Hesi Comprehensive Review for the Nclex-Pn Examination (2017)

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Table of Contents
Cover image
Title page
Copyright
Contributing Authors
Reviewers
Preface
1. Introduction to Testing and the NCLEX-PN® Examination
The NCLEX-PN Licensing Examination
Administration of the NCLEX-PN
Tips for NCLEX-PN Success
2. Leadership and Management
Legal Aspects of Nursing
Review of Legal Aspects of Nursing
Answers to Review
Leadership and Management
Review of Leadership and Management
Answers to Review
Disaster Nursing
Review of Disaster Nursing
Answers to Review
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3. Advanced Clinical Concepts
Respiratory Failure
Review of Respiratory Failure
Answers to Review
Shock
Disseminated Intravascular Coagulation
Review of Shock and DIC
Answers to Review
Resuscitation
Review of Resuscitation
Answers to Review
Fluid and Electrolyte Balance
Review of Fluid and Electrolyte Balance
Answers to Review
Electrocardiogram
Review of Electrocardiogram
Answers to Review
Perioperative Care
Review of Perioperative Care
Answers to Review
HIV Infection
Pediatric HIV Infection
Review of HIV Infection
Answers to Review
Pain
Review of Pain
Answers to Review
Death and Grief
Review of Death and Grief
Answers to Review
4. Medical-Surgical Nursing
Caring and Nursing
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Cultural Diversity
Spiritual Assessment
Respiratory System
Review of Respiratory System
Answers to Review
Renal System
Review of Renal System
Answers to Review
Cardiovascular System
Review of Cardiovascular System
Answers to Review
Gastrointestinal System
Review of Gastrointestinal System
Answers to Review
Endocrine System
Review of Endocrine System
Answers to Review
Musculoskeletal System
Review of Musculoskeletal System
Answers to Review
Neurosensory System
Neurologic System
Review of Neurosensory/Neurologic Systems
Answers to Review
Hematology/Oncology
Review of Hematology/Oncology
Answers to Review
Reproductive System
Review of Reproductive System
Answers to Review
Burns
Review of Burns
Answers to Review
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5. Pediatric Nursing
Growth and Development
Pain Assessment and Management in the Pediatric Client
Child Health Promotion
Review of Child Health Promotion
Answers to Review
Respiratory Disorders
Review of Respiratory Disorders
Answers to Review
Cardiovascular Disorders
Review of Cardiovascular Disorders
Answers to Review
Neuromuscular Disorders
Review of Neuromuscular Disorders
Answers to Review
Renal Disorders
Review of Renal Disorders
Answers to Review
Gastrointestinal Disorders
Review of Gastrointestinal Disorders
Answers to Review
Hematologic Disorders
Hemophilia
Review of Hematologic Disorders
Answers to Review
Metabolic and Endocrine Disorders
Review of Metabolic and Endocrine Disorders
Answers to Review
Skeletal Disorders
Review of Skeletal Disorder
Answers to Review
6. Maternity Nursing
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Anatomy and Physiology of Reproduction
Antepartum Nursing Care
Review of Anatomy and Physiology of Reproduction and Antepartum Nursing Care
Answers to Review
Fetal/Maternal Assessment Techniques
Review of Fetal/Maternal Assessment Techniques
Answers to Review
Intrapartum Nursing Care
Review of Intrapartum Nursing Care
Answers to Review
Normal Postpartum Period (Puerperium)
Review of Normal Puerperium (Postpartum)
Answers to Review
The Normal Newborn
Review of the Normal Newborn
Answers to Review
Complications of Pregnancy
Review of Complications of Pregnancy
Answers to Review
Postpartum Complications
Review of Postpartum Complications
Answers to Review
Complications of the Newborn
Review of Complications of the Newborn
Answers to Review
7. Psychiatric Nursing
Therapeutic Communication
Review of Therapeutic Communication and Treatment Modalities
Answers to Review
Anxiety
Anxiety Disorders
Review of Anxiety and Trauma- and Stressor-Related Disorders
Answers to Review
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Somatic Symptom Disorder and Related Disorders
Review of Somatic Symptom Disorder and Related Disorders
Answers to Review
Dissociative Disorders
Review of Dissociative Disorders
Answers to Review
Personality Disorders (DSM-5 Criteria)
Review of Personality Disorders
Answers to Review
Eating Disorders
Review of Eating Disorders
Answers to Review
Mood Disorders
Review of Mood Disorders
Answers to Review
Schizophrenia Spectrum and Other Psychotic Disorders
Review of Thought Disorders
Answers to Review
Substance Abuse
Review of Substance Abuse Disorder
Answers to Review
Childhood and Adolescent Disorders
Review of Childhood and Adolescent Disorders
Answers to Review
8. Gerontologic Nursing
Theories of Aging
Physiologic Changes
Psychosocial Changes
Dementia
