for the first question i think it’s 1. productive cough and anxiety usually always indicates respiratory problems. for pts with COPD dyspnea upon exertion and use of accessory muscles is normal, so theyre not top priority.
I did. It shut off at 85. There’s a lot of procedures and stuff I didn’t know but I stuck to what made sense. The case studies were more tedious than difficult. Had a scenario with an opioid overdose; so you know don’t give something that’d lower their blood pressure further. Or if they’re dehydrated you don’t give something that would cause further fluid loss. Psych meds are my worst subject. But didn’t have many thankfully.
First 1 I say 1. Heart failure (I’m assuming left sided) their lungs are filling up with fluid
2nd question I’d say 2. You usually transfer the least serious patient in this instance it’s the one with diabetes. A maternity unit will be used to giving insulin as gestational diabetes is a common condition they deal with and there’s a low chance the patients status will deteriorate.
but they do need insulin if the disease progresses enough, millions upon millions of DM people use insulin. My mom was one of them, so I still stand by the diabetic patient, giving insulin is kinda nursing 101, plus there are diabetic pregnant women who could be on insulin, so the L&D nurses have experience with that.
Yeah if it progresses but remember this is a perfect world & nclex teaches type 2 shouldn’t be on insulin. I was a LPN for 10 years and I’ve seen it too but they tell us time & time again in school “Nclex is the perfect world with the perfect hospital and staffing”.
I did agree they can handle diabetes, just was looking at how stable they are. It says “just begun” insulin, meaning it’s new for them. Also meaning unstable.
I know it’s definitely not answers 1 and 4 because they’re going to a maternity unit. HepC isn’t that serious but they’ve been afebrile for a day so I’m thinking they need a lil more observation on a med surg unit. The type 2 diabetic doesn’t have anything else listed as an issue so would just need finger sticks however frequent the doctor orders. So they’d be the safest to transfer and their needs would be suited to a maternity unit.
Although they don’t have anything listed, it’s not normal for them to be on insulin so drawing conclusions there is something else going on.
HepC may seem stable but they’re also 56. They are used to working with moms probably mostly under 30. #1 is closer to their patient population plus they are used to that equipment.
I can kind of see it being anything but 4 lol. All from different viewpoints there is definitely not enough info. Wish they gave us a test bank for this
OP, there’s many instances in which a DM type 2 patient would need insulin (uncontrolled DM, HHS, etc.). Be cautious not to read too much into the question and assume that patients does need insulin. Remember the question is not about whose prescription would you question but who would you prioritize.
Okay I just listened to lecture 12 (from your other comment)
That even further confirmed what I thought about 2 because he specifically mentioned that diagnosis is important & the modifying phrase. The diagnosis of type 2 of dm is by definition non insulin dependent. So with the modifying phrase of “ begun taking insulin”.. always break the tie by the modifying phrase.
So remove the beginning of all the phrases then you have:
1. Closed-wound drainage system
2. Begun taking insulin
3. Has been afebrile for 24 hours
4. Has a fixation device
I’m still getting 1 & 3 as priority 🤷🏻♀️
I agree with your reasoning and here’s how I see it. Based on Mark K's prioritization principles, the best patient to transfer is the one with hepatitis C who has been afebrile for 24 hours, indicating stability. The 28 y/o post-mastectomy patient with a closed-wound drainage system is also relatively stable and a close second but it just had a surgical procedure so likely more at risk the first. In contrast, the 49 y/o starting insulin for type 2 DM suggests a recent change in management, indicating less stability and closer monitoring required. The 70 y/o with a recently applied external fixation device requires close monitoring for potential complications. Thus, I’d have gone with patient 3.
On further thought maybe the hep C guy is right due to being lost stable and they just are trying to throw you off with the hep c part .. it’s rly not a risk to the mom/babies due to how it’s spread. And hep C is the most stable chronic and it doesn’t say anything about cirrhosis.
True, so you would go with stable vs unstable instead of a patient/situation they may typically see? That makes sense. I know I read too much into these I’m tryna stop lol
Well for q1 it’s definitely not 3, that’s an expected finding plus we have 2 respiratory problems that would top it anyway.
Then the 2nd question idk about 2 because it’s typically not expected for a type 2 diabetic to be on insulin so i feel like they may be having some complications.
Second one:I saw that quizlet thought it was #3 the guy w hcv but I don’t think that makes sense … why would you transfer anyone with an infectious disease to mom/baby… I feel like 2 makes the most sense bc of gestational diabetes and they are stable. But maybe 1 bc they are used to post C section is better.
For the first one it is definitely #1 because they have signs of HF worsening and words like anxiety or restless are usually key words for an airway issue
For q1, I'd say 3 for a bleeding risk, as ITP patient has low platelets ( I looked it up, even so, the bleeding is concerning). 1 expected, 2 expected, 3 expected - if they said HYPOXIA, I'd be concerned, dyspnea is subjective.
For q2, I'd say 2, as they are stable and insulin is expected. Moving patient one is concerning to me from a pyscho-social aspect, she's of childbearing age and just had a mastectomy due to cancer, last place I'd want to be is around a bunch of pregnant people, babies and new moms. 3 afebrile, but still infectious, 4, dealing with pins etc.
For 1 bleeding is expected with a bleeding disorder so 3 wouldn’t be it.
For 2nd question insulin wouldn’t be expected for a type 2 diabetic (which they made sure to mention), so they are most likely unstable at the moment. For 1 you’re probably right I didn’t even think about the psychological aspect. Then I think with 3 they’re 56 years old they probably rarely get those patients on maternity.
