Saunders 2020-2021 Strategies for Test Success: Passing Nursing School and the NCLEX Exam (2019)
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Saunders 2020-2021 Strategies for
Test Success
Passing Nursing School and the
NCLEX® Exam
SIXTH EDITION
Linda Anne Silvestri, PhD, RN
Adjunct Professor of Nursing, Salve Regina University, Newport, Rhode
Island
President, Nursing Reviews, Inc. and Professional Nursing, Seminars, Inc.,
Henderson, Nevada
Elsevier Consultant, HESI NCLEX-RN® and NCLEX-PN® Live Review
Courses
Angela E. Silvestri, PhD, APRN, FNP-BC,
CNE
Assistant Professor, University of Nevada, Las Vegas, Las Vegas, Nevada
Test Success
Passing Nursing School and the
NCLEX® Exam
SIXTH EDITION
Linda Anne Silvestri, PhD, RN
Adjunct Professor of Nursing, Salve Regina University, Newport, Rhode
Island
President, Nursing Reviews, Inc. and Professional Nursing, Seminars, Inc.,
Henderson, Nevada
Elsevier Consultant, HESI NCLEX-RN® and NCLEX-PN® Live Review
Courses
Angela E. Silvestri, PhD, APRN, FNP-BC,
CNE
Assistant Professor, University of Nevada, Las Vegas, Las Vegas, Nevada
Saunders 2020-2021 Strategies for
Test Success
Passing Nursing School and the
NCLEX® Exam
SIXTH EDITION
Linda Anne Silvestri, PhD, RN
Adjunct Professor of Nursing, Salve Regina University, Newport, Rhode
Island
President, Nursing Reviews, Inc. and Professional Nursing, Seminars, Inc.,
Henderson, Nevada
Elsevier Consultant, HESI NCLEX-RN® and NCLEX-PN® Live Review
Courses
Angela E. Silvestri, PhD, APRN, FNP-BC,
CNE
Assistant Professor, University of Nevada, Las Vegas, Las Vegas, Nevada
Test Success
Passing Nursing School and the
NCLEX® Exam
SIXTH EDITION
Linda Anne Silvestri, PhD, RN
Adjunct Professor of Nursing, Salve Regina University, Newport, Rhode
Island
President, Nursing Reviews, Inc. and Professional Nursing, Seminars, Inc.,
Henderson, Nevada
Elsevier Consultant, HESI NCLEX-RN® and NCLEX-PN® Live Review
Courses
Angela E. Silvestri, PhD, APRN, FNP-BC,
CNE
Assistant Professor, University of Nevada, Las Vegas, Las Vegas, Nevada
ASSOCIATE EDITOR
Eileen H. Gray, DNP, RN, CPNP
Adjunct Professor of Nursing, Salve Regina University, Newport, Rhode
Island
HESI NCLEX-RN® and NCLEX-PN® Live Review Course Instructor
Eileen H. Gray, DNP, RN, CPNP
Adjunct Professor of Nursing, Salve Regina University, Newport, Rhode
Island
HESI NCLEX-RN® and NCLEX-PN® Live Review Course Instructor
Loading page 4...
Table of Contents
Instructions for online access
Cover image
Title page
Quick Reference Guide to Strategies
Copyright
Dedication
About the Authors
Contributors
Previous Reviewers
Preface
Acknowledgments
Instructions for online access
Cover image
Title page
Quick Reference Guide to Strategies
Copyright
Dedication
About the Authors
Contributors
Previous Reviewers
Preface
Acknowledgments
Loading page 5...
Part I. Study and Test Preparation
Chapter 1. Preparing for Nursing Examinations
When and Why Are Nursing Exams Administered?
The Beginning Nursing Student: What Should You Think About?
What Can You Expect on Nursing Exams?
Your Course Syllabus: Why Is It Important?
How Can You Best Use Your Textbook to Get Ready for
a Nursing Exam?
Classroom Notes: How Can You Best Use Them?
Study Guides
Study Groups
Standardized Testing: Why Is It So Important?
Chapter 2. Developing Study Skills
What Are Good Study Skills?
How Do You Identify and Plan Your Study Times?
What Study Habits Do You Need to Develop?
What Study Skills Are Important?
When Should You Start to Study for an Exam?
Will a Study Group Work for You?
Chapter 1. Preparing for Nursing Examinations
When and Why Are Nursing Exams Administered?
The Beginning Nursing Student: What Should You Think About?
What Can You Expect on Nursing Exams?
Your Course Syllabus: Why Is It Important?
How Can You Best Use Your Textbook to Get Ready for
a Nursing Exam?
Classroom Notes: How Can You Best Use Them?
Study Guides
Study Groups
Standardized Testing: Why Is It So Important?
Chapter 2. Developing Study Skills
What Are Good Study Skills?
How Do You Identify and Plan Your Study Times?
What Study Habits Do You Need to Develop?
What Study Skills Are Important?
When Should You Start to Study for an Exam?
Will a Study Group Work for You?
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Chapter 3. Reducing Test Anxiety
What Is Test Anxiety?
How Can You Know If You Have Test Anxiety?
What Causes Test Anxiety?
What Will Help Prevent Test Anxiety?
What Can You Do When You Are Experiencing Test Anxiety?
What Is Positive Pampering and Why Is It Important?
What Should You Do the Night Before the Exam?
How Can You Control Your Test Anxiety Before the Exam?
How Can You Control Your Test Anxiety During the Exam?
That Positive Attitude: How Can You Maintain It?
Chapter 4. NCLEX® Preparation
Where Does Preparation Begin?
The NCLEX Test Plan: Why Is It So Important?
What Are the Steps for Preparing?
Part II. Strategies for Success
Chapter 5. Alternate Item Formats
Introduction
What Is an Alternate Item Format?
What Is Test Anxiety?
How Can You Know If You Have Test Anxiety?
What Causes Test Anxiety?
What Will Help Prevent Test Anxiety?
What Can You Do When You Are Experiencing Test Anxiety?
What Is Positive Pampering and Why Is It Important?
What Should You Do the Night Before the Exam?
How Can You Control Your Test Anxiety Before the Exam?
