for Students Preparing for the NCLEX-RN® Examination


Introduction for Students Preparing for the NCLEX-RN® Examination



Overview


The NCLEX-RN® examination is integrated and comprehensive. Nursing candidates are required to answer questions that necessitate a recognition and understanding of the physiologic, biologic, and social sciences, as well as the specific nursing skills and abilities involved in a given client situation.


This textbook and CD contain a total of 4210 questions. They include objective multiple-choice questions, as well as alternate-format questions (615 items) such as multiple-response items, ordered-response items, fill-in-the-blank items, hot spot items, exhibit items, and audio items. To answer the questions appropriately, a candidate needs to understand and correlate certain aspects of anatomy and physiology, the behavioral sciences, fundamentals of nursing, the effects of medications administered, the client’s attitude toward illness, and other pertinent factors such as legal responsibilities, leadership and management, and critical thinking. Most questions are based on nursing situations similar to those with which candidates have had experiences because they emphasize the nursing care of clients with representative common health problems. Some questions, however, require candidates to apply basic principles and techniques to clinical situations with which they have had little, if any, actual experience.


To prepare adequately for an integrated comprehensive examination, it is necessary to understand the discrete parts that compose the universe of material under consideration. This is one of the major principles of learning that has contributed to the development of Mosby’s Comprehensive Review of Nursing for the NCLEX-RN® Examination.


Using this principle, the text begins with Unit 1—Foundations of Nursing Practice. The information in this unit is essential to each of the major clinical areas: Unit 2—Medical-Surgical Nursing, Unit 3—Mental Health/Psychiatric Nursing, Unit 4—Childbearing and Women’s Health Nursing, and Unit 5—Child Health Nursing. Chapters at the end of each unit contain questions that test the student’s knowledge of principles and theories underlying nursing care specific to the content within the unit. The questions represent a variety of situations, in a variety of settings, and with a variety of nursing objectives. Each question has rationales for the correct answer and incorrect options, as well as a classification of the question that reflects the NCLEX-RN® examination test plan. The following descriptions are presented to assist in the understanding of these classifications.



Classification of Questions


Every question in the book and in both comprehensive exams is classified by the following categories: Client Need, Cognitive Level, Integrated Process, Nursing Process, and a Reference to content within Mosby’s Comprehensive Review of Nursing for the NCLEX-RN® Examination. In the Comprehensive Exams the percentage of test questions assigned to each Client Need category and subcategory reflects the 2010 NCLEX-RN Test Plan. These percentages are included adjacent to the specific Client Need category.



Client Need


These categories reflect activities most frequently performed by entry-level nurses.



1. Safe and Effective Care Environment


    Management of Care (16% to 22%): These questions provide or direct the nursing activities that promote the delivery of care to clients, family members, significant others, and other health care personnel.


    Safety and Infection Control (8% to 14%): These questions address the protection of clients, family members, significant others, and health care personnel from health and environmental hazards.


2. Health Promotion and Maintenance (6% to 12%)


    These questions provide or direct the nursing care of the client, family members, and significant others. They include knowledge of the principles of growth and development, prevention and/or detection of health problems, and interventions to achieve optimum health.


3. Psychosocial Integrity (6% to 12%)


    These questions provide or direct the nursing care that supports and promotes the emotional, mental, and social well-being of the client, family members, and significant others experiencing stressful events, as well as clients with acute or chronic mental health illness.


4. Physiological Integrity


    Basic Care and Comfort (6% to 12%): These questions address the provision of comfort and support in the performance of the activities of daily living. These include elimination, mobility, hydration, nutrition, hygiene, comfort, rest, and sleep.


    Pharmacological and Parenteral Therapies (13% to 19%): These questions address the provision of care related to the administration of medications, parenteral therapies, and blood products.


    Reduction of Risk Potential (10% to 16%): These questions address the nursing care that may limit the likelihood of the development of complications or health problems related to existing disorders, treatments, or procedures.


    Physiological Adaptation (11% to 17%): These questions address the provision and management of the nursing care for clients with acute, chronic, or life-threatening physical health problems.



Cognitive Level


This category reflects the thinking processes required to answer the question.


Knowledge: These questions require the test taker to recall information from memory. For example, they involve knowledge of facts, principles, generalizations, terminology, and trends.


Comprehension: These questions require the test taker to understand information. They involve the interpretation, paraphrasing, and summarization of information, as well as the determination of implications and consequences of information.


