Hurst Reviews NCLEX-RN Review 1st edition Hurst eBook
Chapter 1: LET’S GET IT STARTED IN HERE!
This is where you need to play the song “Let’s Get It Started in Here” by
the Black Eyed Peas to get you pumped-up!
Now don’t think because this is the first chapter that you can skip it.
You must read it in order to understand how we will work together to
achieve NCLEX® success. This book parallels the same successful
approach I use when teaching NCLEX® Review classes. This chapter
serves as the beginning of your journey in conquering the NCLEX®!
So, you’ve finished nursing school.What an accomplishment! Can
you believe it’s really over? I’ll bet you are still walking around feeling
like you have a care plan to turn in to your clinical instructor! Now
you have to take one more test! I know that’s very frustrating. You’re
anxious to take the test, so you can get to work to help buy that new
car you’ve already picked out. Or, maybe the nurse manager at your
new job or a family member is pressuring you to take the test sooner
rather than later.
Maybe you have taken the test five times already and you feel there is
no hope for you. Guess what? There is hope! Just because a student may
have to take the test more than one time doesn’t mean he or she isn’t
going to be a great nurse. If you follow this book and do what I say, you
will achieve NCLEX® success!
✚ Don’t assume anything
Some of you may assume that passing nursing school and the
NCLEX® predictor tests assures your ability to pass the NCLEX®.
Your teachers have probably emphasized that NCLEX® tests for
minimum nursing competency. You may be saying to yourself, “Surely,
I’m minimally competent.” Unfortunately, these things may set you up
for false reassurance.
Pretend it’s new!
Let me emphasize one important point: NCLEX® is not like any test
you have ever taken. Your safest approach to this test is to pretend you
are starting your very first IV, and you have to remember each step
you learned in the clinical learning laboratory in order to successfully
insert the IV. Doing something for the first time can be very scary,
but I will help you to overcome those feelings as far as NCLEX® is
✚ What’s the good news?
Yes, there is good news! You can pass the first time if you CHOOSE.
Achieving success in anything requires the investment of time. I’m
not advocating weeks and weeks of studying. I’m encouraging you
to study this book thoroughly, so that you can walk into the testing
center with a level of confidence that will propel you to pass the
NCLEX® is not like any test you
have ever taken!
My goal is for you to pass NCLEX®
the first time!
CHAPTER 1 ✚ Let’s Get It Started in Here! 3
WHAT’S THE NCLEX®, AND WHY DO I HAVE
TO TAKE IT?
Look at it this way: This could be the most important test you ever take!
Let’s look more closely at the NCLEX® and why it is important.
✚ Define time
The NCLEX®, or National Council Licensure Examination, is a test that
determines if you have the minimum level of knowledge necessary to
practice nursing safely. The test is written by nurses with advanced
degrees and clinical expertise in each specific area of nursing.1
✚ What exactly does “practice nursing safely”
The American Nurses Association (ANA) developed a standard set of
protocols to guide nurses in making decisions regarding the care of
clients.2 Nursing in its basic form provides care to clients in order
to help them achieve specific goals to return them to wellness, to return
them to an adapted state of wellness, or to help the client die with dignity
and peace.2 Practicing these services without causing harm to the
client, or the lack of practicing these services, at the very least, is what
NCLEX® considers as the minimum level of knowledge needed to
practice nursing safely.1 In other words, nurses are safely helping
clients return to the level of self-care or wellness before their illness.
That was deep!
✚ Applying your knowledge
Passing the NCLEX® does not include learning and memorizing a
never-ending amount of content. Instead, the key is to take what you
DO know and apply it to concepts you may never have heard of. How?
Don’t worry; we’ll work through this together. This concept of applying
your knowledge will prevent you from panicking at the sight of a
question that asks you about some unfamiliar disease. I have successfully
used this method of analyzing test questions since I began teaching
in schools of nursing in 1988. You will learn how to methodically
work through this type of question and confidently select the correct
CASE IN POINT Imagine you work on a medical-surgical unit. You are
given your assignment of six acutely ill clients. Do you know every detail
listed in your clients’ charts? Of course not! But, you are still responsible
for caring for these clients.What do you do? Do you rush to the computer
on your unit to look up the etiology of every disease your clients
have? No way! You implement what you do know by applying basic principles
of safety to prevent harm to your clients.We will use this same
approach with NCLEX® test questions.
Don’t let distractions or a long list
of client needs supersede the
safety of any client!
If you’ve never heard of a disease
or illness that is presented on the
NCLEX®, then no one else has
either! This is most likely a distracter
that the NCLEX® Lady has
4 MARLENE HURST ✚ Hurst Reviews: NCLEX-RN® Review
✚ Don’t believe everything you hear
There is a rumor floating around that if you don’t know the answer on a
standardized test, pick “C.” That is simply untrue; it will not help you
pass this particular exam. The key to passing the NCLEX® is to take the
knowledge you do know and apply it to new and different concepts.
