S1+Rekaps+2021 - Lecture notes 1 PDF

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Need to review our PowerPoint information? You have prerecorded class videos located in your Kaplan online resources located in the Study Plan tab under Phase 2, click on the session number and then click on Lesson on Demand– you can stop, pause, rewind, fast-forward. This is Session 1 Take Notes during class: 1. Content - write down content you need to review including a Pharm sheet. 2. Strategies/Pearls of Wisdom – tips, strategies. 3. Resources - write down links, webpages, location of specific Kaplan resources 4. To do list - make a list of what you need to do everyday

Kaplan Study Plan Phase 1 = content resources (ebook, content videos and Channel) Phase 2 = Strategy resources (LIVE class sessions, prerecorded Lesson on Demand, Channel presentations) Phase 3 = practice questions using our Decision Tree/Strategies after class (in all Phases going from nonpassing to higher passing level questions) Need one on one support? - You have a LIVE Chat option in your resources on the far-right side. There is a tab "Ask A Teacher". Anytime you need support, clarification, help with using our strategies, etc - you can reach out to one of the Kaplan NCLEX prep instructors at this tab. There are specific times they are open but if they are not open to chat LIVE, you can email them at [email protected] Take all the Kaplan exams in "test like conditions" - wear a mask, quiet environment, no food/drinks/cellphone beside you. This can help decrease your anxiety Avoid "hard question hangover". Think of every question as a real client - take care of them and close the door, go to the next question/client. Each client is unique and different. Each client deserves your time, attention and focus on them - just like each question does. Avoid thinking about a previous question. You CAN do it. Be sure to explore the NCSBN website and stay up to date with changes during our COVID 19 pandemic: https://www.ncsbn.org/14506.htm The NCSBN creates the NCLEX exam. Be sure you know information about Before, During and After the Exam: https://www.ncsbn.org/nclex.htm Download the Bulletin to know all the information: https://www.ncsbn.org/candidatebulletin.htm

Test Plan The NCSBN breaks down the content they test you on by using the 8 client needs category. This is called the Test Plan. Kaplan creates all your resources around this test plan:

https://www.ncsbn.org/testplans.htm Management of Care, Pharm and Physiological Adaptation are the highest tested categories = be sure you are strong in this content. After you take a Kaplan Exam, you will have a test result page. At the top right of this Test Result page is a tab Performance/Overall Summary. This summary breaks down how you tested in each of the 8 Client Needs category. This helps you focus on what your weaknesses are and study them to make them stronger. Create a table with all your scores and looks at your trends/issues. Kaplan Target Scores are 60-65% overall and each test plan category. If you signed up with your school/college use their target score. Study scores below 60%, start with the lowest first. Phase 1 Content Resources *Ebook NCLEX RN Content Review Guide - chapters are titled according to the test plan. The Ebook NCLEX RN Content Review Guide can be located in the "Getting Started" or in Phase 1 Essential Nursing Content Tab. There are directions on how to download the ebook. If you have difficulty email our team at [email protected] The eBook is a free download. If you want to purchase a hardcopy of the eBook for this NCLEX prep course, you will have to go to Amazon: Be sure to get the 8th edition. https://www.amazon.com/NCLEXRN-Content-Review-Guidepreparation/dp/1506262910/ref=sr_1_3?crid=2BUMIXR52RYVP&dchild=1&keywords=kaplan+nclex+rn+ content+review+guide&qid=1614617473&sprefix=Kaplan+nclex+rn+content+r%2Caps%2C194&sr=8-3 • •

*Content Videos - 322 short to the point videos according to each test plan category located in Phase 1 Essential Nursing tab. *Channel - 30 - 50 minute content specific presentations that you can attend LIVE or recorded. Located at the top tab or under Phase 1 Essential Nursing Content tab.

Phase 2 Strategy Resources •

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*LIVE Class sessions – includes 6 LIVE sessions and Session 7 taking the NCLEX RN Practice Test and after taking that test attend the Session 8 Roadmap to Success LIVE or recording in the Channel (the instructor will talk about this on during Session 6). *Strategy Posters – located in Phase 1 at the Orientation Video tab and/or at Phase 2 Session 1 tab *Lesson on Demand – prerecorded class videos located in Phase 2 for each class session number at the Lesson on Demand tab. *Channel presentations – each Channel presentation helps to reinforce using the Decision Tree with the practice questions.

