Walkthrough: Reduction of Risk Potential Q7 – NCLEX-RN®

by Rhonda Lawes, PhD, RN

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    00:01 The nurses caring for a client who presents with slurred speech and weakness of the left arm.

    00:07 The symptoms resolved within 10 minutes of arrival without intervention.

    00:12 Which information will the nurse provide to the client? Select all that apply.

    00:18 Hang on, before you even start to respond to that emotionally.

    00:22 Let's go through this question, break it down, so we can give you the best chance of getting all the answers. Correct.

    00:30 So the nurse, that's me, caring for a client who presents with what? Slurred speech, and weakness of the left arm.

    00:40 Now, hey, when I'm testing, and I'm reading a question, I know that I'm stressed.

    00:45 So I'm going to make sure that I do everything I can to focus my brain.

    00:49 So I would even do that.

    00:50 I would say slurred speech and weakness of the left arm.

    00:54 So I would let my left arm flop down, just to orient my brain and make sure I'm engaged in focusing on this question.

    01:02 So they've got slurred speech, and a weakness of the left arm.

    01:08 Remember, you can't read questions out loud in a testing center, but you can do that in your brain.

    01:13 Slurred speech is not normal.

    01:17 Weakness of the left arm is also not normal.

    01:21 So here we have abnormal assessment.

    01:25 We know there's a problem.

    01:28 All right, that's the first sentence.

    01:30 Somebody who presents with abnormal assessment.

    01:33 They have slurred speech, and weakness in their left arm.

    01:38 Next sentence.

    01:39 The symptoms resolve, woohoo, that's good.

    01:42 They resolved within 10 minutes of arrival without intervention.

    01:47 So we didn't do anything that facilitated those symptoms resolving.

    01:52 The patient's body did it all by itself.

    01:56 So now I want you to think, "Hey, what's going on here?" Slurred speech...

    02:01 That's kind of a sign of a stroke.

    02:03 But what a stroke resolved within 10 minutes of arrival without us doing anything.

    02:08 No. So what is this? Likely a TIA.

    02:13 There you go.

    02:14 So which information will the nurse provide to the client? Now, we're ready.

    02:19 Bring it on! Select all that apply? So you've got the topic, right? Put it in your own words.

    02:27 I would say, "What information will I provide to a client who's had a TIA? A Transient Ischemic Attack.

    02:36 Okay, go for it.

    02:38 Write down 1, 2, 3, 4, 5, and 6 as you see these answers appear there.

    02:42 Write that in your practice sheet on your scratch paper, just the numbers, not all the words.

    02:49 I want you to just put down those numbers.

    02:52 Ask yourself six separate times.

    02:54 Treat this as six separate questions.

    02:57 And say, what I say this, what I give this information to a patient who had a TIA.

    03:04 If you say yes, circle that number.

    03:06 If you say no, cross it out.

    03:09 But rather you choose to keep it in or throw that answer out.

    03:13 You've got to say why if you want to get the best chance of getting the answer correct.

    03:19 All right. you can do this.

    03:21 We're practices over and over again.

    03:23 But go ahead. Pause the video, Do the work yourself, then we'll come back and walk through all of the answers.

    03:38 Welcome back.

    03:39 Now you notice this select all that apply had six options.

    03:43 They may have five options or six options.

    03:45 It just depends.

    03:46 But let's start with the first answer.

    03:48 We know the topic of the question is, which information would I as the nurse give a patient who had a transient ischemic attack? Number one.

    03:59 Would I say, "You will need some further testing even though the symptoms are no longer present." Is that appropriate for someone who's had a TIA? Oh, yeah, it is.

    04:10 We want to make sure nothing else is going on.

    04:13 So there you go.

    04:14 Number one, I'm going to leave that in because someone with a TIA has had a significant event in their brain.

    04:22 So we're going to want to do additional testing to make sure they're okay.

    04:26 Or to make sure they don't need further treatment.

    04:29 Number two.

    04:30 Would a nurse say to someone who had a TIA, the symptoms you experienced are caused by the same mechanism as a stroke.

    04:40 Yes, we could say that it is a similar mechanism.

    04:43 The cool part is this resolved within 10 minutes of coming on.

    04:47 But this is correct.

    04:49 We would say that to a patient. So I'm going to leave number two in.

    04:53 Number three.

    04:54 Would I say this to a client who had a TIA? "Next time, wait to see if the symptoms go away on their own." No, I would not say that.

    05:06 <slurred speech> Yeah, come in. Right? Don't hang out at home and let things get worse Time is tissue.

    05:16 Whether we're talking about your heart or your brain, whatever is not getting adequate blood supply, you want to get to a hospital where you can be treated as quickly as possible.

    05:27 The more you delay, you may end up with some residual effects that are not fun or pleasant.

    05:33 So if you can get to the hospital, get safe treatment quickly, might be able to save that tissue.

    05:39 Number four.

    05:40 Okay, so just to review.

    05:42 Number one is in. Number two is in.

    05:43 Number three...

    05:44 out.

