hi everybody my name is amanda from beautifulnursing.com and i wanted to make this video today because i've been getting a lot of messages from people that have failed the nclex from using a variety of resources all over the internet spending tons of time studying spending tons of money and yet they still fail so i wanted to talk to you guys um about why this reason could be from what i've seen and how you can avoid this from happening to you and i just want to say that if you are watching this video because you just failed the nclex or failed a nursing exam it is more common than you think you are so not alone um it's just not as talked about so people sometimes feel really ashamed and really overwhelmed and they just don't want to talk about it i know that you're smart enough to do it everyone i've talked to that failed the exam that retook it pass because they are smart enough to do this and you are too so let's talk about what tips i gave them so you can pass what you're waiting for what is the reason that people fail so it's again not because people are not smart enough to take the nclex or that they don't know the knowledge it's because people struggle with answering nclex style questions and their test anxiety gets the best of them i was the kind of person that had to study so hard for my grades you guys i went from barely passing to a 4.0 gpa and i also passed my nclex and 75 questions so if i can do these things i know that you can too so we are going to go over the way to kind of coax the answer out of nclex style questions even when you don't really necessarily know the answer trust me this is the it video that you're going to want to save rewatch a thousand times whether you're in nursing school about to take the nclex or if you know somebody that is this is the video okay so let's get started when you're reading an exam question quickly block out the answers do not look at the answers and there's a reason why so when you're looking at the question i want you to try to think of any knowledge that you can possibly think of about the subject because if you can try to remember any information you remember on the subject it might actually give you the answer before you look at the answers in front of you because if you look at the answers first it might bias you towards a certain answer and then you might get it wrong so again try to think of what knowledge you know about the subject and then look at the answers and try to see what's closest to what you remember okay let's try one let's cover the answer the nurse has been teaching the role of diet and regulating blood pressure to a client with hypertension which meal selection indicates that the client understands their new diet so before we look at the answers remember you're going to cover them up and try to think of any information you can remember so just take a few moments pause your screen think about what you can remember and just come back all right so hopefully maybe salt came to your mind that salt increases blood pressure maybe the dash diet also came to your mind the dash diet is the dietary approach to stop hypertension it includes decreasing sodium saturated fats and increasing veggies fruits and whole grains so now let's look at the answers all right so a we have corn flakes whole milk and a banana b we have scrambled eggs bacon and butter toast see we have oatmeal apple juice and dry toast and d we have pancakes ham and tomato juice i don't know about you guys but when i see bacon and butter toast together i think high sodium right away so i'm going to cross that one out right away and then when i see ham and tomato juice as well i want to cross out because those also have high sodium and high cholesterol all right so let's talk these last ones through so all right so corn flakes whole milk and a banana versus oatmeal apple juice and dry toast so corn flakes what do i don't know much about corn flakes other than that i use them for cooking i don't know whole milk that doesn't have a lot of fiber in fact that makes you more constipated banana that's that's a fruit but oatmeal on the other hand that has a lot of fiber apple juice again you get that fruit and then dry toast is whole grains so that's three things versus the one in corn flakes i think that has high sodium so let's check what the answer is i think we're gonna go with c guys it is c study tip number two look for key words and phrases and the stem of the question that matches the answer so we're looking here if they're trying to look for some kind of assessment or are they looking for some kind of you know intervention you know what are they looking for it doesn't match with the questions so let's do an example of this here all right so let's start by covering those answers and the question is the nurse is caring for the patient's post-surgical removal of a six millimeter cancerous oral lesion what is the priority nursing measure for this client so looking in the stem of the question what is the priority nursing measure for this client the measure usually means what is the care or the intervention that the nurse is going to do so if we are going to be looking at interventions think in your mind again of any information you can rack in your brain about what interventions we might perform that are the priority to keep this post-surgical patient safe so think of what safety complications what safety concerns we might have for post-surgical patients think about that real quick and we'll come right back okay here is our answers we have a maintain a patent airway b perform meticulous oral care every two hours c ensure that incisional area is kept as dry as possible and assess the client frequently for pain using the visual analog scale all right so right away i want you guys to remember that we're trying to match the stem of the question so this question is asking us for an intervention and right away i saw that d says we are going to assess the client's pain so that is an assessment it is not an intervention