How Can You Control Your Test Anxiety During the Exam?
That Positive Attitude: How Can You Maintain It?
Chapter 4. NCLEX® Preparation
Where Does Preparation Begin?
The NCLEX Test Plan: Why Is It So Important?
What Are the Steps for Preparing?
Part II. Strategies for Success
Chapter 5. Alternate Item Formats
Introduction
What Is an Alternate Item Format?
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What Test-Taking Strategies Are Helpful for Answering Fill-in-the-
Blank Questions?
What Test-Taking Strategies Are Helpful for Answering Multiple
Response Questions?
What Test-Taking Strategies Are Helpful for Answering
Prioritizing (Ordered Response) Questions?
What Test-Taking Strategies Are Helpful for Answering
Figure/Illustration Questions?
What Test-Taking Strategies Are Helpful for Answering
Chart/Exhibit Questions?
What Test-Taking Strategies Are Helpful for Answering Graphic
Item Option Questions?
What Test-Taking Strategies Are Helpful for Answering Audio or
Video Questions?
What Test-Taking Strategies Are Helpful for Answering Testlet
(Case Study) Questions?
Chapter 6. How to Avoid “Reading Into the Question”
Clinical Reasoning/Clinical Judgment
Ingredients of a Question
Strategic Words or Strategic Phrases
The Subject of the Question
Using Nursing Knowledge and the Process of Elimination
Blank Questions?
What Test-Taking Strategies Are Helpful for Answering Multiple
Response Questions?
What Test-Taking Strategies Are Helpful for Answering
Prioritizing (Ordered Response) Questions?
What Test-Taking Strategies Are Helpful for Answering
Figure/Illustration Questions?
What Test-Taking Strategies Are Helpful for Answering
Chart/Exhibit Questions?
What Test-Taking Strategies Are Helpful for Answering Graphic
Item Option Questions?
What Test-Taking Strategies Are Helpful for Answering Audio or
Video Questions?
What Test-Taking Strategies Are Helpful for Answering Testlet
(Case Study) Questions?
Chapter 6. How to Avoid “Reading Into the Question”
Clinical Reasoning/Clinical Judgment
Ingredients of a Question
Strategic Words or Strategic Phrases
The Subject of the Question
Using Nursing Knowledge and the Process of Elimination
Loading page 8...
Chapter 7. Positive and Negative Event Queries
Positive Event Queries
Negative Event Queries
Chapter 8. Questions Requiring Prioritization
Prioritizing
Priority Classification System
Strategic Words or Strategic Phrases
The ABCs
Maslow’s Hierarchy of Needs Theory
Nursing Process (Clinical Problem-Solving Process)
Chapter 9. Leading and Managing, Delegating, and Assignment-
Making Questions
Delegation and Assignment-Making
Time Management
Chapter 10. Communication Questions
How Are Communication Concepts Tested in a Question?
What Guidelines Can Be Used to Answer Communication
Questions?
Communication Techniques
Positive Event Queries
Negative Event Queries
Chapter 8. Questions Requiring Prioritization
Prioritizing
Priority Classification System
Strategic Words or Strategic Phrases
The ABCs
Maslow’s Hierarchy of Needs Theory
Nursing Process (Clinical Problem-Solving Process)
Chapter 9. Leading and Managing, Delegating, and Assignment-
Making Questions
Delegation and Assignment-Making
Time Management
Chapter 10. Communication Questions
How Are Communication Concepts Tested in a Question?
What Guidelines Can Be Used to Answer Communication
Questions?
Communication Techniques
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Why Are Cultural Considerations Important?
Other Cultural Considerations
Sample Communication Questions
Chapter 11. Pharmacology, Medication, and Intravenous Calculation
Questions
Pharmacology: General Guidelines to Follow
Pharmacology: Assessment/Data Collection Guidelines
Pharmacology: Assessment/Data Collection Guidelines to Follow
Medication Effects
Medication Names
Medication Classifications
Commonalities in Medication Names
What Strategies Will Help When Answering Medication and
Intravenous Calculation Questions?
Chapter 12. Additional Pyramid Strategies
Eliminating Options That Contain Closed-Ended Words: How Will
This Help?
Eliminating Options That Contain Medical Rather Than Nursing
Interventions: How Will This Help?
Eliminating Comparable or Alike Options: How Will This Help?
Ensuring That All Parts of an Option Are Correct: How Will This
Other Cultural Considerations
Sample Communication Questions
Chapter 11. Pharmacology, Medication, and Intravenous Calculation
Questions
Pharmacology: General Guidelines to Follow
Pharmacology: Assessment/Data Collection Guidelines
Pharmacology: Assessment/Data Collection Guidelines to Follow
Medication Effects
Medication Names
Medication Classifications
Commonalities in Medication Names
What Strategies Will Help When Answering Medication and
Intravenous Calculation Questions?
Chapter 12. Additional Pyramid Strategies
Eliminating Options That Contain Closed-Ended Words: How Will
This Help?
Eliminating Options That Contain Medical Rather Than Nursing
Interventions: How Will This Help?
Eliminating Comparable or Alike Options: How Will This Help?
Ensuring That All Parts of an Option Are Correct: How Will This
Loading page 10...
Help?
Selecting the Umbrella Option: How Will This Help?
What Strategies Will Help When Answering Questions Related to
Laboratory Values?
Visualizing the Information in the Case Event, Question Query,
and Options: How Will This Help?
Looking for Concepts in the Question That Are Comparable or
Alike to a Concept in One of the Options: How Will This Help?
What Strategies Will Help When Answering Questions Related to
Client Positioning?
What Strategies Will Help When Answering Questions Related to
Therapeutic Diets?
What Strategies Will Help When Answering Questions Related to
Disasters?
Part III. Practice Tests
Chapter 13. Foundations of Care Questions
Chapter 14. Adult Health Questions
Chapter 15. Mental Health Questions
Chapter 16. Maternity Questions
Chapter 17. Pediatric Questions
Selecting the Umbrella Option: How Will This Help?
What Strategies Will Help When Answering Questions Related to
Laboratory Values?
Visualizing the Information in the Case Event, Question Query,
and Options: How Will This Help?
