Verify! When assessing a client, the nurse must verify the assessment with objective data.
Don’t Give Up. Saying “This is too hard” won’t help you.
Don’t Raise Your Voice. You can’t argue with the NCLEX-RN exam.
Strategy One: Maslow
Maslow’s hierarchy of needs is crucial to establishing priorities on the NCLEX-RN exam. Maslow identifies five levels of human needs: PHYSIOLOGICAL, SAFETY AND SECURITY, LOVE AND BELONGING, ESTEEM, AND SELF-ACTUALIZATION.
Use Maslow’s Needs to Establish Priorities
The first strategy to use in establishing priorities is a four-step process, beginning with Maslow’s hierarchy. To use the Maslow strategy, you must first recognize the pattern in the answer choices.
Step1. Look at your answer choices.
If answer choices are both physical and psychosocial, it’s time to “Maslow” the answer choices.
Step2. Eliminate all psychosocial answer choices. If an answer choice is physiological don’t eliminate it yet. Remember, Maslow states that physiological needs must be met first. While pain certainly has a physiological component, reactions to pain are considered “psychosocial” on this exam and will become a lower priority.
Step3. Ask yourself: Does this choice make sense?
Next, consider each of the remaining answer choices. Take the time to read each choice carefully and ask yourself, “Does this answer make sense with regard to the disease or situation as described in the question?” If it makes sense as an answer choice, keep it for consideration and go on to the next choice.
Step4. Can you apply the ABCs?
Look at the remaining answer choices. Can you apply the ABCs? The ABCs mean airway, breathing and circulation. If there is an answer that involves maintaining a patent airway, it will be correct. If not, is there a choice that involves breathing problems? It will be correct. If not, go on with the ABCs. Is there an answer pertaining to the cardiovascular system? It will be correct. What if the ABCs don’t apply? Compare the remaining answer choices and ask yourself, “What is the highest priority?” This is your answer.
Think ABCs. Airway, Breathing, Circulation.
Physical Needs First. Eliminate psychosocial needs.
Remember to Breath. Physiological needs are most important. Psychosocial needs can be eliminated.
Strategy Two: Assessment Versus Implementation
ASSESSMENT is the process of establishing a data profile about the client and his or her health problems. The nurse obtains subjective and objective data in a number of ways: talking to clients, observing clients and/ or significant others, taking a health history, performing a physical examination, evaluating lab results, and collaborating with other members of the healthcare team.
Once you collect the data you compare it to the client’s baseline or normal values. On the NCLEX-RN exam, the client’s baseline may not be given, but as a nursing student you have acquired a body of knowledge. On this exam you are expected to compare the client information you are given to the “normal” values learned from your nursing textbooks.
ASSESSMENT is the first step of the nursing process and takes priority over all other steps. It is essential that you complete the assessment phase of the nursing process before you implement nursing activities. This is a common mistake made by NCLEX-RN exam takers: don’t implement before you assess. For example, when performing CPR, if you don’t access the airway before performing mouth-to-mouth resuscitation, your actions may be harmful!
Nursing Process. Assess, Analyze, Plan, Implement, Evaluate.
Assess First. Always assess before you implement.
You’ve Got the Power. On the NCLEX-RN exam, always assume that you have a physician’s order to intervene.
IMPLEMENTATION is the care you provide to your clients. Implementation includes: assisting in the performance of activities of daily living (ADL); counseling and educating the client and the client’s family; giving care to clients; supervising and evaluating the work of other members of the health team.
Step1. Read the answer choices to establish a pattern. You can use the assessment/validation versus implementation strategy.
Step2. Refer to the question to determine if you should be assessing or implementing. According to the nursing process, you should assess first.
Think Before You Act. Action doesn’t always mean implementation.
Strategy Three: Safety
Nurses have the responsibility of ensuring the safety of clients. This includes clients in healthcare facilities, in the home, at work, and in the community. Safety includes: meeting basic needs (oxygen, food, fluids, etc.), reducing hazards that cause injury to clients (accidents, obstacles in the home), and decreasing the transmission of pathogens (immunizations, sanitation).
Remember the NCLEX-RN exam is a test of minimum competency to determine that you are able to practice safe and effective nursing care. Always think safety when selecting correct answers on the exam. When answering questions about procedures, this strategy will help you establish priorities.
Do No Harm. Decide what will cause the least amount of harm.
It’s as Easy as 1,2,3. Always prioritize: Maslow, Nursing process, Safety
