Nclex HIGH Yield Official Quick Tip PDF PDF

Preview

Summary

nclex notes...

Description

@nclexhighyield

@nclexhighyieldofficial

@nclexhighyield

NHY PODCAST anchor.fm/nclexhighyield

NCLEXHIGHYIELD.COM

NCLEX HIGH YIELD

Quick Tip Dr. Zeeshan's 8 Key NCLEX Prioritization Topics What Are We "Freaking Out About"

ASK GRAPH™ Airway Sepsis K+ (change in Potassium) Glucose (hypoglycemia) LethaRgy Altered mental status Peritonitis Hemorrhage

DR. ZEESHAN'S METHOD™

An Overview of the Famous "Method"

This will help you identify the type of question it is Take control of the question

The situation is just the remainder of the question Compare it to Number 3. By comparing the bottom two, we are able to eliminate one answer

Remember each one of the SATA is a an answer choice of its own

NCLEX HIGH YIELD

Quick Tip Make sure you look for AASH of ASK GRAPH when a client is Post-Op: Airway Altered Mental Status Sepsis Hemorrhage You don’t want your patient to turn into AASHes Post-Op

NCLEX HIGH YIELD

Quick Tip SuPraventricular Tachycardia vs Ventricular Tachycardia suPraventricular tachycardia - there is a P wave SVT is Skinny - it has a NARROW QRS Complex

NCLEX HIGH YIELD

Quick Tip To remember SSRI'S side effects Suicide risk increased Slow onset and slow taper Sweaty hot and fever* Rigid muscles, restless, agitated* Increased HR tachycardia* * = Symptoms of Serotonin Syndrome

NCLEX HIGH YIELD

Quick Tip To remember MAOIs Massive headache Avoid tyramine OTC drugs will cause hypertensive crisis Other antidepressants cannot be mixed with this! Increased risk of suicide

NCLEX HIGH YIELD

Quick Tip Do not let the number of SATAs throughout your exam determine whether you passed or failed! Remember, everyone gets different questions and each question you get is another chance to PASS. Stick to Dr. Zeeshan's Method!

NCLEX HIGH YIELD

Quick Tip HF education: DR. BEEDSSS Diet (no sodium or fluids) Risk for falls (orthostatic hypotension) BP + BNP shouldn’t be elevated Elevate legs with pillows in high Fowler’s Exercise Daily weights Sex (2 flights of stairs with no SOB) Stocking (decreased blood pooling) Smoking cessation

NCLEX HIGH YIELD

Quick Tip The Purpose of Fluids Move between intravascular and extravascular space Ex: Ascites, Pleural Effusions, Increased ICP Replenish volume loss (hypovolemia) Ex: Dehydration, Hemorrhage, DKA, Vomiting, Diarrhea Correct Electrolyte/Sugar Imbalances Ex: Hypo/Hypernatremia, Hypoglycemia

NCLEX HIGH YIELD

Quick Tip The Different Types of Fluids Hypotonic: 0.45% Saline, 2.5% Dextrose Isotonic: Lactated Ringers, 09% Normal Saline Hypertonic: 3% Saline, 5% Dextrose + 0.9% NS, 10% Dextrose, Albumin, Dextran

NCLEX HIGH YIELD

Quick Tip Fluids! Isotonic: think about the "I" - fluid stays "IN" the vascular space Hypotonic: think about the "O" - fluid moves "OUT" of the vascular space Hypertonic: think about the "E" - fluid will "ENTER" the vascular space

NCLEX HIGH YIELD

Quick Tip Use "RIPE" to remember Tuberculosis Treatment Rifampin: Red/orange secretions expected Isoniazid (INH): it's severely hepatotoxic (check AST, ALT, LFTs) causes peripheral neuropathy (give B6 = pyridoxine) Pyrazinamide Ethambutol: can cause visual changes (E for Eye)

NCLEX HIGH YIELD

Quick Tip Do practice questions at the same time that you plan on taking your boards. Make sure you have no distractions! You should now have a daily routine and the day of the test should feel no different than you doing questions at home.

