00:00
So, when you're looking at this list again, remember just
want to bring you back to it to
see we've got 4 major categories and 2 of those major
categories have subcategories
and there's the percentages. So the questions that you see
are going to be broken
down by these percentages. See that range like take for
example look at health
promotion and maintenance. You have a range of 6-12%. So
could be any number within
the range. That's why everyone's test is a little different
as far as the exact
percentages but overall it's going to fall within those
ranges. Now let's talk about some
of the categories. Ready to dive in to an example of one of
the test questions? Well,
before we get to that I want you to know where this test
question is coming from.
00:50
First, it's the NCBSN test plan for the NCLEX, but it's
coming from a very specific category.
00:57
Now the main category is safe and effective care
environment, but we're going to pull
this question directly from the coordinated care
subcategory. Alright? So, the definition
of this subcategory is the LPN or VN collaborates with
healthcare team members to
facilitate effective client care. So, let's take a look at a
question. Now when you're looking
at this question, I want to give you some tips on test
taking strategies that will work
for you in nursing school too but they're essential on
NCLEX. Now first of all, look at the
words of the question. We call that the stem. So you take
the stem of the question and
then I have the 4 answer options. Right? Now, these are
example questions straight
from the NCLEX test plan. So, you know that this accurately
represent the type of content
that could be in this section. So, let me look at that stem
of the question and I'm
going to read it to you. So the nurse in a long-term care
facility is making client care
assignments for unlicensed assistive personnel or UAP. Which
of the following
statements by the nurse would provide the UAP with the best
directions about the
assignment? Now, here's what most of our brains do. We kind
of use this one a scheme
that question and then jump down to the answer choices, we
look for our favorite too.
02:23
We wafu, wafu, wafu, wafu, wafu, wafu, wafu, wafu, wafu and
then you pick your
answer and you go on to the next one. Hey, are you willing
to trust me and see if you
try a little bit different strategy. Instead of spending
more time in the answered
choices, I want you to flip that model and spend more time
in what we call the stem
of the question or the words of the question. Now, here are
things I want you to look
for. So first of all, try to ignore those 4 answer choices.
I know it's really tough
and when you're developing the skill, if you even have to
put your hand over the
answers do it. So let's focus just on that stem of the
question and let's see what kind
of things we're looking for. I'm going to look for what's
particular in this situation.
03:11
What setting are we in? What is the context of this
question? And then I'm going to put
it into my own words. Very important. You want to start
scoring better on your test?
Just do this one thing. Spend more time in the stem, put it
into your own words and
make sure you nail the concept, you're going to see your
test course go up. So let's
take a look. The nurse in a long-term care facility, okay so
I know that's where I am,
is making client care assignments for the unlicensed
assistive personnel. Now, since
I am taking the NCLEX-PN exam, the nurse in this question is
a licensed practical nurse or
licensed vocational nurse. So, the nurse in a long-term care
facility, they're making
client care assignments for unlicensed assistive personnel.
Is that appropriate?
Absolutely, because you can delegate to UAPs. Now the
question says which of the
following statements by the nurse would provide the UAP with
the "uh-oh, yeah."
you know that word tells me right there with the best
directions about the assignment
right there that says "Uhmmm there's probably more than 1
right answer down there."
So, you just got to Elsa that as they say "let it go." If
you spend time arguing with
the screen and being frustrated that there's more than 1
right answer, you're just
wasting your mental energy. Know that we're not even looking
at the answer choices
yet but we know and we see a term like "best, most
important, first." That's going to
tell us it's asking us to prioritize, pick the top answer,
the best answer from all of the
answer choices. So there is likely more than 1 correct
answer. So, let's do what we
said. We're going to look at the stem, we're going to put
into our own words. I'm going to
say a nurse in a long-term care facility is making
assignments to UAPs which they
would be best for the nurse to get directions about the
assignment to the UAP.
05:19
So who am I? I'm the nurse. Who else is in the question? The
UAP and is asking me
what are the best directions about the assignment. So I have
to think about what
I know about delegation. Is this appropriate I delegate to
UAP? Absolutely. Now I'm
going to look at what's the best way because I know when I'm
delegating, I want
the most clear, concise directions. Right? I want to be very
objective. So clear, concise,
and objective are the best type of directions when
delegating. So, now we have our
answer choices. You see we've got 4 options there. Now, I'm
going to pause for a minute
and let you read those. Okay, we got to start somewhere. So,
I'm going to start with
#1. I know this is a prioritization question so I'm going to
have to compare the answers
to the other ones. So, number 1, encourage the client to
increase daily fluid intake.
