PN 154 NCLEX Review

1. PN 154NCLEX Review Spring 2010 Instructor: Lisa Lee Rohm, RN, BSN Creator of this fabulous PowerPoint: Amber Lee, RN, BSN!!

2. Concorde’s Process • A preliminary “Candidate list” is made and sent to OSBN, who then sends the list to Pearson Vue • Applications (both for OSBN and Pearson Vue), fingerprinting, & passport photo will be sent by Concorde to the appropriate places • You may receive your Authorization to Test (ATT) prior to OSBN receiving the official transcripts, however if you take the exam before your transcripts are received, you will not receive a nursing license until after the entire process has been completed • On the graduation date, Concorde will send the official “Candidate List” to OSBN • When all of the grades and SIGNED (by you and the instructors) evaluation forms are turned in, the official transcripts will be sent to OSBN

3. Application Hints • Do not change your name or you appearance from the time you fill out the application and take your passport picture until you receive your license • Do not fill out the blue fingerprinting card until you are in the presence of the “fingerprinter” • For the fingerprinting day: • Make sure you are well hydrated and your hands are moisturized • If you have callouses, seriously consider a (wo)manicure

4. Application Hints (Just say, Yes!) • If you have any “yes” answers on your BON app. • A short, one paragraph, explanation is sufficient • On the chemical substances question, say “yes” even if you have a prescription. • The question reads “Have you ever been arrested, charged with, entered a plea of guilty, no contest, convicted of or been sentenced for ...” • Answer “yes” even if the record has been expunged (juvenile or adult) • If you say “no” and it somehow shows up on your background check, this will delay your process

5. How to apply for an Oregon Nursing License(step by step process) www.osbn.state.or.us/OSBN/newgraduates.shtml

6. How to apply for initial licensure in another state www.ncsbn.org (Click on “Boards of Nursing”, then “member boards,” then click on the state you want to be licensed in)

7. How to register for the NCLEX https://www.ncsbn.org/2009_NCLEX_Candidate_Bulletin.pdf or www.ncsbn.org/Eight_steps_of_NCLEX.pdf (for overview)

8. Scheduling Your Exam • Concorde will send OSBN a “Candidate list” who will then send Pearson Vue a “Candidate List” • After your board of nursing declares you eligible, you will receive your Authorization to Test (ATT) • Pearson Vue will mail each person their ATT. • After you receive your ATT, you may schedule your test with any Pearson Vue Testing Center (200 locations) • Oregon testing centers: Beaverton, Salem, Medford • Average test date is 27 days from the date of scheduling • You must take the exam within 90 days of receiving your ATT (but after graduation date 6/25/10)

9. Scheduling Your Exam • Each ATT is valid for the period of time specified by the board of nursing (BON) (90 days). • Once the BON has declared you eligible to test and your ATT is issued, you must test within the validity dates of your ATT. • These validity dates cannot be extended for any reason. If you do not test within these dates, you will have to re-register and you are responsible for the $200.00 payment.

10. Before the day of the test: • Expect and prepare for stress • Be prepared for others to leave the testing center before or after you • Bring water and snack to keep in the locker • Plan alternate routes to the testing facility • You can take a virtual tour of your testing facility by going to: www.pearsonvue.com/index • Do not carpool, do not make any other plans

11. Day of Test:Bring to Testing Center • ATT letter – You will not be admitted to the exam without your ATT. You will be required to re-register and re-pay to take the exam ($200.00). • 2 forms of ID, one with photo, both with signature • First and Last name must exactly match the name on your ATT letter • VALID Driver’s License or State ID or Passport (MUST NOT BE EXPIRED) and must include a photograph and signature • A small storage space is provided

12. Day of Test • Plan to arrive 30 minutes before your scheduled testing time. (If you arrive late you may be required to forfeit your appointment. Your failure to take the exam will be reported to the BON!) • The test administrator (TA) will provide you with an erasable note board that may be placed

13. Day of Test: Do Not Bring • Any study materials! • Hats, Scarves, Coats, Phones, Watches, Pager • Paper/Pen/Pencil/Calculator (Dry Erase Board, Marker, and Calculator are provided) • Do not take textbooks or notebooks containing NCLEX study materials to the test center as such items are considered prohibited testing aids; doing so may result in dismissal or cancellation of your testing results.

14. Day of Test • You will be fingerprinted, photo taken, and asked to illustrate your signature. • Earplugs provided if needed. • Clock starts as soon as you are “logged in”. • You have 5 hours to complete the NCLEX-PN. • You will receive a tutorial before the exam to familiarize you with the computer.