Application: These questions require the test taker to use information, principles, or concepts. They involve identifying, manipulating, changing, or modifying information as well as performing mathematical calculations.


Analysis: These questions require the test taker to interpret a variety of information. It involves the recognition of commonalities, differences, and interrelationships among data, concepts, principles, and situations.



Integrated Process


Integrated processes are fundamental components critical to the practice of nursing. They include the nursing process, caring, communication and documentation, and teaching and learning. Because the nursing process (a scientific problem-solving process that involves critical thinking) is essential to all nursing care, it is included in each answer/rationale.


Caring: These questions reflect interactions between the nurse and client/significant others that demonstrate mutual trust and respect. They include the nursing care that provides support, encouragement, hope, and compassion.


Communication/Documentation: These questions involve verbal and nonverbal interactions between the nurse and client, significant others, and members of the health care team. Client status, events, and interventions are communicated and documented according to rights, responsibilities, and standards of care.


Teaching/Learning: These questions include nursing assessments and interventions that relate to the attainment of knowledge, skills, or attitudes that meet client needs.



Phases of the Nursing Process


This category reflects the problem-solving process used by nurses to identify client needs, plan and implement nursing care, and evaluate client responses to care.


Assessment/Analysis: This phase requires the nurse to obtain objective and subjective data from primary and secondary sources, to identify and group significant data, and to communicate this information to other members of the health team. This phase also requires the nurse to interpret data gathered through assessment in order to make nursing decisions. Client and family needs are identified, and short-term and long-term goals/outcomes are set.


Planning/Implementation: This phase requires the nurse to design and implement a regimen with the client, family, and other health team members to achieve goals/outcomes set during the assessment/analysis phase. It also requires setting priorities for intervention. The client may be given total care or may be assisted and encouraged to perform activities of daily living or follow the regimen prescribed by the health care provider. In addition, it involves activities such as counseling, teaching, and supervising health team members.


Evaluation/Outcomes: This phase requires the nurse to determine the effectiveness of nursing care. Care is reviewed, the client’s response to intervention is identified, and a determination is made as to whether the client has achieved the predetermined outcomes and goals. It also includes the appraisal of factors that influence goal achievement (e.g., the client’s abilities to fulfill the health care plan—physical, emotional, financial) and modification of the original plan as needed.




General Clues for Answering Multiple-Choice Questions


On a multiple-choice test, the question and possible answers are called a test item. The part of the item that asks the question or poses a problem is called the stem. All of the possible answers presented are called options. One of the options is the correct answer or key; the remaining options are incorrect. The incorrect options are called distractors because their major purpose is to distract the test taker from the correct answer.



A Read the question carefully before looking at the answers.



B Because few things in life are absolute without exceptions, avoid selecting answers that include words such as always, never, all, every, and none. Answers containing these key words are rarely correct.


C Attempt to select the answer that is most complete and includes the other answers within it. An example might be as follows. A stem might ask “A child’s intelligence is influenced by:” and three options might be genetic inheritance, environmental factors, and past experiences. The fourth option might be multiple factors, which is a more inclusive choice and therefore the correct answer.


D Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.


E Watch for grammatical inconsistencies. If one or more of the options is not grammatically consistent with the stem, the alert test taker can identify it as a probable incorrect option. When the stem is in the form of an incomplete sentence, each option should complete the sentence in a grammatically correct way.


F Avoid selecting answers that state hospital rules or regulations as a reason or rationale for action.


G Look for answers that focus on the client or are directed toward feelings.


H If the question asks for an immediate action or response, all of the answers may be correct, so base your selection on identified priorities for action.


I Do not select answers that contain exceptions to the general rule, controversial material, or degrading responses.


J Reread the question if the answers do not seem to make sense, because you may have missed words such as not or except in the statement.


K Do not worry if you select the same numbered answer repeatedly, because there usually is no pattern to the answers.


L Mark the number next to the answer you have chosen.


M Answer every question because on the NCLEX-RN® exam you must answer a question before you can move on to the next question.

Related posts:

  1. Nursing Care of Clients with Disorders Usually First Evident in Infancy, Childhood, or Adolescence
  2. Foundations of Mental Health/Psychiatric Nursing
  3. Nursing Care of the Newborn
  4. Nursing Care of Infants

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Mar 17, 2017 | Posted by in NURSING | Comments Off on for Students Preparing for the NCLEX-RN® Examination

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