so let's press that one out right away all right so then c ensure that the incisional area is kept dry so again if you're thinking your mind of the nurse going over there to look at the incisional area that again is another an assessment not an intervention because the nurse is going to look and assess how that incision looks so that one we are going to cross out as well that leaves us with a maintain a patent airway and b perform meticulous oral care every two hours so we are looking for the priority nursing intervention for this client so i hope you guys thought with post operative clients that they are in the pacu after having anesthesia hopefully you thought of the abcs when it comes to more emergent cases this is air weight breathing and circulation airway is making sure there's nothing blocking that airway with them getting air in and out breathing making sure they are breathing successfully and circulation making sure that they are getting good blood flow to all extremities that they don't have any kind of clot so checking their pulses so when we are looking at the priority here it is going to be a finally i added a few key terms that you might see on assessment versus intervention questions that you might see on the nclex next study tip this one is a hard one cross out the obvious incorrect answers i know some of you are like you cross it out and then you're like but there's a reason you felt that way just trust your gut because sometimes you go back and then you hear the answer from your professor and instructor and you're like wait why didn't i just go with my gut just just do it and then if you get it wrong you'll remember for the next exam or you know if you have to retake the nclex again you'll never forget it again so just be done with it okay and then study it for the next time around so cross out all the incorrect answers that you think and trust your gut so when it comes to those dreaded sad questions those select all that applies saying which ones are correct you know oh i remember my first nursing exam with those i failed with a 58 i already felt like i wasn't smart enough in the first semester of nursing school and then when that test came back i was like oh my gosh um so with those a really great exam tip that i got from another cohort member was that you can make every answer on a sata question into a true or false statement and this really really helped me because it helped me look at each answer individually to the question instead of looking at all of them together because that's kind of what messed me up so when i looked individually each one and i thought okay does this one fit with this question and then i could just cross it out and then you know leave me with which ones and when it comes to sata you know it could either be just one of them or all five or six that could apply for this question okay let's try one so cover your answers the nurse was just assigned a three-year-old diagnosed with measles on a pediatric unit which preventative measures should the nurse take when providing care select all that apply so the first thing i want you to do besides covering the answers is try to think of any information again that you remember about measles which safety precaution is that going to fall under and then what equipment or measures is also under that specific precaution so pause the screen take a minute and come back all right before we look at the answers i'm going to give you guys one more hint from a little tick tock i made on which safety precaution measles might be go to room two suit up they have measles which safety precaution is that standard they're for everyone it's like where's waldo okay girl drop it like it's hot for you come on guys do not come into contact with anything in this sewer unless it's a ninja turtle hi welcome to mtv oh my gosh thank you so much for flying all this way in the air we even got you a private room and hooked you up with a real sick defined mess called nnf all alright so hopefully you gather that it's airborne precautions so let's look at our answers we have a hand hygiene b goggles c and 95 mask d a surgical mask e a negative pressure room and f disposable equipment so let's turn each of these answers into a true and false statement so simply put which of these is going to fall under those airborne precautions so right away with c and d i see two masks on here and usually they both can't fall under the same precaution so i have to kind of think or just memorize you know which one is under which precaution so is a n95 mask under airborne precautions true or false i know that this is true so i would mark down that surgical mask that is false so we're going to cross that out jumping down to f is disposable equipment considered airborne precautions true or false um so when i think of disposable equipment i think of somebody touching it and contaminating it like you know with mrsa skin infection so that is touch contact not airborne so i think we're going to cross that one out all right so b goggles so usually goggles are used by the nurse if there is a possibility of being sprayed or exposed to respiratory secretions or body fluids so that is i know in standard precautions you use it as needed but i don't believe that's airborne so we're also going to cross out goggles as well not forget about e so a negative pressure rim is true because it is like a vacuum it keeps the bacteria or virus from the patient confined in the patient's room so it won't spread to other patients or hospital workers and then finally hand hygiene is always true so you're left with a c and e like study tips so usually in multiple choice if two answers are the same usually both are wrong versus if two answers are opposite usually one is right all right so next study tip so as you guys have probably learned through nursing school so in the medical world you know things are never really just black and white there's always some kind of gray area to every kind of disorder and medication so when you