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NOTES FROM YOUR KAPLAN NCLEX-PN CLASS

Left is the lungs - Right is the rest



Cushings Response = widening pulse pressure

Hypersensitivity to iodine can range from a local reaction (hives, itching) to a
systemic reaction (widening pulse pressure, increased systolic BP and decreased
pulse)

Babinski's Response/Reflex = dorsiflexion of great toe when soles of feet are
stimulated

Normal Specific Gravity = 1.010 - 1.030 (think of it in terms of time - 10:10-10:30)

''Comma, Comma, And Rule'' => all parts of an answer choice MUST be correct or
it's not correct at all

A decrease in alertness or mental function may be an early indication of decreasing
O2 levels => manifestation of hypoxia

3 ''P'' of Diabetes:
o Polydipsia (excessive thirst)
o Polyuria (excessive production of urine)
o Polyphagia (excessive hunger)

Hypersensitivity to iodine can range from a local reaction (hives, itching) to a
systemic reaction (bronchial constriction, decreased BP

MRI - the magnet used can damage tissues if any metal is present - can cause the
metal to heat up as it absorbs the energy

Tip - Always attempt to solve the ''root'' cause

Tip - A mix forces you to go back to the stem of the question to validate your hunch of
what's really going on -> do you need another assessment to clarify something or are
you free to just move on an implement

Tip - Your goal is to logically, methodically work your way through the question to
eliminate as many answers as possible until you get to the legitimate, correct one

The 4 ''G's'' - will decrease platelet aggregation
o Ginkgo
o Ginger
o Garlic
o Ginseng

Tip - Always attempt to solve the ''root'' cause


Scope of Practice:
o RN - does the assessment, teaching, makes nursing judgments
o LPN/LVN - deals with stable pts with a predictable outcome
o NA/UAP - deals with standard, unchanging procedures
o The LPN can differentiate normal from abnormal but it's the responsibility of the
RN to complete the assessment

Erikson's Stages of Development p. 94 of Course Book

RICE:
o R = Rest
o I = Ice
o C = Compression
o E = Elevation

Tip - for balanced suspension traction you must have traction, counter-traction and line
of pull

The 5 "P" of diabetes:
o Paresthesias
o Pulselessness
o Pallor
o Pain
o Paralysis

Psych nurses assess the following on admission and while a pt. is hospitalized ->
Sleep - Appetite - Concentration - Interest - Energy

MRSA - Methicillin Resistant Staphylococcus Aureus

SSRIs - Take 2- 3 weeks to have any effect.

VRE- Vancomycin Resistant Enterococcus

Poor hand washing by health care providers is most common cause of transmission
of VRE and MRSA.

OCD - obsessive thoughts, compulsive behaviors that the client is unable to control

Hospice Care: emphasizes palliative care rather than curative treatment, quality
rather than quantity of life. Provided for clients who are expected to die within the
next six months. Available 24 hours per day.

Hematocrit measures the amount of solids in a liquid. Make sure you know the
normal levels in your Kaplan-PN book.
o Men: 42-50
o Women 40-48

Tip - Watch video on precautions online you have to know this content


VITALS & ABC'S:
o Respiratory Rate = A or B
o Blood Pressure & Pulse = C

Fatty Emboli Syndrome (FES) occurs whenever fat enters into the circulation.
Clients diagnosed with femur or pelvic fractures or total hip replacements are a
higher risk.
o At highest risk for a FES 24 72 hrs. after the fracture/surgery
o Manifestations include: shortness of breath, restlessness and apprehension
(sometimes described as a feeling of impending doom) and petechiae on
the chest

Living Will = signed by competent individual indicates tx or life saving measures to
be used if pt's ability to make decisions is lost

Durable power of attorney = permits a competent adult to appoint surrogate or proxy
in the event that the adult becomes incompetent

Restraints = Chemical or Mechanical On the NCLEX, you are to use the least
restrictive means of restraint thats legitimate. NCLEX loves the patient to be
independent as possible.