Looking for Concepts in the Question That Are Comparable or
Alike to a Concept in One of the Options: How Will This Help?
What Strategies Will Help When Answering Questions Related to
Client Positioning?
What Strategies Will Help When Answering Questions Related to
Therapeutic Diets?
What Strategies Will Help When Answering Questions Related to
Disasters?
Part III. Practice Tests
Chapter 13. Foundations of Care Questions
Chapter 14. Adult Health Questions
Chapter 15. Mental Health Questions
Chapter 16. Maternity Questions
Chapter 17. Pediatric Questions
Loading page 11...
Chapter 18. Pharmacology Questions
Chapter 19. Delegating/Prioritizing Questions
Chapter 20. Leadership/Management Questions
Index
Test-Taking Strategy Guide
Chapter 19. Delegating/Prioritizing Questions
Chapter 20. Leadership/Management Questions
Index
Test-Taking Strategy Guide
Loading page 12...
Quick Reference Guide to
Strategies
Alternate Item Formats, p. 32
How to Avoid “Reading into the Question,” p. 44
Clinical Reasoning, p. 44
Ingredients of a Question, p. 44; Also Refer to Inside
Back Cover of This Book
Words or Strategic Phrases, p. 48
Noting the Subject of the Question, p. 49; Also Refer to
Last Page of This Book
Using Nursing Knowledge and the Process of
Elimination, p. 50
Determining If an Abnormality Exists, p. 51
Focusing on the Client of the Question, p. 53
Considering All Available Resources, p. 53
Positive and Negative Event Queries, p. 57
Questions Requiring Prioritization, p. 66; Also Refer to Inside
Back Cover of This Book
Strategic Words or Strategic Phrases, p. 69
The ABCs–Airway—Breathing—Circulation, p. 71
Maslow’s Hierarchy of Needs Theory, p. 72
The Steps of the Nursing Process (Clinical Problem-
Solving Process), p. 75
Leading and Managing, Delegating, and Assignment-Making
Questions, p. 82
Time Management, p. 90
Communication Questions, p. 92
Cultural Considerations, p. 96
Strategies
Alternate Item Formats, p. 32
How to Avoid “Reading into the Question,” p. 44
Clinical Reasoning, p. 44
Ingredients of a Question, p. 44; Also Refer to Inside
Back Cover of This Book
Words or Strategic Phrases, p. 48
Noting the Subject of the Question, p. 49; Also Refer to
Last Page of This Book
Using Nursing Knowledge and the Process of
Elimination, p. 50
Determining If an Abnormality Exists, p. 51
Focusing on the Client of the Question, p. 53
Considering All Available Resources, p. 53
Positive and Negative Event Queries, p. 57
Questions Requiring Prioritization, p. 66; Also Refer to Inside
Back Cover of This Book
Strategic Words or Strategic Phrases, p. 69
The ABCs–Airway—Breathing—Circulation, p. 71
Maslow’s Hierarchy of Needs Theory, p. 72
The Steps of the Nursing Process (Clinical Problem-
Solving Process), p. 75
Leading and Managing, Delegating, and Assignment-Making
Questions, p. 82
Time Management, p. 90
Communication Questions, p. 92
Cultural Considerations, p. 96
Loading page 13...
Pharmacology, Medication, and Intravenous Calculation
Questions, p. 100
Medication and Intravenous Calculations, p. 109
Closed-Ended Words, p. 112
Medical vs. Nursing Interventions, p. 114
Comparable or Alike Options, p. 115
Parts of an Option, p. 116
Umbrella Option, p. 116
Laboratory Values, p. 117
Visualizing the Information, p. 118
Client Positioning, p. 120
Therapeutic Diets, p. 122
Disasters, p. 123
Questions, p. 100
Medication and Intravenous Calculations, p. 109
Closed-Ended Words, p. 112
Medical vs. Nursing Interventions, p. 114
Comparable or Alike Options, p. 115
Parts of an Option, p. 116
Umbrella Option, p. 116
Laboratory Values, p. 117
Visualizing the Information, p. 118
Client Positioning, p. 120
Therapeutic Diets, p. 122
Disasters, p. 123
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Copyright
Saunders 2020–2021 Strategies for Test Success, Sixth Edition ISBN:
978-0-323-58194-3
Copyright © 2020 by Elsevier, Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any
form or by any means, electronic or mechanical, including
photocopying, recording, or any information storage and retrieval
system, without permission in writing from the publisher. Details on
how to seek permission, further information about the Publisher’s
permissions policies and our arrangements with organizations such as
the Copyright Clearance Center and the Copyright Licensing Agency,
can be found at our website: www.elsevier.com/permissions .
This book and the individual contributions contained in it are
protected under copyright by the Publisher (other than as may be
noted herein).
Notices
Knowledge and best practice in this field are constantly changing.
As new research and experience broaden our understanding,
changes in research methods, professional practices, or medical
treatment may become necessary.
Practitioners and researchers must always rely on their own
experience and knowledge in evaluating and using any information,
methods, compounds, or experiments described herein. In using
Saunders 2020–2021 Strategies for Test Success, Sixth Edition ISBN:
978-0-323-58194-3
Copyright © 2020 by Elsevier, Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any
form or by any means, electronic or mechanical, including
photocopying, recording, or any information storage and retrieval
system, without permission in writing from the publisher. Details on
how to seek permission, further information about the Publisher’s
permissions policies and our arrangements with organizations such as
the Copyright Clearance Center and the Copyright Licensing Agency,
can be found at our website: www.elsevier.com/permissions .
This book and the individual contributions contained in it are
protected under copyright by the Publisher (other than as may be
noted herein).
Notices
Knowledge and best practice in this field are constantly changing.
As new research and experience broaden our understanding,
changes in research methods, professional practices, or medical
treatment may become necessary.
Practitioners and researchers must always rely on their own
experience and knowledge in evaluating and using any information,
methods, compounds, or experiments described herein. In using
Loading page 15...
such information or methods they should be mindful of their own
safety and the safety of others, including parties for whom they have
a professional responsibility.