The NCLEX® Lady views you, the test-taker, as a new nurse
with only two weeks of vast nursing knowledge. This should
be a relief that you do not have to know everything about
nursing! We aren’t trying to make l00% on this test. We got
over that compulsion a long time ago! However, you want to
approach this test as if you are a brand new nurse, not an
experienced nurse. In fact, if you approach the test like you are
an experienced nurse, you will scare the NCLEX® Lady! This
book will show you how to think like a new nurse.
✚ Will taking a million practice tests help me pass?
Many of you have been told you need to take a million practice tests in
order to pass the NCLEX®. Your friends have been smothering you with
study guides, workbooks, and CDs. Your plan is to memorize these questions.
Bad move! No matter how many questions you memorize,
NCLEX® has many thousands more waiting for you. This book will show
you how to answer the test questions in a way that makes the NCLEX®
Lady very happy.
CORE CONTENT AND THE NCLEX®
You will hear me refer to “core content” many times in our journey
together. If you feel you need a quick review of core content please take a
look at my online review. You may want to hear me discuss the patient
core content. So check out www.hurstreview.com. Let’s take a brief look
at core content, because it will be a key factor in your test preparation.
✚ Define time
The core content is the information you must know without a doubt and
without hesitation if you wish to pass the NCLEX® the first time.
✚ Without a doubt and without hesitation
Heavy words! So, what exactly is the core content that I should know
without a doubt and without hesitation? The core content that I will
keep referring to is information such as fluids and electrolytes or
CHAPTER 1 ✚ Let’s Get It Started in Here! 5
CASE IN POINT Let’s take a look at an example that includes core content
that you should know without a doubt and without hesitation.
The nurse is caring for an 8-hour postop thyroidectomy client.Which
client symptom should concern the nurse the most?
1. Slight twitch of the left arm.
2. Depressed patellar reflex.
3. Blood pressure of 136/83 mm Hg, pulse of 72 beats/min, respiratory
rate of 18 breaths/min.
4. Occasional premature ventricular contractions (PVCs) noted per the
Let’s use a step-by-step process to answer this question.
Step #1: Did you know that while reading this question your main
focus should include hypocalcemia? To answer this question, you have
to use multi-logical thinking. You have to be knowledgeable about a
thyroidectomy and the related complications. Remember: NCLEX®
questions usually focus on actual or potential problems that can
occur. There aren’t many “happy” NCLEX® questions. Note: After a
thyroidectomy there is a chance the surgeon could accidentally remove
the parathyroid glands.
Step #2: Now you need to know about the parathyroids. Parathyroids
increase serum calcium. So, if a couple of the parathyroids are accidentally
removed, then the serum calcium goes down. Next, home in
on how fluctuations in calcium affect the body. If the serum calcium is
raised, then the body will be sedated. If the serum calcium is lowered,
the body will be tight or contracted. This is my simple way of looking
Step #3:What can tightened or contracted muscles lead to? Seizures.
When that arm starts to twitch, you should worry and assume the
worst: the client may be headed toward a seizure. The client’s patellar
reflex is depressed due to the effects of general anesthesia. Also, if the
calcium drops, the reflexes increase—not decrease. The vital signs
remain normal. Okay, I know the PVCs worried you, but the answer
choice said “occasional.” You’ll want to watch this to make sure the
PVCs do not increase. This is not highly unusual; many people have
Step #4: Now we have arrived at the correct answer, #1.Muscle twitching
is a specific sign you must watch for in the care of the post-thyroidectomy
See how your knowledge of core content was needed in order to answer
✚ More good news
Once again, the good news is you do not have to know everything in the
world about nursing to pass the NCLEX®. It is not necessary to reread
every class note or textbook. Remember, the NCLEX® Lady thinks of you
6 MARLENE HURST ✚ Hurst Reviews: NCLEX-RN® Review
as someone with only two weeks of vast nursing knowledge! Every test
question stems from core content. This book will provide you with many
opportunities to refresh your core content knowledge and put this
knowledge into practice with test questions.
I’m excited about this opportunity to help you achieve your goal, and
hope you will not only learn, but actually enjoy studying with me.My
successful approach is unique, so it is important for you to pay close
attention to every word in this book. Now let’s get it started in here!
1. National Council of State Boards of Nursing. NCLEX Examinations.
Available at: www.ncsbn.org. Accessed October 25, 2006.
2. American Nurses Association. Nursing: Scope and Standards of Practice.
Introduction.Washington, DC: ANA; 2004.
American Nurses Association. Nursing: Scope and Standards of Practice.
Washington, DC: ANA; 2004.
Huber D. Leadership and Nursing Care Management. 2nd ed.
Philadelphia: Saunders; 2002.
Hurst Review Services. Available at www.hurstreview.com.
National Council of State Boards of Nursing. Available at
You will never be more motivated
than you are right now to study for
the NCLEX®! Now is the time to
take action to pass the test so you
may get on with your life!