NCLEX HIGH YIELD

Quick Tip How to remember NSAIDS (The boards love asking about ulcers and the kidney function) Naproxen Salicylate acid (aspirin) Acetylsalicylic Acid (aspirin) Ibuprofen and indomethacin Ketorolac

NCLEX HIGH YIELD

Quick Tip Math Questions With math questions, you almost always have to convert pounds to kgs! You do this by dividing the weight in lbs by 2.2

NCLEX HIGH YIELD

Quick Tip Math Problems Do your math problems 3 times! It sounds excessive/tedious BUT it ensures you get the questions correct. What if you had a calculator error?! Don’t be missing out on these points!

NCLEX HIGH YIELD

Quick Tip How to Remember Normal Cholesterol Values They are in alphabetical order and increase by 50! HDL: 50 LDL: 100 Triglycerides: 150 Total Cholesterol: 200

NCLEX HIGH YIELD

Quick Tip Passive Learning After all your studying, it is important to unwind and retain all the information you just took in. If you are working out or cooking, watch a lecture recording or listen to the podcasts These activities allow you to comprehend and make connections while doing the simplest tasks

NCLEX HIGH YIELD

Quick Tip The warning signs of cancer can be remembered with "CAUTION" Change in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge from a body orifice Thickening or a lump in the breast or elsewhere Indigestion or difficulty in swallowing Obvious change in wart or mole Nagging cough or hoarseness

NCLEX HIGH YIELD

Quick Tip When you get a patient that’s post-op: Watch for 2 of ASK GRAPH Infection (Sepsis) Bleeding (Hemorrhage)

We are FREAKING OUT! It’s UNEXPECTED!

NCLEX HIGH YIELD

Quick Tip The day before the exam: DO NOT DO ANY QUESTIONS! ONLY REVIEW YOUR PERSONAL NOTES A board exam is not a test you cram for, but an exam that you work hard towards. Nothing last minute will help you, it can only hurt you! If you have stayed true to a routine that works for YOU and listened to Doctor Zeeshan, you should be relaxing!

NCLEX HIGH YIELD

Quick Tip If you see the following in the answer choices: Check HCG Levels Do a Urine Pregnancy Test Ask the patient when their last menstrual cycle was Ask the patient if they are sexually active Ask yourself why is this an option?

The boards rarely put this as an option for an answer, so carefully analyze the situation to make sure you do not miss imaging or medication that could be harmful!

NCLEX HIGH YIELD

Quick Tip Dr. Zeeshan on how to "COPE" with anxiety when you are studying for the NCLEX exam Consistent Practice Organize Your Routine Pace Yourself Educate Your Mind

NCLEX HIGH YIELD

Quick Tip If you have an inflammatory process of the GI tract (diverticulitis, appendicitis, colitis, etc) select all of these: NPO - rest the GI tract and also is useful in case we need to perform an emergency surgery IVF - FLUIDS FLUIDS FLUIDS Pain Control - help make the patient comfortable (PRN) PPI - Proton Pump Inhibitor (PRN)

NCLEX HIGH YIELD

Quick Tip If you see the words: "Drooling," "Accessory Muscles," or "Stridor" used to describe a patient's status, you are FREAKING OUT about this patient! This person is in respiratory distress and your priority! Remember to apply ASK GRAPH to all of your prioritization questions and never deviate from it!

