Hey gang...Bobbi in Alaska~some of you remember me~right???

I am still kicking...but barley. Going to retake the RN exam again...still not giving  up, just totatlly stressed!

I plan to NCLEX exam again, end of month or first of March...still waiting on ATT...in the mean time I am doing some studying and great review...but I do need some help.

How does one determine who to see first (or last) as a home health nurse....

All clients have similar issues, or just released, or recent surgery, etc...what would be the determing factor as to who is seen first or last...

Also, if I am the charge nurse and there is the possiblity that I would have to discharge someone due to disaster and trying to make space for new admit...who would I discharge...the most stable, the furtherst out of surgery, the oldest, who??

Help! Without being a licensed nurse (yet) and not having any experience to draw on...ie, not being able to do the critical thinking in the actual setting, etc...how do I prioritize patients??? I know, think about ABC, Maslow, etc...but I think there is more to it than that?

Same with infection control....who can be placed with one patient, but not another?? Again, protect the client....and others.

I have found NO review questions that are EVEN CLOSE to what I see on NCLEX...so without getting myself in trouble, I am limiting my question to the above...

I am not looking for supportive words, I am looking for ideas on how I can get the skills to answer these tough NCLEX questions that I believe are hindering me from getting my license. I do well on everything else, or so I see on my review of content areas.

So, help me please. I believe I need the most suggestions in Physiologocial Adaption and Reduction of Risk Potential.

Thanks....I appreciate any suggestions or ideas.

first and foremost bobbi, STOP STRESSING OUT.... in my opinion, in any exam, it is the stress that always brings the worst of us. i know it's easy to say but hard to do, but try to RELAX, just tell yourself that you have been studying for this exam, and you know the answer, keep repeating it to yourself, until you believe it =)

and now, some helpful tips, hopefully it will be useful to you.

1. first regarding infection control? when you have to put patients in the same room, you have to consider the epidemiology and mode of transmission of the infecting organism, basically, same patient with the same organism can share the same room. But you have to remember, INFANTS, CHILDREN and PATIENT w/ ALTERED MENTAL status CANNOT cohort with other patient, because these patients can't assist on maintaining infection control precautions.

* another thing to this is that IMMUNOSUPPRED PATIENT should never cohort with any other patient.

2. PRIORITIZATION - ABC always, it doesn't matter whether it is in a hospital or home health. example to this is asthmatic patient, compare to patient who is pregnant and on labor, you still have to choose the patient with an asthma, even if the mother is 8cm.... i know in reality it doesn't work that way, but NCLEX has a perfect world =).

and if ABC, does not apply to any patient, use MASLOW's HIERARCHY of needs..... (don't over analyze). when you are reading the questions, it may seems like they all have the same issues, they don't, otherwise they won't be asking you which one right =)? there's always be just ONE WORD that will different from each other. 

3. lastly, when you are trying to discharge a patient to make space for new admission - you will determine patient that are stable, (ABC can also apply here), any patient that has any problems with airway, even if the patient seems stable, it has to stay in the hospital. post op patient should be monitored for at least 48-72 hours, patient with CVA should stay as well, for monitoring purposes to prevent complication such as stroke (circulation).

patient that can be discharged are those patient that are stable, meaning no immediate threat, patient who has infection receiving antibiotic therapy, new mothers who gave birth (NSD) 24 hours ago w/ no signs of complication/bleeding, and other patient who are STABLE..

.... i hope this helps you, if you have any other questions, just ask, and i will try to answer it to best of my knowledge. having no license or any experience working in a hospital is not an issue on passing the NCLEX (in my opinion), as i said NCLEX has a perfect world, and when you're actually practicing the profession, you will find out.

everything is in the book, FUNDAMENTALS of nursing.... and DO NOT over analyze, what you read in the book, that's all you have to know.  PATIENT"S SAFETY is our PRIORITY.....

i know i'm making it sounds easy.... but it is, if you follow everything BY THE BOOK. i'm a new graduate, and i graduated in the Philippines, these physiological adaptaion and reduction of risk potential, i have no idea about it, from my experiences in my clinical duties in the hospital back there, it does not exist, i know the theory, but the application, NEVER used it.

if you really having trouble with this kind of situations, try SAUDERS Q & A BOOK, it helped me a lot. and the questions that they have in the book are closely similar to the one NCLEX has.

good luck!

Hi all, thank you for your replies...Apyrl Len I really appreciated your information....I plan to do exactly what you suggested! Thanks...I may be contacting you again...I found your information helpful...thank you!

Back to my review!

bj

thanks for your posting dmazment!

Hey gang....Finally got my ATT to take the RN exam...Next Thursday, March 5th is the BIG Day....8am Alaska time....a collective "git er done" would be great!

Anxious, nervous, excited, prepared.....I have all of the above feelings!

I have found the ncsbn Learning Extension site to be very helpful....www.learingext.com

I bought one of the courses and have been plugging away it it...I would suggest it to anyone looking for a good review.

Still looking for suggestions on delegation, prioritization, infection control, documentation...

Oh and another question.....On my last attempt, I did not have ONE, I repeat, ONE medication/dosage calculation question....whats with that??? I was so prepared and yes, disappointed that I could not even jot some numbers down...I still got it though and will be ready shoudl I do get one dosaging question.

In my mind, again, not the perfect mind or world according to NCLEX...on past NCLEX attempts I did have a few questions, but none this time...any quesses as to why?? Just wondering....I would think that an a medication error is going to get a nurse in to trouble a lot sooner than other items would. Just my rambling...back to the review!

I passed~whew!   Can you belive it.???? I am still having hard time believing it myself.

I would compare this feeling to that when I was first pregnant with my oldest son 17  years ago....I did not believe it...but low and behold!

I am totally stoked, shocked, giddy...After multiple attemptss, I FINALLY got it right!

For anyone out there who is frustrated of not passing, DON'T give up!

WHOOP WHOOP~bj