ever see a absolute word like always or never run [Music] because these kind of answers are saying that they apply to a whole population of everybody for this type of patient you always want to do this for this nurse you always or never do this usually these are never going to be the right answer because they just don't apply to everybody because there's always that gray area so if you see absolute answers like always or never usually those aren't the answer so let's talk about stable versus unstable or otherwise known as like chronic versus acute because this is big when you are prioritizing patient care so when you have somebody that's stable usually you're thinking of somebody that has chronic illnesses that is post-doc for over 12 hours maybe they've been sitting in a bed for five days they are ready to go home that's have like an unchanged assessment they're having symptoms that are common for their disorder let's say that they are having ear pain but they have an ear infection right that's not unstable because that is common for their disorder now if they started having uh nuchal rigidity right is this neck and um a positive um rude sinsky sign i can't ever pronounce that with an ear infection maybe that's a little bit unstable and you might be thinking meningitis right that's then they'd be over in that unstable category admitted for over 24 hours again they are going to be considered stable chronic so you would prioritize these little dumplings a little less than these people in the unstable category and so when you're picking which client to see first the nurse should see these unstable clients first because these are the people that if you were going to send them home they probably wouldn't have a good chance of survival you want to make sure that they're going to be safe so let's talk about what qualifies these people as unstable again could be categorized as acute so maybe they're post-op for less than 12 hours maybe they have a rapidly changing assessment so their blood pressure is quickly changing um or their heart rate is you know deteriorating and you know you've noticed that as the nurse so their vitals are changing quickly they could be newly diagnosed with something or they could start again developing some kind of symptoms that are unusual for what they were diagnosed with also maybe this person came in with a burn injury and um they on their way out you see that they had different handwriting and their faces drooping and all of a sudden okay they're unstable again as you were about to discharge them because they've been there a couple days so they again are considered unstable because they're having changed assessments and you are thinking oh my gosh is this person possibly having a stroke so these are considered unstable patients and you are going to prioritize them first all right so let's try a prioritization question together and we're not going to cover the answers because obviously we don't have enough information first so let's look at the question after a change of shift you were assigned to care for the following patients which patient should you assess first eight a 37 year old with a history of asthma complaining of shortness of breath after using a bronchodilator b a 52 year old diagnosed with copd for over 10 years and just had a pulse ox reading of 90 saturation c a 75 year old on a ventilator who requires a sputum sample per the provider's orders or d a 69 year old recently diagnosed with pneumonia and is having a fever of a hundred point four so i want you to look at these real quick try to think about which one you think is the answer you can pause the screen here come back and then we'll talk about it so let's start with a we have this 37 year old with the history of asthma when i see that i think of stable so they have a history it's chronic it's been happening so right away i think stable but it also shows here in the second part that they are complaining of shortness of breath even after using a bronchodilator so even though i thought it was stable i can definitely say now that this patient would probably be marked in that unstable category making them a higher priority so i'm going to leave that one and not cross it out yet because i think that patient would be a high priority all right so now let's look at b we have that 52 year old diagnosed with copd for over 10 years so i'm automatically thinking stable again it's a chronic condition so they've had it a while so that's stable and then they just had a pulse ox reading of 90 saturation remember normal is that 95 to 100 but copd patients can run lower and that's normal for them because they have had that obstructed air flow in the lungs so this also would be considered still a stable situation that is expected further diagnosis so that one we actually could cross out okay and then we have c a 75 year old on a ventilator who requires a sputum sample okay so when i think about ventilators sometimes i do think about complications like a leak but nowhere in this answer does it talk about any of that or alarms going off so we can assume that this is a stable situation with this client on this ventilator and all they're requiring right now is a sputum sample the only thing is sometimes these samples have a time frame attached where they have to be delivered to the lab within like an hour but otherwise this is a non-urgent request so we're going to cross this one out all right that leaves us with d a 69 year old recently diagnosed with pneumonia so recently diagnosed set off bells for me because i think unstable that's like recently admitted changed assessment posts up less than 12 hours acute so let's keep reading and is having a fever of 100.4 so then i think stable and the reason is because this is a common symptom of somebody with pneumonia now a 69 year old having pneumonia with a fever is still something that i would definitely want to prioritize but when i have two different answers here that are looking unstable and i want to make sure