McGraw-Hill Review for the NCLEX-RN Examination (2008)
McGraw-Hill Review for the NCLEX-RN Examination (2008) helps you pass with expert-reviewed materials and study tips.
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McGRAW-HILL
REVIEW FOR THE
NCLEX-RNEXAMINATION
Edited by
Frances D. Monahan, PhD, RN, ANEF
Professor
Department of Nursing
SUNY Rockland Community College
Suffern, New York
New York Chicago San Francisco Lisbon London Madrid Mexico City
Milan New Delhi San Juan Seoul Singapore Sydney Toronto
REVIEW FOR THE
NCLEX-RNEXAMINATION
Edited by
Frances D. Monahan, PhD, RN, ANEF
Professor
Department of Nursing
SUNY Rockland Community College
Suffern, New York
New York Chicago San Francisco Lisbon London Madrid Mexico City
Milan New Delhi San Juan Seoul Singapore Sydney Toronto
Copyright © 2008 by The McGraw-Hill Companies, Inc. All rights reserved. Manufactured in the United States of America. Except as permitted under the
United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or
retrieval system, without the prior written permission of the publisher.
0-07-159336-5
The material in this eBook also appears in the print version of this title: 0-07-146077-2.
All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names
in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in
this book, they have been printed with initial caps.
McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs. For more
information, please contact George Hoare, Special Sales, at george_hoare@mcgraw-hill.com or (212) 904-4069.
TERMS OF USE
This is a copyrighted work and The McGraw-Hill Companies, Inc. (“McGraw-Hill”) and its licensors reserve all rights in and to the work. Use of this work is
subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile,
disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or
any part of it without McGraw-Hill’s prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strict-
ly prohibited. Your right to use the work may be terminated if you fail to comply with these terms.
THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY,
ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN
BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR
IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.
McGraw-Hill and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be
uninterrupted or error free. Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of
cause, in the work or for any damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed through the work.
Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that
result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall
apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise.
DOI: 10.1036/0071460772
United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or
retrieval system, without the prior written permission of the publisher.
0-07-159336-5
The material in this eBook also appears in the print version of this title: 0-07-146077-2.
All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names
in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in
this book, they have been printed with initial caps.
McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs. For more
information, please contact George Hoare, Special Sales, at george_hoare@mcgraw-hill.com or (212) 904-4069.
TERMS OF USE
This is a copyrighted work and The McGraw-Hill Companies, Inc. (“McGraw-Hill”) and its licensors reserve all rights in and to the work. Use of this work is
subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile,
disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or
any part of it without McGraw-Hill’s prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strict-
ly prohibited. Your right to use the work may be terminated if you fail to comply with these terms.
THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY,
ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN
BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR
IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.
McGraw-Hill and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be
uninterrupted or error free. Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of
cause, in the work or for any damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed through the work.
Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that
result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall
apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise.
DOI: 10.1036/0071460772
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Dedicated with all my love—first and foremost to the memory of my husband, William T. Monahan,
also to my family and friends who support and tolerate me while I work and bring meaning and
happiness to my days:
• Michael M. Monahan, my son;
• Kerryane T. Monahan, my daughter, and Robson Diniz, my son-in-law;
• John Donovan, my brother;
• Gerard Donovan, my brother, and Anita Donovan, my sister-in-law;
• Claire T. Torpey, my aunt;
• Suzanne M. Reynolds;
• Mary Ellen Wyllie;
• Josephine and James Hammer.
Many thanks to all of them.
DEDICATION
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
also to my family and friends who support and tolerate me while I work and bring meaning and
happiness to my days:
• Michael M. Monahan, my son;
• Kerryane T. Monahan, my daughter, and Robson Diniz, my son-in-law;
• John Donovan, my brother;
• Gerard Donovan, my brother, and Anita Donovan, my sister-in-law;
• Claire T. Torpey, my aunt;
• Suzanne M. Reynolds;
• Mary Ellen Wyllie;
• Josephine and James Hammer.
Many thanks to all of them.
DEDICATION
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
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v
CONTENTS
Contributors xi
Preface xiii
PART I: TESTING SMART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 1: Preparing for NCLEX-RN® 3
Chapter 2: Test and Language Basics 9
Chapter 3: Sharpening Your Test Taking Skills 19
PART II: CONTENT REVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Chapter 4: Test Plan Category: Safe, Effective Care Environment 27
Sub-category: Management of Care
Topics: Legal Rights and
Responsibilities
Client Rights
Information Technology
Confidentiality/Information
Security
Informed Consent
Advance Directives
Ethical Practice
Chapter 5: Test Plan Client Needs Category: Safe, Effective Care Environment 55
Sub-category: Safety and Infection Control
Topics: Accident Prevention
Disaster Planning
Emergency Response Plan
Error Prevention
Handling Hazardous and
Infectious Materials Home Safety
Chapter 6.Test Plan Category: Health Promotion and Maintenance—Part 1 77
Sub-category: None
Topics: Ant/Intra/Postpartum and
Newborn Care
Concepts of Management
Delegation
Establishing Priorities
Supervision
Continuity of Care
Resource Management
Collaboration with the
Multidisciplinary Team
Ergonomic Principles
Injury Prevention
Medical and Surgical Asepsis
Reporting of Incident/
Event/Irregular Occurrence/
Variance
Advocacy
Referrals
Case Management
Consultation
Performance Improvement/
Quality Improvement
Staff Education
Safe Use of Equipment
Security Plan
Standard/Transmission-
Based/Other Precautions
Use of Restraints/Safety Devices
For more information about this title, click here
CONTENTS
Contributors xi
Preface xiii
PART I: TESTING SMART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 1: Preparing for NCLEX-RN® 3
Chapter 2: Test and Language Basics 9
Chapter 3: Sharpening Your Test Taking Skills 19
PART II: CONTENT REVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Chapter 4: Test Plan Category: Safe, Effective Care Environment 27
Sub-category: Management of Care
Topics: Legal Rights and
Responsibilities
Client Rights
Information Technology
Confidentiality/Information
Security
Informed Consent
Advance Directives
Ethical Practice
Chapter 5: Test Plan Client Needs Category: Safe, Effective Care Environment 55
Sub-category: Safety and Infection Control
Topics: Accident Prevention
Disaster Planning
Emergency Response Plan
Error Prevention
Handling Hazardous and
Infectious Materials Home Safety
Chapter 6.Test Plan Category: Health Promotion and Maintenance—Part 1 77
Sub-category: None
Topics: Ant/Intra/Postpartum and
Newborn Care
Concepts of Management
Delegation
Establishing Priorities
Supervision
Continuity of Care
Resource Management
Collaboration with the
Multidisciplinary Team
Ergonomic Principles
Injury Prevention
Medical and Surgical Asepsis
Reporting of Incident/
Event/Irregular Occurrence/
Variance
Advocacy
Referrals
Case Management
Consultation
Performance Improvement/
Quality Improvement
Staff Education
Safe Use of Equipment
Security Plan
Standard/Transmission-
Based/Other Precautions
Use of Restraints/Safety Devices
For more information about this title, click here
Loading page 8...
vi CONTENTSvi CONTENTS
Chapter 7: Test Plan Category: Health Promotion and Maintenance—Part 2 131
Sub-category: None
Topics: Growth and Development
Aging Process
Development Stages and
Transitions
Chapter 8: Test Plan Category: Health Promotion and Maintenance—Part 3 175
Sub-category: None
Topics: Health and Wellness
Health Screening
Health Promotion Programs
Chapter 9: Test Plan Category: Health Promotion and Maintenance—Part 4 207
Sub-category: None
Topics: Techniques of Physical
Assessment
Chapter 10: Test Plan Category: Psychosocial Integrity—Part 1 237
Sub-category: None
Topics: Mental Health Concepts
Cultural Diversity
Coping Mechanisms
Religious and Spiritual Influences
on Health
Chapter 11: Test Plan Category: Psychosocial Integrity—Part 2 265
Sub-category: None
Topics: Therapeutic
Communication
Therapeutic Environment
Chapter 12: Test Plan Category: Psychosocial Integrity—Part 3 287
Sub-category: None
Topics: Abuse/Neglect
Chemical Dependency
Chapter 13: Test Plan Category: Physiological Integrity 325
Sub-category: Basic Care and Comfort
Topics:Complementary and
Alternative Therapies
Assistive Devices
Elimination
Mobility/Immobility
Expected Body Image Changes
Family Systems
Behavioral Interventions
Crisis Intervention
Human Sexuality
Family Planning
Immunizations
Lifestyle Choices
High-Risk Behaviors
Situational Role Changes
Stress Management
Support Systems
Family Dynamics
Unexpected Body-Image Changes
Grief and Loss
End of Life
Principles of Teaching
and Learning
Sensory/Perceptual Alterations
Psychopathology
Non-Pharmacological Comfort
Interventions
Nutrition and Oral Hydration
Palliative/Comfort Care
Personal Hygiene
Rest and Sleep
Chapter 7: Test Plan Category: Health Promotion and Maintenance—Part 2 131
Sub-category: None
Topics: Growth and Development
Aging Process
Development Stages and
Transitions
Chapter 8: Test Plan Category: Health Promotion and Maintenance—Part 3 175
Sub-category: None
Topics: Health and Wellness
Health Screening
Health Promotion Programs
Chapter 9: Test Plan Category: Health Promotion and Maintenance—Part 4 207
Sub-category: None
Topics: Techniques of Physical
Assessment
Chapter 10: Test Plan Category: Psychosocial Integrity—Part 1 237
Sub-category: None
Topics: Mental Health Concepts
Cultural Diversity
Coping Mechanisms
Religious and Spiritual Influences
on Health
Chapter 11: Test Plan Category: Psychosocial Integrity—Part 2 265
Sub-category: None
Topics: Therapeutic
Communication
Therapeutic Environment
Chapter 12: Test Plan Category: Psychosocial Integrity—Part 3 287
Sub-category: None
Topics: Abuse/Neglect
Chemical Dependency
Chapter 13: Test Plan Category: Physiological Integrity 325
Sub-category: Basic Care and Comfort
Topics:Complementary and
Alternative Therapies
Assistive Devices
Elimination
Mobility/Immobility
Expected Body Image Changes
Family Systems
Behavioral Interventions
Crisis Intervention
Human Sexuality
Family Planning
Immunizations
Lifestyle Choices
High-Risk Behaviors
Situational Role Changes
Stress Management
Support Systems
Family Dynamics
Unexpected Body-Image Changes
Grief and Loss
End of Life
Principles of Teaching
and Learning
Sensory/Perceptual Alterations
Psychopathology
Non-Pharmacological Comfort
Interventions
Nutrition and Oral Hydration
Palliative/Comfort Care
Personal Hygiene
Rest and Sleep
Loading page 9...
CONTENTS viiCONTENTS vii
Chapter 14: Test Plan Category: Physiological Integrity 361
Sub-category: Pharmacological and Parenteral Therapies—Part 1
Topics: Dosage Calculation
Medication Administration
Pharmacological Agents/Actions
Pharmacological Interactions
Chapter 15: Test Plan Category: Physiological Integrity 439
Sub-category: Pharmacological and Parenteral Therapies—Part 2
Topics: Parenteral/Intravenous
Therapy
Chapter 16: Test Plan Category: Physiological Integrity 465
Sub-category: Reduction of Risk Potential—Part 1
Topics: Diagnostic Tests
Laboratory Values
Therapeutic Procedures
Chapter 17: Test Plan Category: Physiological Integrity 517
Sub-category: Reduction of Risk Potential—Part 2
Topics: Vital Signs
System Specific Assessments
Chapter 18: Test Plan Category: Physiological Integrity 551
Sub-category: Reduction of Risk Potential—Part 3
Topics: Potential for Complications
from Surgical Procedures and
Chapter 19: Test Plan Category: Physiological Integrity 633
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Chapter 20: Test Plan Category: Physiological Integrity 677
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body
Systems
Illness Management
Chapter 21: Test Plan Category: Physiological Integrity 703
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Central Venous Access Devices
Blood and Blood Products
Expected Effects/Outcomes
Adverse Effects/Contraindications
and Side Effects
Pharmacological Pain Management
Total Parenteral Nutrition
Diagnostic
Tests/Treatments/Procedures
Monitoring Conscious Sedation
Potential for Complications of
Potential for Alteration in Body
Systems
Health Alterations
Section 1: Cardiovascular
Problems
Section 2: Hematologic
Problems
Section 3: Respiratory Problems
Chapter 14: Test Plan Category: Physiological Integrity 361
Sub-category: Pharmacological and Parenteral Therapies—Part 1
Topics: Dosage Calculation
Medication Administration
Pharmacological Agents/Actions
Pharmacological Interactions
Chapter 15: Test Plan Category: Physiological Integrity 439
Sub-category: Pharmacological and Parenteral Therapies—Part 2
Topics: Parenteral/Intravenous
Therapy
Chapter 16: Test Plan Category: Physiological Integrity 465
Sub-category: Reduction of Risk Potential—Part 1
Topics: Diagnostic Tests
Laboratory Values
Therapeutic Procedures
Chapter 17: Test Plan Category: Physiological Integrity 517
Sub-category: Reduction of Risk Potential—Part 2
Topics: Vital Signs
System Specific Assessments
Chapter 18: Test Plan Category: Physiological Integrity 551
Sub-category: Reduction of Risk Potential—Part 3
Topics: Potential for Complications
from Surgical Procedures and
Chapter 19: Test Plan Category: Physiological Integrity 633
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Chapter 20: Test Plan Category: Physiological Integrity 677
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body
Systems
Illness Management
Chapter 21: Test Plan Category: Physiological Integrity 703
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Central Venous Access Devices
Blood and Blood Products
Expected Effects/Outcomes
Adverse Effects/Contraindications
and Side Effects
Pharmacological Pain Management
Total Parenteral Nutrition
Diagnostic
Tests/Treatments/Procedures
Monitoring Conscious Sedation
Potential for Complications of
Potential for Alteration in Body
Systems
Health Alterations
Section 1: Cardiovascular
Problems
Section 2: Hematologic
Problems
Section 3: Respiratory Problems
Loading page 10...