Health Maintenance and Preventive Care
End-of-Life Care
Review of Gerontologic Nursing
Answers to Review
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Copyright
3251 Riverport Lane
St. Louis, Missouri 63043
HESI COMPREHENSIVE REVIEW FOR THE NCLEX-PN® EXAMINATION,
FIFTH EDITION ISBN: 978-0-323-42933-7
Copyright © 2018 by Elsevier, Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by
any means, electronic or mechanical, including photocopying, recording, or any
information storage and retrieval system, without permission in writing from
the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such
as the Copyright Clearance Center and the Copyright Licensing Agency, can be
found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under
copyright by the Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new
research and experience broaden our understanding, changes in research
methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and
knowledge in evaluating and using any information, methods, compounds,
or experiments described herein. In using such information or methods, they
should be mindful of their own safety and the safety of others, including
parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are
advised to check the most current information provided 1) on procedures
featured or 2) by the manufacturer of each product to be administered to
verify the recommended dose or formula, the method and duration of
administration, and contraindications. It is the responsibility of practitioners,
relying on their own experience and knowledge of their patients, to make
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diagnoses, determine dosages and the best treatment for each individual
patient, and take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors,
contributors, or editors, assume any liability for any injury and/or damage to
persons or property as a matter of products liability, negligence or otherwise,
or from any use or operation of any methods, products, instructions, or ideas
contained in the material herein.
Previous editions copyrighted 2015, 2012, and 2008.
NANDA International Nursing Diagnoses: Definitions and Classifications
2012–2014; Herdman T.H. (Ed.); copyright © 2012, 1994–2012 NANDA
International; Published by John Wiley & Sons, Limited.
NCLEX®, NCLEX-RN®, and NCLEX-PN® are Registered Trademarks of the
National Council of State Boards of Nursing, Inc.
International Standard Book Number: 978-0-323-42933-7
Content Strategist: Jamie Blum
Content Development Manager: Billie Sharp
Associate Content Development Specialist: Samantha Dalton
Publishing Services Manager: Jeff Patterson
Book Production Specialist: Bill Drone
Design Direction: Ryan Cook
Printed in Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
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Contributing Authors
Safa'a Al-Arabi, PhD, RN, MSN, MPH, Associate Professor and Accelerated
BSN Track Administrator, School of Nursing, University of Texas Medical
Branch, Galveston, Texas
Sharon L. Colley, PhD, MSN, BSN, RN, CNE, MSN Program Coordinator,
Associate Professor, School of Nursing, Ferris State University, Big Rapids,
Michigan
Claudine Dufrene, PhD, RN-BC, GNP-BC, CNE, Assistant Professor, Carol
and Odis Peavy School of Nursing, University of St. Thomas, Houston, Texas
Tiffany Jakubowski, BSN, RN, ONC, CMSRN, Adjunct Nursing Faculty,
Front Range Community College, Longmont, Colorado
Sandra R. Jemison, RN, MSN, Assistant Professor, Cox College of Nursing
and Health Sciences, Springfield, Missouri
Necole Leland, MSN, RN, PNP, CPN, School of Nursing, University of
Nevada, Las Vegas, Nevada
Katherine Ralph, MSN, RN, Curriculum Manager, Elsevier
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Reviewers
Kristen M. Bagby, RN, MSN, CNL, Staff Nurse, St. Louis Children’s
Hospital, St. Louis, Missouri
Judy Carlyle, RN, MNS Nursing Administration and Education, Nursing
Education, Arkansas Rural Nursing Education Consortium (ARNEC),
Nashville, Arkansas
Abimbola Farinde, Pharmacist, PhD, Professor, College of Business,
Columbia Southern University, Orange Beach, Alabama
Christina Flint, RN, MSN, MBA, Assistant Professor, Nursing, University of
Indianapolis, Indianapolis, Indiana
Judith M. Hochberger, PhD, RN, Assistant Professor, Nursing, Roseman
University, Henderson, Nevada
Lisa Tardo-Green, ABD, MSN, RN, Assistant Professor, Associate Degree
Nursing, Cabarrus College of Health Sciences, Concord, North Carolina
Laura Williams, MSN, CNS, ONC, CCNS, Clinical Nurse Specialist, Center
for Nursing Research and Advanced Nursing Practice, Orlando Health,
Orlando, Florida
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Preface
Welcome to HESI Comprehensive Review for the NCLEX-PN® Examination with
online study exams by HESI.
