Let’s Get It Started in Here! - Professional · PDF fileCHAPTER 1 Let’s Get It...

Let’s Get It Startedin Here!Let’s Get It Startedin Here!

CHAPTER

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2 MARLENE HURST ✚ Hurst Reviews: NCLEX-RN® Review

LET’S GET IT STARTED IN HERE!This is where you need to play the song “Let’s Get It Started in Here” bythe Black Eyed Peas to get you pumped-up!

Now don’t think because this is the first chapter that you can skip it.You must read it in order to understand how we will work together toachieve NCLEX® success. This book parallels the same successfulapproach I use when teaching NCLEX® Review classes. This chapterserves as the beginning of your journey in conquering the NCLEX®!

So, you’ve finished nursing school. What an accomplishment! Canyou believe it’s really over? I’ll bet you are still walking around feelinglike you have a care plan to turn in to your clinical instructor! Nowyou have to take one more test! I know that’s very frustrating. You’reanxious to take the test, so you can get to work to help buy that newcar you’ve already picked out. Or, maybe the nurse manager at yournew job or a family member is pressuring you to take the test soonerrather than later.

Maybe you have taken the test five times already and you feel there isno hope for you. Guess what? There is hope! Just because a student mayhave to take the test more than one time doesn’t mean he or she isn’tgoing to be a great nurse. If you follow this book and do what I say, youwill achieve NCLEX® success!

✚ Don’t assume anythingSome of you may assume that passing nursing school and theNCLEX® predictor tests assures your ability to pass the NCLEX®.Your teachers have probably emphasized that NCLEX® tests for minimum nursing competency. You may be saying to yourself, “Surely,I’m minimally competent.” Unfortunately, these things may set you upfor false reassurance.

Pretend it’s new!Let me emphasize one important point: NCLEX® is not like any testyou have ever taken. Your safest approach to this test is to pretend youare starting your very first IV, and you have to remember each stepyou learned in the clinical learning laboratory in order to successfullyinsert the IV. Doing something for the first time can be very scary,but I will help you to overcome those feelings as far as NCLEX® isconcerned.

✚ What’s the good news?Yes, there is good news! You can pass the first time if you CHOOSE.Achieving success in anything requires the investment of time. I’m not advocating weeks and weeks of studying. I’m encouraging you to study this book thoroughly, so that you can walk into the testingcenter with a level of confidence that will propel you to pass theFIRST time!

NCLEX® is not like any test youhave ever taken!

My goal is for you to pass NCLEX®

the first time!


CHAPTER 1 ✚ Let’s Get It Started in Here! 3

WHAT’S THE NCLEX®, AND WHY DO I HAVETO TAKE IT?Look at it this way: This could be the most important test you ever take!Let’s look more closely at the NCLEX® and why it is important.

✚ Define timeThe NCLEX®, or National Council Licensure Examination, is a test thatdetermines if you have the minimum level of knowledge necessary topractice nursing safely. The test is written by nurses with advanceddegrees and clinical expertise in each specific area of nursing.1

✚ What exactly does “practice nursing safely”mean?

The American Nurses Association (ANA) developed a standard set ofprotocols to guide nurses in making decisions regarding the care ofclients.2 Nursing in its basic form provides care to clients in order to help them achieve specific goals to return them to wellness, to returnthem to an adapted state of wellness, or to help the client die with dig-nity and peace.2 Practicing these services without causing harm to theclient, or the lack of practicing these services, at the very least, is whatNCLEX® considers as the minimum level of knowledge needed to practice nursing safely.1 In other words, nurses are safely helping clients return to the level of self-care or wellness before their illness.That was deep!

✚ Applying your knowledgePassing the NCLEX® does not include learning and memorizing anever-ending amount of content. Instead, the key is to take what youDO know and apply it to concepts you may never have heard of. How?Don’t worry; we’ll work through this together. This concept of apply-ing your knowledge will prevent you from panicking at the sight of aquestion that asks you about some unfamiliar disease. I have success-fully used this method of analyzing test questions since I began teach-ing in schools of nursing in 1988. You will learn how to methodicallywork through this type of question and confidently select the correctanswer.

CASE IN POINT Imagine you work on a medical-surgical unit. You aregiven your assignment of six acutely ill clients. Do you know every detaillisted in your clients’ charts? Of course not! But, you are still responsiblefor caring for these clients. What do you do? Do you rush to the com-puter on your unit to look up the etiology of every disease your clientshave? No way! You implement what you do know by applying basic prin-ciples of safety to prevent harm to your clients. We will use this sameapproach with NCLEX® test questions.

Don’t let distractions or a long listof client needs supersede thesafety of any client!

If you’ve never heard of a diseaseor illness that is presented on theNCLEX®, then no one else haseither! This is most likely a dis-tracter that the NCLEX® Lady hascooked up!



✚ Don’t believe everything you hearThere is a rumor floating around that if you don’t know the answer on astandardized test, pick “C.” That is simply untrue; it will not help youpass this particular exam. The key to passing the NCLEX® is to take theknowledge you do know and apply it to new and different concepts.