viii CONTENTS
Chapter 22: Test Plan Category: Physiological Integrity 735
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Chapter 23: Test Plan Category: Physiological Integrity 781
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body
Systems
Chapter 24: Test Plan Category: Physiological Integrity 797
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Chapter 25: Test Plan Category: Physiological Integrity 825
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Chapter 26: Test Plan Category: Physiological Integrity 857
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Chapter 27: Test Plan Category: Physiological Integrity 875
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body
Systems
Chapter 28: Test Plan Category: Physiological Integrity 905
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Chapter 29: Test Plan Category: Physiological Integrity 927
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Chapter 30: Test Plan Category: Physiological Integrity 945
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Section 4: Neurologic Problems
Illness Management
Section 5: Eye and Ear Problems
Section 6: Musculoskeletal
Problems
Section 7: Gastrointestinal
Problems
Section 8: Hepatic and Biliary
Tract Problems
Section 10: Urinary Problems
Section 11: Skin Problems
Illness Management
Section 9: Endocrine Problems
Illness Management
Illness Management
Section 12: Male and Female
Reproductive System Problems
Chapter 22: Test Plan Category: Physiological Integrity 735
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Chapter 23: Test Plan Category: Physiological Integrity 781
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body
Systems
Chapter 24: Test Plan Category: Physiological Integrity 797
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Chapter 25: Test Plan Category: Physiological Integrity 825
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Chapter 26: Test Plan Category: Physiological Integrity 857
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Chapter 27: Test Plan Category: Physiological Integrity 875
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body
Systems
Chapter 28: Test Plan Category: Physiological Integrity 905
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Chapter 29: Test Plan Category: Physiological Integrity 927
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Chapter 30: Test Plan Category: Physiological Integrity 945
Sub-category: Physiological Adaptation—Part 1
Topics: Alterations in Body Systems
Illness Management
Section 4: Neurologic Problems
Illness Management
Section 5: Eye and Ear Problems
Section 6: Musculoskeletal
Problems
Section 7: Gastrointestinal
Problems
Section 8: Hepatic and Biliary
Tract Problems
Section 10: Urinary Problems
Section 11: Skin Problems
Illness Management
Section 9: Endocrine Problems
Illness Management
Illness Management
Section 12: Male and Female
Reproductive System Problems
Loading page 11...
CONTENTS ix
Chapter 31: Test Plan Category: Physiological Integrity 971
Sub-category: Physiological Adaptation—Part 2
Topics: Fluid and Electrolyte
Imbalances
Chapter 32: Test Plan Category: Physiological Integrity 1013
Sub-category: Physiological Adaptation—Part 2
Topics: Infectious Diseases
Chapter 33: Test Plan Category: Physiological Integrity 1039
Sub-category: Physiological Adaptation—Part 3
Topics: Pathophysiology
Hemodynamics
PART III: TAKING THE TEST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1071
Chapter 34: Practice Test for NCLEX-RN 1073
Index 1267
Medical Emergencies
Radiation Therapy
Unexpected Response to Therapies
Chapter 31: Test Plan Category: Physiological Integrity 971
Sub-category: Physiological Adaptation—Part 2
Topics: Fluid and Electrolyte
Imbalances
Chapter 32: Test Plan Category: Physiological Integrity 1013
Sub-category: Physiological Adaptation—Part 2
Topics: Infectious Diseases
Chapter 33: Test Plan Category: Physiological Integrity 1039
Sub-category: Physiological Adaptation—Part 3
Topics: Pathophysiology
Hemodynamics
PART III: TAKING THE TEST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1071
Chapter 34: Practice Test for NCLEX-RN 1073
Index 1267
Medical Emergencies
Radiation Therapy
Unexpected Response to Therapies
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CONTRIBUTORS
FEATURED EDITORS
Charlotte E. Blackwell, RN, BSN, MSEd
Pharmacology
Instructor, Department of Nursing
Wake Technical Community College
Raleigh, North Carolina
Judy E. White, RNC, MA, MSN
Maternal-Child Health and Sample Test Question
Faculty, Southern Union State Community College
Opelika, Alabama
CONTRIBUTORS
Susan E. Abbe, PhD, RN
Nursing Curriculum Specialist
Connecticut Community-Technical Colleges
Hartford, Connecticut
Sharon A. Aronovitch, PhD, APRN, BC, CWOCN
Faculty, School of Nursing
Excelsior College
Albany, New York
Mary Sharon Boni, PhD, RN, CCRN
Professor & Dean
School of Nursing and Allied Health Administration
Fairmont State University
Fairmont, West Virginia
Susan R. Bulecza, RN, MSN, CNS, APRN, BC
Florida Department of Health
Office of Public Health Preparedness
Tallahassee, Florida
Patricia D. Coyne, RNC, MSN, MPA
Maternal-Newborn Instructor
Cochran School of Nursing
Yonkers, New York
Adjunct Professor, Maternal-Newborn Nursing
Rockland Community College
Suffern, New York
Paula M. Crawford, RN, MSN
Assistant Professor
Nursing Department
Orange County Community College
Middletown, New York
Dale A. Lange Crispell, RN, BSN, MA
Instructor, Department of Nursing
SUNY Rockland Community College
Suffern, New York
Mary Rose Driggers, RN, MSN
LPN-ADN Online Program Director and Nursing Instructor
Health Technology Division
Davidson Country Community College
Lexington, North Carolina
Miriam Freud, RN, MSN
Director, Adult Day Care Center
Friedwald Center for Rehabilitation & Nursing
New City, New York
Anne Hussey, BS, MSEd, RN (Retired)
Education Specialist School Nurse
Portsmouth Middle School
Portsmouth, New Hampshire
Laima M. Karosas, PhD, APRN
Associate Professor of Nursing
Quinnipiac University
Hamden, Connecticut
Dorothea Lever, RN, MS, CDE, CCRN
Associate Professor and Coordinator
Department of Nursing
SUNY Rockland Community College
Suffern, New York
Lisa L. Lombard, MD
Diplomat American Board of Anesthesiology
Boston, Massachusetts
Jana Henson Lyner, MSN, RN
Faculty, Department of Nursing
Pensacola Junior College
Pensacola Florida
M. Bridget Nettleton, PhD, RN,
Dean, School of Nursing
Excelsior College
Albany, New York
Tina Peer, MS, RN
Assistant Professor of Nursing
Associate Degree Nursing Program
College of Southern Idaho
Twin Falls, Idaho
xi
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
FEATURED EDITORS
Charlotte E. Blackwell, RN, BSN, MSEd
Pharmacology
Instructor, Department of Nursing
Wake Technical Community College
Raleigh, North Carolina
Judy E. White, RNC, MA, MSN
Maternal-Child Health and Sample Test Question
Faculty, Southern Union State Community College
Opelika, Alabama
CONTRIBUTORS
Susan E. Abbe, PhD, RN
Nursing Curriculum Specialist
Connecticut Community-Technical Colleges
Hartford, Connecticut
Sharon A. Aronovitch, PhD, APRN, BC, CWOCN
Faculty, School of Nursing
Excelsior College
Albany, New York
Mary Sharon Boni, PhD, RN, CCRN
Professor & Dean
School of Nursing and Allied Health Administration
Fairmont State University
Fairmont, West Virginia
Susan R. Bulecza, RN, MSN, CNS, APRN, BC
Florida Department of Health
Office of Public Health Preparedness
Tallahassee, Florida
Patricia D. Coyne, RNC, MSN, MPA
Maternal-Newborn Instructor
Cochran School of Nursing
Yonkers, New York
Adjunct Professor, Maternal-Newborn Nursing
Rockland Community College
Suffern, New York
Paula M. Crawford, RN, MSN
Assistant Professor
Nursing Department
Orange County Community College
Middletown, New York
Dale A. Lange Crispell, RN, BSN, MA
Instructor, Department of Nursing
SUNY Rockland Community College
Suffern, New York
Mary Rose Driggers, RN, MSN
LPN-ADN Online Program Director and Nursing Instructor
Health Technology Division
Davidson Country Community College
Lexington, North Carolina
Miriam Freud, RN, MSN
Director, Adult Day Care Center
Friedwald Center for Rehabilitation & Nursing
New City, New York
Anne Hussey, BS, MSEd, RN (Retired)
Education Specialist School Nurse
Portsmouth Middle School
Portsmouth, New Hampshire
Laima M. Karosas, PhD, APRN
Associate Professor of Nursing
Quinnipiac University
Hamden, Connecticut
Dorothea Lever, RN, MS, CDE, CCRN
Associate Professor and Coordinator
Department of Nursing
SUNY Rockland Community College
Suffern, New York
Lisa L. Lombard, MD
Diplomat American Board of Anesthesiology
Boston, Massachusetts
Jana Henson Lyner, MSN, RN
Faculty, Department of Nursing
Pensacola Junior College
Pensacola Florida
M. Bridget Nettleton, PhD, RN,
Dean, School of Nursing
Excelsior College
Albany, New York
Tina Peer, MS, RN
Assistant Professor of Nursing
Associate Degree Nursing Program
College of Southern Idaho
Twin Falls, Idaho
xi
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
Loading page 14...
xii CONTRIBUTORS
Patricia Sue Ragsdale, MSN, RN
Assistant Professor of Nursing
University of Arkansas at Little Rock
Little Rock, Arkansas
Joyce Grant Scott, MSN, BSN, ASN, CLNC, RN
Associate Professor of Nursing
University of Arkansas at Little Rock
Little Rock, Arkansas
Lovely Varghese, MSN, FNP, BC, CNOR
Educator, Department of Nursing Education
Columbia Presbyterian Medical Center
New York, New York
Susan M. Wicks, RNc, BS, MS
Advanced Medical-Surgical Nursing Faculty
Cochran School of Nursing
St. John’s Riverside Health Care System
Yonkers, New York
NCLEX-RN Presenter
Pace University
Pleasantville, New York
Denise D. Wilson, PhD, APN, FNP, ANP
Associate Professor
Mennonite College of Nursing
Illinois State University
Normal, Illinois
Family Nurse Practitioner
Medical Hills Internists & Pediatrics
Bloomington, Illinois
Patricia Sue Ragsdale, MSN, RN
Assistant Professor of Nursing
University of Arkansas at Little Rock
Little Rock, Arkansas
Joyce Grant Scott, MSN, BSN, ASN, CLNC, RN
Associate Professor of Nursing
University of Arkansas at Little Rock
Little Rock, Arkansas
Lovely Varghese, MSN, FNP, BC, CNOR
Educator, Department of Nursing Education
Columbia Presbyterian Medical Center
New York, New York
Susan M. Wicks, RNc, BS, MS
Advanced Medical-Surgical Nursing Faculty
Cochran School of Nursing
St. John’s Riverside Health Care System
Yonkers, New York
NCLEX-RN Presenter
Pace University
Pleasantville, New York
Denise D. Wilson, PhD, APN, FNP, ANP
Associate Professor
Mennonite College of Nursing
Illinois State University
Normal, Illinois
Family Nurse Practitioner
Medical Hills Internists & Pediatrics
Bloomington, Illinois
Loading page 15...
xiii
PREFACE
Dear Soon-to-be Registered Nurse,
The purpose of this book is to help you be successful on
the NCLEX-RN® examination so that you can obtain your
license as a registered nurse. You have worked long and hard
to successfully complete your basic nursing program. Now
the one thing between you and your license is the NCLEX-
RN examination.
This book is designed to guide your review study. There
is a vast amount of nursing knowledge and it can be organ-
ized and focused upon in different ways. This book is
designed to review the content most likely to appear on the
examination and approach it from the perspective of the
examination. Thus, the book begins with a discussion of the
test itself to direct your focus. Because time is a limited and
valuable commodity for all of you as you begin life after
nursing school, strategies for studying in the most effective,
time-efficient manner also are discussed.
A unique feature of this text is a preparatory chapter on
language. Despite advanced study, you may often have a few
words whose meanings were never clearly mastered.
Encountering one of these words in a test question can result
in a wrong answer. Hence, some of the words that are often
used in nursing but are prone to being misunderstood are
identified, defined, and their use illustrated in sentences
reflective of nursing practice. There is also a chapter on test-
taking strategies. You may have already used many of these,
but reviewing them as a unit helps to ensure that you are
approaching the NCLEX-RN with the sharpest test-taking
skills possible. The chapter even provides exercises to allow
you to practice key skills.