    05:45 Number four.

    05:47 Try not to worry.

    05:48 These symptoms don't mean you're at a risk for another stroke.

    05:51 Okay.

    05:53 Wrong.

    05:55 Let's walk through this.

    05:56 First of all, try not to worry.

    05:59 Yeah, that's not therapeutic.

    06:01 Don't say that to a client.

    06:03 It's not our job to choose what they should worry about or not worry about.

    06:07 So nope, not therapeutic.

    06:09 But then look at the rest.

    06:10 "Hey, these symptoms don't mean you're at risk for another stroke." Wrong.

    06:16 People who have a TIA are at an increased risk to experience a stroke in comparison to someone who's never had a TIA.

    06:24 So there you go.

    06:26 Number four.

    06:28 That's wrong.

    06:29 Number five.

    06:31 If this happens, again, visit your primary care provider first before coming to the hospital.

    06:37 A no.

    06:38 No, no, no.

    06:38 Right? Same rationale, as we picked for number three.

    06:42 You need to get to a hospital where you can get appropriate treatment.

    06:47 Your primary care providers probably awesome, but they're not going to be equipped in their office to have the type of treatment that you may need.

    06:56 All right. Last one. Let's look at the sixth option.

    07:01 Now, what a nurse say this to a client who had a TIA? "Even though the symptoms are gone now, this is still a concerning episode.

    07:11 So it's good that you came in." Yeah. This is actually a positive therapeutic response.

    07:17 You're letting them know, "Hey, we recognize the symptoms are gone now." So you're reinforcing a positive.

    07:23 But this is still concerning episode.

    07:26 That's true.

    07:27 We're not saying, "Whom of us gonna die?" We're saying, "Hey, we know that patients who have a TIA have an increased risk to having more TIAs or a possible stroke.

    07:37 So we're supporting them.

    07:38 It's good you came in.

    07:40 That's very therapeutic.

    07:42 It's accurate.

    07:43 It's right on that would be something a nurse would say to someone who had a TIA.

    07:49 Now compare number six, to number three.

    07:52 In next time, just wait and see if the symptoms go away.

    07:55 Yeah, totally different.

    07:56 What about number six and number four? Try not to worry.

    07:59 These symptoms don't mean you're at risk for another stroke.

    08:02 Okay, it's very clear why number six is a better answer than three or four.

    08:08 So I've done the work.

    08:10 I've asked myself the topic of this question six times.

    08:13 Now I'm gonna go back one more time and look at what I kept in and what I threw out.

    08:19 Number one.

    08:20 Yes, that is appropriate to say to someone the TIA.

    08:23 Number two? Yes.

    08:25 Determined, that's appropriate.

    08:27 Number three? No.

    08:29 Number four? No.

    08:31 Number five? No.

    08:33 Number six? That is appropriate.

    08:36 So I've selected number one, number two, number six.

    08:40 Boom.

    08:41 I'm going to hit the submit button and go on to the next question when I'm taking a test.

    08:47 See, the more you spend time in here trying to debate yourself and worry and go back.

    08:53 As long as you've done the work, you know, the topic of the question, you've put it into your own words.

    08:59 You've asked yourself that question, in your own words once for every answer, and you've given the rationale for why you chose to keep it in or throw it out.

    09:09 That is the very best that you can do.

    09:12 You make one quick check at the end.

    09:14 But really watch yourself as far as changing any answers.

    09:18 Make sure you have a super solid rationale.

    09:22 I missed something in that answer choice.

    09:23 That's a reason that you can go back and correct an answer.

    09:26 But if you're like, "I don't know." Yeah, don't do that to yourself.

    09:32 As long as you thought through the question, there's nothing you missed in that answer choice.

    09:37 Stick to what your gut is, think those answers and move on to the next question.

    09:43 Now what about your performance on this one? What do you need to reflect on? Is there anything that needs to go in your notebook as far as information or knowledge you didn't know? Is there any way you could maybe improve your strategy for going through select all that apply? If you're doing all those steps that we talked about, then you just need to keep practicing them.

    10:06 If you're not consistently doing those steps, then we need you to really consider doing that the research supports, using a systematic consistent way of thinking through questions will raise your test scores that effort.

    10:21 You're going to see it pay off and performance after you keep on practicing these strategies.

    About the Lecture

    The lecture Walkthrough: Reduction of Risk Potential Q7 – NCLEX-RN® by Rhonda Lawes, PhD, RN is from the course NCLEX-RN® Question Walkthrough: Reduction of Risk Potential.

    Included Quiz Questions

    1. Weakness on one side of the body
    2. Slurred speech
    3. Blindness
    4. Vertigo
    5. Congestion
    1. Additional testing is required even if symptoms of a TIA have resolved.
    2. Instruct the client to visit their primary care provider before going to the hospital.
    3. The same mechanism as a stroke does not cause symptoms of a TIA.
    4. There is no need to worry if symptoms have subsided.

    Author of lecture Walkthrough: Reduction of Risk Potential Q7 – NCLEX-RN®

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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