As a Medic, this is one of the biggest adjustment I had to get through. I still have issues, BUT I have a good grasp on it! Unlike Medic test that formed from EMS protocols, nursing test are formed from "nursing theory". Nursing theory is listed as "rationales", and a question is formed from that rationale. Questions may invoke Maslow Hierarchy of Needs aka Prioritization, Delegation, Nursing Care Plan Assessment, Diagnosis, Planning, Intervention, Evaluation, & Education.
For Example:
A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees no electrocardiographic complexes on the screen. Which is the priority action of the nurse?
1.Call a code.
2.Call the health care provider.
3.Check the client's status and lead placement.
4.Start Chest compressions.
My Medic brain said: "Start compressions!" There are 2 correct answers. Which one is MORE right?
The answer is 3. The rationale is that "Sudden" loss of EC Complexes is imply ventricular asystole or improper lead placement! It's all critical thinking! Keyword: PRIORITY .....so my nurse brain said: "Assess patient FIRST!"
Great resources to help with test:
www.registerednursern.com (Nurse Sarah gives great lectures to help supplement nursing instructor lectures)
SAUNDERS NCLEX-RN REVIEW BOOK! It's a great outline of each chapter and gives the highlighted rationales for each area. It also has tons of NCLEX review questions.
Believe it or not, QUIZLET has TONSSSSS for practice NCLEX questions to review. BUT, choose the one's with rationales, so that you will understand what you are being tested on!
These test are far from easy, but if you understand the material, think like a nurse, you will be OK!