs). Differences are apparent between states in requirements for foreign educated nurses.
Connecticut: an applicant for RN licensure educated in a foreign country must successfully complete the CGFNS exam prior to being accepted for examination and licensure in the state.
Arizona: As of August 1, 2002, The Arizona Board of Nursing will accept applications from foreign educated nurses who have not completed the CGFNS exam. These nurses will only need the TOEFL or similar English exam, if their nursing education was not in English. Additionally, nurses must have their nursing program transcripts evaluated for equivalency to U. S. nursing educational standards and validation of unrestricted licensure in their country of origin.
California: does not require CGFNS certification or require the foreign educated nurse applicant to pass the CGFNS qualifying exam. It does require that the nurse undergo a credentials review by specialists within the state licensing agency, not through CGFNS. California will review a copy of a credential certificate from another source, but the state must complete its own review of the transcript.
Maryland: has relatively flexible requirements relative to CGFNS certification. A course-by-course evaluation from CGFNS for foreign educated nurses is required. A CGFNS exam may be required after the Maryland Board of Nursing evaluates the applicant's credentials.
New Mexico: does not require CGFNS certification. It does require evaluation of nursing education credentials sent to the state board of nursing directly from a board-recognized credentialing agency or CGFNS.
New York: does not require CGFNS certification. It does require a credentials verification process by an independent organization such as CGFNS. (CGFNS certification is required for RN limited permit applicants; a limited permit authorizes the practice of registered nursing under the immediate and direct supervision of a licensed, currently registered RN, with the endorsement of the employer.)
Ohio: does not require CGFNS certification, but does require a credentials evaluation.
Oregon: does not require CGFNS certification, but applicants must have their credentials evaluated and prove proficiency in English.
Utah: requires applicants to undergo only the CGFNS credentials evaluation. That evaluation, in turn, will determine if the nurse applicant must obtain CGFNS certification before taking the NCLEX.
Michigan: As of June 2007, Governor Jennifer Ganholm has signed into law House Bill 4207, allowing Filipino and other foreign nursing graduates who wish to work in the state to apply to take the National Council Licensing Exam (NCLEX) without the need to pass the Commission on Graduates of Foreign Nursing Schools (CGFNS) qualifying tests.
Unless otherwise mention above, all other States require the CGFNS exam.
[Copywrite 2008 - ] do not republuish without permission
Okay, this is a much needed informational blog that I put together to explain the difference between internal, natural and external disasters. The NCLEX is focusing a lot on this due to the advent of 9/11/2001 and the changing times we live in. What is meant by Internal Disaster was when the buildings actually started emploding [collapsing upon themselves] killing and/or trapping thousands of people inside. This is your INTERNAL DISASTER. You know more than you can handle will be hurt and or dead. What do you do? You are the head of the INTERNAL DISASTER MANAGEMENT TEAM. When a disaster happens INSIDE and enclosed place with lots of people, you help the people that are least hurt first. The reason being, so that they can possible help you, with the other survivors or you have very little time and you know you can move the victim and they have a chance to survive. In an INTERNAL DISASTER help and survival are KEY.
How does this differ from a disaster from which they are now coming to your hospital? Now, we take all the people from the World Trade Center and now, they are start coming to your hospital. Of course, now you are over loaded. It is up to you as the triage nurse NOW to see the most traumatized person FIRST. The rest can wait. Once they are at their destination of medical care, the gear shifts, you help the more tramatized patient first to ensure their chances of survival.
An EXTERNAL DISASTER can also be known as a NATURAL DISASTER in some cases. This involves a disaster that occurs outside the hospital as well such as a plane crash, or a train wreck ect. To summarize the three types of disasters: an INTERNAL DISASTER is a large number of people wounded/hurt/dead in an enclosed place be it inside or outside. [ie: 9/11 with the explosion of the twin towers in New York or the Pentagon in Washington]. An EXTERNAL DISASTER is a disaster away from a medical center and it is "man made". [ie: Plan crash, train wreck or casualties of war].