Congratulations! This outstanding review manual with the companion
Evolve site is designed to prepare nursing students for what is likely the most
important examination they will ever take, the NCLEX-PN Licensing
Examination. As a graduate of a PN nursing program, the student has the basic
knowledge required to pass tests and perform safely and successfully in the
clinical area. HESI Comprehensive Review for the NCLEX-PN® Examination
with the companion Evolve site allows the nursing student to prepare for the
NCLEX-PN licensure exam in a structured way.
• Organize basic nursing knowledge previously learned.
• Review content learned during basic nursing curriculum.
• Identify weaknesses in content knowledge so that study efforts can be
focused appropriately.
• Develop test-taking skills so application of safe nursing practice from
knowledge can be demonstrated.
• Reduce anxiety level by increasing ability to correctly answer NCLEX-type
questions.
• Boost test-taking confidence by being well prepared and knowing what to
expect.
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Organization
Chapter 1, Introduction to Testing and the NCLEX-PN® Examination, gives an
overview of the NCLEX-PN Licensing Exam history and a test plan for the
examination. A review of the nursing process (updated with the latest
NANDA-approved nursing diagnoses), client needs, and prioritizing nursing
care is also presented.
Chapter 2, Leadership and Management, reviews the legal aspects of nursing,
leadership, and management, along with disaster nursing.
Chapter 3, Advanced Clinical Concepts, presents nursing assessment (data
collection), analysis (nursing diagnosis), planning, and intervention at the
practical nurse level. Respiratory failure, shock, disseminated intravascular
coagulation (DIC), resuscitation, fluid and electrolyte balance, acid-base
balance, electrocardiography (ECG), perioperative care, HIV, pain, and death
and grief are reviewed.
Chapters 4 through 8, Medical-Surgical Nursing, Pediatric Nursing,
Maternity Nursing, Psychiatric Nursing, and Gerontologic Nursing, are
presented in traditional clinical areas.
Each clinical area is divided into physiologic components, but essential
knowledge about basic anatomy, medications, nutrition, communication, client
and family education, acute and chronic care, leadership and management, and
clinical decision-making are integrated throughout the different components.
Open-ended style questions appear at the end of each chapter, which
encourage the student to think in depth about the content presented throughout
the individual chapter. When a variety of learning mechanisms is used,
students have the opportunity to comprehensively prepare for the NCLEX.
These strategies include the following:
• Reading the review book.
• Discussing content with others.
• Answering open-ended questions.
• Practicing with study exams that simulate the licensure examination.
These learning experiences are all different ways that students should use to
prepare for the NCLEX. The purpose of the open-ended questions appearing at
the end of the chapter is not a focused practice session on managing NCLEX-
style multiple-choice questions, but instead this learning approach allows for
more in-depth thinking about the particular topics in the chapter. Practice with
multiple-choice–style questions alone cannot provide the depth of critical
thinking and analysis possible with the short-answer–style questions at the end
of the chapter. Additionally, the open-ended questions provide a summary
experience that helps students focus on the main topics that were covered in the
chapter. Teachers use open-ended–style questions to stimulate the critical-
thinking process, and HESI Comprehensive Review for the NCLEX-PN®
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Examination facilitates the critical-thinking process by posing the same type of
questions the teacher might ask.