NCLEX HIGH YIELD

Quick Tip Remember for Hepatitis B Transmission: B for Body Fluids Blood Semen Vaginal secretions

NCLEX HIGH YIELD

Quick Tip B Vitamins B1 (thiamine) - Used in ETOH Intoxication B3 (niacin) - Used for high cholesterol, can cause flushing which can be treated by NSAID's B6 (pyridoxine) - Given in conjunction with Isoniazid to prevent peripheral neuropathy B9 (folate) - Supplement for at least 1 month prior to pregnancy to avoid Neural Tube Defects B12 (cobalamin) - Found in animal products, deficiency leads to anemia and nerve damage

NCLEX HIGH YIELD

Quick Tip "SAD PERSONS" are at risk for completing suicide Sex - Males kill themselves more often than women, women attempt more Age - Young adults and elderly Depression Prior attempt ETOH / Substance abuse Rational thought loss (psychosis) Sickness (terminal illness) Organized Plan No spouse/family Stated future intent

NCLEX HIGH YIELD

Quick Tip Cardiology: Loop Diuretics Furosemide, Bumetanide, Torsemide Think "OOHH DANG!" Orthostatic Hypotension Ototoxicity Hypokalemia Hypomagnesemia Dehydration Allergy (Sulfa's) Nephrotoxic (check BUN and Creatinine) Gout

NCLEX HIGH YIELD

Quick Tip Different ways we can develop a Pulmonary Embolism Fat embolism. This is obtained through fractured long bones Amniotic fluid Thrombus Bacteria Air emboli. Commonly acquired through central lines Tumor

NCLEX HIGH YIELD

Quick Tip When you see the following answers, choose them: Eat Healthy Exercise - as tolerated Decrease or Stop ETOH Smoking Cessation Ask yourself, when would you say the opposite?

NCLEX HIGH YIELD

Quick Tip Extrapyramidal Symptoms A movement disorder Causes: Anti-psychotics and Anti-emetics Remember "ADAPT" Acute Dystonia - muscle spasm, stiffness Akathisia - restlessness Parkinsonism - shuffling gait, pill-rolling, facial grimacing Tardive Dyskinesia - slow writhing movements

NCLEX HIGH YIELD

Quick Tip Celiac Disease Nutrition Remember: these patients are allergic to Gluten AVOID: Barley, Rye, Oats, Wheat

NCLEX HIGH YIELD

Quick Tip POST - OP TWO THINGS YOU MUST ENCOURAGE 1. AMBULATE - the faster we get patients up and walking, the less likely they will develop a DVT 2. INCENTIVE SPIROMETRY - get patients to use their lungs to prevent Atelectasis and further respiratory complications

NCLEX HIGH YIELD

Quick Tip Treatment of Angina “MONA” Morphine (Make sure to check BP and HR first) Oxygen (helps lower the demand on the heart) Nitroglycerin (for vasodilation) Aspirin (125-325 mg)

NCLEX HIGH YIELD

Quick Tip Blood Pressure Medication Safe in Pregnancy “Hypertensive Mothers Love Nifedipine” Hydralazine Methyldopa Labetalol Nifedipine Never give a hypertensive mother ARB's or ACE-I's, these are teratogens and will harm the baby!

NCLEX HIGH YIELD

Quick Tip Remember to look for the following in Metabolic Syndrome: “We Better Think High Glucose” Waist circumference Blood pressure Triglycerides HDL Glucose

NCLEX HIGH YIELD

Quick Tip How to handle "Select All That Apply" Questions Ask yourself if each option is true or false. You can easily get rid of incorrect options using this mindset, remember they are just concepts! On test day, write down 1-5 on your board to make sure you choose and eliminate the correct ones.

NCLEX HIGH YIELD

Quick Tip Antidotes - Substance Abuse Benzodiazepines Overdose Flumazenil OpiOid Overdose - NalOxOne / Naltrexone Methanol / Ethylene Glycol (antifreeze) Fomepizole

NCLEX HIGH YIELD

Quick Tip Remember that heparin and warfarin prevent blood clots, by anti-coagulating. They don't actually break them down.