that they're both going to be kept safe i would definitely prioritize a and the reason is because this is an airway issue this is um an issue with breathing versus an issue with a infection so if you're again looking at those abcs airway breathing circulation um we are going to prioritize our patient with shortness of breath first because they are just not having any kind of relief with their medications next study so as the nurse when you are looking at different interventions that the nurse could start always start with the least invasive one first so if there's different things for like fluid resuscitation you could give like the patient um water po so you know just normal by mouth intake uh sort of peripheral line iv a central line iv like different ways right we want to start with something by mouth because if we start a peripheral or central line like those increase the patient's risk of infection want to always be thinking about safety let's do least invasive options first unless there obviously is a problem in the question with the patient swallowing or something else in that question where the patient just can't take um fluids by mouth so choose least invasive first all right so the next study tip is with therapeutic communication so you do not want to ask yes or no questions except with self-harm self-harm is the only one that you're going to ask okay have you had any thoughts of hurting yourself yes or no otherwise you always want to have open-ended questions with your patient so what are you feeling today well what are your plans today uh what symptoms are you having um you know open-ended so they can really kind of express what they're feeling so you can get more information and assessments from them so these type of questions allow the nurse to have more information on the patient versus those closed end questions that are yes or no do not give the nurses much information so you want to save those only for self-harm so remember that for the nclex only use it for cell phone all right so let's try and collect style question together and cover the answers so here's a question the nurse is caring for a 28 year old client who is having surgery the next day the client verbalizes i'm scared about surgery i've never had surgery before and i'm afraid i might die which response by the nurse is the most therapeutic so i want you to real quick think about all those different therapeutic communication techniques that i talked about earlier and how you would respond as the nurse to this client so take a minute think about your response and then we'll come back and look at the different answers all right let's look at the answers we have a we can call the doctor and cancel the surgery b it is normal to be afraid of something new like surgery tell me how you feel c don't worry you have a good doctor and they do not make mistakes or d i am sorry to hear that but why are you worried about a minor procedure all right so if we start at the top with a we can call the doctor and cancel the surgery so as the nurse this one is not the best answer because we're not really addressing what their actual fears are and this client obviously needs the surgery the next day so this one would be the most therapeutic the most helpful for this client so i think this one we can definitely cross out and then b it is normal to be afraid of something new like surgery tell me how you feel that's a good one i feel like it's not only comforting but it's an open-ended question that allows the patient to really express how they're feeling so let's not cross that one out because i feel like that's a really good answer so let's check out the next one see it says don't worry you have a good doctor i don't like the don't worry so far you have a good doctor and they do not make mistakes um yeah not the greatest because to air is human everyone does makes mistakes sometimes and promising that is not the best idea um so i would definitely cross that one out all right and then finally we have d i'm sorry to hear that but why are you worried about a minor procedure you know i don't like that why it's kind of condescending making them feel belittled for talking about their fears um it started out really good with i'm sorry to hear that but when they say why are you worried and calling it a minor procedure it's still a very scary thing especially when it's your first time getting surgery i still get scared every single time i go in for surgery i haven't had surgery many times but it's still a scary thing so that is not therapeutic that's nothing that would definitely comfort a patient so let's cross that one out and that leaves us with b so this study tip i remember getting this question wrong on a nursing exam um because it was a nurse walking into the room and the patient was having trouble breathing and the answers were like can you do you want to listen to their lungs apply oxygen give them a bronchodilator or something else and i remember the first thing i said was listen to the lungs which was wrong and uh i was i was so sure i was right and now that i think about it i get why it was wrong so here is my next study tip assess unless in distress so when you think of adpie you know you would do the assessments first and then you do your interventions except if it's an emergency situation so if your patient is having trouble breathing or if there is some kind of emergency situation going on you're going to want to do the first thing that's going to help your patient so if that is raising the head of the bed applying oxygen doing whatever you can to help that patient in the moment before you do those different type of assessments i remember yeah getting that question wrong and you know my teachers had to explain that because i am in my brain was like adpie i should assess first what's going on but my teachers were like no your patient is deteriorating like you gotta go help them uh before you listen to their lung sounds so again assess unless in distress you guys remember