In a NATURAL DISASTER, say the San Diago Bridge collapses or there is a giant volcano ect. Still use the same rule as in the 2001 ect above. Help the people off the bridge [the least wounded] before the bridge collapses. The goal here is to save lives. You can not do anything about the people whose cars have already fallen into the ocean or for the people to whom the fire has already engulfed. Once, you get the people into a save distance, then you do the whole triage thing helping the most wounded.
Does that make it any clearer? Please continue to ask your questions. This is an important area of discussion. My goal personally, is not to answer the actual questions. You will never pass the nclex memorizing questions. We must understand CONCEPTS to pass the NCLEX.
Now, let us move on to delegating in terms of triage:
How do you prioritize in a disaster? Remember the word T-R-I-A-G-E. Trauma, R=respiratory, Intracranial pressure & mental status, An infection, GI-upper, Elimination-lower. In that order. Prioritizing, starting with trauma first and lower GI injuries last. You will not need to know how to tag for the nclex but I place this here so that you can understand the concept.
Triage is a French verb that means "to sort". The goal of triage is to do the greatest good for the greatest numbers of individuals. This is accomplished by having a system to quickly assess each patient, categorize and prioritize them according to their needs. Be sure to evaluate the hazards before entering an area to perform triage. Triage should be initiated whenever there are more injured persons than rescuers.
The four (4) triage categories and a description of their meanings are:
• Green is the lowest priority and is used for walking wounded or patients who may not need to go to the hospital. Patients in this category may have minor musculoskeletal or soft tissue injures. They can wait for treatment and/or transport until all other patients have been removed from the scene.
• Moving up the tag, yellow is the next category and is used for patients who definitely need to go to a hospital, but not immediately. These patients have injuries that are serious but not life-threatening, such as burns without airway problems, major or multiple bone or joint injuries, and back injuries without spinal cord damage. These patients will be treated and transported after the critical (or red-tagged) patients have been taken to trauma centers or hospitals.
• The highest priority is red, and it is used for critically-injured patients with treatable life-threatening injuries or illnesses. This might include airway and breathing difficulties, decreased mental status, and uncontrolled bleeding. These patients will be treated and transported from the scene first.
• The final category is black and it is used for dead and unsalvageable patients such as someone in cardiac arrest. These victims will be removed from the scene, but only after all of the living/salvageable patients.
START Now METTAGs in hand, you now begin the tremendous responsibility of organizing the chaos. Simple Triage And Rapid Treatment, or START, is a triage system that was developed in California in the early 1980s. It is simple and fast, requiring less than sixty seconds for each patient. It does not require any special assessment or diagnostic tools. EMTs do not need a blood pressure cuff, a stethoscope or even a penlight. The system provides for rapid life saving stabilization such as airway control and bleeding control, but excludes CPR. A word here about cardiopulmonary resuscitation: CPR is not performed in these situations because two or three rescuers would be required to treat a single patient whose probability of survival (in the chaos) is zero-to-none. On the other hand, those same two or three rescuers could play an important role in treating five, ten, or maybe even more patients.
How to Start The first (and easiest) thing you must do is separate the walking wounded from the other victims with more severe injuries. This can be done by shouting slowly and clearly or using a bullhorn. Designate an area for walking wounded and instruct anyone who can walk to get up and move to that area. (Note: Some victims may be unwilling to leave their friends or family members who are ill or injured; permit them to stay as they can help you with managing the patient.) The theory here is that if a person can walk, he does not need immediate medical care. Green-tagged patients will not be ignored. Rather, they will be further assessed and treated when all of the red and yellow patients have been treated and/or transported and resources become available to take care of them.
All of the patients in this area are considered to be "green tags." Later you will return to the "green" area and "officially" tag them but only after you have triaged the red and yellow victims. With this green group in a separate (safe) location, you are well on the way to being organized.
Evaluating the Remaining Victims The next step is to triage the remaining victims. By evaluating respiration, perfusion and mental status, you sort and separate them into three categories which give the greatest priority to those victims who are most critically injured, and have the greatest chance of survival. Let's quickly review our color-coded tags:
• Red Tag: those victims whose injuries are life-threatening and must be immediately treated and transported.