With respect to any drug or pharmaceutical products identified,
readers are advised to check the most current information provided
(i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or
formula, the method and duration of administration, and
contraindications. It is the responsibility of the practitioner, relying
on their own experience and the knowledge of their patients, to
make diagnoses, to determine dosages and the best treatment for
each individual patient, and to take all appropriate safety
precautions.
To the fullest extent of the law, neither the Publisher nor the
authors, contributors, or editors, assume any liability for any injury
and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of
any methods, products, instructions, or ideas contained in the
material herein.
NCLEX®, NCLEX-RN®, and NCLEX-PN® are registered trademarks
of the National Council of State Boards of Nursing, Inc.
Previous editions copyrighted 2018, 2016, 2014, 2010, and 2005.
International Standard Book Number: 978-0-323-58194-3
Senior Content Strategist: Jamie Blum
Senior Content Development Specialist: Laura Goodrich
Publishing Services Manager: Julie Eddy
Senior Project Manager: Cindy Thoms
Designer: Bridget Hoette
Printed in China
safety and the safety of others, including parties for whom they have
a professional responsibility.
With respect to any drug or pharmaceutical products identified,
readers are advised to check the most current information provided
(i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or
formula, the method and duration of administration, and
contraindications. It is the responsibility of the practitioner, relying
on their own experience and the knowledge of their patients, to
make diagnoses, to determine dosages and the best treatment for
each individual patient, and to take all appropriate safety
precautions.
To the fullest extent of the law, neither the Publisher nor the
authors, contributors, or editors, assume any liability for any injury
and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of
any methods, products, instructions, or ideas contained in the
material herein.
NCLEX®, NCLEX-RN®, and NCLEX-PN® are registered trademarks
of the National Council of State Boards of Nursing, Inc.
Previous editions copyrighted 2018, 2016, 2014, 2010, and 2005.
International Standard Book Number: 978-0-323-58194-3
Senior Content Strategist: Jamie Blum
Senior Content Development Specialist: Laura Goodrich
Publishing Services Manager: Julie Eddy
Senior Project Manager: Cindy Thoms
Designer: Bridget Hoette
Printed in China
Loading page 16...
Last digit is the print number: 9 8 7 6 5 4 3 2 1
3251 Riverport Lane
St. Louis, Missouri 63043
3251 Riverport Lane
St. Louis, Missouri 63043
Loading page 17...
Dedication
To all nursing students, your commitment to becoming successful
and your dedication to the profession of nursing will bring never-
ending rewards!
To all nursing students, your commitment to becoming successful
and your dedication to the profession of nursing will bring never-
ending rewards!
Loading page 18...
About the Authors
Linda Anne Silvestri, PhD, RN
Linda Anne Silvestri, PhD, RN
Loading page 19...
As a child, I always dreamed of becoming either a nurse or a
teacher. Initially I chose to become a nurse because I really wanted to
help others, especially those who were ill. Then I realized that both of
my dreams could come true: I could be both a nurse and a teacher. So,
I pursued my dreams.
I received my diploma in nursing at Cooley Dickinson Hospital
School of Nursing in Northampton, Massachusetts. Afterward, I
worked at Baystate Medical Center in Springfield, Massachusetts.
While there, I cared for clients in acute medical-surgical units, the
intensive care unit, the emergency department, pediatric units, and
other acute care units. Later I received an Associate Degree from
Holyoke Community College in Holyoke, Massachusetts; my BSN
from American International College in Springfield, Massachusetts;
and my MSN from Anna Maria College in Paxton, Massachusetts,
with a dual major in Nursing Management and Patient Education. I
received my PhD in Nursing from the University of Nevada, Las
Vegas, and conducted and published research on self-efficacy and the
predictors for NCLEX® success. I am also a member of the Honor
Society of Nursing, Sigma Theta Tau International, Phi Kappa Phi, the
American Nurses Association, the National League for Nursing, the
Western Institute of Nursing, the Eastern Nursing Research Society,
and the Golden Key International Honour Society. Additionally, I
received the 2012 Alumna of the Year/Nurse of the Year Award from
the University of Nevada, Las Vegas, School of Nursing.
As a native of Springfield, Massachusetts, I began my teaching
career as an instructor of medical-surgical nursing and leadership-
management nursing at Baystate Medical Center School of Nursing in
1981. In 1989, I relocated to Rhode Island and began teaching medical-
surgical nursing and psychiatric nursing to RN and LPN students at
the Community College of Rhode Island. Later in 1994, I began
teaching nursing at Salve Regina University in Newport, Rhode
Island, and remain there as an adjunct faculty member.
I established Professional Nursing Seminars, Inc. in 1991 and
Nursing Reviews, Inc. in 2000. Both companies are located in
teacher. Initially I chose to become a nurse because I really wanted to
help others, especially those who were ill. Then I realized that both of
my dreams could come true: I could be both a nurse and a teacher. So,
I pursued my dreams.
I received my diploma in nursing at Cooley Dickinson Hospital
School of Nursing in Northampton, Massachusetts. Afterward, I
worked at Baystate Medical Center in Springfield, Massachusetts.
While there, I cared for clients in acute medical-surgical units, the
intensive care unit, the emergency department, pediatric units, and
other acute care units. Later I received an Associate Degree from
Holyoke Community College in Holyoke, Massachusetts; my BSN
from American International College in Springfield, Massachusetts;
and my MSN from Anna Maria College in Paxton, Massachusetts,
with a dual major in Nursing Management and Patient Education. I
received my PhD in Nursing from the University of Nevada, Las
Vegas, and conducted and published research on self-efficacy and the
predictors for NCLEX® success. I am also a member of the Honor
Society of Nursing, Sigma Theta Tau International, Phi Kappa Phi, the
American Nurses Association, the National League for Nursing, the
Western Institute of Nursing, the Eastern Nursing Research Society,
and the Golden Key International Honour Society. Additionally, I
received the 2012 Alumna of the Year/Nurse of the Year Award from
the University of Nevada, Las Vegas, School of Nursing.
