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12

Preparing for the NCLEX

Say it 1,000
times: Studying for
the exam is fun
studying for the
exam is fun

safety concerns are met can concerns involving


love and belonging be addressed, and so forth.
Apply the principles of Maslows hierarchy of
needs to the following sample question:
A client complains of severe pain 2 days
after surgery. Which action should the nurse
perform first?
1. Offer reassurance to the client that he
will feel less pain tomorrow.
2. Allow the client time to verbalize his
feelings.
3. Check the clients vital signs.
4. Administer an analgesic.

Phys before psych

In this example, two of the options 3 and


4 address physiologic needs. Options 1 and
2 address psychosocial concerns. According
to Maslow, physiologic needs must be met
before psychosocial needs, so you can eliminate options 1 and 2.

Final elimination

Client safety
takes a high
priority on the
NCLEX.

Client first, equipment second

You may encounter a question in which


some options address the client and others
address the equipment. When in doubt, select
an option relating to the client; never place
equipment before a client.
For example, suppose a question asks
what the nurse should do first when entering
a clients room where an infusion pump alarm
is sounding. If two options deal with the infusion pump, one with the infusion tubing, and
another with the clients catheter insertion
site, select the one relating to the clients catheter insertion site. Always check the client
first; the equipment can wait.

Now, use your nursing knowledge to choose


the best answer from the two remaining
options. In this case, option 3 is correct
because the clients vital signs should be
checked before administering an analgesic
(assessment before intervention). When
prioritizing according to Maslows hierarchy,
remember your ABCs airway, breathing,
circulation to help you further prioritize.
Check for a patent airway before addressing
breathing. Check breathing before checking
the health of the cardiovascular system.

Therapeutic communication

One caveat

Room for improvement

Just because an option appears on the NCLEX


doesnt mean its a viable choice for the client
referred to in the question. Always examine
your choice in light of your knowledge and
experience. Ask yourself, Does this choice
make sense for this client? Allow yourself
to eliminate choices even ones that might
normally take priority if they dont make
sense for a particular clients situation.

Client safety
As you might expect, client safety takes high
priority on the NCLEX. Youll encounter

313419NCLEX-RN_Chap01.indd 12

many questions that can be answered by


asking yourself, Which answer will best
ensure the safety of this client? Use client
safety criteria for situations involving laboratory values, drug administration, activities of
daily living, or nursing care procedures.

Some NCLEX questions focus on the nurses


ability to communicate effectively with the
client. Therapeutic communication incorporates verbal or nonverbal responses and
involves:
listening to the client
understanding the clients needs
promoting clarification and insight about
the clients condition.

Like other NCLEX questions, those dealing


with therapeutic communication commonly
require choosing the best response. First,
eliminate options that indicate the use of poor
therapeutic communication techniques, such
as those in which the nurse:
tells the client what to do without regard to
the clients feelings or desires (the do this
response)
asks a question that can be answered
yes or no, or with another one-syllable
response
seeks reasons for the clients behavior
implies disapproval of the clients behavior
offers false reassurances

4/7/2010 5:08:59 PM