HESI Comprehensive Review for the NCLEX-RN Examination 5th edition eBook


  • Download: HESI Comprehensive Review for the NCLEX-RN Examination 5th edition eBook
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  • Published: 2016
  • ISBN-13: 978-0323394628
  • ISBN-10: 0323394620


HESI Comprehensive Review for the NCLEX-RN Examination 5th edition eBook

The NCLEX-RN Licensing Examination

A. The main purpose of a licensing examination like the NCLEX-RN is to

protect the public.


1. Was developed by the National Council of State Boards of Nursing (the

Council; this abbreviation is used to refer to the NCSBN throughout this


2. Is administered by the State Board of Nurse Examiners

3. Is designed to test candidates’

a. Capabilities for safe and effective nursing practice

b. Essential entry-level nursing knowledge

Job Analysis Studies

A. Essential knowledge is determined by job analysis studies.


The Council wants to ensure that the licensing examination measures current

entry-level nursing behaviors. For this reason, job analysis studies are

conducted every 3 years. These studies determine how frequently various

types of nursing activities are performed, how often they are delegated, and

how critical they are to client safety, with criticality given more value than


B. Job analysis studies indicate that newly licensed registered nurses are using

all five categories of the nursing process and that such use is evenly distributed

throughout the five nursing process areas. Therefore equal attention is given to

each part of the nursing process in selecting test items (Table 1-1).

Nursing Diagnoses

A. Nursing diagnoses are formulated during the analysis portion of the nursing

process. They give form and direction to the nursing process, promote priority

setting, and guide nursing actions (Table 1-2).

B. To qualify as a nursing diagnosis, the primary responsibility and

accountability for recognition and treatment rest with the nurse.

C. The National Conference of the North American Nursing Diagnosis

Association (NANDA) provided the following definition of a nursing diagnosis:

“Nursing diagnosis is a clinical judgment about individual, family, or

community responses to actual and potential health problems/life processes.

Nursing diagnoses provide the basis for selection of nursing interventions to

achieve outcomes for which the nurse is accountable” (Box 1-1). NCLEX-RN

does not use NANDA; however, NANDA is used in this book to provide a

guide in the formulation and development of the nursing process.


The Nursing Process


Components of a Nursing Diagnosis

D. NCLEX-RN questions regarding nursing diagnosis can take several forms:

1. You may be given the nursing diagnosis in the stem and asked to select an

appropriate nursing intervention based on the stated nursing diagnosis.

2. You may be asked to select, from among the choices provided, the most

appropriate nursing diagnosis(es) for the described case.

B O X 1 – 1 N A N D A – A p p r o v e d N u r s i n g D i a g n o s e s


Activity/Risk for activity intolerance

Ineffective airway clearance

Risk for allergy response


Risk for aspiration

Risk for impaired attachment


Disorganized infant behavior (Risk for)

Risk for bleeding

Risk for unstable blood glucose level

Disturbed body image

Risk for imbalanced body temperature

Ineffective breastfeeding

Ineffective breathing pattern


Decreased cardiac output

Caregiver role strain (risk for)

Ineffective childbearing process

Impaired comfort

Impaired verbal communication

Acute confusion (risk for)

Chronic confusion

Risk for contamination

Ineffective coping

Compromised family coping


Death anxiety

Risk for Sudden Infant Death Syndrome

Decisional conflict

Risk for delayed development


Risk for electrolyte imbalance

Disturbed energy field

Impaired environmental interpretation


Adult failure to thrive

Dysfunctional family process

Fluid volume deficit (risk for)

Excess fluid volume


Impaired gas exchange

Dysfunctional gastrointestinal motility

Grieving/risk for complicated grieving

Delayed growth and development


Risk-prone health behavior

Ineffective health maintenance




Ineffective impulse control

Bowel incontinence

Urinary incontinence

Risk for infection

Decreased intracranial adaptive capacity


Neonatal jaundice (risk for)


Deficient knowledge


Risk for disturber maternal-fetal dyad

Impaired memory

Impaired physical mobility

Moral distress



Unilateral neglect

Imbalanced nutrition: less than body requirements


Impaired oral mucous membrane


Acute/Chronic pain

Impaired parenting

Disturbed personal identity

Risk for poisoning

Posttrauma syndrome (risk for)

Powerlessness (risk for)


Rape-trauma syndrome

Impaired religiosity

Risk for ineffective renal perfusion

Impaired individual resilience

Parental role conflict

Ineffective role performance


Chronic low self esteem


Sexual dysfunction

Social isolation

Risk for suicide


Ineffective thermal regulation

Impaired tissue integrity

Ineffective peripheral tissue perfusion

Risk for decreased cardiac tissue perfusion

Risk for ineffective cerebral tissue perfusion

Risk for trauma


Impaired urinary elimination

Urinary retention


Risk for vascular trauma

Impaired spontaneous ventilation

Dysfunctional ventilatory weaning response

Risk for other directed violence


Impaired walking


3. You may be asked to choose, from four nursing diagnoses, the one that

should have priority based on the data in the stem.


A nursing diagnosis must be subject to oversight by nursing management. It

is not a medical diagnosis.

The cause may or may not arise from a medical diagnosis.

Client Needs

A. Job analysis studies have identified categories of care provided by nurses

called client needs. The test plan is structured according to these categories

(Table 1-3).

Prioritizing Nursing Care

A. Many NCLEX-RN test items are designed to test your ability to set priorities

—for example:

1. Identify the most important client needs.

2. Which nursing intervention is most important?

3. Which nursing action should be done first?

4. Which response is best?

B. Setting priorities

1. What should be done first or next? Remember, client safety is paramount.

2. Those taking the NCLEX-RN should “remember Maslow” (Table 1-4).

3. The Five Rights of Delegation (see Chapter 2, p. 16)


Answering NCLEX-RN questions correctly often depends on setting

priorities properly, on making judgments about priorities, and on analyzing

the case and formulating a decision about care (or the correct response)

based on priorities. Using Maslow’s hierarchy of needs can help you to set


The NCLEX-RN Computer Adaptive Testing

A. Computer adaptive testing (CAT) is used for implementation of the NCLEXRN.

B. The CAT is administered at a testing center selected by the Council.

C. Pearson VUE is responsible for adapting the NCLEX-RN to the CAT format,

processing candidate applications, and transmitting test results to its data

center for scoring.

D. The testing centers are located throughout the United States.

E. The Council generates the NCLEX-RN test items.

The Way It Works

A. The NCLEX-RN consists of 75 to 265 multiple-choice or alternative-format

questions (15 of which are “pilot items”) presented on a computer screen.


Components of the NCLEX-RN® Test Plan


Maslow’s Hierarchy of Needs

HESI Comprehensive Review for the NCLEX-RN Examination 5th edition eBook

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