To all graduate nurses who will be taking the July NLE, I would like to share these strategies posted months ago.

Remember...

1. What’s the answer ( ANSWER FIRST)
2. What’s the question (REPHRASING)

· Numbers ( age, lab values, percentage)

· Signs & Symptoms

· Acute or Chronic

3. ELIMINATION

· True or False

· Clustering (GROUPING)

o A. hypertension (BP)

o B. tachycardia (HR)

o C. hypotension (BP)

o D. bradycardia (HR)

· Odd Man Out/In (TOO OBVIOUS)

· Comma-Comma-And, “Rule”

o ___, ___, & ___ (ELIMINATE VERTICALLY)

4. ALL OF THE ABOVE

· Eliminate AOTA if there is an: OPPOSITE TERM

o A. tachycardia, bradycardia & tachypnea

o B. hypertension, hypotension & pyrexia

5. KEYWORDS

· Eliminate choices with the ff words:

o Always,

o Never,

o Necessarily,

o Any,

o Only,

o Must,

o Completely,

o Totally

6. TRAPS

· Be aware of the ff words that are often missed:

o Inappropriate

o Not applicable

o Ineffective

o Further teaching

CRITICAL THINKING

· Validate & Organize data

· Look for patterns & relationship

· Transfer knowledge

· Evaluate

1. Identify the topic of the question

o NO: Read the choices and restate the problem

o YES: Proceed to 2

2. The Nursing Process

o Assessment & Implementation = Read the stem carefully

o All Assessment & Implementation = Proceed to 3

3. Does Maslow fit?

o YES: Physical vs. Psychosocial

ü PHYSICAL FIRST!

ü If all Physical, ABC!

o NO: Focus on the TOPIC/ PROBLEM

PSYCHIATRIC QUESTIONS

WRONG

· False assurance

· Personal opinion/ advice

· Should not insist

· Blocking

· Why?

CORRECT

· Listening to client’s concern

· Assessing & acknowledging client’s response

· Encourage to talk more about the client’s feelings

· Focus on the concern of the client

· Use open ended questions

IMPORTANT TERMS

· Laenec’s disease- liver cirrhosis 2^nd to alcoholism

· Homman’s sign- distention in the calf that is used to determine Deep Vein Thrombosis

· Hegar’s sign- softening of the Uterus

· Goodel’s sign- softening of the Cervix

· Chadwick’s sign- bluish discoloration of the Vagina

· Korsakoff- complication of Chronic Alcoholism manifested by Confabulation

· Confabulation- making up stories

· Illusion- with stimulus ( Desert- water)

· Hallucination- without stimulus ( Auditory)

· Delusion- false belief

SIGNS & SYMPTOMS

· Tachycardia (Cardiac Rate) = Mild Dehydration

· Hyperthermia (Temperature) = Moderate to Severe Dehydration

· ↓ K+ = Severe Vomiting

· ↑ Glucose = Diarrhea

· ↓ Cal+ = Trosseau’s Sign

· Hyperventilation = DM Ketoacidosis

· N pH = 7. 35 – 7. 45

· N pCO₂ = 35 – 45 / partial pressure of Carbon Dioxide

· N pO₂ = 95 – 100 / partial pressure of Oxygen

· N HCO₃ = 22 – 26 / Bicarbonate

· Metabolic (HCO₃)

o Acidosis (↓pH, ↓ HCO₃)

o Alkalosis (↑ pH, ↑ HCO₃)

· Respiratory (pCO₂)

o Acidosis (↑ pH, ↓ pCO₂)

o Alkalosis (↓ pH, ↑ pCO₂)