15. Day of Test • Optional Breaks provided at 2 hours, and at 3.5 hours • Breaks count against your testing time, when you return from break, you will be fingerprinted again • You will be asked to complete a survey at the end of the exam • Do not give any information about the exam to anyone, including instructors!

16. Day of Test • The test administrator (TA) will provide you with an erasable board that may be replaced as needed during testing. • The TA will give you a short orientation and then will escort you to a computer terminal. You must remain in your seat during the exam, except when authorized to leave by test center staff. • You may not change your computer terminal unless a TA directs you to do so.

17. Day of Test • Raise your hand to notify the TA if You: • Believe you have a problem with your computer • Need to change note boards • Need to take a break • Need the administrator for any reason • When you have finished the test and questionnaire, raise your hand. The TA will collect and inventory all note boards. • The TA will dismiss you when all requirements are fulfilled.

18. ~48 hours after the NCLEX • Results will not be released until the Board of Nursing receives you official transcripts from Concorde • Oregon License Verification (free): www.oregon.gov/OSBN or call 971-673-0679 • You may also obtain unofficial NCLEX exam results two business days after taking the exam by phone (1-900-776-2539) or on the web at www.pearsonvue.com/nclex. The cost is $7.95 via the website or $9.95 per phone call. • If results are taking longer than 2 weeks, contact the Board of Nursing

19. Common Questions and Myths About the NCLEX • Passing Score depends on what the average score of all people taking the test across the nation • There’s lots of drug questions • Can you have a piece of scratch paper/pencil/ calculator? • Passing Score is 77% • If you think you failed, you passed

20. Common Questions and Myths About the NCLEX • It is hard! • Can you take the NCLEX in another state? • How many times can you retake the exam? • Test-takers are selected randomly to take a certain number of questions. • If you miss a question on a particular subject, you will get more questions on that topic.

21. FYI • OSBN is now requiring that you notify them of name changes, address changes, email changes, employment changes, and lost card • You must work 960 hours/5 years (about 1 weekend a month) to maintain your license • May be any employment that is at a nurse level • May be volunteer work (if volunteer or self-employment, you are responsible for keeping track of your hours) • Your employer may narrow your scope of practice, but may not broaden your scope of practice

22. Test Breakdown • 85- 205 questions (There are thousands of questions in the test bank) • 25 pre-test questions on every NCLEX-PN exam (60 official plus 25 pre-test questions make up your first 85 questions) • Pre-test questions are written by nurses • Questions are reviewed by “Item Reviewers” who are nurses that are currently practicing nursing • Questions must be approved by a “Panel of Judges” • Then the questions will be “pre-test” questions • You will not know which questions count towards your exam

23. NCLEX Breakdown • Up to 5 hours to take the exam (Speed per question is not a factor in the final score, but figure approx. 1 minute per question) • Exam will end when: • At least the minimum number of questions (85) questions are answered and there is a 95% certainty the test-taker will pass or fail • Maximum number of questions (205) have been answered • Maximum time (5 hours) has passed

24. Pass or Fail? • It is impossible to take a test which will cover every subject, it would be way too long and take too much time. • Instead the computer decides based off your answers to a minimum amount of questions whether it is 95% certain you would pass or fail if you answered every question on every subject.

25. Passing with 95% Confidence

26. Failing with 95% Confidence

27. Pass or Fail? • After 85 questions the computer will begin to determine the 95% confidence • If at 85 questions, the test taker is not passing or failing, you will continue to answer questions until there is 95% confidence, on way or another. OR

28. Pass or Fail? • If the maximum number of questions (205) has been reached or 5 hours has passed, and the computer can still not determine a 95% confidence: • The computer will look back at the last 60 questions. • If at any point the test taker falls below the standard- the test taker fails. • If the test taker remains above the standard for the last 60 questions, they pass

29. Should you “give up” if you take more than 85 questions?

30. NO! • Stay focused. Relax. You still have plenty of opportunities to pass. • Test takers who took 205 questions have passed

31. Questions About How CAT works? • National Council of State Boards of Nursing, Inc. (NCSBN) • www.ncsbn.org • Toll free: 1.866.293.9600 • E-mail: nclexinfo@ncsbn.org

32. 2007 87% test takers passed on the first time 75% of all the test takers in 2007 passed the NCLEX 2008 85% of test takers have passed on the first time 78% of test takers have passed the NCLEX so far Pass Rates *Your best chance to pass is to take the exam sooner than later* (<1month)