As a native of Springfield, Massachusetts, I began my teaching
career as an instructor of medical-surgical nursing and leadership-
management nursing at Baystate Medical Center School of Nursing in
1981. In 1989, I relocated to Rhode Island and began teaching medical-
surgical nursing and psychiatric nursing to RN and LPN students at
the Community College of Rhode Island. Later in 1994, I began
teaching nursing at Salve Regina University in Newport, Rhode
Island, and remain there as an adjunct faculty member.
I established Professional Nursing Seminars, Inc. in 1991 and
Nursing Reviews, Inc. in 2000. Both companies are located in
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Henderson, Nevada, and are dedicated to helping nursing graduates
achieve their goals of becoming registered nurses, licensed
practical/vocational nurses, or both.
Today I am the successful author of numerous review products that
prepare students for the NCLEX® examination. Also, I serve as an
Elsevier Consultant for HESI live reviews, the review courses for the
NCLEX examination conducted throughout the country. I am so
pleased that you have decided to join me on your journey to success
in testing for nursing examinations and for the NCLEX examination!
achieve their goals of becoming registered nurses, licensed
practical/vocational nurses, or both.
Today I am the successful author of numerous review products that
prepare students for the NCLEX® examination. Also, I serve as an
Elsevier Consultant for HESI live reviews, the review courses for the
NCLEX examination conducted throughout the country. I am so
pleased that you have decided to join me on your journey to success
in testing for nursing examinations and for the NCLEX examination!
Loading page 21...
Angela Silvestri, PhD, APRN, FNP-BC, CNE
When asked what I wanted to do with my life and as a career, I
always answered that I wanted to work in the medical field. At first
my ambition was to become a physician; however, learning that
nurses interact with their patients more often than physicians do
swayed me to pursue nursing. While in nursing school, I worked as a
tutor for my peers. I realized how much I enjoyed doing this and how
much of a difference my help made in these students’ college careers
and ultimately their lives.
I received my baccalaureate degree in Nursing and Sociology at
Salve Regina University in Newport, Rhode Island. After earning my
degree, I worked in long-term care, rehabilitation, and acute care
settings. I then went on to earn my master’s degree and PhD in
Nursing and published the findings related to cultural competence in
the curriculum. I am a member of Nevada Nurses Association, Sigma
Theta Tau International Honour Society, and Golden Key
International Honour Society. I received a scholarship from Sigma
Theta Tau for academic excellence while attending Salve Regina
University and an award from the University of Nevada, Las Vegas,
for Outstanding MSN Student. I have also received the Xu Family
Scholarship for research in cultural competence, the Harry & Rebecca
Lahr Scholarship, and the Sierra Health Nursing Fellowship at the
University of Nevada, Las Vegas. I am an Assistant Professor at the
University of Nevada, Las Vegas, and teach Fundamental Skills and
Medical-Surgical Nursing in the didactic, simulation, skills lab, and
clinical settings. My short-term goals include conducting research
focused on nursing education and finding the best student-centered
teaching strategies to help students transition to successful nurses at
practice. I recently graduated from my post-Master's graduate
certificate program for Family Nurse Practitioner and plan to focus on
entering practice as an FNP and developing a research program in
advanced practice.
Working with students while having been a student for quite some
time helped me understand and realize the individual needs of each
When asked what I wanted to do with my life and as a career, I
always answered that I wanted to work in the medical field. At first
my ambition was to become a physician; however, learning that
nurses interact with their patients more often than physicians do
swayed me to pursue nursing. While in nursing school, I worked as a
tutor for my peers. I realized how much I enjoyed doing this and how
much of a difference my help made in these students’ college careers
and ultimately their lives.
I received my baccalaureate degree in Nursing and Sociology at
Salve Regina University in Newport, Rhode Island. After earning my
degree, I worked in long-term care, rehabilitation, and acute care
settings. I then went on to earn my master’s degree and PhD in
Nursing and published the findings related to cultural competence in
the curriculum. I am a member of Nevada Nurses Association, Sigma
Theta Tau International Honour Society, and Golden Key
International Honour Society. I received a scholarship from Sigma
Theta Tau for academic excellence while attending Salve Regina
University and an award from the University of Nevada, Las Vegas,
for Outstanding MSN Student. I have also received the Xu Family
Scholarship for research in cultural competence, the Harry & Rebecca
Lahr Scholarship, and the Sierra Health Nursing Fellowship at the
University of Nevada, Las Vegas. I am an Assistant Professor at the
University of Nevada, Las Vegas, and teach Fundamental Skills and
Medical-Surgical Nursing in the didactic, simulation, skills lab, and
clinical settings. My short-term goals include conducting research
focused on nursing education and finding the best student-centered
teaching strategies to help students transition to successful nurses at
practice. I recently graduated from my post-Master's graduate
certificate program for Family Nurse Practitioner and plan to focus on
entering practice as an FNP and developing a research program in
advanced practice.
Working with students while having been a student for quite some
time helped me understand and realize the individual needs of each
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student. This experience, in addition to my experience in item writing
and other contributions to nursing textbooks, has helped me coauthor
this text. I am very excited to be a part of this opportunity to further
assist nursing students in their ultimate goal: passing nursing school
and the NCLEX® exam!
and other contributions to nursing textbooks, has helped me coauthor
this text. I am very excited to be a part of this opportunity to further
assist nursing students in their ultimate goal: passing nursing school
and the NCLEX® exam!
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Contributors
Associate Editor
Eileen H. Gray, DNP, RN, CPNP
Adjunct Professor of Nursing, Salve Regina University, Newport,
Rhode Island
HESI NCLEX-RN® and NCLEX-PN® Live Review Course Instructor
Consultants
Dianne E. Fiorentino, Research Coordinator, Nursing Reviews,
Inc. Henderson, Nevada
James Guilbault Jr. BS, PharmD , Clinical Pharmacist Greenfield,
Massachusetts Pharmacology Consultant, Nursing Reviews, Inc.
