Page 229 - Saunders Comprehensive Review For NCLEX-RN

Introduction

Pyramid to Success

Pyramid Points focus on fluids and electrolytes, acid–base balance, vital signs,
laboratory reference intervals, and nutrition. Fluids and electrolytes and acid–base
balance constitute a content area that is sometimes complex and difficult to
understand. For a client who is experiencing these imbalances, it is important to
remember that maintenance of a patent airway is a priority, and the nurse needs to
monitor vital signs, physiological status, intake and output, laboratory reference
intervals, and arterial blood gas values. Be certain to know the normal vital sign
values and the baseline values for each client that you are caring for so that you are
able to determine changes in the client status. Remember that pain is also a vital
sign, and to assess each client for verbal and nonverbal signs of pain. It is also
important to remember that normal laboratory reference levels may vary slightly,
depending on the laboratory setting and equipment used in testing. If you are
familiar with the normal reference intervals, you will be able to determine whether
an abnormality exists when a laboratory value is presented in a question. The
specific laboratory reference levels identified in the NCLEX® test plan that you need
to know include arterial blood gases known as ABGs (pH, PO , Pco , SaO , HCO ),
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blood urea nitrogen (BUN), cholesterol (total), glucose, hematocrit, hemoglobin,
glycosylated hemoglobin (HgbA1C), platelets, potassium, sodium, white blood cell
(WBC) count, creatinine, prothrombin time (PT), activated partial thromboplastin
time (aPTT), and international normalized ratio (INR). The questions on the NCLEX-
RN examination related to laboratory reference intervals will require you to identify
whether the laboratory value is normal or abnormal, and then you will be required
to think critically about the effects of the laboratory value in terms of the client. Note
the disorder presented in the question and the associated body organ affected as a
result of the disorder. This process will assist you in determining the correct answer.
Nutrition is a basic need that must be met for all clients. The NCLEX-RN
examination addresses the dietary measures required for basic needs and for
particular body system alterations. When presented with a question related to
nutrition, consider the client’s diagnosis and the particular requirement or restriction
necessary for treatment of the disorder.
On the NCLEX-RN, safety and infection control concepts, including standard
precautions and transmission-based precautions related to client care, are a priority
focus. Medication or intravenous (IV) calculation questions are also a focus on the
NCLEX-RN examination. Fill-in-the-blank questions may require that you calculate a
medication dose or an IV flow rate. Use the on-screen calculator for these
medications and IV problems, and then recheck the calculation before selecting an
option or typing the answer.

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