Management of Care Issues:
o Chain of Command means you take issues vertically to the authority figure
over you vs. going horizontal to your colleagues or other patients
o All legal, ethical, harassment and confidentiality issue always choose the
Chain of Command answer.

Legal Issues:
o Negligence - Failure of nurse to use ordinary and reasonable care during
care of a client
o Assault and battery. = Fearful that the nurse will cause harmful or offensive
contact, such as use of physical restraints without clients permission
o Battery occurs when offensive or unwanted contact takes place; client has
right to refuse treatment

Gloves should be worn whenever in contact with an infected area, a contaminated
area, or an area that is moist

Need to know stages of Erikson!

Therapeutic Response:
o Respond to feeling and tone
o Provide information
o Do not ask "why questions
o Do not ask "yes / no questions
o Do not focus on the nurse
o Do not explore (dont be nosey)
o Do not say, "don't worry"



Tip - Anything in a question or an answer is REAL in the NCLEX world. If its there it is
FAIR GAME as an answer option!

Tip - In the NCLEX hospital, the patient's picture may be in the chart - if that is what the
answer states, it is
o When caring for a child, it is okay to ask parent to identify child.

Risk Factors for HTN:
o Age
o Race
o Weight
o Diet
o Labs (Na, etc.)
o Family History

Know your positions!
o Prone - lying down
o Hyperextending neck - moving neck back
o Abduct - away from the body
o Adduct - towards the body

Walking with assistive devices crutches, walkers, etc.
o Don't put crutches under arms - can damage nerves.
o Up with the good, down with the bad for crutches on stairs.
o Proper fit of a cane is when handle at the level of the greater trochanter with the
elbow flexed 20 to 30 degrees.
o Cane should be held on unaffected side.

Isometric Exercises - ''Iso'' means same: -> so you are working with the same
muscle -> contracting and relaxing the ''same'' muscle

Pain is what the client says it is. Patient says he's in pain = he is!

The LPN/LVN calculates the 8-hour intake of a client. During the last 8 hours, the
client consumed:
o 2 cups coffee = 16 oz x 30mL = 480mL
o 1/2 jello = 4 oz x 30mL= 120 mL
o 8 oz milk = 8 oz x 30mL = 240mL
o 1 cup juice = 8 oz x 30mL = 240 mL
o 1 1/2cup soup = 12 oz x 30mL= 360mL
o 3 cups water = 24 oz x 30mL = 720mL
o Total mL => 2160

Measurements:
o 1 cup = 8 oz
o 1oz = 30ml






Psyche conditions:
o Schizophrenic - delusion, out of touch with reality
o Denial - denying the event or circumstance
o Depression - expected reaction due to loss of body part. Signs = insomnia,
lack of interest.
o Depression affects:
! Sleep
! Appetite
! Concentration
! Interest
! Energy

Review defense mechanisms in your book. This is a frequently tested topic.

Stages of grief
o Shock and disbelief
o Awareness of the pain of loss
o Restitution

Stages of dying
o Denial
o Anger
o Bargaining
o Depression
o Acceptance

Acute Alcohol withdrawal indications:
o Tremors
o Easily startled
o Insomnia
o Anxiety
o Anorexia
o Alcohol hallucinations.

Intermittent claudication: Calf pain that occurs with activity then decreases with
rest. Achy pain.

Signs of RIGHT heart failure: dependent edema, liver enlargement, anorexia,
nausea, bloating, anxiety, fear, depression

Signs of LEFT heart failure signs: dyspnea, orthopnea, pleural effusion, Cheyne
Stokes respirations, cough with frothy blood tinged sputum, edema, weight gain,
fatigue and muscle weakness.









Eye Conditions:
o Cataracts: causes opacity of lens of the eye. Gradual loss of vision, blurred
vision, sensitivity to light, opaque appearance to the eye.
o Glaucoma: increased intraocular pressure. Too much production or poor
drainage of aqueous humor. Poor night vision, halos around lights.
o Astigmatism: curving of the cornea will cause blurred vision
o Retinal detachment: retinal layers separate from the choroids;
o Floaters, flashes of light, or description of a curtain falling down over the
visual field.

