Hesi hints

Chapter 1 the NCLEX examHESI Hint Most questions are written in a positiveStyleHESI Hint Negative style questions will contain key words that denote the negative style.EXAMPLES1. Which response indicates to the nurse a need to re-teach the client about? (Which information/understanding by the client is incorrect?)2. Which prescription (order) should the nursequestion? (Which prescription is unsafe, not beneficial, inappropriate to this client situation, etc?)HESI Hint The Council wants to ensure that thelicensing exam measures current entry-level nursing behaviors. For this reason, job analysis studies are conducted every 3 years. These studies determine howfrequently various types of nursing activities are performed, how often they are delegated, and how critical they are to client safety, with criticality given more value than frequencyHESI Hint A nursing diagnosis is not a medicaldiagnosis. It must be subject to oversight by nursing management. The cause may or may not arise from a medical diagnosis.HESI Hint Answering NCLEX-RN questionscorrectly often depends on setting priorities properly, on making judgments about priorities, and on analyzing the case and formulating a decision about care (or the correct response) based on priorities. Using Maslows Hierarchy of Needs can help you to set priorities.HESI Hint One or more of the choices are likely to be very wrong. You usually will be able to rule out two of the four choices rather quickly. Reread the question and choices again if necessary. Ask yourself which choice answers the question being asked. Even if you have absolutely no ideawhat the correct answer is, you will have a 50/50 chance of guessing the right answer if you follow this process.Your first response will provide an educated guess and will usually be the correct answer. Go with your gut response!Pace yourself from the beginning of the test. Allowapproximately 1.5 minutes per question.HESI Hint The NCSBN Candidate Bulletin isavailable at http://www.ncsbn.org.Then select: Examinations/Candidates/BasicInformation/Bulletin.HESI Hint The night before taking the NCLEX-RN, allow only 30 minutes of study time. This 30-minute period should be designated for review of test-taking strategies only. Practice these strategies with variouspractice test items if you wish (for 30 minutes only; do not take an entire test). Spend the night before the exam doing something you enjoy, something that promotes stress reduction, something that does not involve alcohol or other mind-altering drugs. Only you can identify the special something that will work for you. Remember, you can be successful!HESI Hint Often an NCLEX-RN question askswho should explain a surgical procedure to the client.The answer is the health care provider. Rememberthat it is the nurses responsibility to be sure that the operative permit is signed and is on the chart. It is not the nurses responsibility to explain the procedure to the client.Chaper 2 leadership/mgmtHESI Hint Often questions are asked regarding the Good Samaritan Act, which is the means of protecting a nurse when she or he is performing emergency care.HESI Hint If the nurse carries out a health careproviders prescription for which he or she is notprepared and does not inform the health care provider of his or her lack of preparation, the nurse is solely liable for any damages.If the nurse informs the health care provider of his or her lack of preparation in carrying out a prescription and carries out the prescription anyway, the nurse and the health care provider are liable for any damages.HESI Hint Restraints of any kind may constitutefalse imprisonment.Freedom from unlawful restraint is a basic human right and is protected by law.HESI Hint Assignments are often tested on theNCLEX-RN. The Nurse Practice Acts of each stategovern policies related to making assignments. Usually,when determining who should be assigned to do a sterile dressing change, for example, a licensed nurse should be chosenthat is, an RN or licensed practical nurse (LPN) who has been checked off on this procedure.HESI Hint Assertive communication starts withI need rather than with You must.HESI Hint Motivation comes from within anindividual. A nurse leader can provide an environment that will promote motivation through positive feedback, respect, and seeking input. Look for responses that demonstrate these behaviors.BOX 2-1 Skills and Characteristics of theNurse ManagerSkills of the Nurse ManagerCharacteristics ofthe Nurse ManagerCommunicationAct as a liaison between clientsand others.Engage in conflict resolution asneeded with staff.AuthorityOrganizationPlan overall strategies to addressclient problems.Review management outcomes.AccountabilityDelegationIdentify roles/responsibilities ofhealth care team members.ResponsibilitySupervisionSupervise care provided by others(e.g., LPN/VN[vocational nurse],assistive personnel, other RNs).LeadershipCritical thinkingServe as resource person toother staff.Commitment toqualityClassic Leadership StylesBehavior AssociatedWith Leadership StylesDemocratic (participative) AssertiveAuthoritarian (autocratic) AggressiveLaissez-faire (permissive) PassiveHESI Hint Effective leadership involves assertivemanagement skills. Look for responses that demonstrate that the nurse is using assertive communication skills.HESI Hint NCLEX-RN questions often includeexamples of nursing interventions that do or do notdemonstrate these skills and characteristics.HESI Hint Delegating to the right person requiresthat the nurse be aware of the qualifications of thedelegatee: Appropriate education, training, skills,experience, and demonstrated and documentedcompetence.HESI Hint UAPs generally do not perform invasive or sterile procedures.HESI Hint The RN is accountable for adhering tothe three basic aspects of supervision when delegating to other health care personnel, such as LPNs, graduate nurses, inexperienced nurses, student nurses, and UAPs.HESI Hint Remember the nursing process:Assessments, analysis, diagnosis, planning, and evaluation (any activity requiring nursing judgment) may not be delegated to UAP. Delegated activities fall within the implementation phase of the nursing process.HESI Hint Priorities often center on which clientshould be assessed first by the nurse. Ask yourself: Whichclient is the most critically ill? Which client is most likely to experience a significant change in condition? Which client requires assessment by an RN?HESI Hint The nurse manager must analyze allthe desired outcomes involved when assigning rooms for clients or assigning client care responsibilities.A client with an infection should not be assigned toshare a room with a surgical or immunocompromised client. A nurses client care management should be based on the nurses abilities, the individual clients needs, and the needs of the entire group of assignedclients. Safety and infection control are highpriorities.Lewins Change TheoryNurses Act as ChangeAgents, Which Involves:Unfreezing Initiation of a changeMoving Motivation toward a changeRefreezing Implementation of a changeHESI Hint Change causes anxiety. An effective nurse change agent uses problem-solving skills to recognize factors such as anxiety that contribute to resistance to change and uses decision-making and interpersonal skills to overcome that resistance. Interventions that demonstrate these skills include seeking input, showingrespect, valuing opinions, and building trustHESI Hint It is important to remember that indisaster and bioterrorism management, the nurse must consider both the individual and the community.Chapter 3 advance clinical conceptsHESI Hint ARDS is an unexpected, catastrophicpulmonary complication occurring in a person with no previous pulmonary problems. Clients are critically ill and are managed in an intensive care setting. The mortality rate is high (50%).HESI Hint Interventions to prevent complications of clients on mechanical ventilation with ARDS: Elevate head of bed (HOB) to at least 30 degrees. Assist with daily awakening (sedation vacation). Implement a comprehensive oral hygiene program. Implement a comprehensive mobilization program.HESI Hint Suction only when secretions are presentHESI Hint Before drawing a sample for ABGsfrom the radial artery, perform the Allen test to assess collateral circulation. Make the clients hand blanch by obliterating both the radial and the ulnar pulses. Thenrelease the pressure over the ulnar artery only. If flow through the ulnar artery is good,flushing will be seen immediately. The Allen test is then positive, and the radial artery can be used for puncture. If the Allen test is negative, repeat on the other arm. If this test is also negative, seek another site for arterial puncture. The Allen test ensures collateral circulation to the hand if thrombosis of the radial artery should follow the puncture.HESI Hint Cardinal signs of Acute RespiratoryFailure in children are Restlessness, Tachypnea,Tachycardia, and Diaphoresis.HESI Hint Pco2 >45 or Po2