NCLEX HIGH YIELD

Quick Tip Do 4 sets of 40 questions, not timed and off of tutor mode taking a 5-7 min break between each one Why? Stimulate the actual exam every day as a part of your routine to build stamina and avoid mental fatigue

NCLEX HIGH YIELD

Quick Tip Variable Deceleration Early Deceleration (stop oxytocin) Acceleration Late Deceleration (always turn off oxytocin) Cord Compression - change mom's position to knees up to move the cord Head compression- baby is ready for delivery Okay! Placental Insufficiency - change mom's position

NCLEX HIGH YIELD

Quick Tip The NCLEX will try to trick you when it comes to the following signs and symptoms Glaucoma: halo vision, loss of peripheral vision (closed-angle Glaucoma is an emergency)!! Retinal Detachment: floaters, "curtains falling" flashes but NO PAIN. Cataracts: blurry eyes - worse at night Macular Degeneration: loss of central vision (PAIN)

NCLEX HIGH YIELD

Quick Tip When you see a question ending with "...what is the nurse's best response?" Look for: "Tell Me More" It's right more times than not!

NCLEX HIGH YIELD

Quick Tip Hypoglycemia Treatment "Cold and Clammy, Give them Candy" "Warm and Dry, Sugar is High"

NCLEX HIGH YIELD

Quick Tip The Parkland Formula Protocol Used to estimate the amount of replacement fluid required for the first 24 hours in a burn patient to ensure he remains hemodynamically stable. 24-hour fluid requirement calculation: 4mL x body weight (kg) x total body surface area burned (%) First 8 hour fluid administration: 50% of total fluid requirement Remaining 16-hour fluid administration: 50% of total fluid requirement

NCLEX HIGH YIELD

Quick Tip Remember in Cirrhosis to Know Your ABC lab values Albumin Ammonia Bilirubin Bile Salts Clotting Factors

NCLEX HIGH YIELD

Quick Tip 4 S's for Soothing Infant in Pain Sucrose Sucking (pacifier) Skin to Skin Swaddle

NCLEX HIGH YIELD

Quick Tip PAD P - Pale, cool skin - Punched out appearance ulcer, PM Pain A - Absent pulse, Activity causes pain (intermittent claudication) D - Dry, scaly skin Patients with PAD should dangle their legs

NCLEX HIGH YIELD

Quick Tip DelegaTion SATAs Think of the T in delegaTion as “Team” because when determining how to delegate on these SATAS, you must understand who is on your Team!

NCLEX HIGH YIELD

Quick Tip Understanding Intravenous Catheters Think “opposite” when determining what size to use The bigger the gauge, the smaller the catheter is! The smaller the gauge, the bigger the catheter is! For example: an 18 gauge intravenous catheter involves a larger catheter than a 22 gauge intravenous catheter.

NCLEX HIGH YIELD

Quick Tip The Double "A" You look at a telemetry strip and see Asystole; what do you do first? Think “Double-A”- Asystole, Assess! Because you always need to assess the patient and the leads first before you take the situation any further

NCLEX HIGH YIELD

Quick Tip "Intub8" When applying the Glasgow Coma Scale, think 8, intub8! Because with a score of 8 or less, the patient will need to be intub8ed and you are FREAKING OUT!!!

NCLEX HIGH YIELD

Quick Tip If you are given an age, gender, ethnicity, religion, etc... you are given that for a reason! Ask yourself "why is this in the question?

NCLEX HIGH YIELD

Quick Tip USE the mnemonic PIMP to help remember some illnesses that require droplet precautions Pertussis Influenza B Meningitis Pneumonia

NCLEX HIGH YIELD

Quick Tip When taking the exam Critically think about your options with the information provided without adding to it. If you have to say “yeah but” or “what if” then you’re probably adding to it. "Best." If You can do or say one thing, and one thing only what can I do or say that will get me the most information, maintain safety and/or be therapeutic. "First." If I don’t go see this person right now, the client is going to die. Who am I freaking out about? Most appropriate action equals “best”

NCLEX HIGH YIELD

Quick Tip For Select All That Apply Questions First of all, stay confident with these questions (your attitude is at least half of your success)! They are usually (Risk Factors, Signs & Symptoms, Education, or Concepts) Stick to THE METHOD (Never deviate from the method)!!! Treat each option as a True or False When you tell yourself “True” or “False” as your initial instinct for these questions, do not go back (Remember, your first instinct is always going to be more likely correct than that “second-guessing instinct”). Do not let the number of SATAS throughout your exam determine whether you passed or failed (Remember, everyone gets different questions and each question you get is another chance to PASS)!