When students need to practice multiple-choice–style questions, the Study
Exams offer extensive opportunities for practice and skill-building to improve
their test-taking abilities. The Study Exams contain seven content-specific
exams (Medical-Surgical Nursing, Pharmacology, Pediatrics, Fundamentals,
Maternity, Psychiatric-Mental Health Nursing, and Gerontology) and two
comprehensive exams patterned after categories on the NCLEX. The Study
Exams can be accessed as many times as necessary, and no questions are
repeated. For instance, the Medical-Surgical exam does not contain questions
that are on the Pediatrics exam. The purpose of providing these exams is to
allow practice and exposure to the critical-thinking–style questions that
students will encounter on the NCLEX. However, the Study Exams should not
be used to predict performance on the NCLEX. Only the HESI Exit Exam—a
secure, computerized exam that simulates the NCLEX test plan and has
evidenced-based results from numerous research studies indicating a high level
of accuracy in predicting NCLEX success—is offered as a true predictor of
NCLEX performance. Students are allowed unlimited practice on each Study
Exam so that they can have the opportunity to review all of the rationales for
the questions.
Here is a plan for students to use with the companion Evolve site:
• Trial 1: Take the PN Practice Exam without studying for it to determine your
areas of strengths and weaknesses.
• Trial 2: After going over the content that relates to the practice questions on a
particular practice test (for instance, Pediatrics, Medical-Surgical, Maternity),
review that section of the manual and take the test again to determine
whether you have been able to improve your scores.
• Trial 3: Purposely miss every question on the exam so that you can view
rationales for every question.
• Trial 4: Take the exam again under timed conditions at the pace that you
would have to progress to complete the NCLEX in the time allowed
(approximately 1 minute per question). Find out whether being placed under
timing constraints affects your performance.
• Trial 5: Put the exam away for a while and continue review and remediation
with other textbook resources, results of any secure exams that you are taking
at your school, and other study aids. Take the practice exams again after this
study period to see whether your performance improves with in-depth study
and a few weeks’ break from the questions.
Trial 5 represents a good activity in preparation for the HESI Exit Exam
presented in your final semester of the program, especially if you have not used
the Evolve question site for several weeks. Repeated exposure to the questions,
however, will make them less useful over time because students tend to
memorize the answers. For this reason, these tests are useful only for practice
and are not a prediction of NCLEX-PN success. The tendency to memorize the
questions after viewing them multiple times falsely elevates the student’s scores
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on the study exams.
Additional assistance for students to study for the NCLEX-PN Licensing
Examination can be obtained from a variety of products in the Elsevier family.
Many nursing schools have also adopted the following resources:
• HESI Examinations—a comprehensive set of examinations designed to
prepare nursing students for the NCLEX exam. These enable customized
remediation from Mosby and Saunders textbooks that saves time for faculty
and students. Each student is given an individualized report detailing exam
results and is allowed to view questions and rationales for items that were
answered incorrectly. The electronic remediation, a complimentary feature of
the HESI specialty and exit exams, can be obtained on the subject matter in
which the student did not answer a question correctly.
• HESI-PN Practice Test—a test that provides an introduction to real-world
client situations with critical-thinking questions. These questions cover
nursing care for clients with a wide range of physiologic and psychosocial
alterations and a related coordination of client care, pharmacology, and
nursing concepts.
• HESI Complete PN Case Study Collection—prepares students to manage
complex patient conditions and make sound clinical judgments. These online
case studies cover a broad range of physiologic and psychosocial alterations,
in addition to related coordination of care, pharmacology, and therapeutic
concepts.
• HESI Live Review—a Live Review Course presented by an expert faculty
member who has received training by the Manager of Review Courses for
Elsevier Review and Testing. Students are presented with a workbook and
practice NCLEX-style questions that are used during the course.
• eBooks—online versions of the all Mosby and Saunders textbooks used in the
student’s Nursing Curriculum. Search across titles, highlight, make notes,
and more—all on your computer.
• Elsevier Simulations—using virtual clinical cases, standardized simulation
scenarios, and electronic documentation software, Elsevier Simulations allow
students to practice and apply skills in a controlled, monitored environment.
• Evolve Courses—created by experts using instructional design principles, this
interactive content engages students with reading, animation, video, audio,
interactive exercises, and assessments.
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The NCLEX-PN Licensing Examination
A. The main purpose of a licensing examination such as the NCLEX-PN is to
protect the public.
B. The NCLEX-PN is:
1. Developed by the National Council of State Boards of Nursing.
2. Administered by the State Board of Nursing.
3. Designed to test the candidate’s capability for safe and effective nursing
practice by measuring current, entry-level practical nursing behavior.
Job Analysis Studies
A. “Essential” knowledge on the NCLEX-PN test is determined by practice
analysis studies.
B. Practical nurses (PNs or vocational nurses [VNs]) submit statements about
the frequency of nursing activities and the related impact on client safety.