Phase 3 Preparation after class until the day before NCLEX • •

Question Trainers 4 through 7 – the Trainers” will get longer and more difficult with each exam to “train” your endurance and stamina Qbank – bank of questions where you will create the exams.

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Sample Exams – 4 exams where one is all alternate style questions, one is Who do you see First questions. Readiness Test – to be taken 1 to 2 weeks before the NCLEX exam.

COVID Changes for the NCLEX (expected until 2023) The minimum number of test items will be 75. The maximum number of test items will be 145. The maximum testing time will be 5 hours. The NCLEX Exam is a Computer Adaptive Test = it adapts to you. If you get a question correct, you get a more difficult question. If you get a question incorrect, you will get a less difficulty question. There is no partial credit for any question – you either get it right or get it wrong. As long as you are getting questions = you are still in the game. Don't give up! Pearson Vue is the testing center site - they administer and proctor the NCLEX exam - Know all the testing rules: https://portal.ncsbn.org/ Plan on being at the testing center site for up to 5 hours-- this way you are prepared if you have to be there the entire time (brings snacks/drinks, take breaks) Info on during the exam/breaks: https://www.ncsbn.org/exam-day.htm A dry erase noteboard is available and given to you to use during the NCLEX exam. Know all the NCLEX rules: https://www.ncsbn.org/1268.htm Be sure to read the NCLEX Bulletin - information on how to register, testing accommodations, etc. https://www.ncsbn.org/NCLEX_Candidate_Bulletin_2021.pdf Strategy: SAFETY is the number one thing being tested on the NCLEX. Always think "What is the safest most effective answer option". Blooms Taxonomy is about the difficulty level of questions. The lower difficulty of questions are remembering (recall) and comprehension (understanding) type questions – these are nonpassing below passing line type questions. Passing Level questions = application/analysis level type questions. These questions make you use critical thinking to make a safe effective nursing judgment. Accuracy is the key, as you get a question correct, the next question will be more challenging and difficult. It will keep giving you harder questions as you get them correct to determine your level of competency. Celebrate challenging/harder questions - > think "give me more" To PASS the NCLEX, you MUST be ABOVE the passing line Select All that Apply Rules -> New RULES!! It can be one answer or all of them. Know the FAQs -> https://www.ncsbn.org/9010.htm Multiple response items may require a candidate to select a single correct response, have more than one correct response, or require all responses to be correct regardless of the number of possible responses

NCLEX requires Complex Critical Thinking- Slow down and systematically/methodically think • • •

Identify the topic and Eliminate the answers (do not just grab one you think is correct). Focus on the right here right now information that you need to take care of the client safely, discriminate what is important vs what is not important Avoid making up stories - concentrate on what you have not what the "what ifs". NCLEX will give you what you need, do not add information.

Decision Tree includes 5 steps: Decision Tree Resources: • •

Ebook Content Review Guide Chapter 2 Phase 2 Session 1 Lesson on Demand – fast-forward to the Decision Tree section

Step 1: Know the topic - Read the stem only (the stem is just the question itself -- not the answers, so avoid looking at the answers and just look at the question) rephrase into 2-3 of your own words A Priority Question - asks you what is "First, Next, Most Important, Best, Initial *ACTION/Response*” = more than one could be correct and you aren’t just finding the correct one but the BEST, Most important one. The NCLEX is asking you to establish priority - Use ALL 5 Steps of the Decision Tree An Evaluation Question - asks you to discriminate and determine if something is right/wrong, correct/incorrect, true/false or need “special evaluation criteria” (Who do you see First, Delegation, Therapeutic communication, teaching/learning, risk factors, all alternate format, dietary, documentation, infection control). Use the Shortcut = Step 1 and Step 5. Know your topic and then evaluate according to what the NCLEX is asking you. Not sure about your topic or do not know the medication/word/etc – look at the answers for clues to the topic/words/etc. The answers can give you clues. Don’t let one word take you out of the game. Go with what you do know, don’t focus on what you don’t know. Be a detective and slow down and think through it.