Henderson, Nevada
Nicholas L. Silvestri, BA , Editorial and Communications Analyst,
Nursing Reviews, Inc. Henderson, Nevada
Previous Item Writers
Linda Ann Aubrey, MSN, RN, CMSRN, CNE
Martha Barry, RN, CNM, MS
Jacqueline Rosenjack Burchum, DNSc, FNP-BC, CNE
Reitha Cabaniss, MSN
Mary C. Carrico, MS, RN
Mary L. Dowell, PhD, RN, BC
Kimberly R. Foisy, RN, MSN, CMSRN
Lena R. Greene, MSN, RN
Associate Editor
Eileen H. Gray, DNP, RN, CPNP
Adjunct Professor of Nursing, Salve Regina University, Newport,
Rhode Island
HESI NCLEX-RN® and NCLEX-PN® Live Review Course Instructor
Consultants
Dianne E. Fiorentino, Research Coordinator, Nursing Reviews,
Inc. Henderson, Nevada
James Guilbault Jr. BS, PharmD , Clinical Pharmacist Greenfield,
Massachusetts Pharmacology Consultant, Nursing Reviews, Inc.
Henderson, Nevada
Nicholas L. Silvestri, BA , Editorial and Communications Analyst,
Nursing Reviews, Inc. Henderson, Nevada
Previous Item Writers
Linda Ann Aubrey, MSN, RN, CMSRN, CNE
Martha Barry, RN, CNM, MS
Jacqueline Rosenjack Burchum, DNSc, FNP-BC, CNE
Reitha Cabaniss, MSN
Mary C. Carrico, MS, RN
Mary L. Dowell, PhD, RN, BC
Kimberly R. Foisy, RN, MSN, CMSRN
Lena R. Greene, MSN, RN
Loading page 24...
Rebecca Russo Hill, DNP, FNP-C
Tiffany Jakubowski, RN
Christina Keller, RN, MSN
Lynn M. Korvick, PhD, RN, CNE
Terri Peterson, RN, BSN, MSNEd
Donna Russo, RN, MSN, CCRN, CNE
Julie S. Snyder, MSN, RN-BC
Bethany Hawes Sykes, EdD, RN, CEN, CCRN
Linda Turchin, MSN, RN, CNE
Koni J. Utley, MSN, RN
Polly Gerber Zimmermann, RN, MS, MBA, CEN, FAEN
Tiffany Jakubowski, RN
Christina Keller, RN, MSN
Lynn M. Korvick, PhD, RN, CNE
Terri Peterson, RN, BSN, MSNEd
Donna Russo, RN, MSN, CCRN, CNE
Julie S. Snyder, MSN, RN-BC
Bethany Hawes Sykes, EdD, RN, CEN, CCRN
Linda Turchin, MSN, RN, CNE
Koni J. Utley, MSN, RN
Polly Gerber Zimmermann, RN, MS, MBA, CEN, FAEN
Loading page 25...
Previous Reviewers
Rita R. Armstrong, DNP, MSN Ed, RN , Professor, Dallas
Nursing Institute, Dallas, Texas
Anna M. Bruch, RN, MSN , Nursing Professor, Illinois
Valley Community College, Oglesby, Illinois
Lisa Hollett, RN, BSN, MA, MICN, TCRN, CFN, DABFN
, Trauma Performance Improvement Coordinator,
MedPartners, Ennis, Texas
Peter D. Smith, BA, MSN, RN , Instructor & Clinical
Lead/Critical Care Nurse, Otolaryngology/Plastics & Cardio-
Thoracic Acute Care, Goldfarb School of Nursing at Barnes-
Jewish College, Barnes-Jewish Hospital, St. Louis, Missouri
Elaine Kay Strouss, MSN, RN, CNE , Professor—
Nursing, Community College of Beaver County, Monaca,
Pennsylvania
Elizabeth Wright, MSN, RN, CNE , Assistant Professor of
Nursing, Indiana Wesleyan University, Marian, Indiana
Rita R. Armstrong, DNP, MSN Ed, RN , Professor, Dallas
Nursing Institute, Dallas, Texas
Anna M. Bruch, RN, MSN , Nursing Professor, Illinois
Valley Community College, Oglesby, Illinois
Lisa Hollett, RN, BSN, MA, MICN, TCRN, CFN, DABFN
, Trauma Performance Improvement Coordinator,
MedPartners, Ennis, Texas
Peter D. Smith, BA, MSN, RN , Instructor & Clinical
Lead/Critical Care Nurse, Otolaryngology/Plastics & Cardio-
Thoracic Acute Care, Goldfarb School of Nursing at Barnes-
Jewish College, Barnes-Jewish Hospital, St. Louis, Missouri
Elaine Kay Strouss, MSN, RN, CNE , Professor—
Nursing, Community College of Beaver County, Monaca,
Pennsylvania
Elizabeth Wright, MSN, RN, CNE , Assistant Professor of
Nursing, Indiana Wesleyan University, Marian, Indiana
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Preface
Welcome to Saunders Pyramid to Success!
Saunders 2020–2021 Strategies for Test Success: Passing Nursing School
and the NCLEX Exam is one in a series of products designed to assist
you in achieving your goal of passing your nursing courses and
becoming a licensed nurse. This product provides you with test-taking
strategies that will help you pass your nursing examinations and the
NCLEX examination.
Organization
Saunders 2020–2021 Strategies for Test Success: Passing Nursing School
and the NCLEX Exam contains three parts and 20 chapters. The
chapters in Part I include information on test preparation and the
NCLEX exam. The chapters in Part II describe the test-taking
strategies and include several sample questions that illustrate how to
use each test-taking strategy. The sample questions represent all types
of question formats, including multiple choice and alternate item
formats. In addition to the sample questions in the chapters, a total of
1200 practice questions accompany this book. In Part III of the book,
there are 200 practice questions, and the accompanying Evolve site
contains the 200 practice questions from the book along with an
additional 1000 practice questions. All of the practice questions reflect
the framework and the content identified in the most current NCLEX
test plans. The practice questions in this resource relate to each Client
Needs category and each Integrated Process of the NCLEX exam. The
Client Needs categories include Safe and Effective Care Environment,
Health Promotion and Maintenance, Psychosocial Integrity, and
Welcome to Saunders Pyramid to Success!
Saunders 2020–2021 Strategies for Test Success: Passing Nursing School
and the NCLEX Exam is one in a series of products designed to assist
you in achieving your goal of passing your nursing courses and
becoming a licensed nurse. This product provides you with test-taking
strategies that will help you pass your nursing examinations and the
NCLEX examination.