The next 30 chapters of the book present the review of
nursing content. The title of each chapter consists of one of
the major NCLEX-RN test plan categories followed by the
subcategories and topics from the plan to be covered in that
chapter. Precise headings found on the NCLEX-RN test plan
have been used to help you think about the content in the
same way that the test is organized and the questions are
designed. There are separate sections in the text dealing with
the child-bearing client and with gerontology just as there
are in the test plan. Care of the pediatric client is incorpo-
rated throughout the text. Icons in the margin are alerts that
the information applies specifically to a pediatric client or a
child-bearing client.
To help you recognize and learn critical points of con-
tent, the following alerts, which highlight key pieces of
information, have been included in the chapters:
Assessment Alerts are key considerations related to
assessing a particular type of client. These are factors
with potential for significant impact on the client’s
health status if they not recognized and usually repre-
sent variations from the norm.
Nursing Intervention Alerts are dos and don’ts of practice
that have significant import for the client’s well being and
that apply to a specific client problem not to all clients.
Clinical Alerts are specific items of information unique
to a health problem, treatment, or test, which if not
known can lead to incorrect interpretation of a clinical
situation and an incorrect nursing action.
Practice Alerts are critical guidelines such as legal
requirements or standards, which relate to the practice
of nursing in general.
In addition to the alerts, complications and client teach-
ing are highlighted areas because each is a separate section
on the NCLEX-RN test plan. A complications heading fol-
lows the Rx heading in the presentation of health problems,
surgery, treatments, and diagnostic tests whenever there are
significant complications that should be known. In addition,
there is a table summarizing complications related to major
disorders. A section on client teaching, which lists specific
information that needs to be taught to the client, is part of
the presentation of virtually every health problem and major
diagnostic or treatment modality.
Think Smart—Test Smart boxes found throughout the
book are designed to make you stop and think about the dif-
ferences between similar or frequently confused words or
concepts, the different ways the information could be
worded, how questions could be asked in different ways to
test the same content, or to identify a memory trick related
to content to be learned.
Also unique to this book are worksheets at the end of
each chapter. These worksheets allow you to actively engage
with the content; help to further “cement” content into
memory; and provide a check of your understanding of basic
facts and concepts. This is important because NCLEX-RN is
primarily a test of application of knowledge and one cannot
apply what one does not know.
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
PREFACE
Dear Soon-to-be Registered Nurse,
The purpose of this book is to help you be successful on
the NCLEX-RN® examination so that you can obtain your
license as a registered nurse. You have worked long and hard
to successfully complete your basic nursing program. Now
the one thing between you and your license is the NCLEX-
RN examination.
This book is designed to guide your review study. There
is a vast amount of nursing knowledge and it can be organ-
ized and focused upon in different ways. This book is
designed to review the content most likely to appear on the
examination and approach it from the perspective of the
examination. Thus, the book begins with a discussion of the
test itself to direct your focus. Because time is a limited and
valuable commodity for all of you as you begin life after
nursing school, strategies for studying in the most effective,
time-efficient manner also are discussed.
A unique feature of this text is a preparatory chapter on
language. Despite advanced study, you may often have a few
words whose meanings were never clearly mastered.
Encountering one of these words in a test question can result
in a wrong answer. Hence, some of the words that are often
used in nursing but are prone to being misunderstood are
identified, defined, and their use illustrated in sentences
reflective of nursing practice. There is also a chapter on test-
taking strategies. You may have already used many of these,
but reviewing them as a unit helps to ensure that you are
approaching the NCLEX-RN with the sharpest test-taking
skills possible. The chapter even provides exercises to allow
you to practice key skills.
The next 30 chapters of the book present the review of
nursing content. The title of each chapter consists of one of
the major NCLEX-RN test plan categories followed by the
subcategories and topics from the plan to be covered in that
chapter. Precise headings found on the NCLEX-RN test plan
have been used to help you think about the content in the
same way that the test is organized and the questions are
designed. There are separate sections in the text dealing with
the child-bearing client and with gerontology just as there
are in the test plan. Care of the pediatric client is incorpo-
rated throughout the text. Icons in the margin are alerts that
the information applies specifically to a pediatric client or a
child-bearing client.
To help you recognize and learn critical points of con-
tent, the following alerts, which highlight key pieces of
information, have been included in the chapters:
Assessment Alerts are key considerations related to
assessing a particular type of client. These are factors
with potential for significant impact on the client’s
health status if they not recognized and usually repre-
sent variations from the norm.
Nursing Intervention Alerts are dos and don’ts of practice
that have significant import for the client’s well being and
that apply to a specific client problem not to all clients.
Clinical Alerts are specific items of information unique
to a health problem, treatment, or test, which if not
known can lead to incorrect interpretation of a clinical
situation and an incorrect nursing action.
Practice Alerts are critical guidelines such as legal
requirements or standards, which relate to the practice
of nursing in general.
In addition to the alerts, complications and client teach-
ing are highlighted areas because each is a separate section
on the NCLEX-RN test plan. A complications heading fol-
lows the Rx heading in the presentation of health problems,
surgery, treatments, and diagnostic tests whenever there are
significant complications that should be known. In addition,
there is a table summarizing complications related to major
disorders. A section on client teaching, which lists specific
information that needs to be taught to the client, is part of
the presentation of virtually every health problem and major
diagnostic or treatment modality.
Think Smart—Test Smart boxes found throughout the
book are designed to make you stop and think about the dif-
ferences between similar or frequently confused words or
concepts, the different ways the information could be
worded, how questions could be asked in different ways to
test the same content, or to identify a memory trick related
to content to be learned.
Also unique to this book are worksheets at the end of
each chapter. These worksheets allow you to actively engage
with the content; help to further “cement” content into
memory; and provide a check of your understanding of basic
facts and concepts. This is important because NCLEX-RN is
primarily a test of application of knowledge and one cannot
apply what one does not know.
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
Loading page 16...
xiv PREFACE
Of course, the book also contains hundreds of practice
questions. Practice questions are given at the end of each
chapter as well as in the last chapter of the book, which con-
sists of 198 pages of questions. Questions are in NCLEX-RN
format and consist of both traditional multiple choice as well
as the newer alternative style items. For all questions, the
correct answer is explained; for multiple-choice questions,
reasons why options are incorrect are also given. In many
cases, these explanations are “mini lectures,” which serve to
synthesize and or highlight an area of information. Thus the
content review chapters and the final question chapter work
together to present key concepts for review.
I believe that this book will help you be successful on
the NCLEX-RN. It is based on more than 25 years of teach-
ing nursing students and giving NCLEX-RN review classes. I
wish you success on the examination and hope that you find
nursing a fulfilling and rewarding profession.
Sincerely,
Fran Monahan, PhD, RN, ANEF
Of course, the book also contains hundreds of practice
questions. Practice questions are given at the end of each
chapter as well as in the last chapter of the book, which con-
sists of 198 pages of questions. Questions are in NCLEX-RN
format and consist of both traditional multiple choice as well
as the newer alternative style items. For all questions, the
correct answer is explained; for multiple-choice questions,
reasons why options are incorrect are also given. In many
cases, these explanations are “mini lectures,” which serve to
synthesize and or highlight an area of information. Thus the
content review chapters and the final question chapter work
together to present key concepts for review.
I believe that this book will help you be successful on
the NCLEX-RN. It is based on more than 25 years of teach-
ing nursing students and giving NCLEX-RN review classes. I
wish you success on the examination and hope that you find
nursing a fulfilling and rewarding profession.
Sincerely,
Fran Monahan, PhD, RN, ANEF
Loading page 17...
Part I
TESTING
SMART
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
TESTING
SMART
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Loading page 18...
This page intentionally left blank
Loading page 19...
3
CHAPTER 1
Preparing for
NCLEX-RN ®
PART 1: THE TEST
Purpose of NCLEX-RN®
The purpose of this examination is to protect the safety of
the public. The examination is designed to determine
whether candidates for licensure as registered nurses have
the minimum level of knowledge needed to practice compe-
tently, knowledgeably, and safely at an entry level.
In preparing for the examination, key words from the
stated purpose of the examination that you should think
about are minimum level, safely, and entry level. These
words can help focus your preparation and ease your
mind. What they tell you is that the examination questions
will test general principles and commonly encountered
patient care situations. The focus will not be on testing
obscure pieces of knowledge applicable only rarely in
practice. Neither will the test focus on situations that
demand a complexity of judgment, which can be expected
only with time and experience. What can be expected to
be stressed are nursing assessments and actions that pro-
tect patients from harm. This means that in preparing, you
must give special attention to facts and procedures that
promote physical safety, emotional safety, and protection
from, or early identification of, disease complications or
iatrogenic problems.
Development of the NCLEX-RN®
Knowing the basic process by which the examination is
developed will further help direct your preparation. It
will reinforce the fact that the questions focus on critical
information regularly used by new graduates in daily
practice.
NCLEX-RN® has been developed by the National
Council of State Boards of Nursing (NCSBN) and is updated
on the basis of a work-study analysis of what new graduates
do in the workplace. All aspects of nursing practice are
observed and then classified into categories and subcate-
gories. These categories and subcategories then form the
basis of the test plan, which specifies the content to be cov-
ered and the number of questions to be asked related to each
area. Job analyses are done periodically and the test plan is
changed, if required, according to the results. This ensures
that the test remains accurate and consistent with current
practice. Content of the examination is matched to the scope
of practice.
In selecting the content to be tested, there are two major
considerations: the frequency with which the information is
needed in day-to-day practice and the criticality of the infor-
mation to the patient.
The test questions are written by nurses who practice in
a setting where they work with new graduates. The ques-
tions are carefully edited for any type of bias. They are also
reviewed for clarity and correctness of the key by other prac-
titioners. This ensures that the questions and answers repre-
sent accepted principles of safe practice and not a regional
practice or opinion.
The Test Plan Content
The content is organized around four categories of human
needs, which have been identified by the NCSBN. The four
categories and their related subcategories are as follows:
• Safe, effective care environment
—Management of care
—Safety and infection control
• Health promotion and maintenance
—Growth and development through the lifespan
—Prevention and early detection of disease
• Psychosocial integrity
—Coping and adaptation
—Psychosocial adaptation
• Physiological integrity
—Basic care and comfort
—Pharmacological and parenteral therapies
—Reduction of risk potential
—Physiological adaptation
Each of these subcategories constitutes 5–13% of the
test except for Reduction of Risk Potential and Physiological
Adaptation each of which accounts for 12–18% of the total
questions.
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
CHAPTER 1
Preparing for
NCLEX-RN ®
PART 1: THE TEST
Purpose of NCLEX-RN®
The purpose of this examination is to protect the safety of
the public. The examination is designed to determine
whether candidates for licensure as registered nurses have
the minimum level of knowledge needed to practice compe-
tently, knowledgeably, and safely at an entry level.
In preparing for the examination, key words from the
stated purpose of the examination that you should think
about are minimum level, safely, and entry level. These
words can help focus your preparation and ease your
mind. What they tell you is that the examination questions
will test general principles and commonly encountered
patient care situations. The focus will not be on testing
obscure pieces of knowledge applicable only rarely in
practice. Neither will the test focus on situations that
demand a complexity of judgment, which can be expected
only with time and experience. What can be expected to
be stressed are nursing assessments and actions that pro-
tect patients from harm. This means that in preparing, you
must give special attention to facts and procedures that
promote physical safety, emotional safety, and protection
from, or early identification of, disease complications or
iatrogenic problems.
Development of the NCLEX-RN®
Knowing the basic process by which the examination is
developed will further help direct your preparation. It
will reinforce the fact that the questions focus on critical
information regularly used by new graduates in daily
practice.
NCLEX-RN® has been developed by the National
Council of State Boards of Nursing (NCSBN) and is updated
on the basis of a work-study analysis of what new graduates
do in the workplace. All aspects of nursing practice are
observed and then classified into categories and subcate-
gories. These categories and subcategories then form the
basis of the test plan, which specifies the content to be cov-
ered and the number of questions to be asked related to each
area. Job analyses are done periodically and the test plan is
changed, if required, according to the results. This ensures
that the test remains accurate and consistent with current
practice. Content of the examination is matched to the scope
of practice.
In selecting the content to be tested, there are two major
considerations: the frequency with which the information is
needed in day-to-day practice and the criticality of the infor-
mation to the patient.
The test questions are written by nurses who practice in
a setting where they work with new graduates. The ques-
tions are carefully edited for any type of bias. They are also
reviewed for clarity and correctness of the key by other prac-
titioners. This ensures that the questions and answers repre-
sent accepted principles of safe practice and not a regional
practice or opinion.
The Test Plan Content
The content is organized around four categories of human
needs, which have been identified by the NCSBN. The four
categories and their related subcategories are as follows:
• Safe, effective care environment
—Management of care
—Safety and infection control
• Health promotion and maintenance
—Growth and development through the lifespan
—Prevention and early detection of disease
• Psychosocial integrity
—Coping and adaptation
—Psychosocial adaptation
• Physiological integrity
—Basic care and comfort
—Pharmacological and parenteral therapies
—Reduction of risk potential
—Physiological adaptation
Each of these subcategories constitutes 5–13% of the
test except for Reduction of Risk Potential and Physiological
Adaptation each of which accounts for 12–18% of the total
questions.
