Strategies & Techniques In Taking The ExamPresentation Transcript
STRATEGIES & TECHNIQUES IN TAKING THE EXAM Irene M. Magbanua, RN Professional Review Specialist St. Paul University Manila
FIRST- FIRST IN THE TEST QUESTION:
The nurse is caring for a patient in the emergency department with a gunshot wound to the chest. The nurse observes carefully for signs and symptoms of tension pneumothorax. Which of the following will be seen FIRST:
B. Crackles sound audible on inspection
C. Restlessness, sudden onset of persistent chest pain and
MOST IMPORTANT- IN THE TEST QUESTION
A client diagnosed with Bipolar disorder exhibits square dancing, unkempt appearance and have not slept for 36 hours. The MOST IMPORTANT nursing care appropriate for this client during manic episodes will be:
A. Confront the client’s inappropriate dancing and bad body odor
B. Send client to chestboard game to divert client’s energy
C. Let the client lad a singing group
D. Provide the client high caloric finger foods
INITIAL- IN THE TEST QUESTION
A child with Insulin Dependent Diabetes Mellitus (IDDM)
develops weakness and cold clammy skin. Which of the
following should the nurse do initially?
A. Give subcutaneous glucagons
B. Administer the prescribed insulin
C. Increase recommended carbohydrate in the diet
D. Check capillary blood glucose and give a glass of orange juice
BEST- IN THE TEST QUESTION
A client with admitting symptoms of occipital headache in the morning, palpitations and epistaxis has been diagnosed with HYPERTENSION. Medical and nursing management will be based on:
B. Diet and regular exercise
C. Diet, regular exercise and antihypertensive
D. Diet, regular exercise, antihypertensive medications
and avoidance of alcohol
MEMORIZATION-MNEMONICS Assessment of pain/ABC’s
Interventions for COPD (Chronic Obstructive Pulmonary
Disease) are the following:
A. Propranolol, 6L oxygen and rest
B. Aminophylline, Bronchodilators, Chest physiotherapy, Deliver O2 2L, Expectorants and Force fluids
C. Bronchodilators, Betablockers and Buspar
D. Increase fluids, increase oxygen and decrease chest physiotherapy
RULE OF 2’S- AS A WAY TO REMEMBER TOXICITY LEVEL
A client’s digoxin blood level is 2.2 ng/dL. The MOST APPROPRIATE nursing actions:
A. withdraw blood and check electrolyte level
B. withhold digoxin, assess for toxicity and notify the
C. give client citrus juice to replace the lost of potassium
D. increase the IV, client will manifest diuresis
NEGATIVE MODIFIERS- word or words that would make the option incorrect
The nurse is counseling a parent about the management of her 6-year-old child who has chickenpox. Which statement by the parent indicates that the teaching by the nurse has NOT BEEN EFFECTIVE?
A. “I will keep my child’s fingernails cut short.”
B. “I will never send my child in school again.”
C. “If one of the chickenpox becomes swollen and ooze
yellow drainage, I will call the doctor.”
D. “I will give my child diphenhydramine (Benadryl) if the itching becomes severe.
POSITIVE MODIDIFIERS- Words that would make the option correct
A client who have undergone episiotomy asked the nurse when she can resume sexual intercourse. The appropriate response of the nurse would be:
A. “It is impossible for you to indulge in sex since it will cause injury to the wound.”
B. “Why don’t you ask the doctor for this?”
C. Usually, it will take about 4 to 6 weeks and until
D. “Anytime you are ready.”
A client has undergone
thyroidectomy. Which of the following
symptom is considered the
HALLMARK SIGN of THYROID STORM
D. uncontrolled fever, 100 to 106 degree F
PRIORITY- use ABC
Which assessment area would the nurse
give the highest PRIORITY when
admitting a client to the emergency
A. nutritional status
B. airway status
C. elimination status
D. psychotic status
A client with a spinal cord injury at the level of C4 has a weakened respiratory effort, ineffective cough, and is using accessory muscles in breathing. The nurse carefully monitors of the following nursing diagnoses?
A. Ineffective breathing pattern
B. Risk for impaired skin integrity
C. Risk for injury
D. Risk for infection
A client for whom NARDIL was prescribed for depression is brought to the ER with severe occipital headaches for eating pepperoni pizza for lunch. Which of the following interpretation is it important for the nurse to make regarding these findings?
A. Allergic reaction related to ingestion of processed food
B. Hypertensive crisis related to drug and food reaction
C. Panic anxiety related to unresolved issues, uncontrolled anxiety
D. Ineffective individual coping related to MAOI treatment
- Stay with the patient
- Broad openings
- Open-ended questions
- Focusing on the client’s feeling
- Explore the client’s feeling
- Validate the client’s feeling
Orientation to reality
A nurse finds a newly admitted patient to the psychiatric unit in her
room clutching her knees close to her and staring blankly ahead.
When the nurse greets the patient, she responds in incomprehensible
words. What would be the nurse’s INITIAL intervention?
A. Ask the client, “Why you were brought here?”
B. Provide information regarding the whole activities of the hospital.
C. Tell the patient, “I will stay with you until you calm down.”
D. Begin the saying, “I will now take your history.”
Process of Elimination (POE)
Criteria for eliminating the remaining incorrect answer choice:
Choices that contain absolutes (i.e., always, all) are more likely to be incorrect
Choices with qualifiers in them (i.e., commonly, possibly) are more likely to be correct
Information repeated from the question may be repeated in the correct response
Use Common Sense
This requires understanding concepts, not memorizing diseases.
A client is admitted to the emergency room in a HONKC. After ascertaining that her airway is patent and her heart rhythm is sinus, the nurse should assess:
Family’s coping mechanism
Use of Prefixes and Suffixes
If a question contains the word hemopoiesis, you do not need to memorize what it means. Just think about it.
Hemo = blood
-poiesis = making,forming
Priority questions may take a few forms on the exam. They might ask you:
What is the most important?
What is the initial (first) action of the nurse?
What is the best nursing action?
Which client would the nurse care for first?
Here are a few hints that can help you find the
correct answers to priority questions.
Use Maslow’s Hierarchy of Needs. The hierarchy includes (in
descending order) 1)physiological needs (survival); 2) safety needs (both physical and psychological); 3) a priority question, you need to choose the response that ranks the highest in the hierarchy.
2. Use the Nursing Process (APIE) to establish priorities. You must first assess, then plan, then implement, and finally evaluate. Select responses in which you assess the client before you implement the care.
3 . Use ABC’s . When you encounter a question that requires you to establish priorities, think airway, breathing, and then circulation. Your first priority in an emergency situation would be to establish a patient airway.
4. Use RACE . When you see priority questions that deal with fires, think: remove the clients, the sound the alarm, call the fire department, and finally extinguish the fire. The safety of the clients is the first priority.