7/28/2019 NCLEX Strategies

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Breaking down the NCLEX questions

Read directions. What are you being asked to do?

Answering Questions:Read the Stem. Do you know the correct answer before reading the options? Identifypatient-centered options. When any part of an option is wrong, entire answer is wrong.

Identify opposites - If two choices have opposites, like increased heart rate or decreasedheart rate, one of the two choices is usually the correct answer. Identify Absoluteanswers- choices containing the words all, never, always and the like are very likely tobe incorrect. Unrelated to the question- if the question asks for interventions and theaction in the choice is an assessment, it is obviously incorrect.

NCLEX Questions:

 The Stem is the question.

 The case scenario which explains the situation or patient’s condition

 The issue is the specific problem or subject of the question

 The analysis focuses on what you know about the issue:

Problem

Procedure

Drug

Disorder

Behavior

 The options = choice of answers, and distractors (choices that look correct but areactually wrong). It is easier to analyze once you have identified the different partsof the question.

Look for keywords: words that set priority or directionalized care:No matter how a long a question is, there is that one word or phrase that bears the mostweight. Key words may relate to the patient, the actual problem, and to specific aspectsof the problem.

General Keywords Universal Keywords Negative Keywords

Initial or priority nursingaction

Day of admission

After several days Early

Late

Immediately after

Most likely

Least likely

All

Only

Entire

Every

Always

Contraindicated

Inappropriate

Not

No

Never

Rarely

Least Essential

Distractors: Answers that don’t answer the question.

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Repeated words: The same words may appear in the NCLEX question and in thecorrect answer. It may be the same word or a synonym of the word.

The Odd answer: The one answer that is different from the rest is apt to be the correctanswer.

Umbrella principle: If all answers seem to be correct and applicable, choose the onethat includes all the choices in it. One answer is better than all the others because it

includes them.

Eliminate obvious answers: In NCLEX questions asking for a single answer, somechoices are obvious to be incorrect. You should be able to identify some of theseincorrect responses if they are/have:

The same idea: Eliminates choices that have the same concept or idea. These choicesare just reworded but if you analyze them carefully, they are actually one and the sameAfter eliminating the obvious incorrect answers, analyze the remaining choices andselect the option that best answers the stem.

Prioritize based on patient’s needs:Questions containing the words initial, first, priority- is asking for your prioritizing skills. The choices are usually all correct but only one should be done first. When prioritizing,you should always remember the following:

ABC’s- Use ABC’s (airway, breathing and circulation). Patients with airwayproblems or interventions to provide airway management are top priority.

Maslow’s hierarchy of needs- Remember the hierarchy and from there you willknow that physiologic needs come first before safety and security and so on and soforth. This is typically used in patients with multiple problems to be addressed.

Nursing process- Assessment should always be done before planning anything orinstituting interventions. Unless the question already has subjective and objectivedata about the patient, assessment is at the top of the list

Patient first before equipment- If a patient is attached to an equipment and

sudden removal of the equipment causes problems, primary assessment and

interventions should be directed to the patient and not to the equipment.

How to answer T/F questions: Determine keywords – always, never, all, or none

statements using these words are probably false. If any part of a statement is false,

entire statement is false. Don’t pause to analyze too much, work quickly, and don’t

second guess yourself.