• Yellow Tag: those whose injuries will allow for delayed treatment and transport.
• Black Tag: those who are dead or unsalvageable.
How do we make that determination? RPM.
R = Respirations
The first assessment is for presence and rate of respiration (RPM). Is the victim breathing? If there is no respiratory effort, reposition his head and reassess. If there is still no respiratory effort, the victim is considered "dead/non-salvageable." Apply a black tag and move on to the next victim.
What if he is breathing? Assess the rate. If the rate is above 30 breaths-per-minute, the patient is critical and requires immediate care. (Remember from your EMT-B class that a respiratory rate above 30 and below eight breaths-per-minute (BPM) is not adequate to meet the body's needs and may quickly progress to cellular death.) As triage officer, however, you do not stop to ventilate this patient! He is given a red tag and you move on to the next victim. You do not need to complete any other components of the START assessment on this patient.
If the patient requires simple airway maintenance (e.g. manual head positioning), you will need to assign someone to this task. If no emergency service personnel are available, remember that you have a pool of human resources in the green tag area. If no one there is available, you will need to improvise by placing something under the patient's head/neck to keep the airway open. It should also be noted here that airway maintenance might need to be done without standard cervical spine precautions. If the respiratory rate is less than 30 breaths-per-minute, move on to the next part of the assessment process.
P = Perfusion
The next step is to assess for Perfusion (RPM). As you may remember from your EMT-B course or core refresher, perfusion is the circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs. If the body lacks adequate perfusion or circulation, cells, tissues, and organs will die.
How do we assess perfusion in victims at an MCS? Check for the presence of radial pulses. However, note that we are not concerned with a pulse rate at this time. If the patient has no radial pulses, he is critical and in immediate need of care. You apply a red tag to the patient and move on to the next patient.
If there are no radial pulses, there is no need to check for carotid pulses. Why not? If the patient does not have a carotid pulse, then he will also have no respiratory effort, and therefore, would have been triaged as dead/non-salvageable in the previous step. Recall also that the presence of a radial pulse correlates to a systolic blood pressure of at least 80 to 90 mmHg. If radial pulses are present, move onto the next assessment.
There is one other assessment-finding related to perfusion status which must be mentioned here: severe bleeding. Uncontrolled bleeding is potentially life threatening and must be treated when found. Again, you may have to improvise by using the cleanest piece of cloth around which may not be sterile.
Do not forget your human resources available in the green area. Delegate someone to maintain direct pressure on the wound and move on to the next victim. Your job remains triage.
M = Mentation
The third and final assessment is for Mentation (RPM) or mental status. A patient who is either unconscious, or conscious but unable to follow directions, is critical and requires immediate care. You will apply a red tag to this patient and move on to the next victim. If the patient has a normal level of consciousness and can follow directions, he is not in immediate need of care and is triaged as yellow.
As soon as a patient meets any one of the criteria for triage as critical/immediate, you should apply a red tag, delegate someone to provide rapid treatment (e.g. maintain an airway or control bleeding), stop any further assessment and move on to the next victim.
Any patient who makes it through all three assessments, without any findings that would result in triaging as critical/immediate, is given a yellow tag. No triage system is 100% fail safe. It is, however, reasonable to assume, that a patient who cannot walk, but is maintaining his own airway, breathing at a rate less than 30 breaths- per-minute, perfusing radial pulses, has no sign of uncontrolled bleeding and follows commands, is in need of medical attention at the hospital, but can wait until all of the critical/immediate (red tags) are removed from the scene.
Secondary Triage
Let's quickly review how START integrates with the METTAG system. • Anyone who gets up and walks to the designated area is given a green tag (may not even require hospital care). • Anyone who is not breathing is given a black tag (dead/non- salvageable). • Anyone who fails one of the RPM assessments is given a red tag (critical/immediate). • Anyone who cannot walk but passes all of the assessments is given a yellow tag (delayed).