HESI Hint
The 2015 LPN/VN Practice Analysis: Linking the NCLEX-PN Examination to
Practice (Vol. 58) determines how frequently new practical nurses perform
more than 150 types of nursing care activities. From the analysis, the 2017
NCLEX-PN Test Plan (effective April 1, 2017) identifies four major client
needs categories, and two of those categories are further divided into a total
of six subcategories and five fundamental nursing processes. They provide a
basis for establishing a minimum level of knowledge and skills for PNs to
use with a diverse patient population, in any setting, and within the laws
and rules of each state (Table 1.1, Client Needs, and Table 1.2,
Practical/Vocational Nursing Processes).
HESI Hint
For more information on the NCLEX-PN Test Plan and content related to
each category, go to www.ncsbn.org.
The Nursing Process and Nursing Diagnoses
A. PN role in the nursing process: Practical nurses use the nursing process to
critically think and problem solve (see Table 1.2).
B. Practical nurses assist the health care team to gather and organize data and
recognize client needs and problems regardless of the client’s developmental
stage or the health care setting. They also assist the RN in formulating nursing
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diagnoses and developing plans of care.
C. The National Conference of the North American Nursing Diagnosis
Association (NANDA) guides nurses in the selection of nursing interventions
for the purpose of achieving specific outcomes; outcomes and interventions are
associated with specific diagnoses (Table 1.3, Components of a Nursing Diagnosis,
and Appendix A, NANDA-Approved Nursing Diagnoses).
HESI Hint
A nursing diagnosis is not a medical diagnosis because a nursing diagnosis:
Is subject to nursing management.
May or may not come from a medical diagnosis.
Is formulated and written by nurses.
Is implemented from nursing orders (care plan and nursing interventions).
Prioritizing Nursing Care on NCLEX-PN
A. Many NCLEX-PN test items are designed to test your ability to set priorities.
B. Some examples include:
1. Identify the MOST IMPORTANT client needs.
2. Identify the MOST IMPORTANT nursing intervention.
3. Which nursing action should be done FIRST?
4. Which client should be cared for FIRST?
Examination Item Formats
A. Several different item types (alternate item formats) are presented on the
NCLEX-PN examination.
TABLE 1.1
Client Needs with Threaded Integrated Processes: Caring, Clinical
Problem Solving, Culture & Spirituality, Communication & Documentation,
and Teaching & Learning
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Based on the results of the 2014 LPN/VN Practice Analysis: Linking the NCLEX-PN Examination to
Practice (Vol. 58). The percentages indicate the amount of questions written for each client need
category in the 2015 NCLEX-PN Test Plan.
Adapted from National Council of State Boards of Nursing, Inc. NCLEX-PN Examination: Test Plan for
the National Council Licensure Examination for Licensure Practical/Vocational Nurses, 2015, Chicago,
IL. www.ncsbn.org.
1. The majority of the questions are multiple-choice items with four choices
(answers) from which to choose one correct answer.
2. Multiple-response items require the candidate to select one or more
responses from five to seven choices. The item instructs the candidate to
choose all that apply.
3. Fill-in-the-blank questions require the candidate to calculate the answer
and type in the numbers.
4. Hot-spot items require the candidate to identify an area on a picture or
graph and click on the area.
5. Chart/exhibit format presents a chart or exhibit that the candidate needs
to read to be able to answer the problem.
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TABLE 1.2
Practical/Vocational Integrated Nursing Processes
TABLE 1.3
Components of a Nursing Diagnosis
6. Ordered response items require a candidate to rank order or move
options to provide the correct order of actions or events.
7. Graphic format items require the candidate to choose the correct graphic
in response to the question.
8. Audio format items require the candidate to listen to an audio clip using
headphones and then select the correct option that applies to the audio
clip.
B. There is no set percentage of alternate items on the NCLEX-PN examination.
All examination items are scored either right or wrong. There is no partial credit
in scoring any examination questions.
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Administration of the NCLEX-PN
A. The NCLEX-PN Computer Adaptive Testing (CAT) is administered at
Pearson Professional Centers in the United States, selected by the National
Council of State Boards of Nursing (NCSBN).
B. Pearson VUE is responsible for adapting the NCLEX-PN examination to the
CAT format, processing candidate applications, and transmitting test results to
its data center for scoring.