Step 2: Assessments vs Implementation Look at the answers and determine if they are Assessments/data (action that gives you information) or implementations (action that does something for the problem/situation) If you have a mix -- then you have the ability to prioritize and eliminate answer options. *Assessment/Data answer options are actions that give you information about the client or situation (asking questions, findings, lab values, Vital signs, etc) *Implementation answer options are actions that you do to help the problem/situation (sitting client up, giving meds, turning the client, etc) If you have that “mix” then Start with looking at the data answers first and determine if you need more "data" in this situation (we would “assess” before we would implement-establishing priority). The data must make sense for the topic, and you need it –it will make a difference, and/or if it may confirm

"validates" what you were thinking. Consider the “need” to know from the “nice” to know data. We would keep the need/must know data = we would need that data BEFORE we implement. Validation = confirm -> gives you concrete evidence of what you “suspected” was happening. An Assessment/data answer that “validates” what you suspected is a good priority answer option. When you have a data answer option that makes sense think “do I need this BEFORE I implement?” If you do then it is a priority answer option because it will make a difference in what you would do next. If you have more than one assessment that makes sense and you need, consider the earliest fastest indicator of the status of the client/change in the client. The assessment that gives me the earliest indicator will take priority. For example: for fluid volume status – a blood pressure will give me an earlier indicator of fluid volume versus obtain the weight or monitoring urinary output. The weight change and urinary output will be a later indicator. The blood pressure will give me the right here right now earliest indicator of fluid volume status.

Step 3: Maslow Determine if answer options are Physical or Psychosocial. Physical takes priority over psychosocial. Physical answer options are needed for survival = basic needs – air, water, food, shelter, safety, etc Psychosocial answer options are emotional needs, cognitive needs = thoughts/feelings, love/belonging, social activities, emotional support, expected pain, teaching for later use, etc. Physical answer options take priority over psychosocial answer options = Eliminate psychosocial answer options if they do not make sense. The client will not “die” if they do not receive psychosocial support -> think "what will kill them first" Physical problem = physical answer, Psychosocial problem (client is scared/afraid) = psychosocial answer Pain that is expected, chronic is considered Psychosocial – it will not kill the client (hit my toe on my desk- it will hurt but not kill me). If pain is caused by an ischemic event and/or is severe/excruciating/uncontrolled/unexpected then we consider it physical. If pain is being caused by or can cause a life-threatening event (loss of a limb, organ, life) then it is physical. Some examples of pain that is physical could be an MI, Kidney Stones, Sickle Cell Crisis, Compartment Syndrome, etc. Step 4: Use ABC's to prioritize. When you have all Physical answer left, use the ABC's to prioritize your answer options. Airway, Breathing and Circulation answer options take priority over other answer options (musculoskeletal, neuro, integumentary, urinary, GI). We need an Airway, Breathing and Circulation to survive. Airway problem, airway answer. Breathing problem, breathing answer. Circulation problem, circulation answer. Step 5: Evaluation Evaluate the answer option according to the criteria: What is the outcome, if I do this what will be the outcome? Is this outcome desired for this problem/topic?

Does this make sense for my topic? Is this safe and effective? If I can do 1 thing and walk away…is this the safest?

Page 125 Review somogyi effect versus dawn phenomenon. This is essential content you need to understand to get this question correct. The blood sugar can go low during the night and then rebound in the morning or the blood sugar could be remaining high all through the night. Strategy: Be aware of vague answers. The safest answer will be specific and address the need/problem in the client. Page 149 Strategy: "who do you see FIRST" questions (what med do you give first, who do you call first, etc= more than one client) . Evaluation questions because you have more than one client and you have to find the most Unstable client = TRIAGE – who would die on you first -> The topic will always be “Most UNSTABLE client” Use Step 1 and go directly to Step 5 Evaluation each answer as Unstable vs Stable, Unexpected vs expected, ABCs, Acute vs chronic, Actual/Real vs potential problem. The Unstable, Unexpected, ABC, Acute, Actual problem will take priority and you would need to see them first. Page 153 Select All that Apply Rules -> Know the FAQs - > scroll down to the “alternate questions types” at https://www.ncsbn.org/9010.htm One answer could be the only one correct, more than one, or all of them. Remember that you cannot get partial credit for any answer. Take your time on these Strategy: Select All That Apply questions (SATA) = Evaluation questions – use Step 1 and Step 5 = turn these into true/false, expected/unexpected, correct/incorrect questions = Know the topic and when evaluating each answer option ask yourself "is this true or false related to my topic?" Each answer is an independent true/false question. Check out our Channel presentation on SATA questions. Something Wrong questions - key words = requires intervention, concerns, should question, further teaching, requires follow up, considered negligent, need to evaluate, etc. These are negatively phrased type questions. Remember you are looking for something unsafe, may cause harm, something is wrong/false. Something Right questions - key words = teaching is successful, expects to see, should implement, indicates success. You are looking for something safe, correct, appropriate, expected....