NCLEX HIGH YIELD

Quick Tip More than 5 contractions in a fetal EKG strip is BAD. This is Uterine Tachysystole! We need to decrease/stop oxytocin.

NCLEX HIGH YIELD

Quick Tip Delegation: RN doesn’t delegate what you can’t EAT… Educate Assessment Teach Also, don’t delegate to an LPN what a UAP is capable of doing (Ex. Stable vital signs, ADL’s)

NCLEX HIGH YIELD

Quick Tip Causes of DKA- 4 S's -

Sepsis Sickness Stress Skipping insulin

NCLEX HIGH YIELD

Quick Tip Remember with Malignant Hyperthermia and Neuroleptic Malignant Syndrome patients get Cooked like a HAM: High temperatures (104-105) Altered Mental Status Muscle Rigidity

NCLEX HIGH YIELD

Quick Tip Pancreatitis Risk Factors The GATE might lead you to have Pancreatitis Gall Stones Alcohol Trauma (accidents, bike handle hit the pancreas) ERCP

NCLEX HIGH YIELD

Quick Tip Growth and Development Age Groups IN (Infant) 0-1 TIME (Toddler) 1-3 PEOPLE (Pre-School) 3-5 SHALL (School-Age) 5 -12 AGE (Adolescent) 12 - older

NCLEX HIGH YIELD

Quick Tip To remember presumptive pregnancy signs "PRESUME" Period absent Really tired (fatigue) Enlarged breast Sore breast Urination increased Movement of fetus in the uterus, fluttering (quickening) sensation in the lower abdomen. Occurs at 16-20 weeks Emesis + Nausea

NCLEX HIGH YIELD

Quick Tip The Boards love drugs with a Narrow Therapeutic Index Warning, These Drugs are Pretty Lethal! Warfarin: INR 2-3 Theophylline: 10-20 mcg/mL Digoxin: 0.5-2.0 ng/mL Phenytoin: 10-20 mcg/mL Lithium: 0.6-1.2 mEq/L

NCLEX HIGH YIELD

Quick Tip ACE Inhibitor Acronym “ACE-I” Angioedema - ASK GRAPH (Instead use ARBs) Cough - not worried (Instead use ARBs) Excess Potassium - ASK GRAPH Instead use ARBs Both ARBs and ACE-I cause Excess Potassium and are Teratogens

NCLEX HIGH YIELD

Quick Tip Risk Factors for Cholelithiasis The 6 F’s Family History Fair (skin tone) Fat (BMI >30) Female Fertile Forty (>40 y/o)

NCLEX HIGH YIELD

Quick Tip When approaching Select All That Apply (SATA) You can have anywhere from 1 - 6 correct answers. SATA’s are usually one of the following: Signs / Symptoms Risk Factors Education Concepts Look for these to be your SATA’s

NCLEX HIGH YIELD

Quick Tip Indications for dialysis in Acute Kidney Injury AEIOU A - Acidemia (metabolic) E - Electrolyte Imbalances (K+ ASK GRAPH) I - Intoxication (overdose) O - Overload of fluid U - Uremia

NCLEX HIGH YIELD

Quick Tip When approaching Select All That Apply (SATA) You can have anywhere from 1 - 6 correct answers. SATA’s are usually one of the following: Signs / Symptoms Risk Factors Education Concepts Look for these to be your SATA’s...