C. The NCSBN generates the NCLEX-PN test items.
Understanding CAT
A. NCLEX-PN consists of 85 to 205 multiple-choice or alternative format items.
B. The candidate is presented with a test item.
1. If the question is answered correctly, a slightly more difficult item follows,
and the level of difficulty increases with each item until an item is missed.
2. If the question is answered incorrectly, a slightly less difficult item follows,
and the level of difficulty decreases with each item until the candidate
answers an item correctly.
C. The process continues until the candidate has achieved a definite “pass” or
“fail” score. A message indicating that the candidate has completed the
examination appears on the screen.
D. The item number the candidate is currently answering appears in the upper
right side of the screen.
E. The greatest number of items appearing on your examination is 205.
Taking the Test
A. A test administrator provides each candidate with an erasable note board
that may be replaced as needed while testing. A candidate may not bring his or
her own note boards, scratch paper, or writing instruments to the examination.
B. You must answer each question before proceeding to the next one. Returning
to a question or skipping a question is not allowed during testing. You will not
be able to change an answer once you proceed to the next question; this works
in your favor.
C. When taking the examination, read carefully and maintain a reasonable pace.
Time Frame and Breaks
A. The candidate receives up to 5 hours to complete the examination. The 5
hours include a tutorial, sample questions, breaks, and completion of the
examination.
B. Two programmed optional breaks are given, one after 2 hours of testing and
another after 3½ hours of testing. A candidate may take an unscheduled break
at any time. All breaks count against testing time.
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C. When candidates take a break, they must leave the testing room and will be
required to provide a fingerprint before and after the break.
Results and Scoring
A. When the candidate answers the minimum number of items (85) and has
performed with 95% certainty above or below the passing standard, the
computer test stops and calculates whether the candidate has passed or failed.
B. If a candidate has answered the maximum number of items (205) and is not
at the end of the 5-hour limit, the candidate’s ability estimate is precise. So if the
ability estimate is at or above the passing standard, the candidate passes, and if
the ability estimate is at or below the passing standard, the candidate fails.
C. If a candidate has run out of time (5-hour limit) and has not answered the
maximum number of items (205) but shows a consistent pattern above the
passing standard, then the candidate will pass even if he or she has run out of
time.
D. A specific passing score is recommended by the NCSBN. All states require
the same score to pass, so if you pass in one state, you are eligible to practice
nursing in any other state.
HESI Hint
Results are not given at the testing centers. Results are mailed to the
candidate by the boards of nursing about 1 month after taking the
examination. The testing center staff does not have access to test results. The
NCSBN does not want the testing center to be in a position of managing
candidates’ reactions to scores, nor does it want those waiting to take their
examinations to be influenced by such reactions.
Item Strategy
A. Every question must be answered to move to the next question, so make
your best guess if you are not sure of the answer.
B. One or more choices are likely to be very wrong. Quickly eliminate those
choices that do not answer the question.
C. Decide between two choices by:
1. Rereading the question for qualifiers or other words that specify what the
question is asking.
2. Rereading the choices and deciding what makes them different from one
another.
3. Examining the choice; it may contain correct information but not answer
the question.
4. Using information from Maslow’s Hierarchy of Needs (Table 1.4) or
Erikson’s Stages of Development (Table 1.5) to choose the correct response.
D. Trust your instincts. The first response you have is a gut instinct and is an
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Tips for NCLEX-PN Success
Overall Planning
A. Eat a well-balanced diet and drink plenty of water.
B. Maintain a normal exercise program. This is the perfect activity for a study
break.
C. Get plenty of sleep while studying because you will study more efficiently
when well rested.
D. Limit your social life for this short period of time before the examination so
that you have plenty of time to study. This will help you achieve your goal of
becoming a nurse.
E. Eliminate alcohol and recreational drugs from your lifestyle because the time
involved in their use will waste the time you have to prepare for the test.
F. Avoid negative people and think positively. Stay away from people who
have test anxieties or project their problems onto you. Sometimes this person is
a fellow classmate, a colleague, or your best friend. They will still be present
when the examination is over. Right now you need to take care of yourself;
therefore, surround yourself with positive, optimistic people.
1. Write “I WILL BE SUCCESSFUL!” on a sticky note, and put it where you
will see it every day.
2. Choose a relaxation and affirmation method that you are comfortable with
and that meets your needs.
3. Repeat to yourself, “I have the knowledge to successfully complete the
NCLEX-PN.”
