8 Essential Concepts 4 NCLEX RN-4

8 Essential Concepts 4 NCLEX RN
1. INFECTION CONTROL: Know if it’s Standard, Contact, Droplet or

Airborne.
You can put 2 people in the same room if they have the same bacteria or virus
UNLESS there is something else going on with the individual then place in a
private room.
*Bacteria Example: Person with glomeronephrititis & strep could go in the same
room because they’re both caused by the streptococcal bacteria.
*Virus Example: Shingles & Chickenpox because they’re caused by the same virus.
Example: If a client with a decubitus ulcer had shingles then they would get the
private room.
USUALLY ON NCLEX AIRBORNE PRECAUTION WOULD GET THE PRIVATE ROOM.
2. DELEGATION: WHAT YOU CAN & CAN NOT DELEGATE
WHAT YOU CAN DELEGATE
*Things that FREQUENTLY OCCUR (Having LPN administering meds)
*Things that are technical by nature (Having LPN change foley catheter)
*Standard/Stable & Unchanging things (Make sure client is stable)
*Things that have predictable results (Like a sliding scale for insulin)
*Things that have minimal potential for risk

WHAT YOU CAN NOT DELEGATE
*New admissions or assessments

*Teaching
*Management
*Discharges
FYI: Don’t delegate PICC line could cause infection in bloodstream = sepsis
3. PRIORITIZATION: Acute vs Chronic & Sypmtom of Disease

*Acute vs Chronic
When NCLEX gives you 1 particular disease process (ex. Diabetes) if all the answer
choices deal with that particular topic, then you pick the ACUTE SYMPTOM over
the chronic symptom.
EXAMPLE: A Diabetic with poor vision, 40% heart blockage is NORMAL
Acute Symptom: A Diabetic all of a sudden is cold/clammy or unconscious which

IS NOT NORMAL so on NCLEX YOU’D PICK THIS ANSWER CHOICE
CHRONIC: SOMETHING THAT YOU LIVE WITH DAY TO DAY THAT’S CONTROLLED
BY MEDICATION.
**FYI** When the NCLEX gives you 4 different disease processes at you NEVER
pick the symptom of disease.
EXAMPLE: Diabetic has tingling in extremities DO NOT pick this answer because
it’s NORMAL
EXAMPLES: Don’t pick COPD with pursed-lip breathing because it’s NORMAL
Lung cancer client with BP 90/60 is NOT NORMAL. PICK IT THAT’S YOUR ANSWER
***PICK ACUTE OVER CHRONIC & PICK THE SYMPTOM THAT DOES NOT GO
WITH THE DISEASE
4. PAIN
For NCLEX pain IS USUALLY NOT the answer HOWEVER every once in a while it
is!
 Pain is a psychosocial need that always comes after a physiological needs

 If there’s no physiological need in the answer choices & you can narrow it
down to 2 pain answers. Pick the answer that is more precise
 Whenever you see a pain level & a scale PICK IT THAT’S YOUR ANSWER
EXAMPLE: Client with Ulcerative Colitis with bloody diarrhea (NORMAL DO NOT
PICK IT)
VS
Headache pain Level 7 on Scale from 1-10 (THIS IS YOUR ANSWER)
Example #2 Ulcerative Colitis with 4 episodes of bloody diarrhea in 6hrs

(ABNORMAL)
VS
Headache with pain Level 7 on scale from 1-10
DO NOT PICK PAIN IN THIS INSTANCE BECAUSE THERE IS A PHYSIOLOGICAL

NEED THAT’S ABNORMAL
5. TRIAGE: Use T.R.A.U.M.A. acronym
T = Trauma
R = Respiratory
I = Intrcranial Pressure/Mental Status
A = And Infection
G = GI Wounds
E = Extremities
 Internal Forward (AT THE HOSPITAL)
 External Backwards (AT THE SCENE OF ACCIDENT) Take the acronym & go
backwards
At the scene (EXTERNAL) help the least injured first. You’re helping the most
amount of people in the least amount of time. We do NOT do CPR! Only thing we
check for is a pulse.
First help the person that can move (ex has broken EXTREMITIES) Give Green Tag
2nd G = Person with GI Wounds (limb stuck in stomach)
3rd A = Person with an Infection
4th I = Person with Intracranial Pressure/Mental Confusion (laceration to head)
5th R = Person with Respiratory Issue
Last T= Person with Trauma (Usually get a black tag)
At the hospital (INTERNAL) Follow the T.R.I.A.G.E in order

6. Dealing with the Doctor
Most the time calling the Doctor is NOT answer
Call the Doctor when:

*You have an unexplained weight loss or gain
* You need to clarify an order
* When you see severe side effects of a medicine & signs of toxicity
UNLESS IT’S OF THESE 3 DO NOT PICK IT
7. THERAPUTIC COMMUNICATION
1. Don’t ask “WHY” questions
2. Don’t patronize (Oh you’ll be fine, everyone is) Don’t compare to others
3. Mirror or paraphrase what client says to you (keeps convo open-ended)
4. Assess the needs of the caregiver (What has your family done to help you)
5. Include clients & caregivers when possible (Ex. Mother is demanding baby to
stop crying. You say “Lets see how she responds when you use a softer tone)
6. Don’t be judgemental. Stay neutral
7. MULTI-DISCIPLINARY TEAMWORK
1. COMMUNICATION: ALWAYS FIRST communicate team leader to team

leader
2. COLLABORATION:
3. SHARED RESPONSIBILTY:
*Pick client who needs the most team members of the multi=disciplinary team.
Don’t think or pick most critical client

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8 Essential Concepts 4 NCLEX RN

1. INFECTION CONTROL: Know if it’s Standard, Contact, Droplet or

USUALLY ON NCLEX AIRBORNE PRECAUTION WOULD GET THE PRIVATE ROOM.

2. DELEGATION: WHAT YOU CAN & CAN NOT DELEGATE

WHAT YOU CAN DELEGATE

*Things that FREQUENTLY OCCUR (Having LPN administering meds)

*Standard/Stable & Unchanging things (Make sure client is stable)

*Things that have minimal potential for risk

*New admissions or assessments

3. PRIORITIZATION: Acute vs Chronic & Sypmtom of Disease

EXAMPLE: A Diabetic with poor vision, 40% heart blockage is NORMAL

Acute Symptom: A Diabetic all of a sudden is cold/clammy or unconscious which

 Pain is a psychosocial need that always comes after a physiological needs

Headache pain Level 7 on Scale from 1-10 (THIS IS YOUR ANSWER)

Example #2 Ulcerative Colitis with 4 episodes of bloody diarrhea in 6hrs

Headache with pain Level 7 on scale from 1-10

DO NOT PICK PAIN IN THIS INSTANCE BECAUSE THERE IS A PHYSIOLOGICAL

I = Intrcranial Pressure/Mental Status

2nd G = Person with GI Wounds (limb stuck in stomach)

3rd A = Person with an Infection

4th I = Person with Intracranial Pressure/Mental Confusion (laceration to head)

5th R = Person with Respiratory Issue

Last T= Person with Trauma (Usually get a black tag)

At the hospital (INTERNAL) Follow the T.R.I.A.G.E in order

Most the time calling the Doctor is NOT answer

Call the Doctor when:

* You need to clarify an order

UNLESS IT’S OF THESE 3 DO NOT PICK IT

1. COMMUNICATION: ALWAYS FIRST communicate team leader to team

Don’t think or pick most critical client

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