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
Loading page 20...
4 PART I: Testing Smart
Integrated throughout each of the client needs cate-
gories are the steps of the nursing process, caring, commu-
nication and documentation, and teaching and learning.
NCLEX-RN® Style
In preparing for any examination, it is always helpful to
have some idea of what to expect in terms of style. This
helps prevent surprises, which can be distracting and can
create anxiety. Knowing about the examination style in
advance, helps free your mind to focus on the content of the
questions. Some key points about the style of the NCLEX-
RN® are that it
• uses the term “client,” not “patient,” to refer to the recipi-
ent of care.
• is an integrated examination, that is, it covers clients of all
ages, backgrounds, and levels of health or illness.
• is gender neutral.
• is reviewed to remove any culturally biased terms.
• has primarily a multiple-choice format: stem and four
options only one of which is the answer to the question.
• includes some other types of questions, for example,
—those that require the test taker to fill in the blanks with
numerals or words rather than selecting an answer from
a list of four options.
Example:
What is the normal heart rate in a newborn?
_____beats per minute.
—those that contain pictures/diagrams and ask the test
taker to identify a particular site by touching the correct
area on the diagram.
Example:
Where would the nurse auscultate for the apical pulse?
The test taker has to touch an area on a diagram of the
chest. If the test taker touches the correct area or “hot
spot,” the answer is correct.
—those that present a list of assessment findings or nurs-
ing actions, etc., and ask the test taker to identify all
those that are appropriate for a particular type of
patient.
Example:
Which of the following are risk factors for cancer of the
breast?
Mark all that apply.
■ Family history
■ Nulliparity
■ Age over 50 years
■ Late menopause
■ Breast-feeding
■ Cigarette smoking
■ Provides a drop-down calculator as needed.
Administration of the NCLEX-RN®
To be admitted to the NCLEX-RN®
, you need
• an Authorization to Text letter (This is sent to you upon
receipt of application and fees and verification of eligibility.)
• two forms of ID—one of which must be a photograph ID
and both of which must be signed
NCLEX-RN® is administered by computer. Taking the
test on the computer is not complicated; it only requires use
of the SPACE bar, the ENTER key, and for fill-in-the-blank
answers, the keyboard. For multiple-choice and other similar
questions, the cursor is moved to highlight the option
selected as the answer by pressing the SPACE bar. When the
option(s) selected is highlighted, the ENTER button is
pressed. Then there is an opportunity to check your answer
selection. If the option(s) highlighted is not the answer you
want to give, you may change to another. If the answer you
wish to give is highlighted, you press the ENTER key a sec-
ond time to register your answer. Some very important points
for you to remember about taking the examination are that
• after the ENTER key is pressed a second time to register
your answer, there is no returning to the question or
changing the answer.
• every question must be answered; you cannot skip a
question.
• there is no penalty for guessing.
Number of Questions on the NCLEX-RN®
As a test taker, you of course, would like to know as part of
your mental preparation and planning for the examination,
how many questions you will be asked. For the NCLEX-RN®
,
there is no precise answer to this question because it is a com-
puter adaptive test (CAT). This means that the computer
selects the next question based on whether your answer to
the previous question was right or wrong. If the previous
answer was correct, the computer will select a slightly more
difficult question for the next one; if the answer was incor-
rect, the computer will present a slightly easier question.
Thus, each person takes a unique test. The maximum num-
ber of questions a candidate can have is 265. However, the
computer is programmed to make a decision of competent or
incompetent based on the level of difficulty of questions
answered correctly or incorrectly so relatively few candidates
receive 265 questions. The minimum number of questions a
candidate can receive is 75. Of these 75, 15 pretest items, i.e.,
items that are being tested for future use, are interspersed.
These pretest items do not influence your passing or failing.
Examination Time
In preparing for an examination, it is also important to know
how much time you will be allowed to complete it. The total
time allowed for the NCLEX-RN ® is 6 hours. If at the end of
6 hours, you have not answered enough questions for the
Integrated throughout each of the client needs cate-
gories are the steps of the nursing process, caring, commu-
nication and documentation, and teaching and learning.
NCLEX-RN® Style
In preparing for any examination, it is always helpful to
have some idea of what to expect in terms of style. This
helps prevent surprises, which can be distracting and can
create anxiety. Knowing about the examination style in
advance, helps free your mind to focus on the content of the
questions. Some key points about the style of the NCLEX-
RN® are that it
• uses the term “client,” not “patient,” to refer to the recipi-
ent of care.
• is an integrated examination, that is, it covers clients of all
ages, backgrounds, and levels of health or illness.
• is gender neutral.
• is reviewed to remove any culturally biased terms.
• has primarily a multiple-choice format: stem and four
options only one of which is the answer to the question.
• includes some other types of questions, for example,
—those that require the test taker to fill in the blanks with
numerals or words rather than selecting an answer from
a list of four options.
Example:
What is the normal heart rate in a newborn?
_____beats per minute.
—those that contain pictures/diagrams and ask the test
taker to identify a particular site by touching the correct
area on the diagram.
Example:
Where would the nurse auscultate for the apical pulse?
The test taker has to touch an area on a diagram of the
chest. If the test taker touches the correct area or “hot
spot,” the answer is correct.
—those that present a list of assessment findings or nurs-
ing actions, etc., and ask the test taker to identify all
those that are appropriate for a particular type of
patient.
Example:
Which of the following are risk factors for cancer of the
breast?
Mark all that apply.
■ Family history
■ Nulliparity
■ Age over 50 years
■ Late menopause
■ Breast-feeding
■ Cigarette smoking
■ Provides a drop-down calculator as needed.
Administration of the NCLEX-RN®
To be admitted to the NCLEX-RN®
, you need
• an Authorization to Text letter (This is sent to you upon
receipt of application and fees and verification of eligibility.)
• two forms of ID—one of which must be a photograph ID
and both of which must be signed
NCLEX-RN® is administered by computer. Taking the
test on the computer is not complicated; it only requires use
of the SPACE bar, the ENTER key, and for fill-in-the-blank
answers, the keyboard. For multiple-choice and other similar
questions, the cursor is moved to highlight the option
selected as the answer by pressing the SPACE bar. When the
option(s) selected is highlighted, the ENTER button is
pressed. Then there is an opportunity to check your answer
selection. If the option(s) highlighted is not the answer you
want to give, you may change to another. If the answer you
wish to give is highlighted, you press the ENTER key a sec-
ond time to register your answer. Some very important points
for you to remember about taking the examination are that
• after the ENTER key is pressed a second time to register
your answer, there is no returning to the question or
changing the answer.
• every question must be answered; you cannot skip a
question.
• there is no penalty for guessing.
Number of Questions on the NCLEX-RN®
As a test taker, you of course, would like to know as part of
your mental preparation and planning for the examination,
how many questions you will be asked. For the NCLEX-RN®
,
there is no precise answer to this question because it is a com-
puter adaptive test (CAT). This means that the computer
selects the next question based on whether your answer to
the previous question was right or wrong. If the previous
answer was correct, the computer will select a slightly more
difficult question for the next one; if the answer was incor-
rect, the computer will present a slightly easier question.
Thus, each person takes a unique test. The maximum num-
ber of questions a candidate can have is 265. However, the
computer is programmed to make a decision of competent or
incompetent based on the level of difficulty of questions
answered correctly or incorrectly so relatively few candidates
receive 265 questions. The minimum number of questions a
candidate can receive is 75. Of these 75, 15 pretest items, i.e.,
items that are being tested for future use, are interspersed.
These pretest items do not influence your passing or failing.
Examination Time
In preparing for an examination, it is also important to know
how much time you will be allowed to complete it. The total
time allowed for the NCLEX-RN ® is 6 hours. If at the end of
6 hours, you have not answered enough questions for the
Loading page 21...
CHAPTER 1 Preparing for NCLEX-RN® 5
computer to determine whether you are competent, you fail
by default. Based on the maximum of 265 questions and the
maximum time of 6 hours (360 minutes), there is slightly
more than one and a third minutes allowed per question.
However, since few candidates receive the maximum allow-
able number of questions, the time available is generally
more. Nonetheless, time is not unlimited so you should not
spend excessive time on any one question.
Report of Pass—Fail
Forty-eight hours after you take the test, the Board of Nurs-
ing in the state where you are applying for licensure gets the
pass/fail result. The Board then checks that all other require-
ments for licensure are met, and then sends out your results.
Results are only reported in writing and never by telephone.
If you have failed the examination, it may be taken again
in 3 months. How many times the test may be repeated
depends on the State Board of Nursing.
NCLEX Myths
The NCLEX-RN® is one of the most important examinations
that nurses ever take. To reach the point of taking the exami-
nation, much time, energy, and money have been invested and
many sacrifices have been made. Because of these facts, you
will hear many stories about the examination and receive
much advice. This type of impromptu shared information
often contributes to “myths” about the NCLEX-RN®
, which
serve as sources of undue anxiety. Some of the more common
myths, and the corrections to them, are presented below.
The number of questions one receives indicates pass or fail.—This
is not true. Candidates can answer the minimum number of
questions, all of which are difficult, correctly and pass. Other
candidates can answer the minimum number of questions, all
of which are easy, and fail. It is not the number of items but the
difficulty of the items that determines pass or fail.
Extra long tests are given randomly to selected test takers.—This
is not true. The number of questions is determined by the
difficulty of questions you answer correctly or incorrectly.
One needs to memorize everything.—This is not true. The
test is looking at determining safe, entry-level practice
based on the job analysis of what new graduates actually
do in the work place. It is also testing generally accepted
standards/methods of care. It is not testing rare, regionally
variable information.
How good you are with the computer determines how well you
do on the examination.—The Educational Testing Service
has done research on the question as to whether computer
skill influences examination performance. The results
show that the test-taker’s computer skill does not influ-
ence the score on the examination.
For more information about NCLEX, see the NCLEX
Candidate Bulletin which can be accessed at the NCSBN
Web site www.ncsbn.org.
PART 2: STUDYING FOR THE TEST
Study smart and study well! Remember, this is your future. It
represents short-term sacrifice for a long-term gain.
Identify Areas for Intensive Review
Evaluate your own strengths and weaknesses. Often, it is a
temptation to spend most of your study time reviewing
material you already know quite well. This is because what
you know best is most often material that you like, find easy,
and are interested in (that is why you learned it well in the
beginning). It is comfortable material and makes you feel
good about taking the examination. Avoid this pitfall. Spend
most of the time on what you do not know so well.
Begin identifying what you do not know so well by think-
ing about what areas you did least well on in nursing school or
had the least experience with—write them down. These may
be broad areas of practice, for example, pediatrics or mental
health/psychiatric nursing or specific topics such as acid—base
balance, burns, or problems of the nervous system. If you are
not a recent graduate, also identify those things that you did
well in nursing school but have not had any recent experience
with; these areas will need review but not as much time as those
areas you did not know really well in the beginning. Be careful
about assuming that since you have a lot of experience in a
practice area you do not need to review. Remember NCLEX is
a theory/textbook-oriented examination. The questions and
answers are based on what “should be” in practice, not on the
shortcuts and improvisations that “are.” Whether you are a new
or a not-so-new graduate, review the list of topics in the
NCLEX-RN® test plan found in this book and judge your level
of comfort with each, referring of course to the list you made as
the first part of this exercise. Mark with two checks those top-
ics you feel you really do not know; make one check by those
that you probably do not know really well. This will serve as a
guide to make sure you review the areas most important to you.
Select Backup Review Materials
This book, like all review books, is written in an abbreviated
format that assumes basic understanding and focuses on key
points. If you never mastered an area well or you encounter
content in this book that you do not understand the basis of,
it is important to go to a basic classroom text for clarification
and additional discussion.
NCLEX-RN® utilizes selected texts as references. Lists of
text books are sent to schools of nursing with directions to
indicate those which are used in the curriculum and to add
any that are used but do not appear on the list. Reference
texts are selected based on the extent of use in schools of
nursing. Questions are designed to address basic principles
of practice about which all texts agree, not to test about
uncommon pieces of information, which are debatable. The
current list can be accessed at the NCSBN Web site.
computer to determine whether you are competent, you fail
by default. Based on the maximum of 265 questions and the
maximum time of 6 hours (360 minutes), there is slightly
more than one and a third minutes allowed per question.
However, since few candidates receive the maximum allow-
able number of questions, the time available is generally
more. Nonetheless, time is not unlimited so you should not
spend excessive time on any one question.
Report of Pass—Fail
Forty-eight hours after you take the test, the Board of Nurs-
ing in the state where you are applying for licensure gets the
pass/fail result. The Board then checks that all other require-
ments for licensure are met, and then sends out your results.
Results are only reported in writing and never by telephone.
If you have failed the examination, it may be taken again
in 3 months. How many times the test may be repeated
depends on the State Board of Nursing.
NCLEX Myths
The NCLEX-RN® is one of the most important examinations
that nurses ever take. To reach the point of taking the exami-
nation, much time, energy, and money have been invested and
many sacrifices have been made. Because of these facts, you
will hear many stories about the examination and receive
much advice. This type of impromptu shared information
often contributes to “myths” about the NCLEX-RN®
, which
serve as sources of undue anxiety. Some of the more common
myths, and the corrections to them, are presented below.
