Table of Contents
Cover image
Title page
Copyright
Contributing Authors
Reviewers
Preface
1. Introduction to Testing and the NCLEX-PN® Examination
The NCLEX-PN Licensing Examination
Administration of the NCLEX-PN
Tips for NCLEX-PN Success
2. Leadership and Management
Legal Aspects of Nursing
Review of Legal Aspects of Nursing
Answers to Review
Leadership and Management
Review of Leadership and Management
Answers to Review
Disaster Nursing
Review of Disaster Nursing
Answers to Review
3. Advanced Clinical Concepts
Respiratory Failure
Review of Respiratory Failure
Answers to Review
Shock
Disseminated Intravascular Coagulation
Review of Shock and DIC
Answers to Review
Resuscitation
Review of Resuscitation
Answers to Review
Fluid and Electrolyte Balance
Review of Fluid and Electrolyte Balance
Answers to Review
Electrocardiogram
Review of Electrocardiogram
Answers to Review
Perioperative Care
Review of Perioperative Care
Answers to Review
HIV Infection
Pediatric HIV Infection
Review of HIV Infection
Answers to Review
Pain
Review of Pain
Answers to Review
Death and Grief
Review of Death and Grief
Answers to Review
4. Medical-Surgical Nursing
Caring and Nursing
5. Pediatric Nursing
Growth and Development
Pain Assessment and Management in the Pediatric Client
Child Health Promotion
Review of Child Health Promotion
Answers to Review
Respiratory Disorders
Review of Respiratory Disorders
Answers to Review
Cardiovascular Disorders
Review of Cardiovascular Disorders
Answers to Review
Neuromuscular Disorders
Review of Neuromuscular Disorders
Answers to Review
Renal Disorders
Review of Renal Disorders
Answers to Review
Gastrointestinal Disorders
Review of Gastrointestinal Disorders
Answers to Review
Hematologic Disorders
Hemophilia
Review of Hematologic Disorders
Answers to Review
Metabolic and Endocrine Disorders
Review of Metabolic and Endocrine Disorders
Answers to Review
Skeletal Disorders
Review of Skeletal Disorder
Answers to Review
6. Maternity Nursing
A. NANDA-Approved Nursing Diagnoses and Definitions
B. Normal Values Index
Copyright
3251 Riverport Lane
St. Louis, Missouri 63043
HESI COMPREHENSIVE REVIEW FOR THE NCLEX-PN® EXAMINATION,
FIFTH EDITION ISBN: 978-0-323-42933-7
Copyright © 2018 by Elsevier, Inc. All rights reserved.
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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 1) on procedures featured or 2) 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 practitioners, relying on their own experience and knowledge of their patients, to make
diagnoses, determine dosages and the best treatment for each individual patient, and take all appropriate safety precautions.
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Previous editions copyrighted 2015, 2012, and 2008.
NANDA International Nursing Diagnoses: Definitions and Classifications 2012–2014; Herdman T.H. (Ed.); copyright © 2012, 1994–2012 NANDA
International; Published by John Wiley & Sons, Limited. NCLEX® , NCLEX-RN® , and NCLEX-PN® are Registered Trademarks of the National Council of State Boards of Nursing, Inc.
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Preface
Welcome to HESI Comprehensive Review for the NCLEX-PN® Examination with online study exams by HESI.
Congratulations! This outstanding review manual with the companion Evolve site is designed to prepare nursing students for what is likely the most important examination they will ever take, the NCLEX-PN Licensing Examination. As a graduate of a PN nursing program, the student has the basic knowledge required to pass tests and perform safely and successfully in the clinical area. HESI Comprehensive Review for the NCLEX-PN® Examination with the companion Evolve site allows the nursing student to prepare for the NCLEX-PN licensure exam in a structured way
• Organize basic nursing knowledge previously learned
• Review content learned during basic nursing curriculum.
• Identify weaknesses in content knowledge so that study efforts can be focused appropriately.
• Develop test-taking skills so application of safe nursing practice from knowledge can be demonstrated
• Reduce anxiety level by increasing ability to correctly answer NCLEX-type questions.
• Boost test-taking confidence by being well prepared and knowing what to expect.
Examination facilitates the critical-thinking process by posing the same type of questions the teacher might ask.
