Walkthrough: Physiological Adaptation Q17 – NCLEX-RN®

00:00 The nurse is caring for a client who is diagnosed with liver failure and is on the transplant list. Which client statement indicates further teaching from the nurse is needed regarding postoperative care after a liver transplant. Okay, when you're reading things in your head, that's what I want you to do. You see a bold statement? It's there for a reason so make sure you emphasize that and tell your brain to process what it is, but let's start with the first of the 2 sentences. The nurse is caring for a client who is diagnosed with. I'm going to pay attention to that. The next diagnosis is liver failure and it's so significant that they're on the transplant list. So we know that it's bad. So I'm a nurse taking care of a client who is in liver failure that's so severe, they're on the transplant list. That's the first sentence. Look at that 2nd sentence. Which client statement indicates, look at that bold word, further teaching from the nurse is needed regarding postoperative care after a liver transplant? Now, when I work with brand new freshman students, this is the type of question that drives them nuts because they're not used to seeing that last line and it kind of blows their mind. Well, it really doesn't have to and if you've been taking nursing questions, you probably already know this but humor me, let's walk through it. When it indicates further teaching, what I'm looking for for the answer is they don't quite understand it, yes. So their statement is going to be something that is wrong or unsafe. So which client statement indicates the need for further teaching means okay. They don't quite get it so they're saying something that's wrong or incorrect and the topic of this question is postoperative care after a liver transplant. So, you're going to see 4 statements. Right? Anytime you see something like this you're going to see 4 statements. This could also be a select-all-that-apply question but this one is not that. Okay. So, we've got 4 options coming up in just a minute when we show you the answer choices. You're looking for the one that indicates the need for further teaching. So 4 times, we have to be really particular about saying. Read statement number 1 or start wherever you want, but let's start with number 1. Now remember, you can't see the answers yet because I want you to know the strategy. When you look at answer choice number 1, you're going to read it and then say "Does this indicate the need for further teaching?" Number 2, does this indicate the need for further teaching? Number 3, does this indicate the need for further teaching? So, I know that seems very tedious and if you're just learning these skills, it's going to feel like you're swimming through Jel-O. It's going to seem so slow. That's okay. Slow and steady wins the course. Okay, that's what you want. So you want to make sure if you're slowing down, you're observing things that you may have been missing in other questions and as you practice more questions you'll come up to a normal speed but we still want you seeping through questions because that's when students make the biggest errors. So, you have your scratch paper there, you have just the numbers; number 1, number 2, number 3, and number 4 written on that. Please use that part of your scratch paper as you're going through each one of these 4 options. When you eliminate an answer, cross through the number and say why you did. When you keep an answer in there, brilliant, say why you did it. Now, remember sometimes it's a game of narrowing it down and comparing the answers to each other. So, take all the time you need to do the work that you need to do to think through these carefully at whatever speed is appropriate for you. Remember, it's just you and me doing this. So don't worry about anyone else or how quickly other people go through the test. Do your best, come back, and we'll walk through the question together.

04:08 Welcome back. So, how did it feel going through that process? Listen, I know I'm not trying to be your diary, but I want you to think about your thoughts. That's called metacognition. It's really a cool thing, but oftentimes when we're nervous and when we're stressed we don't pause and do that. Doing that while you're practicing, taking test questions is really going to help you identify what's the best investment of your time to do better. See, nobody has got time to be just studying for 9 hours a day. We want to make sure that we help you identify where the best investment of your time is.

04:41 If you only have this amount of time to study, then where you should focus that effort? So, thinking about your thinking feels kind of weird but if you do it it's just between you and your NCLEX notebook. Right. No one else has to know. It will really help you choose how you're going to invest your study time. So, we got number 1, if I start experiencing belly pain I will notify someone. So does that indicate further teaching for postoperative liver transplant? Okay, so if they start experiencing belly pain, should they notify someone? Yeah, they should and that would not indicate the need for further teaching because I'm looking for something that's wrong or unsafe. So number 1, I'm going to cross you off and that's why because that is not wrong or unsafe. I would want them to do that after our transplant. Number 2, is it wrong or unsafe that I will continue to abstain from alcohol use? That is not wrong and that is actually the safest. Right? They've got a liver transplant, it's just getting settled in there. Abstaining from alcohol is going to give you a much better shot at that liver getting going and doing what we need it to do. So number 2, I am going to get rid of you and that's why I want you to abstain from alcohol. That is not an unsafe statement so I know that further teaching is not required. Now, number 3. A slight fever is expected and I'll take acetaminophen if I get one. Now, those are not 2 separate statements, they don't go together. So, a slight fever is expected. You might be I'm not sure but I'll take acetaminophen if I get one. Now think about the organ they just replaced, right, and does that drug have any impact on the liver. Yeah, sure does. That's where it's metabolized. So, I'm going to leave that one in. See, I'm not convinced. That's the right answer, but for now I don't have a strong enough argument to eliminate it so I'm just going to say "Alright, you're here for a minute and then I'm going to go on to the next one and see what I think." I'll be on medication for the rest of my life. Does that indicate the need for further teaching after a liver transplant? No, because that's true. It's not wrong or unsafe, they will be on medication for the rest of their life so that does not indicate the need for further teaching. When I compare 3-4, it's very clear 3 is one that they need further teaching. We're going to want them to really limit the Tylenol and off these 4 answers. Okay, stop for just a minute and think about what we're talking here. Of these 4 answers, see I like things neat and tidy when it comes to thinking. I like things I'm more comfortable where things are black and white. Very few things on an NCLEX or any nursing exam are black and white. So I want you to think about this is like you're playing a game of cards and I dealt you 4 cards. You have to play the hand ____. It doesn't really do any good for you to argue, say that's not a great answer, I would have worded it differently, blah, blah, blah. Again, nobody cares except us. Right? Just at the one who's yelling at their computer screen. So just know there's never one answer that's always correct. It's all relative. It is relative to the other answer options because you're looking for the one that best indicates the need for further teaching.

08:17 Okay with all that said, that is a concept to take to all your questions because that's the goal. If you're going to spend this much time practicing for your success, then you want to know concepts and ideas and strategies, not just to answer 1 particular question but to improve your skills answering all the questions. So, good job doing the work, write yourself some notes about your thought process on this.

08:42 Is there any content from this question that you need to add to your notebook that you want to keep adding to that notebook of review and that's going to help you retain even the content and information that was a little sketchy for you. So good job, come back, and let's do another question when you're ready.