The number of questions one receives indicates pass or fail.—This
is not true. Candidates can answer the minimum number of
questions, all of which are difficult, correctly and pass. Other
candidates can answer the minimum number of questions, all
of which are easy, and fail. It is not the number of items but the
difficulty of the items that determines pass or fail.
Extra long tests are given randomly to selected test takers.—This
is not true. The number of questions is determined by the
difficulty of questions you answer correctly or incorrectly.
One needs to memorize everything.—This is not true. The
test is looking at determining safe, entry-level practice
based on the job analysis of what new graduates actually
do in the work place. It is also testing generally accepted
standards/methods of care. It is not testing rare, regionally
variable information.
How good you are with the computer determines how well you
do on the examination.—The Educational Testing Service
has done research on the question as to whether computer
skill influences examination performance. The results
show that the test-taker’s computer skill does not influ-
ence the score on the examination.
For more information about NCLEX, see the NCLEX
Candidate Bulletin which can be accessed at the NCSBN
Web site www.ncsbn.org.
PART 2: STUDYING FOR THE TEST
Study smart and study well! Remember, this is your future. It
represents short-term sacrifice for a long-term gain.
Identify Areas for Intensive Review
Evaluate your own strengths and weaknesses. Often, it is a
temptation to spend most of your study time reviewing
material you already know quite well. This is because what
you know best is most often material that you like, find easy,
and are interested in (that is why you learned it well in the
beginning). It is comfortable material and makes you feel
good about taking the examination. Avoid this pitfall. Spend
most of the time on what you do not know so well.
Begin identifying what you do not know so well by think-
ing about what areas you did least well on in nursing school or
had the least experience with—write them down. These may
be broad areas of practice, for example, pediatrics or mental
health/psychiatric nursing or specific topics such as acid—base
balance, burns, or problems of the nervous system. If you are
not a recent graduate, also identify those things that you did
well in nursing school but have not had any recent experience
with; these areas will need review but not as much time as those
areas you did not know really well in the beginning. Be careful
about assuming that since you have a lot of experience in a
practice area you do not need to review. Remember NCLEX is
a theory/textbook-oriented examination. The questions and
answers are based on what “should be” in practice, not on the
shortcuts and improvisations that “are.” Whether you are a new
or a not-so-new graduate, review the list of topics in the
NCLEX-RN® test plan found in this book and judge your level
of comfort with each, referring of course to the list you made as
the first part of this exercise. Mark with two checks those top-
ics you feel you really do not know; make one check by those
that you probably do not know really well. This will serve as a
guide to make sure you review the areas most important to you.
Select Backup Review Materials
This book, like all review books, is written in an abbreviated
format that assumes basic understanding and focuses on key
points. If you never mastered an area well or you encounter
content in this book that you do not understand the basis of,
it is important to go to a basic classroom text for clarification
and additional discussion.
NCLEX-RN® utilizes selected texts as references. Lists of
text books are sent to schools of nursing with directions to
indicate those which are used in the curriculum and to add
any that are used but do not appear on the list. Reference
texts are selected based on the extent of use in schools of
nursing. Questions are designed to address basic principles
of practice about which all texts agree, not to test about
uncommon pieces of information, which are debatable. The
current list can be accessed at the NCSBN Web site.
Loading page 22...
6 PART I: Testing Smart
Develop a Realistic Schedule for Review
Dividing up material into achievable goals is smart. Each
time you meet a goal, you feel more positive about yourself
and your ability to deal with the material and the examina-
tion. This reduces stress and hence supports your ability to
be successful. There are different ways to develop a realistic
schedule. One way is to determine the number of days until
you are scheduled to take the NCLEX-RN ®
. Also, determine
how many hours on how many of these days can you realis-
tically study. Be sure to allow for down time. After all, no one
can study without a break and everyone must eat, sleep,
bathe, etc. Tally total available study times/hours. Now
assign study times/hours to the topics for review. Working
from the test plan topics that you have marked according to
how well you feel you know them, assign hours first to the
topics needing in-depth review. These are the most impor-
tant topics to review because you have already acknowl-
edged that you do not feel you know them. Next, assign
study times to those topics, which you decided you probably
do not know well, and then to those needing a less-detailed
review. Finally, place the topics in the order you will study
them. Alternate hard and easy topics and topics you like
with those you do not like—this will help keep you from
shortening your scheduled study time.
To have enough time to study well you may need to
make some temporary changes in your lifestyle. You may
need to take time off from work, negotiate sharing of house-
hold tasks with others in the house, delay some projects or
activities, and limit your social life. Only you can determine
what is the best approach to ensure the time you need
for study but as you consider your options remember—
cramming is not one of them. It will not work. There is way
too much material.
Select a Study Place That Works for You
Your study place should be quiet and convenient. A place
you will be undisturbed but with space for your study mate-
rials. It should have good light to facilitate reading without
developing eyestrain and/or a headache, a comfortable seat,
and an ambient temperature that is not so warm that it
makes you sleepy and not so cold that it distracts you from
studying. Lying in bed or on a couch to study is not a good
idea as it is at best relaxing, and at worst, sleep-inducing. A
certain level of awake alertness is necessary for successful
studying.
Select a Study Time That Works for You
Different people are most alert at different times of the day.
Some people are “morning people” and concentrate best on
first getting up; others are night people and concentrate best
in the evening. Some people have periods of best function at
two different times of the day. Analyze yourself to determine
when your most productive intellectual periods are and then
plan to study the most challenging material during these
times. Plan to review material that needs less intense study at
other times. If you have family responsibilities around which
you must organize study time, involve family members in
planning how to make your best study times available for
working on your NCLEX-RN® review.
Make Use of All Available Time for Study
You can learn a great deal, relatively painlessly, by making
good use of small amounts of available time throughout the
day. You may have done this during nursing school. If so,
recall some of your strategies. If not, begin to develop time-
effective study techniques now.
Examples of how you can capitalize on bits of unused
time:
• Review a brief set of laboratory values, the principles of a
nursing procedure, or assessment parameters for a specific
disease in the 5 minutes before you take a shower, then
use the time in the shower to repeat them to yourself.
• Write information to be learned on an index card(s) and
study when standing in line at the grocery store or when
waiting to pick children up at the school bus, etc.
Prepare Yourself for Studying
Collect your notes, books, pens, highlighters, etc.
Eliminate potential distractions: Shut off the cell phone; get
out of range of the land phone; shut off the TV, CD player,
and radio.
Go to the bathroom.
Refresh yourself: Wash your face and hands. Brush your
teeth.
Get something to drink.
Do whatever you need to do so that you will not feel uncom-
fortable or have to interrupt your studying.
Study Effectively
When you study, engage yourself with the content; mechan-
ical reading of notes is useless. Research shows that the
more actively you engage with the content, the better you
learn. So take notes, underline or highlight, repeat content
out loud; walk back and forth while you memorize; try to
think what questions could be asked about the subject
being reviewed.
Use a sequence of study—rest/reward—review. For
example, study for 50 minutes. Take a 10-minute break.
Reward yourself. Have a cup of tea or take a shower. Do not get
involved in a mentally demanding activity that will cause you
to lose your focus on the examination material. Take 10 min-
utes to review the material you just studied. As you review,
mark any areas for which you think, “I don’t really know that”
or “I had forgotten about that.” Go back and review the marked
areas at the beginning of your next day’s study.
Develop a Realistic Schedule for Review
Dividing up material into achievable goals is smart. Each
time you meet a goal, you feel more positive about yourself
and your ability to deal with the material and the examina-
tion. This reduces stress and hence supports your ability to
be successful. There are different ways to develop a realistic
schedule. One way is to determine the number of days until
you are scheduled to take the NCLEX-RN ®
. Also, determine
how many hours on how many of these days can you realis-
tically study. Be sure to allow for down time. After all, no one
can study without a break and everyone must eat, sleep,
bathe, etc. Tally total available study times/hours. Now
assign study times/hours to the topics for review. Working
from the test plan topics that you have marked according to
how well you feel you know them, assign hours first to the
topics needing in-depth review. These are the most impor-
tant topics to review because you have already acknowl-
edged that you do not feel you know them. Next, assign
study times to those topics, which you decided you probably
do not know well, and then to those needing a less-detailed
review. Finally, place the topics in the order you will study
them. Alternate hard and easy topics and topics you like
with those you do not like—this will help keep you from
shortening your scheduled study time.
To have enough time to study well you may need to
make some temporary changes in your lifestyle. You may
need to take time off from work, negotiate sharing of house-
hold tasks with others in the house, delay some projects or
activities, and limit your social life. Only you can determine
what is the best approach to ensure the time you need
for study but as you consider your options remember—
cramming is not one of them. It will not work. There is way
too much material.
Select a Study Place That Works for You
Your study place should be quiet and convenient. A place
you will be undisturbed but with space for your study mate-
rials. It should have good light to facilitate reading without
developing eyestrain and/or a headache, a comfortable seat,
and an ambient temperature that is not so warm that it
makes you sleepy and not so cold that it distracts you from
studying. Lying in bed or on a couch to study is not a good
idea as it is at best relaxing, and at worst, sleep-inducing. A
certain level of awake alertness is necessary for successful
studying.
Select a Study Time That Works for You
Different people are most alert at different times of the day.
Some people are “morning people” and concentrate best on
first getting up; others are night people and concentrate best
in the evening. Some people have periods of best function at
two different times of the day. Analyze yourself to determine
when your most productive intellectual periods are and then
plan to study the most challenging material during these
times. Plan to review material that needs less intense study at
other times. If you have family responsibilities around which
you must organize study time, involve family members in
planning how to make your best study times available for
working on your NCLEX-RN® review.
Make Use of All Available Time for Study
You can learn a great deal, relatively painlessly, by making
good use of small amounts of available time throughout the
day. You may have done this during nursing school. If so,
recall some of your strategies. If not, begin to develop time-
effective study techniques now.
Examples of how you can capitalize on bits of unused
time:
• Review a brief set of laboratory values, the principles of a
nursing procedure, or assessment parameters for a specific
disease in the 5 minutes before you take a shower, then
use the time in the shower to repeat them to yourself.
• Write information to be learned on an index card(s) and
study when standing in line at the grocery store or when
waiting to pick children up at the school bus, etc.
Prepare Yourself for Studying
Collect your notes, books, pens, highlighters, etc.
Eliminate potential distractions: Shut off the cell phone; get
out of range of the land phone; shut off the TV, CD player,
and radio.
Go to the bathroom.
Refresh yourself: Wash your face and hands. Brush your
teeth.
Get something to drink.
Do whatever you need to do so that you will not feel uncom-
fortable or have to interrupt your studying.
Study Effectively
When you study, engage yourself with the content; mechan-
ical reading of notes is useless. Research shows that the
more actively you engage with the content, the better you
learn. So take notes, underline or highlight, repeat content
out loud; walk back and forth while you memorize; try to
think what questions could be asked about the subject
being reviewed.
Use a sequence of study—rest/reward—review. For
example, study for 50 minutes. Take a 10-minute break.
Reward yourself. Have a cup of tea or take a shower. Do not get
involved in a mentally demanding activity that will cause you
to lose your focus on the examination material. Take 10 min-
utes to review the material you just studied. As you review,
mark any areas for which you think, “I don’t really know that”
or “I had forgotten about that.” Go back and review the marked
areas at the beginning of your next day’s study.
Loading page 23...
CHAPTER 1 Preparing for NCLEX-RN® 7
To keep up your motivation, you can also do things like
putting signs on your wall that say “You can do it.” or “This
will be over in__days.” You can plan to go out to eat or buy
a new dress if you meet your goal. Again, think about what
motivational tricks work for you and use them.
Know When to Stop
When scheduling study, it is also important to recognize
when you have studied to your capacity. Your time is valu-
able and you do not want to waste it by trying to study
when you are beyond your ability to concentrate. It is better
to take a break or accomplish something else that needs to
get done and then return to studying with refreshed con-
centration. You will learn more in the end. So, again analyze
yourself. You did a lot of studying in nursing school. What
is the length of time you can usually concentrate? What are
the telltale signs of when you are no longer learning effec-
tively? Take these factors into consideration as you schedule
study.
WORKSHEET
QUESTIONS
Do you have key facts from this chapter on your NCLEX-RN® knowledge ring? Complete the worksheet below to help
you check.
1. Why is passing the NCLEX-RN ® a requirement for being licensed as a registered nurse?
2. At what level of practice is the NCLEX-RN ® designed to measure competence?
3. What are the two major considerations in the selection of content to be tested on the NCLEX-RN ®
?
4. Who are the writers of NCLEX-RN ® test questions?
5. What is the predominant type of question found on the NCLEX-RN®
?
6. How many questions does one have to get right in order to pass the NCLEX-RN ®
?
7. What is the maximum length of time that one can take to complete the NCLEX-RN ®
?
8. Do you need to be proficient in use of a computer in order to do well on NCLEX-RN ®
?
9. Can you skip a question on NCLEX-RN® and go back to it if you are not sure of the answer?
10. Does having the test stop when only 75 questions have been answered mean that you have failed?
To keep up your motivation, you can also do things like
putting signs on your wall that say “You can do it.” or “This
will be over in__days.” You can plan to go out to eat or buy
a new dress if you meet your goal. Again, think about what
motivational tricks work for you and use them.