Organization
Saunders 2020–2021 Strategies for Test Success: Passing Nursing School
and the NCLEX Exam contains three parts and 20 chapters. The
chapters in Part I include information on test preparation and the
NCLEX exam. The chapters in Part II describe the test-taking
strategies and include several sample questions that illustrate how to
use each test-taking strategy. The sample questions represent all types
of question formats, including multiple choice and alternate item
formats. In addition to the sample questions in the chapters, a total of
1200 practice questions accompany this book. In Part III of the book,
there are 200 practice questions, and the accompanying Evolve site
contains the 200 practice questions from the book along with an
additional 1000 practice questions. All of the practice questions reflect
the framework and the content identified in the most current NCLEX
test plans. The practice questions in this resource relate to each Client
Needs category and each Integrated Process of the NCLEX exam. The
Client Needs categories include Safe and Effective Care Environment,
Health Promotion and Maintenance, Psychosocial Integrity, and
Loading page 27...
Physiological Integrity. The Integrated Processes include Caring,
Communication and Documentation, Culture and Spirituality,
Nursing Process (Clinical Problem-Solving Process), and Teaching
and Learning.
Part I: Study and Test Preparation
Chapter 1: Preparing for Nursing Examinations
The information in this chapter focuses on the exams that you will
take during your nursing program and provides you with information
on how to prepare for these exams. Topics include the purpose of
nursing exams, what you can expect on nursing exams, how nursing
exams are different from other exams, and the types of questions on
nursing exams. Additional topics include preparing for a nursing
exam using your syllabus, textbook, classroom notes, flash cards,
study guides, and study groups.
Chapter 2: Developing Study Skills
This chapter discusses several topics related to study skills and study
habits. It provides you with information on how to develop or refine
study skills and how to develop good study habits so that you will be
well prepared for your nursing exams. Included are the top 10
Pyramid Points and study habits. Also, study skills such as listening,
note-taking, reading, remembering content, and critical thinking skills
are discussed.
Chapter 3: Reducing Test Anxiety
This chapter focuses on the important points related to test anxiety. In
this chapter, you are provided with self-assessment points to
determine if you experience test anxiety. Additionally, the causes of
test anxiety, how to prevent test anxiety, and how to control test
anxiety before an exam are discussed. Points about maintaining a
positive attitude and what you can do when you experience test
anxiety are presented in this chapter.
Communication and Documentation, Culture and Spirituality,
Nursing Process (Clinical Problem-Solving Process), and Teaching
and Learning.
Part I: Study and Test Preparation
Chapter 1: Preparing for Nursing Examinations
The information in this chapter focuses on the exams that you will
take during your nursing program and provides you with information
on how to prepare for these exams. Topics include the purpose of
nursing exams, what you can expect on nursing exams, how nursing
exams are different from other exams, and the types of questions on
nursing exams. Additional topics include preparing for a nursing
exam using your syllabus, textbook, classroom notes, flash cards,
study guides, and study groups.
Chapter 2: Developing Study Skills
This chapter discusses several topics related to study skills and study
habits. It provides you with information on how to develop or refine
study skills and how to develop good study habits so that you will be
well prepared for your nursing exams. Included are the top 10
Pyramid Points and study habits. Also, study skills such as listening,
note-taking, reading, remembering content, and critical thinking skills
are discussed.
Chapter 3: Reducing Test Anxiety
This chapter focuses on the important points related to test anxiety. In
this chapter, you are provided with self-assessment points to
determine if you experience test anxiety. Additionally, the causes of
test anxiety, how to prevent test anxiety, and how to control test
anxiety before an exam are discussed. Points about maintaining a
positive attitude and what you can do when you experience test
anxiety are presented in this chapter.
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Chapter 4: NCLEX® Preparation
This chapter focuses on preparing for the NCLEX exam—the exam
that you must take and pass after you graduate from nursing school in
order to become a licensed nurse. This chapter emphasizes the
important point that NCLEX preparation begins the moment you
enter your nursing program. Specific to the NCLEX, it provides you
with the steps for preparing for the NCLEX, self-assessment points to
determine your readiness, and a plan for preparation.
Part II: Strategies for Success
Chapter 5: Alternate Item Formats
Alternate item format questions are designed to test competency in
nursing skills and abilities. This chapter describes the various types of
alternate item format questions that you may encounter on the
NCLEX examination and on nursing school examinations and
provides you with test-taking strategies to answer them correctly.
These alternate item format types include fill-in-the-blank, multiple
response, prioritizing (ordered response), figure or illustration (hot
spot), chart/exhibit, graphic item options, testlets (case studies), and
audio and video.
Chapter 6: How to Avoid “Reading into the Question”
One of the pitfalls that can cause a problem when answering a
question is “reading into the question.” This means that you are
considering issues beyond the information presented in the question.
This chapter describes the strategies to use when answering a
question to prevent this from happening and includes topics such as
how to read a question, using strategic words, identifying the subject
of the question, determining if an abnormality exists, focusing on the
client of the question, considering available resources, and using
nursing knowledge and the process of elimination.
Chapter 7: Positive and Negative Event Queries
This chapter focuses on preparing for the NCLEX exam—the exam
that you must take and pass after you graduate from nursing school in
order to become a licensed nurse. This chapter emphasizes the
important point that NCLEX preparation begins the moment you
enter your nursing program. Specific to the NCLEX, it provides you
with the steps for preparing for the NCLEX, self-assessment points to
determine your readiness, and a plan for preparation.
Part II: Strategies for Success
Chapter 5: Alternate Item Formats
Alternate item format questions are designed to test competency in
nursing skills and abilities. This chapter describes the various types of
alternate item format questions that you may encounter on the
NCLEX examination and on nursing school examinations and
provides you with test-taking strategies to answer them correctly.
These alternate item format types include fill-in-the-blank, multiple
response, prioritizing (ordered response), figure or illustration (hot
spot), chart/exhibit, graphic item options, testlets (case studies), and
audio and video.
Chapter 6: How to Avoid “Reading into the Question”
One of the pitfalls that can cause a problem when answering a
question is “reading into the question.” This means that you are
considering issues beyond the information presented in the question.
