Quick Reference Guide to Strategies Alternate Item Formats, p. 30 Avoiding “Reading into the Question”, p. 42 Ingredients of the Question, p. 42 Strategic Words or Phrases, p. 46 The Subject of the Question, p. 47 Nursing Knowledge and the Process of Elimination, p. 48 Positive and Negative Event Queries, p. 52 Prioritization, p. 61 Strategic Words or Phrases, p. 64 The ABCs–Airway, Breathing, Circulation, p. 66 Maslow’s Hierarchy of Needs Theory, p. 67 The Steps of the Nursing Process (Clinical Problem-Solving Process), p. 70 Delegating and Assignment Making, p. 77 Time Management, p. 85 Communication, p. 87 Cultural Considerations, p. 90 Pharmacology, p. 100 Medications and Intravenous Calculations, p. 111 Closed-ended Words, p. 113 Medical vs. Nursing Interventions, p. 115 Comparable or Alike Options, p. 116 Parts of an Option, p. 117 Umbrella Option, p. 117 Laboratory Values, p. 118 Visualizing the Information, p. 121 Client Positioning, p. 122 Therapeutic Diets, p. 124 Disasters, p. 129 SAUNDERS 2014–2015 for PASSING NURSING SCHOOL and the NCLEX® EXAM Even More Questions on ! http://evolve.elsevier.com/Silvestri/strategies/ Evolve Access Code: How to Use the Online Practice Questions Customize your study session for your time and your own unique needs Study Mode Receive immediate feedback after each question Select questions by Strategy, Client Needs, Integrated Process, Alternate Item Format Type, or specific Content Area. The answer, rationale, test-taking strategy, question codes, and reference source(s) for further remediation appear immedi- ately after you answer each question. Exam Mode Take a practice exam, and receive your results and feedback at the end Select questions by Strategy, Client Needs, Integrated Process, Alternate Item Format Type, or specific Content Area. Then select the number of questions you'd like to take in your exam—10, 25, 50, or 100. When you've finished the exam, the percentage of questions you answered correctly will be shown in a table, and you can go back to review the correct answers—as well as rationales, test-taking strate- gies, question codes, and reference(s)—for each question. CHAPTER 2 iii SAUNDERS 3 2014–2015 EDITION for Passing Nursing School and the NCLEX® Exam Linda Anne Silvestri, PhD, RN Instructor of Nursing Salve Regina University Newport, Rhode Island President Nursing Reviews, Inc. and Professional Nursing Seminars, Inc. Charlestown, Rhode Island Instructor NCLEX-RN® and NCLEX-PN® Review Courses Angela Silvestri, RN, MSN Graduate Assistant, School of Nursing University of Nevada, Las Vegas Las Vegas, Nevada 3251 Riverport Lane St. Louis, Missouri 63043 SAUNDERS 2014-2015 STRATEGIES FOR TEST SUCCESS: PASSING NURSING SCHOOL AND THE NCLEX® EXAM ISBN: 978-1-4557-3319-4 Copyright © 2014, 2010, 2005 by Saunders, an imprint of 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 organiza- tions 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 treat- ment 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, includ- ing 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 practitioners, relying on their own experience and 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, instruc- tions, 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. Library of Congress Cataloging-in-Publication Data or Control Number Silvestri, Linda Anne. Saunders 2014-2015 strategies for test success: passing nursing school and the NCLEX exam / Linda Anne Silvestri, Angela Silvestri. – 3rd ed. p. ; cm. 2014-2015 strategies for test success Saunders strategies for test success Rev. ed. of: Saunders strategies for test success / Linda Anne Silvestri. 2nd ed. c2010. Includes bibliographical references and index. ISBN 978-1-4557-3319-4 (pbk. : alk. paper) I. Silvestri, Angela E. II. Title. III. Title: 2014-2015 strategies for test success. IV. Title: Saunders strate- gies for test success. [DNLM: 1. Nursing Care–methods–Examination Questions. 2. Nursing Process–Examination Questions. 3. Test Taking Skills–methods–Examination Questions. WY 18.2] 610.73076–dc23 2012050954 Executive Content Strategist: Kristin Geen Associate Content Developmental Specialist: Laura Goodrich Content Coordinator: Hannah Corrier Publishing Services Manager: Jeff Patterson Project Manager: Bill Drone Design Direction: Brian Salisbury Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 To all nursing students, Your commitment to becoming successful and your dedication to the profession of nursing will bring never-ending rewards! Intentionally left as blank 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 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 psychiatric nursing to RN and LPN students at the Community College of Rhode Island. Later in 1994, I began teaching nursing at Salve Regina University in Newport, Rhode Island, and remain there as an adjunct faculty member. My experiences as a student, nursing educator, and item writer for the NCLEX exams aided me as I developed a comprehensive review course to prepare nurs- ing students and graduates for the NCLEX examination. In 1991, I established Professional Nursing Seminars, Inc., and in 2000, I started Nursing Reviews, Inc. Both companies are dedicated to conducting review courses for the NCLEX-RN and the NCLEX-PN examinations and assisting nursing graduates to achieve their goals of becoming Registered Nurses and/or Licensed Practical/Vocational Nurses. Today, I conduct review courses for NCLEX examinations throughout New England and am the author of numerous successful review products. I am so pleased that you have decided to let me join you in your journey to success in testing for nursing examinations and for the NCLEX examination! vii viii About the Authors Angela Silvestri, RN, MSN When asked what I wanted to do with my life and as a career, I always answered that I wanted to work in the medical field. At first my ambition was to become a physician; however, learning that nurses interact with their patients more often than physicians do swayed me to pursue nursing. While in nursing school, I worked as a tutor for my peers. I realized how much I enjoyed doing this and how much of a difference my help made in these students’ college careers and ultimately their lives. I received my baccalaureate degree in Nursing and Sociology at Salve Regina University in Newport, Rhode Island. After earning my degree, I worked in long- term care, rehabilitation, and acute care settings. I then went on to earn my mas- ter's degree in Nursing Education at the University of Nevada, Las Vegas.