Know When to Stop
When scheduling study, it is also important to recognize
when you have studied to your capacity. Your time is valu-
able and you do not want to waste it by trying to study
when you are beyond your ability to concentrate. It is better
to take a break or accomplish something else that needs to
get done and then return to studying with refreshed con-
centration. You will learn more in the end. So, again analyze
yourself. You did a lot of studying in nursing school. What
is the length of time you can usually concentrate? What are
the telltale signs of when you are no longer learning effec-
tively? Take these factors into consideration as you schedule
study.
WORKSHEET
QUESTIONS
Do you have key facts from this chapter on your NCLEX-RN® knowledge ring? Complete the worksheet below to help
you check.
1. Why is passing the NCLEX-RN ® a requirement for being licensed as a registered nurse?
2. At what level of practice is the NCLEX-RN ® designed to measure competence?
3. What are the two major considerations in the selection of content to be tested on the NCLEX-RN ®
?
4. Who are the writers of NCLEX-RN ® test questions?
5. What is the predominant type of question found on the NCLEX-RN®
?
6. How many questions does one have to get right in order to pass the NCLEX-RN ®
?
7. What is the maximum length of time that one can take to complete the NCLEX-RN ®
?
8. Do you need to be proficient in use of a computer in order to do well on NCLEX-RN ®
?
9. Can you skip a question on NCLEX-RN® and go back to it if you are not sure of the answer?
10. Does having the test stop when only 75 questions have been answered mean that you have failed?
Loading page 24...
8 PART I: Testing Smart
ANSWERS & RATIONALES
WORKSHEET ANSWERS
1. Why is passing the NCLEX-RN ® a requirement for being licensed as a registered nurse?
Answer
To protect the safety of the public by limiting the practice of Registered Nursing to those individuals who have passed
an examination, which documents ability to practice competently, knowledgeably, and safely.
2. At what level of practice is the NCLEX-RN ® designed to measure competence?
Answer
Entry-level Registered Nurse Practice.
3. What are the two major considerations in the selection of content to be tested on the NCLEX-RN ®
?
Answer
Frequency with which the information is needed in day-to-day practice and the criticality of the information to the
patient.
4. Who are the writers of NCLEX-RN ® test questions?
Answer
Registered nurses who work with new graduates in their practice.
5. What is the predominant type of question found on the NCLEX-RN®
?
Answer
Multiple-choice question.
6. How many questions does one have to get right in order to pass the NCLEX-RN ®
?
Answer
It varies because NCLEX-RN ® is a computer adaptive test and the decision on whether a test taker passes or fails is
based on the difficulty of the questions answered and not on the absolute number.
7. What is the maximum length of time that one can take to complete the NCLEX-RN ®
?
Answer
6 hours.
8. Do you need to be proficient in use of a computer in order to do well on NCLEX-RN ®
?
Answer
No, studies have shown that computer proficiency has no effect on passing or failing.
9. Can you skip a question on NCLEX-RN® and go back to it if you are not sure of the answer?
Answer
No, a question cannot be skipped and once a question has been answered and the ENTER key has been hit the sec-
ond time to register the answer, one cannot go back to the question.
10. Does having the test stop when only 75 questions have been answered mean that you have failed?
Answer
When the test stops after the minimum of 75 questions have been answered can mean one either passed or failed. The
pass/fail decision is based on the difficulty of the questions answered correctly or incorrectly, not on the number.
ANSWERS & RATIONALES
WORKSHEET ANSWERS
1. Why is passing the NCLEX-RN ® a requirement for being licensed as a registered nurse?
Answer
To protect the safety of the public by limiting the practice of Registered Nursing to those individuals who have passed
an examination, which documents ability to practice competently, knowledgeably, and safely.
2. At what level of practice is the NCLEX-RN ® designed to measure competence?
Answer
Entry-level Registered Nurse Practice.
3. What are the two major considerations in the selection of content to be tested on the NCLEX-RN ®
?
Answer
Frequency with which the information is needed in day-to-day practice and the criticality of the information to the
patient.
4. Who are the writers of NCLEX-RN ® test questions?
Answer
Registered nurses who work with new graduates in their practice.
5. What is the predominant type of question found on the NCLEX-RN®
?
Answer
Multiple-choice question.
6. How many questions does one have to get right in order to pass the NCLEX-RN ®
?
Answer
It varies because NCLEX-RN ® is a computer adaptive test and the decision on whether a test taker passes or fails is
based on the difficulty of the questions answered and not on the absolute number.
7. What is the maximum length of time that one can take to complete the NCLEX-RN ®
?
Answer
6 hours.
8. Do you need to be proficient in use of a computer in order to do well on NCLEX-RN ®
?
Answer
No, studies have shown that computer proficiency has no effect on passing or failing.
9. Can you skip a question on NCLEX-RN® and go back to it if you are not sure of the answer?
Answer
No, a question cannot be skipped and once a question has been answered and the ENTER key has been hit the sec-
ond time to register the answer, one cannot go back to the question.
10. Does having the test stop when only 75 questions have been answered mean that you have failed?
Answer
When the test stops after the minimum of 75 questions have been answered can mean one either passed or failed. The
pass/fail decision is based on the difficulty of the questions answered correctly or incorrectly, not on the number.
Loading page 25...
CHAPTER 2
Test and Language
Basics
9
To answer an examination question correctly, knowing the
subject content is not enough. You have to clearly under-
stand each part of the question in the context of nursing
and correctly interpret the meaning of the question itself.
Because nursing is a practice profession and the NCLEX-
RN is measuring basic practice competencies, questions
typically contain a clinical scenario followed by the ques-
tion stem. In the case of multiple-choice questions, options
follow.
When taking an examination, it is important for you to
recognize each of these question parts, so read the following
definitions and look at the example carefully.
• Clinical scenario: This part of the question tells you about
the clinical situation.
• Stem: This part of the question contains the actual prob-
lem/question to be answered.
• Options: These are the answer choices provided. Options
are also called alternatives and in the case of traditional
multiple-choice questions, consist of one correct answer
(the key) and three distracters or incorrect answers.
It is important that you read and understand each of these
parts correctly for a lot of reasons.
• Facts provided in the scenario are often critical to select-
ing the best answer to the question. If these facts are not
correctly understood, it is difficult to select the best
answer.
• If the question being asked is not correctly understood,
distracters, which sometimes answer a different question
than the one asked in the stem or assume information not
provided in the stem or in the scenario, are more likely to
be perceived as the correct answer.
• Most questions also contain key words. These are
words that direct the answer; hence, attention to them
along with clear understanding of their meaning is
essential.
KEY WORDS
Because key words are so important in determining the cor-
rect answer to a question, a list of frequently used key words
is presented below for your review. Note that some of the
words are negative.
First
Priority
Next
Best
Most
Least
Appropriate
Inappropriate
Last
Suitable
Not
Early
Late
Immediately
Initial
Only
After
Every
Expected
Contraindicated
Partial
Unexpected
Independently
Common
Uncommon
The following question illustrates the use and impor-
tance of a key word:
When giving medications to a client, what should the
nurse do first?
1. Position the client
2. Check the client’s identity
3. Explain what he/she is going to do
4. Ask how the client is feeling
In this example, all options are correct nursing actions
when giving medications but which one is the correct
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
Test and Language
Basics
9
To answer an examination question correctly, knowing the
subject content is not enough. You have to clearly under-
stand each part of the question in the context of nursing
and correctly interpret the meaning of the question itself.
Because nursing is a practice profession and the NCLEX-
RN is measuring basic practice competencies, questions
typically contain a clinical scenario followed by the ques-
tion stem. In the case of multiple-choice questions, options
follow.
When taking an examination, it is important for you to
recognize each of these question parts, so read the following
definitions and look at the example carefully.
• Clinical scenario: This part of the question tells you about
the clinical situation.
• Stem: This part of the question contains the actual prob-
lem/question to be answered.
• Options: These are the answer choices provided. Options
are also called alternatives and in the case of traditional
multiple-choice questions, consist of one correct answer
(the key) and three distracters or incorrect answers.
It is important that you read and understand each of these
parts correctly for a lot of reasons.
• Facts provided in the scenario are often critical to select-
ing the best answer to the question. If these facts are not
correctly understood, it is difficult to select the best
answer.
• If the question being asked is not correctly understood,
distracters, which sometimes answer a different question
than the one asked in the stem or assume information not
provided in the stem or in the scenario, are more likely to
be perceived as the correct answer.
• Most questions also contain key words. These are
words that direct the answer; hence, attention to them
along with clear understanding of their meaning is
essential.
KEY WORDS
Because key words are so important in determining the cor-
rect answer to a question, a list of frequently used key words
is presented below for your review. Note that some of the
words are negative.
First
Priority
Next
Best
Most
Least
Appropriate
Inappropriate
Last
Suitable
Not
Early
Late
Immediately
Initial
Only
After
Every
Expected
Contraindicated
Partial
Unexpected
Independently
Common
Uncommon
The following question illustrates the use and impor-
tance of a key word:
When giving medications to a client, what should the
nurse do first?
1. Position the client
2. Check the client’s identity
3. Explain what he/she is going to do
4. Ask how the client is feeling
In this example, all options are correct nursing actions
when giving medications but which one is the correct
Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use.
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10 PART I: Testing Smart
Directions: Read each of the following questions. If the
question contains a key word, underline it.
1. Which clinical manifestation would the nurse expect
when assessing a client admitted with a diagnosis of
bacterial pneumonia?
2. Which sign should alert the nurse to a potential
problem in a client with a history of a CVA?
3. What is the primary goal for the hospice care of a
client with lung cancer?
4. Which nursing intervention should be given priority in
the plan of care for a teenager with sickle cell anemia?
5. The nurse is assessing the nutritional status of a
client who is 3 months pregnant. Which information
is most important for the nurse to obtain?
6. The nurse is obtaining a health history of a debili-
tated client with sacral pressure ulcers. Which ques-
tion should the nurse ask to elicit information effec-
tively about the client’s dietary intake?
7. Which behavior by a client with a newly created
colostomy should alert the nurse to the need for
teaching regarding skin care?
8. What is the best way to assess for shortness of
breath in a 3-year-old client with congenital heart
disease?
9. The nurse is assessing a family’s ability to provide
emotional support to a family member diagnosed
with cancer. Which observation is most essential?
10. In analyzing a teenage primipara’s need for teaching,
the clinic nurse should ask which question?
11. Which finding should the nurse expect when check-
ing urinary output of a client with SIADH?
12. Which information would be most helpful when
preparing to do a home assessment prior to discharge
of a low birth weight newborn?
13. Why is it important to monitor pulse rate in a client
on digoxin?
14. A 25-year-old woman comes to the clinic com-
plaining of lower left abdominal pain. Which
additional information should the nurse obtain
initially?
15. Which assessment question should receive priority?
FREQUENTLY
MISUNDERSTOOD/MISREAD
ENGLISH WORDS
Almost everyone has one or more words that he/she somehow
learned incorrectly and as a result misunderstands its precise
meaning. These can be very common, simple words and often
the person is unaware of the error. This can be a particular
problem when English is a person’s second language, or is not
the language of the household. Words that are similar in
spelling and in pronunciation are particularly at risk of being
misread, misused, or misunderstood. Because errors of this
type can cause an NCLEX-RN question to be answered incor-
rectly, a list of potentially misleading, common English words
follows. Each word is followed by its definition and a sentence
illustrating its use in nursing practice. You should read each
one carefully and ask yourself if you were clear about the use
of the word and its meaning. If your answer is Yes—great! If
the answer is No, mark the word to be reviewed again.
Accept—to agree or receive.
Examples:
The client accepted the diagnosis of breast cancer with
surprising calm.
The client accepted the nurse’s recommendation that all
his drugs be ordered at the same pharmacy.
Except—indicates something is to be omitted or left out.
Example: All the assessment findings except the rash are
consistent with a lower respiratory infection.
Advice—suggestion, guidance, or counsel.
Example: The client asked the nurse for advice on the
best way to apply the ileostomy bag.
Advise—to give a suggestion, guidance, or counsel.
Example: The nurse advised the new mother to nap in
the afternoon when the baby is sleeping.
Assent—to agree to.
Example: The nurse assented to a change in unit assign-
ment for the day.
Ascent—to rise or to climb.
Example: The ascent of carbon monoxide levels in an
enclosed area when a car is left running is rapid and can
result in fatality.
Breath—air pulled into the lungs in one inhalation.
answer is determined by the qualifying word “first.” The first
action is to check the client’s identity.
Practice identifying key words by completing the
following exercise:
WORKSHEET 1: IDENTIFICATION OF KEY WORDS
Directions: Read each of the following questions. If the
question contains a key word, underline it.
1. Which clinical manifestation would the nurse expect
when assessing a client admitted with a diagnosis of
bacterial pneumonia?
2. Which sign should alert the nurse to a potential
problem in a client with a history of a CVA?
3. What is the primary goal for the hospice care of a
client with lung cancer?
4. Which nursing intervention should be given priority in
the plan of care for a teenager with sickle cell anemia?
5. The nurse is assessing the nutritional status of a
client who is 3 months pregnant. Which information
is most important for the nurse to obtain?