Putting pregnant mom on her left side displaces the uterus. This allows circulation
thru the vena cava. Pregnant women often experience vena cava syndrome from
the fetus putting pressure on the inferior vena cava. When hypotension and
dizziness occur always turn on left side.

An abnormal bowing of the spine is also known as a 'hunchback' posture. It's
commonly seen in elderly clients and may be due to osteoarthritis or osteoporosis.

Tuberculosis: Airborne precautions using N-95 mask

RACE
o R = Rescue
o A = Alarm
o C = Contain
o E = Extinguish

For who to see first questions:
o Determine Stable vs. Unstable. To determine who is stable vs. unstable use
the ABCs, real vs. potential problems, and chronic vs. acute.

Client should not get pregnant for at least 4 weeks after receiving the rubella
vaccine.

Live vaccines like MMR, chicken pox and the inhaled flu vaccine should not be
administered to pregnant women, and immuno-compromised pts.

HPV = Human Papillomavirus

Intrinsic factor, located in the gastric mucosa, is necessary for the absorption of
vitamin B12.

Normal gastric aspirate is pH 1 to 4

Don't put anything in the mouth of someone having a seizure.

Common cause of hypercalcemia is metastasis of cancer to the bone.

Stomatitis common side effect of chemotherapy.

Do not encourage high fiber or spicy food for clients on radiation therapy.

Creatinine is a by-product of muscle metabolism. Excreted only through the
kidney. If the kidney function fails, the creatinine goes up.

Peripheral cyanosis is a bluish discoloration cause by room temperature, peripheral
arterial disease, and venous insufficiency and not related to oxygenation.

Lantus - is a long-acting insulin and does not have a peak effect. Usually
administered at bedtime, and reduces risk of nighttime hyperglycemia.

Follow the 6 rights of medication administration:
o Right client
o Right medication
o Right dose
o Right route
o Right time
o Right documentation

Select all that apply strategy:
o Read the stem.
o When you re-word the question, read that for each answer.
o Answer yes/no.
o Put the question in front of each one. They can be confusing. Don't get mixed
up.

Still worried about meds & calculations? Here are some tips:
o Conversion Equivalents are in your PN Course book
o You have to know this content for the NCLEX - PN.

In your Kaplan online, there are a TON of content videos about medications - IV
therapy, blood infusion, side effects, meds. It definitely includes some calculation
work for you





















Exam Time Thoughts:
o Do not chew gum during the NCLEX. The camera may think you are talking to
someone else.
o Bring a snack for the exam and take the breaks offered to re-energize.
o Dress in layers
o Review the content videos online in your Kaplan materials. Listen to those
lectures.
o You can review these questions again with Lessons On Demand. It's like taking
the class again.
o Use that Decision Tree.


Between end of class and the exam:
o Select the week you will test
o Review Chapter two in your NCLEX-PN book. It will help you determine the
number of questions to answer daily. It helps you make a study plan.
o Use all the questions in the Q-Bank. Review the right and wrong answers.
o Keep testing yourself!
o Create your exams based on what you don't know.
o Fix those weaknesses!


If you have questions about your online Q-Bank questions, you can email nclex-
expert@kaplan.com


Having trouble with your online resources? Here are some tips:
o Go to - www.kaplannursing.com
o Next, sign in. Your email is your user name
o Click 'My Kaplan'
o On My Course Syllabus, click Go!
o There is a TON of info here. To get to the Q Bank, click My Toolbox.

Still having trouble?
o Call 1-800-KAPTEST, they can guide you on the phone.
o Send an email to customer.care@kaplan.com


* Retail Student Technical Assistance/Books -> 1-800-KAP-TEST
* Kaplan IT Student Tech Assist -> call 877-572-8457
* Customer Care -> Customer.Care@Kaplan.com
* Class Code - #NJUA11800
* Online Nursing Content Questions
(include question ID#-> NCLEX-Expert@Kaplan.com)

Retail students -> http://www.kaptest.com/
IT students -> log into your resources as you normally do



Check it during break today. We can help you if it doesn't work for you today :)

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