Saunders 2018-2019 Strategies for Test Success Passing Nursing School and the NCLEX® Exam FIFTH EDITION Linda Anne Silvestri, PhD, RN Instructor of Nursing, Salve Regina University, Newport, Rhode Island President Nursing Reviews, Inc., Henderson, Nevada Elsevier Consultant, HESI NCLEX-RN® and NCLEX-PN® Live Review Courses Angela Silvestri, PhD, RN, CNE Assistant Professor, University of Nevada, Las Vegas, Las Vegas, Nevada Associate Editor Marilyn Greer, MS, RN Associate Professor of Nursing, Rockford College, Rockford, Illinois 2 Table of Contents Instructions for online access Cover image Title page Copyright Dedication About the Authors Contributors Reviewers Preface Welcome to Saunders Pyramid to Success! Organization Special Features of the Book How to Use This Book RN Products PN Products Acknowledgments Chapter 1: Preparing for Nursing Examinations When and Why Are Nursing Exams Administered? The Beginning Nursing Student: What Should You Think About? What Can You Expect on Nursing Exams? Your Course Syllabus: Why Is It Important? How Can You Best Use Your Textbook to Get Ready for a Nursing Exam? Classroom Notes: How Can You Best Use Them? Study Guides Study Groups Standardized Testing: Why Is It So Important? 3 Chapter 2: Developing Study Skills What Are Good Study Skills? How Do You Identify and Plan Your Study Times? What Study Habits Do You Need to Develop? What Study Skills Are Important? When Should You Start to Study for an Exam? Will a Study Group Work for You? Chapter 3: Reducing Test Anxiety What Is Test Anxiety? How Can You Know If You Have Test Anxiety? What Causes Test Anxiety? What Will Help Prevent Test Anxiety? What Can You Do When You Are Experiencing Test Anxiety? What Is Positive Pampering, and Why Is It Important? What Should You Do the Night Before the Exam? How Can You Control Your Test Anxiety Before the Exam? How Can You Control Your Test Anxiety During the Exam? That Positive Attitude: How Can You Maintain It? Chapter 4: NCLEX® Preparation Where Does Preparation Begin? The NCLEX Test Plan: Why Is It So Important? What Are the Steps for Preparing? Chapter 5: Alternate Item Formats Introduction What Is an Alternate Item Format? What Test-Taking Strategies Are Helpful for Answering Fill-in-the-Blank Questions? What Test-Taking Strategies Are Helpful for Answering Multiple Response Questions? What Test-Taking Strategies Are Helpful for Answering Prioritizing (Ordered Response) Questions? What Test-Taking Strategies Are Helpful for Answering Figure/Illustration Questions? What Test-Taking Strategies Are Helpful for Answering Chart/Exhibit Questions? What Test-Taking Strategies Are Helpful for Answering Graphic Item Option Questions? What Test-Taking Strategies Are Helpful for Answering Audio or Video Questions? What Test-Taking Strategies Are Helpful for Answering Testlet (Case Study) Questions? Chapter 6: How to Avoid “Reading into the Question” Clinical Reasoning Ingredients of a Question Strategic Words or Strategic Phrases The Subject of the Question 4 Using Nursing Knowledge and the Process of Elimination Chapter 7: Positive and Negative Event Queries Positive Event Queries Negative Event Queries Chapter 8: Questions Requiring Prioritization Prioritizing Priority Classification System Strategic Words or Strategic Phrases The ABCs Maslow’s Hierarchy of Needs Theory Nursing Process (Clinical Problem-Solving Process) Chapter 9: Leading and Managing, Delegating, and Assignment-Making Questions Delegation and Assignment-Making Time Management Chapter 10: Communication Questions How Are Communication Concepts Tested in a Question? What Guidelines Can Be Used to Answer Communication Questions? Communication Techniques Why Are Cultural Considerations Important? Other Cultural Considerations Sample Communication Questions Chapter 11: Pharmacology, Medication, and Intravenous Calculation Questions Pharmacology: General Guidelines to Follow Pharmacology: Assessment/Data Collection Guidelines Pharmacology: Assessment/Data Collection Guidelines to Follow Medication Effects Medication Names Medication Classifications Commonalities in Medication Names What Strategies Will