from fundamentals maslow's hierarchy of needs so with that the biggest takeaway is that the patient's physical needs so air water food shelter that should be prioritized over their psychosocial so their mental health you know their emotional well-being so you know when you're prioritizing your patient care their physical needs are going to come before their psychosocial needs so when you're prioritizing just remember maslow's next study tip if you have never heard of an answer just don't pick it i know you're probably like panicking like oh my gosh i just don't know the answer to this question and i i just don't know what to pick pick something you've heard of because there's a chance if you've heard it in lecture maybe it's because it's the right answer and if you've never heard it i mean there's not a chance that it's the right answer because you haven't heard in lecture you haven't heard in your book so pick something you actually have heard in lecture or from your instructors don't pick something you haven't heard of okay so if you see a question that asks you what is the nurse's best action that means what is the one thing the one thing that the nurse can do that might actually solve this problem so let's do a question like this together and talk through it so in some of these nclex questions you might see something that says what is the first thing that the nurse should do so when you're looking at a list of chronological steps that the nurse should do for a certain task what is the actual first thing that the nurse is going to do so let's say that they are going to insert a fully catheter what is the first thing that the nurse is going to do right so it could be if there's a list and it says um hand hygiene uh you know lubricate tip of catheter insert uh saline into the balloon um cleanse urinary meatus right the first thing you'd probably see is the hand hygiene so in a list of all these different steps the first thing you're going to say is that first step so when you say the nurses first action it's the first in the steps let's try an nclex style question and cover the answers a 34 year old client in the last trimester is admitted to the labor and delivery unit complaining of vaginal bleeding with very little discomfort the nurse's first action should be to so again try to think of any information that you can on the subject and think about in a list of steps what should the nurse do first so again this is where you pause the screen and try to think of what the nurse should do in this situation all right so hopefully you remember the two big bleeding disorders that you see in late pregnancy is placenta previa and abraptio placentae so a little mnemonic that's in my book to remember is with the placenta previa just remember the peas placenta painless so you usually see that painless bright red vaginal bleeding um in placenta previous so that's where the placenta implants in the lower part of the uterus or cervical os instead of the fundus versus abrepto placente remember the ace abreptio abdominal pain that's where there is a premature separation of the placenta from the uterus so that is very painful so you're going to have that abdominal pain that dark red vaginal bleeding so now that you know this information let's look at those answers all right so our answers could be a assess fetal heart tones b check for cervical dilation c check for firmness of uterus or d obtain a detailed history so right away i think d is probably going to be crossed out just because of that tip i said of assess unless and distress now we have a client coming in with vaginal bleeding in a late trimester now bleeding during pregnancy is not normal especially in a late trimester and if we are just asking many questions without intervening we could be increasing the client and their baby's chance of complications of mortality so we want to intervene right away and make sure we're going to be keeping our clients safe so we're going to cross out d because this is just going to harm our clients all right so the next one that also sticks out is b check for cervical dilation because doing a vaginal exam on a client with placenta previa is a big no-no it is contraindicated because it can induce more bleeding and result in a severe hemorrhage so let's cross that one out right away too all right so then we're down to a or c which both seem like good answers for this client but when we come to the first action so if it's a list of steps and we have these two interventions with interventions again another tip i gave was do the least invasive first and again we're thinking of safety so which one would be least invasive it'd probably be assessed fetal heart tones and that is the correct answer and i wasn't gonna announce this but i'm i'm just gonna do it i was on the pilot program for the next generation um 2023 nclex and so i do want to make a whole video about this nclex how it's different than the one now um but i will say this that the information that you need to know for this next nclex is the same so you should be studying the same it's just that the way that the information is presented is going to be different and i will talk about the way that they set up the questions um because there is a different way that they do it but you still need to know the same information so make sure to check out my one hour nclex review video it goes over all the big safety topics that you need to know for the nclex um and otherwise you guys i really wish you luck this time around and i also do have a five dollar nclex bundle that is available on etsy if anybody needs that extra little nclix review um it just again goes over more information that you should know for the nclex it's less than the price of a hamburger so i just wanted to make things really affordable make things really easy so you guys can pass i just want you guys to pass if you guys love if you guys anything at all just leave a message in the comments i'll try to get to it um all right bye you guys [Music]