6. The nurse is obtaining a health history of a debili-
tated client with sacral pressure ulcers. Which ques-
tion should the nurse ask to elicit information effec-
tively about the client’s dietary intake?
7. Which behavior by a client with a newly created
colostomy should alert the nurse to the need for
teaching regarding skin care?
8. What is the best way to assess for shortness of
breath in a 3-year-old client with congenital heart
disease?
9. The nurse is assessing a family’s ability to provide
emotional support to a family member diagnosed
with cancer. Which observation is most essential?
10. In analyzing a teenage primipara’s need for teaching,
the clinic nurse should ask which question?
11. Which finding should the nurse expect when check-
ing urinary output of a client with SIADH?
12. Which information would be most helpful when
preparing to do a home assessment prior to discharge
of a low birth weight newborn?
13. Why is it important to monitor pulse rate in a client
on digoxin?
14. A 25-year-old woman comes to the clinic com-
plaining of lower left abdominal pain. Which
additional information should the nurse obtain
initially?
15. Which assessment question should receive priority?
FREQUENTLY
MISUNDERSTOOD/MISREAD
ENGLISH WORDS
Almost everyone has one or more words that he/she somehow
learned incorrectly and as a result misunderstands its precise
meaning. These can be very common, simple words and often
the person is unaware of the error. This can be a particular
problem when English is a person’s second language, or is not
the language of the household. Words that are similar in
spelling and in pronunciation are particularly at risk of being
misread, misused, or misunderstood. Because errors of this
type can cause an NCLEX-RN question to be answered incor-
rectly, a list of potentially misleading, common English words
follows. Each word is followed by its definition and a sentence
illustrating its use in nursing practice. You should read each
one carefully and ask yourself if you were clear about the use
of the word and its meaning. If your answer is Yes—great! If
the answer is No, mark the word to be reviewed again.
Accept—to agree or receive.
Examples:
The client accepted the diagnosis of breast cancer with
surprising calm.
The client accepted the nurse’s recommendation that all
his drugs be ordered at the same pharmacy.
Except—indicates something is to be omitted or left out.
Example: All the assessment findings except the rash are
consistent with a lower respiratory infection.
Advice—suggestion, guidance, or counsel.
Example: The client asked the nurse for advice on the
best way to apply the ileostomy bag.
Advise—to give a suggestion, guidance, or counsel.
Example: The nurse advised the new mother to nap in
the afternoon when the baby is sleeping.
Assent—to agree to.
Example: The nurse assented to a change in unit assign-
ment for the day.
Ascent—to rise or to climb.
Example: The ascent of carbon monoxide levels in an
enclosed area when a car is left running is rapid and can
result in fatality.
Breath—air pulled into the lungs in one inhalation.
answer is determined by the qualifying word “first.” The first
action is to check the client’s identity.
Practice identifying key words by completing the
following exercise:
WORKSHEET 1: IDENTIFICATION OF KEY WORDS
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CHAPTER 2 Test and Language Basics 11
Example: Take a deep breath and hold it while I listen
with the stethoscope over your lungs.
Breathe—the act of inhaling and exhaling air from the lungs.
Example: Breathe in slowly and deeply through your
mouth.
Caster—wheel on a swivel.
Example: Many pieces of hospital equipment such as IV
pumps and over-the-bed tables are on casters for ease of
transport.
Castor—oil from castor beans, used as a laxative.
Example: A single dose of castor oil was ordered as part
of the prep for the client’s upcoming bowel surgery.
Charted (Not chartered)—entered in the client record.
Example: The nurse charted the appearance of the
wound in the client’s record.
Sight (Not site or cite)—vision.
Example: Eyesight typically declines with age.
Site (not cite)—location.
Example: The planned donor site for the skin graft was
the left, upper, outer thigh.
Coarse (not course)—rough, uneven.
Example: The skin of clients with hypofunction of the
thyroid is often coarse in texture.
Course—progression, order, direction.
Example: The course of the disease is characterized by
exacerbations and remissions.
Compliment—praise.
Example: The supervisor complimented the nurse on
her efficient handling of the multiple emergency admis-
sions, which occurred during her shift.
Complement—add to or mix well.
Example: Participation in a support group can comple-
ment individual counseling.
Complaint—expression of something wrong.
Example: The client’s chief complaint was a sharp pain
in the left chest.
Compliant—willing to follow requirements or directions.
Example: The client verbalized a desire to be compliant
with the medication regimen but stated he could not be
because he could not afford to buy the medications
ordered.
Continuous—going on without stopping.
Example: The client was receiving continuous feedings
via a nasogastric tube.
Continually—happening at regular intervals or again and
again.
Example: The client continually complained of nausea
while receiving the antibiotic.
Defective—faulty or abnormal.
Example: The neonate was diagnosed with a defective
mitral valve.
Deficient—lack of.
Example: Genetic syndromes characterized by deficient
chromosomal material are more often fatal than those
characterized by excess chromosomal material.
Dessert (not desert)—sweet foods served at the end of a
meal.
Example: The nurse advised the client to eliminate
desserts as a step in controlling weight.
Uninterested (not disinterested)—not caring.
Example: The client appeared markedly uninterested in
learning about the prescribed diet.
Elicit—draw out information.
Example: The nurse’s questions while obtaining the
client history are designed to elicit complete, accurate
information on which to base a nursing diagnosis.
Illicit—illegal.
Example: When obtaining a history, questions should
be asked about the use of prescription drugs, over-the-
counter drugs, herbal preparations, nutritional supple-
ments, and illicit drugs.
Imminent (not Eminent)—about to happen.
Example: An aura, unique to the individual, is often the
sign of an imminent seizure.
Farther—greater distance.
Example: The client should be ambulating farther than
the bathroom.
Further—more.
Example: Before discharging the client, the physician
decided further discussion with the family concerning
plans for home care was necessary.
Former—the first of two. (Latter refers to the second of
two.)
Example: Nausea and vomiting are common side effects
to some medications.The former is a symptom because
it cannot be seen, felt, or heard by an external observer;
the latter is a sign because it can be observed.
Healthy—not ill, well.
Example: The child appeared healthy.
Healthful—promoting wellness.
Example: Adequate daily intake of calcium is healthful.
Lose—misplace, be deprived of.
Example: Clients lose central vision with macular
degeneration; they lose peripheral vision with glau-
coma.
Example: Take a deep breath and hold it while I listen
with the stethoscope over your lungs.
Breathe—the act of inhaling and exhaling air from the lungs.
Example: Breathe in slowly and deeply through your
mouth.
Caster—wheel on a swivel.
Example: Many pieces of hospital equipment such as IV
pumps and over-the-bed tables are on casters for ease of
transport.
Castor—oil from castor beans, used as a laxative.
Example: A single dose of castor oil was ordered as part
of the prep for the client’s upcoming bowel surgery.
Charted (Not chartered)—entered in the client record.
Example: The nurse charted the appearance of the
wound in the client’s record.
Sight (Not site or cite)—vision.
Example: Eyesight typically declines with age.
Site (not cite)—location.
Example: The planned donor site for the skin graft was
the left, upper, outer thigh.
Coarse (not course)—rough, uneven.
Example: The skin of clients with hypofunction of the
thyroid is often coarse in texture.
Course—progression, order, direction.
Example: The course of the disease is characterized by
exacerbations and remissions.
Compliment—praise.
Example: The supervisor complimented the nurse on
her efficient handling of the multiple emergency admis-
sions, which occurred during her shift.
Complement—add to or mix well.
Example: Participation in a support group can comple-
ment individual counseling.
Complaint—expression of something wrong.
Example: The client’s chief complaint was a sharp pain
in the left chest.
Compliant—willing to follow requirements or directions.
Example: The client verbalized a desire to be compliant
with the medication regimen but stated he could not be
because he could not afford to buy the medications
ordered.
Continuous—going on without stopping.
Example: The client was receiving continuous feedings
via a nasogastric tube.
Continually—happening at regular intervals or again and
again.
Example: The client continually complained of nausea
while receiving the antibiotic.
Defective—faulty or abnormal.
Example: The neonate was diagnosed with a defective
mitral valve.
Deficient—lack of.
Example: Genetic syndromes characterized by deficient
chromosomal material are more often fatal than those
characterized by excess chromosomal material.
Dessert (not desert)—sweet foods served at the end of a
meal.
Example: The nurse advised the client to eliminate
desserts as a step in controlling weight.
Uninterested (not disinterested)—not caring.
Example: The client appeared markedly uninterested in
learning about the prescribed diet.
Elicit—draw out information.
Example: The nurse’s questions while obtaining the
client history are designed to elicit complete, accurate
information on which to base a nursing diagnosis.
Illicit—illegal.
Example: When obtaining a history, questions should
be asked about the use of prescription drugs, over-the-
counter drugs, herbal preparations, nutritional supple-
ments, and illicit drugs.
Imminent (not Eminent)—about to happen.
Example: An aura, unique to the individual, is often the
sign of an imminent seizure.
Farther—greater distance.
Example: The client should be ambulating farther than
the bathroom.
Further—more.
Example: Before discharging the client, the physician
decided further discussion with the family concerning
plans for home care was necessary.
Former—the first of two. (Latter refers to the second of
two.)
Example: Nausea and vomiting are common side effects
to some medications.The former is a symptom because
it cannot be seen, felt, or heard by an external observer;
the latter is a sign because it can be observed.
Healthy—not ill, well.
Example: The child appeared healthy.
Healthful—promoting wellness.
Example: Adequate daily intake of calcium is healthful.
Lose—misplace, be deprived of.
Example: Clients lose central vision with macular
degeneration; they lose peripheral vision with glau-
coma.
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12 PART I: Testing Smart
Loose—opposite of tight.
Example: Loose bowel movements can be a problem for
clients following an intestinal resection.
Nauseous—inducing a feeling of nausea.
Example: The nauseous smell of the drainage made the
dressing difficult to change.
Nauseated—experiencing nausea.
Example: The client became nauseated 2 hours after the
chemotherapy was administered.
Past—time gone by, ago.
Example: The time is past that medications could have
helped; now surgery is the only option.
Passed—moved along, went away, departed, succeeded on
a test.
Examples:
The suppository passed the rectal sphincter without dif-
ficulty.
The client passed a renal calculus last evening.
Patient—recipient of care.
Example: The patient thanked the nurse for making her
comfortable.
Patience—tolerance or understanding.
Example: Patience is often needed when dealing with
sick children.
Peace—calmness, tranquility.
Example: Helping the client achieve peace of mind is a
goal of the hospice nurse.
Piece—part or section.
Example: The piece of the Foley catheter that inflates to
hold the catheter in the urinary bladder is called the
balloon.
Personal—private.
Example: Use of personal information about clients is
governed by the HIPAA regulations.
Personnel—employees.
Example: Nurses are licensed health care personnel.
Prescribe—order for.
Example: The nurse practitioner prescribed the
antibiotic Cipro for the client with a urinary tract
infection.
Proscribe—prohibit.
Example: Leaving the unit with the narcotics key is pro-
scribed.
Principal—of major importance.
Example: A principal use of digitalis is to strengthen
the contraction of the myocardium in cases of heart
failure.
Principle—a truth.
Example: The principle underlying use of a fan for cool-
ing is that one of the ways heat is lost from the body is
by convection.
Proceed—go on, continue.
Example: The nurse proceeded with the dressing
change after the client had stopped coughing.
Precede—go before.
Example: Mild signs of an upper respiratory infection
preceded the development of the rash.
Quite—a great deal.
Example: The client was quite verbal regarding his
opinion of his care.
Quit—leave or stop.
Example: The client stated he wished he could quit
smoking.
Rise—get oneself up.
Example: The client who had a CVA said to the nurse “I
look forward to the day I can rise out of the bed in the
morning without assistance.”
Raise—lift or elevate an object or person.
Example: During a breast examination, the client needs
to raise her arms over her head so the contours of the
breast can be inspected.
Stationary—not moving.
Example: The brake on the wheelchair should be set
when the client is being moved in or out of the chair in
order to keep the chair stationary and help prevent the
client from falling.
Stationery—paper.
Example: Official letters should be written on stationery
imprinted with the agency letterhead.
Statute—legal restriction.
Example: The statute of limitation for malpractice cases
differs state to state.
Stature—person’s size.
Example: The client’s stature was consistent with a diag-
nosis of hypopituitary dwarfism.
Adequate—sufficient.
Example: It is the nurse’s responsibility to determine if
the client’s 24-hour fluid intake and output is adequate.
Aggravate—make worse.
Example: Straining at stool will aggravate hemor-
rhoids.
Allay—put at rest or cause to subside.
Example: Providing the client with information about a
procedure to be done can allay anxiety.
Loose—opposite of tight.
Example: Loose bowel movements can be a problem for
clients following an intestinal resection.
Nauseous—inducing a feeling of nausea.
Example: The nauseous smell of the drainage made the
dressing difficult to change.
Nauseated—experiencing nausea.
Example: The client became nauseated 2 hours after the
chemotherapy was administered.
Past—time gone by, ago.
Example: The time is past that medications could have
helped; now surgery is the only option.
Passed—moved along, went away, departed, succeeded on
a test.
Examples:
The suppository passed the rectal sphincter without dif-
ficulty.