When students need to practice multiple-choice–style questions, the Study Exams offer extensive opportunities for practice and skill-building to improve their test-taking abilities The Study Exams contain seven content-specific exams (Medical-Surgical Nursing, Pharmacology, Pediatrics, Fundamentals, Maternity, Psychiatric-Mental Health Nursing, and Gerontology) and two comprehensive exams patterned after categories on the NCLEX. The Study Exams can be accessed as many times as necessary, and no questions are repeated For instance, the Medical-Surgical exam does not contain questions that are on the Pediatrics exam The purpose of providing these exams is to allow practice and exposure to the critical-thinking–style questions that students will encounter on the NCLEX. However, the Study Exams should not be used to predict performance on the NCLEX. Only the HESI Exit Exam a secure, computerized exam that simulates the NCLEX test plan and has evidenced-based results from numerous research studies indicating a high level of accuracy in predicting NCLEX success is offered as a true predictor of NCLEX performance. Students are allowed unlimited practice on each Study Exam so that they can have the opportunity to review all of the rationales for the questions.
Here is a plan for students to use with the companion Evolve site:
• Trial 1: Take the PN Practice Exam without studying for it to determine your areas of strengths and weaknesses.
• Trial 2: After going over the content that relates to the practice questions on a particular practice test (for instance, Pediatrics, Medical-Surgical, Maternity), review that section of the manual and take the test again to determine whether you have been able to improve your scores
• Trial 3: Purposely miss every question on the exam so that you can view rationales for every question.
• Trial 4: Take the exam again under timed conditions at the pace that you would have to progress to complete the NCLEX in the time allowed (approximately 1 minute per question) Find out whether being placed under timing constraints affects your performance.
• Trial 5: Put the exam away for a while and continue review and remediation with other textbook resources, results of any secure exams that you are taking at your school, and other study aids. Take the practice exams again after this study period to see whether your performance improves with in-depth study and a few weeks’ break from the questions
Trial 5 represents a good activity in preparation for the HESI Exit Exam presented in your final semester of the program, especially if you have not used the Evolve question site for several weeks. Repeated exposure to the questions, however, will make them less useful over time because students tend to memorize the answers For this reason, these tests are useful only for practice and are not a prediction of NCLEX-PN success. The tendency to memorize the questions after viewing them multiple times falsely elevates the student’s scores
on the study exams.
Additional assistance for students to study for the NCLEX-PN Licensing Examination can be obtained from a variety of products in the Elsevier family. Many nursing schools have also adopted the following resources:
• HESI Examinations a comprehensive set of examinations designed to prepare nursing students for the NCLEX exam. These enable customized remediation from Mosby and Saunders textbooks that saves time for faculty and students. Each student is given an individualized report detailing exam results and is allowed to view questions and rationales for items that were answered incorrectly. The electronic remediation, a complimentary feature of the HESI specialty and exit exams, can be obtained on the subject matter in which the student did not answer a question correctly.
• HESI-PN Practice Test a test that provides an introduction to real-world client situations with critical-thinking questions. These questions cover nursing care for clients with a wide range of physiologic and psychosocial alterations and a related coordination of client care, pharmacology, and nursing concepts.
• HESI Complete PN Case Study Collection prepares students to manage complex patient conditions and make sound clinical judgments. These online case studies cover a broad range of physiologic and psychosocial alterations, in addition to related coordination of care, pharmacology, and therapeutic concepts.
• HESI Live Review a Live Review Course presented by an expert faculty member who has received training by the Manager of Review Courses for Elsevier Review and Testing. Students are presented with a workbook and practice NCLEX-style questions that are used during the course
• eBooks online versions of the all Mosby and Saunders textbooks used in the student’s Nursing Curriculum. Search across titles, highlight, make notes, and more all on your computer.
• Elsevier Simulations using virtual clinical cases, standardized simulation scenarios, and electronic documentation software, Elsevier Simulations allow students to practice and apply skills in a controlled, monitored environment
• Evolve Courses created by experts using instructional design principles, this interactive content engages students with reading, animation, video, audio, interactive exercises, and assessments.
Introduction to Testing and the NCLEX-PN® Examination
The NCLEX-PN Licensing Examination
A. The main purpose of a licensing examination such as the NCLEX-PN is to protect the public.
B The NCLEX-PN is:
1 Developed by the National Council of State Boards of Nursing
2. Administered by the State Board of Nursing.
3. Designed to test the candidate’s capability for safe and effective nursing practice by measuring current, entry-level practical nursing behavior.