06:23
Does that seem wrong? Well, nothing in the question tells me
that they are a renal
patient or CHF patient so there's nothing wrong with that,
but I don't know if it's the
best directions yet. So what's my next step? I'm going to
look at answer #2. That says
ambulate the client 20 feet or 6.7 meters every 4 hours
beginning at 0900. Now between
answer # 1 and answer #2, which one seems the most clear,
concise, and objective,
because I'm delegating? Right. #2 is a more clear, concise,
and objective answer than
#1. Now, let's cross off #1 because that's what I want you
to do is to eliminate an
answer. Don't just gravitate to the one you like. Eliminate
#1, we're keeping #2 in
for now. And now let's look at #3. Assist the client to
perform passive range of motion
exercises. Now, what do you think? Is that one more clear,
concise, and objective than
#2? Or which one is a better direction? Actually, #2 is
still the winner. There's nothing
wrong with #3. It's okay. You're going to help them perform
passive range of motion
and that's what you would do. So, that's why #2 is a better
answer, it's more clear,
it's more concise, it's more objective, and specific. Now,
#4, let's see if it's going to be
#2 or #4 that wins. Reinforce physical therapy instructions
about the proper use of a
walker. Okay, is there anything wrong with that? Can I do
that? As a UAP, I can. Right?
Because reinforcing teaching is good, I can't do the initial
teaching as a UAP but I
reinforce with the healthcare team has asked me to do, but
which one is the best set of
directions. It doesn't mean these other things won't be
done, they're just asking you
"Can you identify which is the best set of directions?"
There you go, #2 is the winner.
08:34
That is more clear or concise and more objective than #4.
Okay, so really all four of these
answers could potentially be correct but once they ask me to
prioritize, ask me what
the best directions are then I know I have to compare each
of the answers to each
other, eliminate them one by one until I can arrive at the
best correct answer. Let's
take a look at another one of the categories. So, we're
going to look at safe and
effective care environment, that's the category. And then
we're going to look at safety
and infection control which is one of the 2 subcategories of
safe and effective care
environment. Now, the NCBSN defines this as safety and
infection control, is the LPN
contributes to the protection of clients and healthcare
personnel both from health and
environmental hazards. Alright, you ready? Let's take a look
at another question.
09:28
Now remember the recommendations, don't look at the answer
choices until you really
rip up hard that stem. So let's look at the stem, the nurse
is reinforcing teaching
with the client who's using a mechanical lift. Which of the
following information should
the nurse reinforce? Alright, so the nurse, say LPN or the
LVN, you as soon as you
get your license, you're reinforcing teaching with the
client who's using a mechanical
lift. That makes sense. They have used it before, they have
been taught before,
I'm just reinforcing it. Which of the following information
should the nurse reinforce?
Okay, that's just another way of asking me what's the best
instruction to reinforce
with this client to keep them safe? Remember talking about
environmental hazards,
health hazards, so this is an appropriate question in this
subcategory. So we've got
4 options. Look at the stem, I've put it into my own words.
Now I'm going to work
my way through the options. Honestly, it doesn't matter if
you start top to bottom,
middle to top, it doesn't matter but the idea is eliminate
each answer one at a time
and that way you can make sure you get your best answer.
Now, #1. Place your hands
on the sling. Is that reinforcing safe teaching for the
client? Really isn't. Okay, you
don't want their hands on the sling. That's very specific to
a safety hazard with using a
mechanical lift. So we can cross out and eliminate #1 and
what I recommend to
students, take a piece of scratch paper, write down 1, 2, 3,
4 and force yourself to
cross write to #1 in this case. Now when you take your NCLEX
exam, you'll be allowed
to use a write-on wipe-off board. Once you fill it up,
they'll give you another one,
you don't get to erase it, but I would encourage you to use
this strategy in the exam
testing center because this is one they'll allow you to use.
They don't like you to write
lots of things on it, but they will allow you to write like
1, 2, 3, 4. You can write numbers
on it and cross through them. So, we identified that #1 is
not good safety teaching,
right, to put their hands on the sling of a mechanical lift.
Let's look at #2. You should
lie prone on the sling. Wait a minute, picture what prone
is. So, is that lying on my back?
No, prone is lying on my stomach. Do we ever put a patient
prone in a mechanical lift?
No. Now let me tell you, a stressed brain is likely to get
confused by things that in the
light of day you would not be confused. Why do I know this?
Because as a faculty
when I do exam reviews with students, they come into my
office, we look at a test
question and I look at them and say "Why did you pick #2 on
this question?" They will
say "I have no idea why I picked that answer." If you read
it too quickly, if you're not
slowing down, if you're not picturing what that answer
choice is saying, you might miss
that it was prone but we all know since we're doing this
together that is not
appropriate. Next, we've got #3 and #4. Again, it doesn't
matter which way you
want to go. Look at #3, look at #4. Now, let's just keep
going in order. So, #3, place
your arms across your chest. Hey, if I'm taking the test I'm
going to place my arms
across my chest. I use my body in very discreet movements to
help my brain focus
because a stressed brain is not usually as efficient. So
anything I can do to help my
brain out to focus, I do. So #3. Anything wrong with that?
No, actually that seems
pretty good. Well let me compare it to #4. You will need to
rock to a standing position.
13:25
Okay, between #3 and 4, which one seems the safest? Correct,
#3 is appropriate for
using a mechanical lift, it will protect my patient and keep
them the safest that's why
the 3rd option, #3, is the correct answer.