The client passed a renal calculus last evening.
Patient—recipient of care.
Example: The patient thanked the nurse for making her
comfortable.
Patience—tolerance or understanding.
Example: Patience is often needed when dealing with
sick children.
Peace—calmness, tranquility.
Example: Helping the client achieve peace of mind is a
goal of the hospice nurse.
Piece—part or section.
Example: The piece of the Foley catheter that inflates to
hold the catheter in the urinary bladder is called the
balloon.
Personal—private.
Example: Use of personal information about clients is
governed by the HIPAA regulations.
Personnel—employees.
Example: Nurses are licensed health care personnel.
Prescribe—order for.
Example: The nurse practitioner prescribed the
antibiotic Cipro for the client with a urinary tract
infection.
Proscribe—prohibit.
Example: Leaving the unit with the narcotics key is pro-
scribed.
Principal—of major importance.
Example: A principal use of digitalis is to strengthen
the contraction of the myocardium in cases of heart
failure.
Principle—a truth.
Example: The principle underlying use of a fan for cool-
ing is that one of the ways heat is lost from the body is
by convection.
Proceed—go on, continue.
Example: The nurse proceeded with the dressing
change after the client had stopped coughing.
Precede—go before.
Example: Mild signs of an upper respiratory infection
preceded the development of the rash.
Quite—a great deal.
Example: The client was quite verbal regarding his
opinion of his care.
Quit—leave or stop.
Example: The client stated he wished he could quit
smoking.
Rise—get oneself up.
Example: The client who had a CVA said to the nurse “I
look forward to the day I can rise out of the bed in the
morning without assistance.”
Raise—lift or elevate an object or person.
Example: During a breast examination, the client needs
to raise her arms over her head so the contours of the
breast can be inspected.
Stationary—not moving.
Example: The brake on the wheelchair should be set
when the client is being moved in or out of the chair in
order to keep the chair stationary and help prevent the
client from falling.
Stationery—paper.
Example: Official letters should be written on stationery
imprinted with the agency letterhead.
Statute—legal restriction.
Example: The statute of limitation for malpractice cases
differs state to state.
Stature—person’s size.
Example: The client’s stature was consistent with a diag-
nosis of hypopituitary dwarfism.
Adequate—sufficient.
Example: It is the nurse’s responsibility to determine if
the client’s 24-hour fluid intake and output is adequate.
Aggravate—make worse.
Example: Straining at stool will aggravate hemor-
rhoids.
Allay—put at rest or cause to subside.
Example: Providing the client with information about a
procedure to be done can allay anxiety.
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CHAPTER 2 Test and Language Basics 13
Anticipate—take up or use ahead of time.
Example: Prior to entering an isolation room, it is impor-
tant that the nurse anticipate client needs so that she is
prepared with knowledge and equipment to provide the
needed care.”
Avoid—keep away from.
Example: Immunosuppressed clients need to avoid
crowds because of the risk of exposure to infection.
Competitive—contest between rivals.
Example: In competitive inhibition of enzyme activity,
the inhibitor competes with the substrate for binding on
the enzyme.
Compromised—to endanger.
Example: Circulation to the lower extremities is com-
promised when the client is in lithotomy position.
Assume—take for granted.
Example: The nurse should never assume the client has
understood instructions; validation of understanding by
repeating the instructions or by return demonstration is
always necessary.
At least—the very minimum.
Example: If the client refuses to lie in the prone posi-
tion, at least have him lie on his side.”
Confer—consult or to bestow.
Example: The Client Care team conferred to determine
the best approach to manage the bladder retraining pro-
gram of a newly admitted client.
Deny—declare not to be true.
Example: Clients sometimes deny use of illegal drugs
because they fear the reaction of the health care provider.
Determine—to come to a decision or to obtain first hand
knowledge.
Example: To determine the causative organism of a
wound infection, a culture is done.
Differentiate—discriminate or identify differences.
Example: When examining the chest, it is important to
differentiate between crackles and wheezes.
Exacerbate—worsen.
Example: Exposure to cold and damp can exacerbate
the symptoms of a sinus infection.
Enhance—augment.
Example: Comfort measures such as clean linen, a back
rub, and pleasant music can enhance the action of pain
medications.
Excessive—more than acceptable, exorbitant.
Example: The bleeding was excessive following the
surgery.
Expectorate—cough up and spit out mucus.
Example: To prevent spread of infection, the nurse
instructed the client to expectorate into a tissue and dis-
pose of it in the provided plastic bag.
Flushed—any tinge of red.
Example: The client’s face was flushed and he was warm
to the touch.
Flaccid—without resistance.
Example: A flaccid muscle is one with less than normal tone.
Tense—rigid, feeling nervous.
Examples:
A sign of increased intracranial pressure in a neonate is
a tense fontanelle.
The client complained of feeling extremely tense when-
ever an interview with the psychiatrist was scheduled.
Hoarseness—grating sounds.
Example: Hoarseness is a characteristic symptom of
laryngitis.
Impinge—come into close contact.
Example: The CAT scan showed that the tumor was
impinging on the recurrent laryngeal nerve thus
accounting for the hoarseness.
Inept—not apt, unable to do well.
Example: The client remained inept at handling the
insulin syringe, so additional teaching was planned.
Insulation—prevent transfer of electricity, heat, or sound.
The insulation in the walls of hospital rooms helps clients to
rest by decreasing nose heard from other areas of the unit.
Intact—without injury.
Example: The client’s skin remained intact despite the
long period of bed rest.
Isolation—loneliness, separation.
Examples:
Clients having intracavitary radiation treatments are at
risk for feelings of isolation.
Clients presenting with active, drug resistant tuberculo-
sis are placed in isolation.
Lead to—results in.
Example: An untreated streptococcal sore throat can
lead to glomerulonephritis in susceptible children.
Least likely—in the smallest degree, lowest chance.
Example: The client least likely to develop constipa-
tion is the one with a liberal fluid and roughage intake,
who exercises regularly, and obeys the urge to defecate.
Most likely—to the greatest degree, highest chance.
Example: Of antibiotics, diuretics, or calcium channel
blockers, the drugs most likely to cause allergic reactions
are the antibiotics.
Anticipate—take up or use ahead of time.
Example: Prior to entering an isolation room, it is impor-
tant that the nurse anticipate client needs so that she is
prepared with knowledge and equipment to provide the
needed care.”
Avoid—keep away from.
Example: Immunosuppressed clients need to avoid
crowds because of the risk of exposure to infection.
Competitive—contest between rivals.
Example: In competitive inhibition of enzyme activity,
the inhibitor competes with the substrate for binding on
the enzyme.
Compromised—to endanger.
Example: Circulation to the lower extremities is com-
promised when the client is in lithotomy position.
Assume—take for granted.
Example: The nurse should never assume the client has
understood instructions; validation of understanding by
repeating the instructions or by return demonstration is
always necessary.
At least—the very minimum.
Example: If the client refuses to lie in the prone posi-
tion, at least have him lie on his side.”
Confer—consult or to bestow.
Example: The Client Care team conferred to determine
the best approach to manage the bladder retraining pro-
gram of a newly admitted client.
Deny—declare not to be true.
Example: Clients sometimes deny use of illegal drugs
because they fear the reaction of the health care provider.
Determine—to come to a decision or to obtain first hand
knowledge.
Example: To determine the causative organism of a
wound infection, a culture is done.
Differentiate—discriminate or identify differences.
Example: When examining the chest, it is important to
differentiate between crackles and wheezes.
Exacerbate—worsen.
Example: Exposure to cold and damp can exacerbate
the symptoms of a sinus infection.
Enhance—augment.
Example: Comfort measures such as clean linen, a back
rub, and pleasant music can enhance the action of pain
medications.
Excessive—more than acceptable, exorbitant.
Example: The bleeding was excessive following the
surgery.
Expectorate—cough up and spit out mucus.
Example: To prevent spread of infection, the nurse
instructed the client to expectorate into a tissue and dis-
pose of it in the provided plastic bag.
Flushed—any tinge of red.
Example: The client’s face was flushed and he was warm
to the touch.
Flaccid—without resistance.
Example: A flaccid muscle is one with less than normal tone.
Tense—rigid, feeling nervous.
Examples:
A sign of increased intracranial pressure in a neonate is
a tense fontanelle.
The client complained of feeling extremely tense when-
ever an interview with the psychiatrist was scheduled.
Hoarseness—grating sounds.
Example: Hoarseness is a characteristic symptom of
laryngitis.
Impinge—come into close contact.
Example: The CAT scan showed that the tumor was
impinging on the recurrent laryngeal nerve thus
accounting for the hoarseness.
Inept—not apt, unable to do well.
Example: The client remained inept at handling the
insulin syringe, so additional teaching was planned.
Insulation—prevent transfer of electricity, heat, or sound.
The insulation in the walls of hospital rooms helps clients to
rest by decreasing nose heard from other areas of the unit.
Intact—without injury.
Example: The client’s skin remained intact despite the
long period of bed rest.
Isolation—loneliness, separation.
Examples:
Clients having intracavitary radiation treatments are at
risk for feelings of isolation.
Clients presenting with active, drug resistant tuberculo-
sis are placed in isolation.
Lead to—results in.
Example: An untreated streptococcal sore throat can
lead to glomerulonephritis in susceptible children.
Least likely—in the smallest degree, lowest chance.
Example: The client least likely to develop constipa-
tion is the one with a liberal fluid and roughage intake,
who exercises regularly, and obeys the urge to defecate.
Most likely—to the greatest degree, highest chance.
Example: Of antibiotics, diuretics, or calcium channel
blockers, the drugs most likely to cause allergic reactions
are the antibiotics.
Loading page 30...
14 PART I: Testing Smart
WORKSHEET 2: VOCABULARY
Directions: Match the definitions in column B with the words in column A.
Column A Column B
1. ____Site a. something to be left out
2. ____Coarse b. progress
3. ____Imminent c. without intending to
4. ____Deficient d. rough
5. ____Former e. create a tendency to
6. ____Enhance f. saturate
7. ____Impinge g. location
8. ____Tense h. a truth
9. ____Predispose i. at any time
10. ____Sedentary j. unable to do well
11. ____Except k. inactive
12. ____Principal l. shaky
13. ____Loose m. opposite of tight
14. ____Exacerbate n. eliminate
15. ____Profuse o. pouring forth
p. easy going
q. of major importance
r. cause discomfort
s. rigid
t. worsen
u. about to happen
v. first of two
w. misplace
x. augment
y. lack of
z. come into close contact
Liberally—freely, unchecked.
Example: The client should be encouraged to use the
Calamine lotion liberally to control the itch of the
poison ivy.
Predispose—create a tendency to.
Example: Use of immunosuppressant drugs predisposes
the client to infection.
Permit—let.
Example: Elevating a Foley catheter drainage bag above
the level of the client’s pelvis permits backflow of urine
into the bladder.
Profuse—pouring forth.
Example: Vaginal drainage was yellow, profuse, and
malodorous.
Refrain—keep oneself from doing.
Example: The client was instructed to refrain from lift-
ing anything over 5 lbs following repair of his hernia.
Sparingly—frugally.
Example: It is important to apply the skin preparation
sparingly in accordance with the directions.
Spasm—involuntary contracture.
Example: The client complained of repeated leg spasms
during the night.
Sedentary—physically inactive.
Example: A sedentary lifestyle predisposes to obesity.
Check your basic test vocabulary by completing the fol-
lowing vocabulary exercise.
WORKSHEET 2: VOCABULARY
Directions: Match the definitions in column B with the words in column A.
Column A Column B
1. ____Site a. something to be left out
2. ____Coarse b. progress
3. ____Imminent c. without intending to
4. ____Deficient d. rough
5. ____Former e. create a tendency to
6. ____Enhance f. saturate
7. ____Impinge g. location
8. ____Tense h. a truth
9. ____Predispose i. at any time
10. ____Sedentary j. unable to do well
11. ____Except k. inactive
12. ____Principal l. shaky
13. ____Loose m. opposite of tight
14. ____Exacerbate n. eliminate
15. ____Profuse o. pouring forth
p. easy going
q. of major importance
r. cause discomfort
s. rigid
t. worsen
u. about to happen
v. first of two
w. misplace
x. augment
y. lack of
z. come into close contact
Liberally—freely, unchecked.
Example: The client should be encouraged to use the
Calamine lotion liberally to control the itch of the
poison ivy.
Predispose—create a tendency to.
Example: Use of immunosuppressant drugs predisposes
the client to infection.
Permit—let.
Example: Elevating a Foley catheter drainage bag above
the level of the client’s pelvis permits backflow of urine
into the bladder.
Profuse—pouring forth.
Example: Vaginal drainage was yellow, profuse, and
malodorous.
Refrain—keep oneself from doing.
Example: The client was instructed to refrain from lift-
ing anything over 5 lbs following repair of his hernia.
Sparingly—frugally.
Example: It is important to apply the skin preparation
sparingly in accordance with the directions.
Spasm—involuntary contracture.
Example: The client complained of repeated leg spasms
during the night.
Sedentary—physically inactive.
Example: A sedentary lifestyle predisposes to obesity.
Check your basic test vocabulary by completing the fol-
lowing vocabulary exercise.
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Subject
National Council Licensure Examination