33. What If I Fail? • You will receive a performance report in the mail, which will show you your weak areas • You may retake the exam after 45 days as many times as it takes for up to three years

34. NCLEX REVIEW NCLEX TEST PLAN www.ncsbn.org

35. Components of Test Plan • Each exam question addresses: • A level of cognitive ability • A client needs category • An integrated process

36. Levels of Cognitive Ability • Knowledge Recall • Comprehension • Application • Analysis

37. Levels of Cognitive Ability • Knowledge: recall • A nurse reviews the laboratory results of a client’s blood glucose level. The nurse knows that which of the following is a normal level? • 1.) 40mg/dL • 2.)100 mg/dL • 3.) 180 mg/dL • 4.) 220 mg/dL

38. Levels of Cognitive Ability • Knowledge: recall • A nurse reviews the laboratory results of a client’s blood glucose level. The nurse knows that which of the following is a normal level? • 1.) 40mg/dL • *2.)100 mg/dL • 3.) 180 mg/dL • 4.) 220 mg/dL

39. Levels of Cognitive Ability • Comprehension: understand information and draw inferences based on that information • A hospitalized client with Type 1 diabetes mellitus complains of hunger and nervousness and the nurse notes that the client is diaphoretic. The nurse understands that the client is most likely experiencing: • 1. anxiety related to the hospitalization • 2. signs related to an infection • 3. a hyperglycemic reaction • 4. a hypoglycemic reaction

40. Levels of Cognitive Ability • Comprehension: understand information and draw inferences based on that information • A hospitalized client with Type 1 diabetes mellitus complains of hunger and nervousness and the nurse notes that the client is diaphoretic. The nurse understands that the client is most likely experiencing: • 1. anxiety related to the hospitalization • 2. signs related to an infection • 3. a hyperglycemic reaction • *4. a hypoglycemic reaction

41. Levels of Cognitive Ability • Application: Intervention, nursing action, decision or problem that needs to be addressed • A client is experiencing a hypoglycemic reaction. The nurse administers which best item to the client to treat the reaction? • 1. water • 2. diet soda • 3. milk • 4. one sugar-free cookie

42. Levels of Cognitive Ability • Application: Intervention, nursing action, decision or problem that needs to be addressed • A client is experiencing a hypoglycemic reaction. The nurse administers which best item to the client to treat the reaction? • 1. water • 2. diet soda • *3. milk • 4. one sugar-free cookie

43. Levels of Cognitive Ability • Analysis: Consider/examine possibly several concepts in order to answer the question correctly • The nurse administers 10 units of Regular insulin at 0700 to a client with Type 1 diabetes mellitus. The nurse monitors the client most closely for a hypoglycemic reaction during which hours? • 1. 0900 to 1000 • 2. 1300 to 1900 • 3. 0900 to 1500 • 4. 1100 to 1200

44. Levels of Cognitive Ability • Analysis: Consider/examine possibly several concepts in order to answer the question correctly • The nurse administers 10 units of Regular insulin at 0700 to a client with Type 1 diabetes mellitus. The nurse monitors the client most closely for a hypoglycemic reaction during which hours? • *1. 0900 to 1000 • 2. 1300 to 1900 • 3. 0900 to 1500 • 4. 1100 to 1200

45. Client Needs • 1 Safe, effective care environment • 2. Health promotion and maintenance • 3. Psychosocial integrity • 4. Physiological integrity

46. Client Needs • Safe and Effective Care Environment • Coordinated Care • Safety and Infection Control • Health Promotion and Maintenance • Psychosocial Integrity • Physiological Integrity • Basic Care and Comfort • Pharmacologic Therapies • Reduction of Risk Potential • Physiological Adaptation

47. Clients are defined as individuals, families and significant others.

48. Safe and Effective Care • The practical nurse provides nursing care that contributes to the enhancement of the health care delivery setting and protects clients and health care personnel by: • Collaborating with health care team members to facilitate effective client care. • Contributing to the protection of clients and health care personnel from health and environmental hazards.

49. Safe and Effective Care Environment:Coordinated Care (12-18%) • Client Rights • Client includes individuals, families, and significant others • Advance Directives • Advocacy • Client Care Assignments (delegation) • Ethical Practice • Informed Consent • Information Technology

50. Safe and Effective Care Environment:Coordinated Care cont… • Legal Responsibilities • Collaboration with the Interdisciplinary Team • Concepts of Management and Supervision • Confidentiality/Information Security • Continuity of Care • Establishing Priorities • Performance Improvement/Quality Improvement • Referral Process • Resource Management • Staff Education