Job Analysis Studies
A. “Essential” knowledge on the NCLEX-PN test is determined by practice analysis studies.
B. Practical nurses (PNs or vocational nurses [VNs]) submit statements about the frequency of nursing activities and the related impact on client safety
HESI Hint
The 2015 LPN/VN Practice Analysis: Linking the NCLEX-PN Examination to Practice (Vol. 58) determines how frequently new practical nurses perform more than 150 types of nursing care activities From the analysis, the 2017 NCLEX-PN Test Plan (effective April 1, 2017) identifies four major client needs categories, and two of those categories are further divided into a total of six subcategories and five fundamental nursing processes. They provide a basis for establishing a minimum level of knowledge and skills for PNs to use with a diverse patient population, in any setting, and within the laws and rules of each state (Table 1.1, Client Needs, and Table 1.2, Practical/Vocational Nursing Processes).
HESI Hint
For more information on the NCLEX-PN Test Plan and content related to each category, go to www.ncsbn.org.
The Nursing Process and Nursing Diagnoses
A. PN role in the nursing process: Practical nurses use the nursing process to critically think and problem solve (see Table 1.2).
B Practical nurses assist the health care team to gather and organize data and recognize client needs and problems regardless of the client’s developmental stage or the health care setting. They also assist the RN in formulating nursing
diagnoses and developing plans of care
C. The National Conference of the North American Nursing Diagnosis Association (NANDA) guides nurses in the selection of nursing interventions for the purpose of achieving specific outcomes; outcomes and interventions are associated with specific diagnoses (Table 1 3, Components of a Nursing Diagnosis, and Appendix A, NANDA-Approved Nursing Diagnoses).
HESI Hint
A nursing diagnosis is not a medical diagnosis because a nursing diagnosis: Is subject to nursing management. May or may not come from a medical diagnosis. Is formulated and written by nurses. Is implemented from nursing orders (care plan and nursing interventions).
Prioritizing Nursing Care on NCLEX-PN
A. Many NCLEX-PN test items are designed to test your ability to set priorities.
B. Some examples include:
1. Identify the MOST IMPORTANT client needs.
2. Identify the MOST IMPORTANT nursing intervention.
3 Which nursing action should be done FIRST?
4. Which client should be cared for FIRST?
Examination Item Formats
A. Several different item types (alternate item formats) are presented on the NCLEX-PN examination.
TABLE 1.1
Client Needs with Threaded Integrated Processes: Caring, Clinical Problem Solving, Culture & Spirituality, Communication & Documentation, and Teaching & Learning
1.2
TABLE 1 3
Components of a Nursing Diagnosis
6. Ordered response items require a candidate to rank order or move options to provide the correct order of actions or events
7. Graphic format items require the candidate to choose the correct graphic in response to the question.
8. Audio format items require the candidate to listen to an audio clip using headphones and then select the correct option that applies to the audio clip
B. There is no set percentage of alternate items on the NCLEX-PN examination. All examination items are scored either right or wrong. There is no partial credit in scoring any examination questions.
Administration of the NCLEX-PN
A. The NCLEX-PN Computer Adaptive Testing (CAT) is administered at Pearson Professional Centers in the United States, selected by the National Council of State Boards of Nursing (NCSBN)
B Pearson VUE is responsible for adapting the NCLEX-PN examination to the CAT format, processing candidate applications, and transmitting test results to its data center for scoring.
C. The NCSBN generates the NCLEX-PN test items.
Understanding CAT
A. NCLEX-PN consists of 85 to 205 multiple-choice or alternative format items.
B. The candidate is presented with a test item.
1. If the question is answered correctly, a slightly more difficult item follows, and the level of difficulty increases with each item until an item is missed
2 If the question is answered incorrectly, a slightly less difficult item follows, and the level of difficulty decreases with each item until the candidate answers an item correctly.
C. The process continues until the candidate has achieved a definite “pass” or “fail” score. A message indicating that the candidate has completed the examination appears on the screen
D. The item number the candidate is currently answering appears in the upper right side of the screen.
E. The greatest number of items appearing on your examination is 205.
Taking the Test
A. A test administrator provides each candidate with an erasable note board that may be replaced as needed while testing. A candidate may not bring his or her own note boards, scratch paper, or writing instruments to the examination.
B. You must answer each question before proceeding to the next one. Returning to a question or skipping a question is not allowed during testing You will not be able to change an answer once you proceed to the next question; this works in your favor.
C. When taking the examination, read carefully and maintain a reasonable pace.
Time Frame and Breaks
A The candidate receives up to 5 hours to complete the examination The 5 hours include a tutorial, sample questions, breaks, and completion of the examination.
B. Two programmed optional breaks are given, one after 2 hours of testing and another after 3½ hours of testing. A candidate may take an unscheduled break at any time All breaks count against testing time