Help When Answering Medication and Intravenous Calculation Questions? Chapter 12: Additional Pyramid Strategies Eliminating Options That Contain Closed-Ended Words: How Will This Help? Eliminating Options That Contain Medical Rather Than Nursing Interventions: How Will This Help? Eliminating Comparable or Alike Options: How Will This Help? Ensuring That All Parts of an Option Are Correct: How Will This Help? Selecting the Umbrella Option: How Will This Help? 5 What Strategies Will Help When Answering Questions Related to Laboratory Values? Visualizing the Information in the Case Event, Question Query, and Options: How Will This Help? Looking for Concepts in the Question That Are Comparable or Alike to a Concept in One of the Options: How Will This Help? What Strategies Will Help When Answering Questions Related to Client Positioning? What Strategies Will Help When Answering Questions Related to Therapeutic Diets? What Strategies Will Help When Answering Questions Related to Disasters? Chapter 13: Fundamentals of Care Questions Chapter 14: Adult Health Questions Chapter 15: Mental Health Questions Chapter 16: Maternity Questions Chapter 17: Pediatric Questions Chapter 18: Pharmacology Questions Chapter 19: Delegating/Prioritizing Questions Chapter 20: Leadership/Management Questions References Index 6 Copyright 3251 Riverport Lane St. Louis, Missouri 63043 Saunders 2018–2019 Strategies for Test Success, Fifth Edition ISBN: 978-0-323-47960-8 Copyright © 2018 by Elsevier, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and the knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. NCLEX®, NCLEX-RN®, and NCLEX-PN® are registered trademarks of the National Council of State Boards of Nursing, Inc. Previous editions copyrighted 2016, 2014, 2010, and 2005. International Standard Book Number: 978-0-323-47960-8 Senior Content Strategist: Jamie Blum Senior Content Development Manager: Laurie Gower 7 Senior Content Development Specialist: Laura Goodrich Publishing Services Manager: Jeff Patterson Book Production Specialist: Bill Drone Designer: Bridget Hoette Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 8 Dedication To all nursing students, your commitment to becoming successful, and your dedication to the profession of nursing, will bring never-ending rewards! 9 About the Authors Linda Anne Silvestri, PhD, RN As a child, I always dreamed of becoming either a nurse or a teacher. Initially I chose to become a nurse because I really wanted to help others, especially those who were ill. Then I realized that both of my dreams could come true: I could be both a nurse and a teacher. So, I pursued my dreams. I received my diploma in nursing at Cooley Dickinson Hospital School of Nursing in Northampton, Massachusetts. Afterward, I worked at Baystate Medical Center in Springfield, Massachusetts. While there, I cared for clients in acute medical-surgical units, the intensive care unit, the emergency department, pediatric units, and other acute care units. Later I received an Associate Degree from Holyoke Community College in Holyoke, Massachusetts; my BSN from American International College in Springfield, Massachusetts; and my MSN from Anna Maria College in Paxton, Massachusetts, with a dual major in Nursing Management and Patient Education. I received my PhD in Nursing from the University of Nevada, Las Vegas, and conducted and published research on self-efficacy and the predictors for NCLEX® success. I am also a member of the Honor Society of Nursing, Sigma Theta Tau International, Phi Kappa Phi, the American Nurses Association, the National League for Nursing, the Western Institute of Nursing, the Eastern Nursing Research Society, and the Golden Key International Honour Society. Additionally, I received the 2012 Alumna of the Year/Nurse of the Year Award from the University of Nevada, Las Vegas, School of Nursing. As a native of Springfield, Massachusetts, I began my teaching career as an instructor of medical- surgical nursing and leadership-management nursing at Baystate Medical Center School of Nursing in 1981. In 1989, I relocated to Rhode Island and began teaching medical-surgical nursing and 10