This chapter describes the strategies to use when answering a
question to prevent this from happening and includes topics such as
how to read a question, using strategic words, identifying the subject
of the question, determining if an abnormality exists, focusing on the
client of the question, considering available resources, and using
nursing knowledge and the process of elimination.
Chapter 7: Positive and Negative Event Queries
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This chapter describes the differences between a positive and a
negative event query in a question. Reading the question carefully and
noting the type of query used are important to assist in answering a
question correctly. This chapter also identifies the strategic words or
phrases that indicate whether the question contains a positive or
negative event query.
Chapter 8: Questions Requiring Prioritization
Some of the test questions on your nursing exams and on the NCLEX
will require you to use the skill of prioritizing nursing actions. These
types of questions can be difficult because when a question requires
prioritization, all of the options may be correct, and you will need to
determine the correct order of action. This chapter describes the test-
taking strategies that you can use to answer prioritizing questions
correctly. Some of these strategies include the ABCs—airway,
breathing, andcirculation—Maslow’s Hierarchy of Needs theory, and
the steps of the nursing process (clinical problem-solving process).
Also included in this chapter are the strategies for determining the
need to contact the primary health care provider.
Chapter 9: Leading and Managing, Delegating, and
Assignment-Making Questions
Some test questions that you will need to answer will relate to the
nurse’s responsibilities regarding delegating care and assignment-
making and the supervisory role of these responsibilities. This chapter
reviews the guidelines and principles related to delegating and
assignment-making, two very important roles of the nurse as a leader
and manager. It also provides you with information about the tasks
and activities that can be delegated and assigned to unlicensed
assistive personnel (UAP), licensed practical/vocational nurses, and
registered nurses. Guidelines for time management are also reviewed,
because managing time efficiently is a key factor for completing
activities and tasks within a given time period.
Chapter 10: Communication Questions
negative event query in a question. Reading the question carefully and
noting the type of query used are important to assist in answering a
question correctly. This chapter also identifies the strategic words or
phrases that indicate whether the question contains a positive or
negative event query.
Chapter 8: Questions Requiring Prioritization
Some of the test questions on your nursing exams and on the NCLEX
will require you to use the skill of prioritizing nursing actions. These
types of questions can be difficult because when a question requires
prioritization, all of the options may be correct, and you will need to
determine the correct order of action. This chapter describes the test-
taking strategies that you can use to answer prioritizing questions
correctly. Some of these strategies include the ABCs—airway,
breathing, andcirculation—Maslow’s Hierarchy of Needs theory, and
the steps of the nursing process (clinical problem-solving process).
Also included in this chapter are the strategies for determining the
need to contact the primary health care provider.
Chapter 9: Leading and Managing, Delegating, and
Assignment-Making Questions
Some test questions that you will need to answer will relate to the
nurse’s responsibilities regarding delegating care and assignment-
making and the supervisory role of these responsibilities. This chapter
reviews the guidelines and principles related to delegating and
assignment-making, two very important roles of the nurse as a leader
and manager. It also provides you with information about the tasks
and activities that can be delegated and assigned to unlicensed
assistive personnel (UAP), licensed practical/vocational nurses, and
registered nurses. Guidelines for time management are also reviewed,
because managing time efficiently is a key factor for completing
activities and tasks within a given time period.
Chapter 10: Communication Questions
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Communication is a process through which information is exchanged,
either verbally or nonverbally, between two or more individuals and
is an extremely important role of the nurse. This chapter reviews the
guidelines to follow when answering communication questions and
identifies various cultural aspects to consider when communicating
and caring for clients. Additionally, therapeutic and nontherapeutic
communication techniques are presented.
Chapter 11: Pharmacology, Medication, and Intravenous
Calculation Questions
Pharmacology is one of the most difficult nursing content areas to
master and feel comfortable with. One reason that it is so difficult is
because of the enormous number of medications available. Another
reason is that there is a vast amount of information to know about
each medication. It is important for you to spend ample time studying
and reviewing pharmacology in preparation for your nursing exams
and for the NCLEX and to use this knowledge to answer
pharmacology questions. However, you may be presented with
pharmacology questions on your exams that present medications you
are unfamiliar with, in which case you will need to make an educated
guess to answer the question. This chapter provides you with the
strategies and general guidelines to use for making an educated guess
to answer pharmacology questions correctly. This chapter also
includes medication and intravenous calculations strategies and
examples.
Chapter 12: Additional Pyramid Strategies
This chapter reviews additional helpful strategies that will assist in
answering a test question correctly. Also included in this chapter are
strategies that are useful for answering questions related to laboratory
values, client positioning, and therapeutic diets. Strategies that will be
helpful when answering questions related to disasters are also
presented in this chapter.
either verbally or nonverbally, between two or more individuals and
is an extremely important role of the nurse. This chapter reviews the
guidelines to follow when answering communication questions and
identifies various cultural aspects to consider when communicating
and caring for clients. Additionally, therapeutic and nontherapeutic
communication techniques are presented.
Chapter 11: Pharmacology, Medication, and Intravenous
Calculation Questions
Pharmacology is one of the most difficult nursing content areas to
master and feel comfortable with. One reason that it is so difficult is
because of the enormous number of medications available. Another
reason is that there is a vast amount of information to know about
each medication. It is important for you to spend ample time studying
and reviewing pharmacology in preparation for your nursing exams
and for the NCLEX and to use this knowledge to answer
pharmacology questions. However, you may be presented with
pharmacology questions on your exams that present medications you
are unfamiliar with, in which case you will need to make an educated
guess to answer the question. This chapter provides you with the
strategies and general guidelines to use for making an educated guess
to answer pharmacology questions correctly. This chapter also
includes medication and intravenous calculations strategies and
examples.
Chapter 12: Additional Pyramid Strategies
This chapter reviews additional helpful strategies that will assist in
answering a test question correctly. Also included in this chapter are
strategies that are useful for answering questions related to laboratory
values, client positioning, and therapeutic diets. Strategies that will be
helpful when answering questions related to disasters are also
presented in this chapter.
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Subject
National Council Licensure Examination