Page 110 - Saunders Comprehensive Review For NCLEX-RN

medications or any other medications, such as herbal
preparations, unless they are approved for use by the
primary health care provider.
6. The client needs to avoid consuming alcohol.
7. Medications are never administered if the prescription
is difficult to read, is unclear, or identifies a
medication dose that is not a normal one. It is safer if
medications are prescribed electronically.
8. Additional strategies for answering pharmacology
questions are presented in Saunders Strategies for Test
Success: Passing Nursing School and the NCLEX® Exam.
XIII. Answering Complex Questions Using Clinical Judgment
A. You may encounter questions on the NCLEX exam that present a
scenario with information or data. Included in the scenario may be
demographic information such as age and gender, chief concern,
admitting diagnosis, history of present illness, past medical
history, surgical history, family history, social history, allergies,
and medications, which provides the situation and background for
the case.
B. These scenarios may also include data such as vital signs, physical
assessment findings, laboratory and diagnostic test results, client
prescriptions, and a medication administration record.
C. The candidate may be required to discern between important,
relevant data to the clinical situation and data that, although it is
important to be aware of, may not have any bearing, relevance, or
effect on nursing interventions for the client and the current
medical problems.
D. While reviewing the case, try to look at each piece of data in a
step-by-step fashion and decide whether it has bearing, relevance,
or a potential effect on nursing interventions for the client (see Box
4-23).

Box 4-23
Case Scenario: Strategies for Analyzing Data Using
Clinical Judgment

Situation/Background:
Subjective
Chief Complaint (CC):
“I am not feeling any better since starting the antibiotics 4 days ago.”
History of Present Illness (HPI):
Reports flu-like symptoms with congestion, throat pain, productive cough with
approximately 2 tablespoons of yellow sputum daily, weakness, fatigue. Started 9 days
ago, constant, started on cephalexin 4 days ago for the same symptoms with no effect.
Also reports cerumen impaction for the last month and wants to know whether she can
have it removed.
Past Medical History (hx) (PMH):
Medical hx includes heart failure (type and ejection fraction unknown), hyperlipidemia,
hypertension, heart disease with defibrillator/pacemaker placement, type 2 diabetes,
pneumonia with pleural effusions requiring thoracentesis × 2, chronic kidney disease
(CKD) (stage unknown due to lack of trending labs). Surgical hx includes

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