The NCLEX® Lady views you, the test-taker, as a new nursewith only two weeks of vast nursing knowledge. This shouldbe a relief that you do not have to know everything aboutnursing! We aren’t trying to make l00% on this test. We gotover that compulsion a long time ago! However, you want toapproach this test as if you are a brand new nurse, not anexperienced nurse. In fact, if you approach the test like you arean experienced nurse, you will scare the NCLEX® Lady! Thisbook will show you how to think like a new nurse.

✚ Will taking a million practice tests help me pass?Many of you have been told you need to take a million practice tests inorder to pass the NCLEX®. Your friends have been smothering you withstudy guides, workbooks, and CDs. Your plan is to memorize these ques-tions. Bad move! No matter how many questions you memorize,NCLEX® has many thousands more waiting for you. This book will showyou how to answer the test questions in a way that makes the NCLEX®Lady very happy.

CORE CONTENT AND THE NCLEX®

You will hear me refer to “core content” many times in our journeytogether. If you feel you need a quick review of core content please take alook at my online review. You may want to hear me discuss the patientcore content. So check out www.hurstreview.com. Let’s take a brief lookat core content, because it will be a key factor in your test preparation.

✚ Define time The core content is the information you must know without a doubt andwithout hesitation if you wish to pass the NCLEX® the first time.

✚ Without a doubt and without hesitationHeavy words! So, what exactly is the core content that I should knowwithout a doubt and without hesitation? The core content that I willkeep referring to is information such as fluids and electrolytes oracid–base balance.


CHAPTER 1 ✚ Let’s Get It Started in Here! 5

CASE IN POINT Let’s take a look at an example that includes core contentthat you should know without a doubt and without hesitation.

The nurse is caring for an 8-hour postop thyroidectomy client. Whichclient symptom should concern the nurse the most?

1. Slight twitch of the left arm.

2. Depressed patellar reflex.

3. Blood pressure of 136/83 mm Hg, pulse of 72 beats/min, respiratoryrate of 18 breaths/min.

4. Occasional premature ventricular contractions (PVCs) noted per themonitor.

Let’s use a step-by-step process to answer this question.

� Step #1: Did you know that while reading this question your mainfocus should include hypocalcemia? To answer this question, you haveto use multi-logical thinking. You have to be knowledgeable about athyroidectomy and the related complications. Remember: NCLEX®questions usually focus on actual or potential problems that canoccur. There aren’t many “happy” NCLEX® questions. Note: After athyroidectomy there is a chance the surgeon could accidentally removethe parathyroid glands.

� Step #2: Now you need to know about the parathyroids. Parathyroidsincrease serum calcium. So, if a couple of the parathyroids are acci-dentally removed, then the serum calcium goes down. Next, home inon how fluctuations in calcium affect the body. If the serum calcium israised, then the body will be sedated. If the serum calcium is lowered,the body will be tight or contracted. This is my simple way of lookingat it.

� Step #3: What can tightened or contracted muscles lead to? Seizures.When that arm starts to twitch, you should worry and assume theworst: the client may be headed toward a seizure. The client’s patellarreflex is depressed due to the effects of general anesthesia. Also, if thecalcium drops, the reflexes increase—not decrease. The vital signsremain normal. Okay, I know the PVCs worried you, but the answerchoice said “occasional.” You’ll want to watch this to make sure thePVCs do not increase. This is not highly unusual; many people haveoccasional PVCs.

� Step #4: Now we have arrived at the correct answer, #1. Muscle twitch-ing is a specific sign you must watch for in the care of the post-thy-roidectomy client.

See how your knowledge of core content was needed in order to answerthis question?

✚ More good newsOnce again, the good news is you do not have to know everything in theworld about nursing to pass the NCLEX®. It is not necessary to rereadevery class note or textbook. Remember, the NCLEX® Lady thinks of you



as someone with only two weeks of vast nursing knowledge! Every testquestion stems from core content. This book will provide you with manyopportunities to refresh your core content knowledge and put thisknowledge into practice with test questions.

SUMMARYI’m excited about this opportunity to help you achieve your goal, andhope you will not only learn, but actually enjoy studying with me. Mysuccessful approach is unique, so it is important for you to pay closeattention to every word in this book. Now let’s get it started in here!

References1. National Council of State Boards of Nursing. NCLEX Examinations.

Available at: www.ncsbn.org. Accessed October 25, 2006.

2. American Nurses Association. Nursing: Scope and Standards of Practice.Introduction. Washington, DC: ANA; 2004.

BibliographyAmerican Nurses Association. Nursing: Scope and Standards of Practice.

Washington, DC: ANA; 2004.

Huber D. Leadership and Nursing Care Management. 2nd ed.Philadelphia: Saunders; 2002.

Hurst Review Services. Available at www.hurstreview.com.

National Council of State Boards of Nursing. Available atwww.ncsbn.org.

You will never be more motivatedthan you are right now to study forthe NCLEX®! Now is the time totake action to pass the test so youmay get on with your life!


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