Study Skills
Logically, you will study less familiar topics more than those you have already
mastered. When developing a study plan, consider the following:
A. Study plan.
1. Study every day, except the night before the exam, until you take the
examination. Schedule study time on your daily calendar.
2. Make a list of topics you want to study in order of importance.
3. Build your confidence by alternating areas of strength with areas that need
further review.
B. Vary learning techniques: study alone, study in a group, or study content or
sample NCLEX-PN questions.
C. Organize the material in each topic. Increasing the time you work with the
material will increase your knowledge base and confidence. Use organizational
methods such as:
1. Write your own fill-in-the-blank tests.
2. Prepare flash cards.
3. Rewrite material in your own words.
4. Make charts and tables of the material.
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5. Label or explain pictures.
D. Rewrite test questions in your own words, with special emphasis on
understanding the rationale.
E. Identify areas for further review, and seek clarification for complete
understanding.
F. Develop test-taking skills to demonstrate your knowledge. This is very
important because these skills help increase your ability to:
1. Determine what each question is asking.
2. Eliminate test responses or answers that are obviously incorrect.
3. Identify the best response or prioritize.
G. Know what to expect. Remember: “Knowledge is power” when you know
what to expect. In addition, your confidence will soar, and your anxiety will
decrease.
H. Read the NCLEX-PN Candidate Bulletin.
Test-Day Preparation
A. Test-Day Checklist: Gather all necessary materials the night before the
examination and put them in a large envelope.
1. Admission ticket
2. Directions to the testing center
3. Identification
4. Money for lunch
5. Glasses or contact lenses
B. Approved Items: Candidates are allowed to bring only identification forms
into the testing room. The following items are not allowed: watches, candy,
chewing gum, food, drinks, purses, wallets, pens, pencils, beepers, cellular
phones, Post-it® notes, study materials or aids, or calculators.
C. Allow Plenty of Traveling Time: Plan to arrive 30 minutes early. Allow for
traffic jams and time for parking. Arriving early will give you a chance to get
settled before beginning the test.
D. Dress Comfortably: Dress in loose layers so that you can adjust your
clothing to the temperature of the testing room.
E. Do Not Discuss the Examination: Avoid discussing the examination during
breaks and while waiting to take the examination.
F. Avoid Distraction: If the typing noise of other test takers is a problem, ask
the test administrator for earplugs, which are available at each center.
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Legal Aspects of Nursing
Laws Governing Nursing
A. Nurse Practice Acts provide the laws that control and regulate nursing
practice in each state to protect the public from harm. Under the law, the
practice of nursing is restricted to licensed professionals. All states have nursing
practice acts, and these laws contain state standards for nursing care.
B. Nurse Practice Acts govern the practical nurse’s (PN) responsibility in
assigning, supervising, and accepting assignments and making assignments.
Each state sets educational and examination requirements for that state.
1. Assignments should be commensurate with the nursing personnel’s
educational preparation, skills, experience, and knowledge.
2. The PN should supervise care provided by nursing personnel delegated by
a registered nurse (RN) or assigned PN. Some states do not authorize PNs
to delegate nursing care.
3. Unstable patient and sterile or invasive procedures should be assigned to
and supervised by RNs (these should be supervised by an RN at all times,
but laws related to this may differ among states).
4. Documentation is a legal document.
Organization of Laws
A. Laws are divided into two large groups: criminal (public) law and civil
(private) law. Criminal laws are crimes against the country, state, or local
government (Table 2.1, Organization of Law). Constitutional, administrative, and
criminal are the three types of criminal law. Civil law is separated into two
large groups: contract and tort law. Tort law is further divided into intentional
and unintentional torts.
Crime
A. Nurses remain bound by all criminal laws, although court cases involving
nurses generally involve tort laws. Crimes occur when criminal statutes are
violated. These acts are crimes against the state (government), they usually
include intent, and they are punishable by the state.
B. A crime is committed when:
1. The act is contrary to a criminal law or statute.
2. An act is not performed when a legal obligation exists to perform the act—
for example, refusing to assist in childbirth if the refusal results in injury to
the child.
3. Two or more persons agree to commit a crime—that is, criminal
conspiracy.
4. One person is aware a crime is being committed and helps another person
in committing the crime. Both participants are equally guilty.
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Hesi Comprehensive Review for the Nclex-Pn Examination (2017)

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