NCLEX STUDY GUIDE Comprehensive Study Guide

NCLEX Study Guide Notes

Advice for NCLEX

  • Duration of Study: Plan to study for the NCLEX for at least one month.

    • If graduated from the nursing program over a year ago, consider more time.

  • Key to Passing:

    • Take as many practice questions as possible.

    • Recommended to use this guide alongside any test bank of choice.

    • Importance of understanding what questions are really asking, especially for Select All That Apply (SATA) questions.

  • Recommended Test Banks:

    • U-World: Top choice, read entire rationale for every question.

    • Nurse Achieve: CAT format, similar to NCLEX.

    • Recommended to take a few CAT exams 1-2 weeks before the NCLEX date.

    • Saunders Comprehensive Review for the NCLEX-RN: Comprehensive review book; consider purchasing if graduated a while ago and need material refresh.

NCLEX Study Schedule

  • Study Calendar:

    • Week Overview (Example):

    • Monday: Med Surg

    • Tuesday: Critical Care

    • Wednesday: Pediatrics

    • Thursday: Maternity

    • Friday: Review Test Questions

    • Saturday: Review Previous Concepts

    • Sunday: Test Questions.

  • Second Schedule Example:

    • Monday: Mental Health

    • Tuesday: Pharmacology

    • Wednesday: Leadership

    • Sunday: NCLEX Review Test Questions

Labs Cheat Sheet

Basic Metabolic Panel (7) and Chem 10

  • Sodium (Na): 135-145 mEq/L

    • Function: Aids in water excretion, osmotic pressure, acid-base balance.

  • Potassium (K): 3.5-5 mEq/L

    • Function: Transmits electrical impulses in cardiac & skeletal muscle.

  • Chloride (Cl): 95-105 mEq/L

    • Function: Maintains blood volume, BP, pH of body fluids.

  • Blood Urea Nitrogen (BUN): 7-22 mg/dL

    • Indicates effectiveness of kidneys filtering waste.

  • Creatinine (Cr): 0.7-1.4 mg/dL

    • Better marker of kidney function than BUN.

  • Glucose: 70-100 mg/dL

    • Indicates blood sugar levels, metabolic status.

  • Calcium (Ca): 8.5-10.5 mg/dL

    • Function: Bone health, muscle contraction.

Complete Blood Count (CBC)

  • Red Blood Cells (RBC): 4.5-5 million cells/mcL.

  • White Blood Cells (WBC): 4.5-10k cells/mcL.

  • Platelet (PLT): 150-300k cells/mcL.

  • Hemoglobin (Hgb): 12-16 g/dL female; 14-18 g/dL male.

  • Hematocrit (Hct): 36-44% female; 41-50% male.

Coagulation Studies

  • Prothrombin Time (PT): 9-11 seconds.

    • Indicates the time it takes for blood to clot.

  • International Normalized Ratio (INR): 0.9-1.2 (on Warfarin: 2-3).

  • Partial Thromboplastin Time (PTT): 20-35 seconds (on Heparin: 60-70 seconds).

Cardiac Markers

  • Troponin: <0.4 ng/mL, primary test for heart damage.

  • C-Reactive Protein (CRP): <0.30 mg/dL, indicates inflammation associated with heart disease.

Must Know

Lab Values and Their Importance

  • Electrolyte Levels:

    • PT (Prothrombin Time): >11-13.5 seconds.

    • INR: Normal <1; Warfarin: 2-3.

Common Medications

  • Antidotes:

    • For Heparin: Protamine Sulfate

    • For Warfarin: Vitamin K

IV Complications

  • Infiltration: IV fluid/med leaks into surrounding tissues.

  • Phlebitis: Inflammation of vein; stop infusion.

Hallmark Signs of Conditions

  • Angina: Sharp chest pain.

  • Asthma: Expiratory wheezing.

Patient Positioning

High Fowlers Position (60-90 degrees)

  • Used for:

    • NG tube placement.

    • Patients with shortness of breath (e.g., COPD, asthma).

Semi-Fowlers Position (30-45 degrees)

Use in:

  • Myocardial infarction cases for comfort and reduced abdominal strain.

Supine Position

Used for:

  • Post lumbar puncture to prevent headaches.

Diagnostic Signs/Tests

  • Murphy's Sign: Pain upon palpation of gallbladder area.

  • Cullen's Sign: Indicates internal hemorrhage due to pancreatitis.

Fundamentals of Nursing

Safety and Assessment Framework

  • Fire Safety - RACE: Rescue, Activate alarm, Contain the fire, Extinguish if able.

  • Nursing Process: Assessing, Diagnosing, Planning, Implementing, Evaluating (ADPIE).

Important Interventions

  • Administering medication:

    • At least 1 hour before meals or 2 hours after.

    • Monitor for adverse reactions.

Glasgow Coma Scale Assessment

  • Eye-opening Response: 1-4 score.

  • Verbal Response: 1-5 score.

  • Motor Response: 1-6 score.

Pharmacology Highlights

Cardiovascular Medications

  • ACE Inhibitors: -pril, e.g., Lisinopril.

    • Monitor: cough, hypotension, renal function.

  • Beta Blockers: -lol, e.g., Metoprolol.

    • Monitor: heart rate, adverse effects in asthmatics.

Neurology Medications

  • Anticonvulsants: e.g., Phenytoin, Valproic acid.

    • Monitor: therapeutic levels, signs of toxicity.

Respiratory Agents

  • Albuterol & Ipratropium: For acute asthma attacks.

  • Corticosteroids: For chronic respiratory conditions, monitor fluid retention.

Leadership and Responsibilities

RN Delegation vs. LVN/PN Tasks

  • RN: Assessment and critical thinking.

  • LVN: Tasks within scope but cannot perform assessments.

Mental Health Nursing Interventions

Common Conditions

  • Delirium: Focus management on safety and reassurance.

  • Alzheimer’s Disease: 5 A's to assess cognitive decline.

Interventions for Substance Use Disorder

  • Withdrawal Assessment: Monitor for s/sx, provide supportive care.

  • Therapeutic communication: Maintain non-judgmental and empathetic dialogue.

Additional Notes

  • Patient Self-Management: Educate patients on medication management, side effects.

  • Infection Control: Emphasize hand hygiene and PPE during care.