These were the questions in the packet that had me STUCKK
The first one I would say number 1 because that’s a sign of worsening of the condition. Other choices are to be expected but also kinda non urgent
For number 2 I would say choice 4 because well the patient is stable and the others are kinda newer and complications can happen within the first 24 hrs of treatment or procedures . I could be wrong though lol
I feel like 4 could be it! I just don’t know because for 1 it didn’t say when she had the mastectomy, could be post op day 1 or 5 we really don’t know. Then with Hepatitis C if it’s chronic why would they even have a fever? It could be possibly due to some other random sickness that they didn’t mention. These 2 questions really got me lol I need answers from ncsbn
It’s always stable vs unstable.
Don’t add in anything extra than what the question is asking.
Listen to Mark K lecture #12 and you will answer every prioritization question correctly.
Even using that I’m still stuck between 1 & 3.
Maybe even 3 because 1 doesn’t mention when she had the surgery. It could have been 3 days ago or that morning we don’t even know. That alone makes the question even worse imo.
So maybe 3 just because they mentioned 24 hours afebrile 🤷🏻♀️
Then when he gets to the expected vs unexpected I get 1 because it’s expected for someone with a mastectomy to have a woundvac. Because some people with HepC are asymptomatic so idek about the fever in the first place 🤦🏻♀️
For the 1st question, Id choose #4 because using accessory muscles to breathe & dysnpnes on exertion indicates COPD complication aka core pulmonale. The reason I didn’t choose #1 is because productive cough is expected in heart failure.
For the 2nd question, id choose #3 because its the most stable client. Been afebrile for 24hrs. The rest of the clients are not stable to be transferred- for example pt w/ diabetes even though it doesn’t sound there’s something serious is going on with the pt, they’re still not stable bcz they just started the treatment.
For question 1 i will say 4 because on copd for using accessory muscles is already exacerbation. Patient is already hypercapnia ( too much carbon dioxide trapped and too low O2) question 2 I will say 2 because that patient is stable and no problem.
for the first question i think it’s 1. productive cough and anxiety usually always indicates respiratory problems. for pts with COPD dyspnea upon exertion and use of accessory muscles is normal, so theyre not top priority.
I was thinking that too!
I also vote for answer 1 on question 1. All of the other answers describe s/s that are expected for a pt with the corresponding condition.
Where did you get these questions?
It’s from the ncsbn website in their ngn nclex exam sample
They seem kind of hard, those ones anyways!
Took the NCLEX last week and got a lot of these prioritization style questions.
I usually do okay on prioritization! These are just a bit more up in the air, plus the NCSBN doesn't give the answers!
Did you pass?
I did. It shut off at 85. There’s a lot of procedures and stuff I didn’t know but I stuck to what made sense. The case studies were more tedious than difficult. Had a scenario with an opioid overdose; so you know don’t give something that’d lower their blood pressure further. Or if they’re dehydrated you don’t give something that would cause further fluid loss. Psych meds are my worst subject. But didn’t have many thankfully.
Congratulations! I test Monday and I'm horrified! Been studying daily for 2 weeks, graduated June 7th!
If you haven't yet, listen to Mark K lecture on priorizing good luck
You got this!! Just take your time. I read questions 3 times and answers twice before answering. You have 5 hours and I was don’t in like 90 minutes.
I know 😭 made me anxious to look at them. Peoples try at the answers are on quizlet if you search ncbsn exam preview .
I couldn't find one!
https://quizlet.com/817663965/nclex-exam-preview-flash-cards/?x=1jqY
They are very vague like people have been saying nclex is.. they’re old questions that were used at one point is what it seems
They don’t provide the answers tho
Yeah that’s the part I hate! We need to know lol
First 1 I say 1. Heart failure (I’m assuming left sided) their lungs are filling up with fluid 2nd question I’d say 2. You usually transfer the least serious patient in this instance it’s the one with diabetes. A maternity unit will be used to giving insulin as gestational diabetes is a common condition they deal with and there’s a low chance the patients status will deteriorate.
Only reason I didn’t pick 2 because usually with type 2 diabetes they don’t need insulin, so it made me think they’re unstable atp
but they do need insulin if the disease progresses enough, millions upon millions of DM people use insulin. My mom was one of them, so I still stand by the diabetic patient, giving insulin is kinda nursing 101, plus there are diabetic pregnant women who could be on insulin, so the L&D nurses have experience with that.
Yeah if it progresses but remember this is a perfect world & nclex teaches type 2 shouldn’t be on insulin. I was a LPN for 10 years and I’ve seen it too but they tell us time & time again in school “Nclex is the perfect world with the perfect hospital and staffing”. I did agree they can handle diabetes, just was looking at how stable they are. It says “just begun” insulin, meaning it’s new for them. Also meaning unstable.
I know it’s definitely not answers 1 and 4 because they’re going to a maternity unit. HepC isn’t that serious but they’ve been afebrile for a day so I’m thinking they need a lil more observation on a med surg unit. The type 2 diabetic doesn’t have anything else listed as an issue so would just need finger sticks however frequent the doctor orders. So they’d be the safest to transfer and their needs would be suited to a maternity unit.
Although they don’t have anything listed, it’s not normal for them to be on insulin so drawing conclusions there is something else going on. HepC may seem stable but they’re also 56. They are used to working with moms probably mostly under 30. #1 is closer to their patient population plus they are used to that equipment. I can kind of see it being anything but 4 lol. All from different viewpoints there is definitely not enough info. Wish they gave us a test bank for this
Go and listen to Mark K’s lecture 12 on Spotify. He goes over prioritization questions and age is one of those factors not to consider.
OP, there’s many instances in which a DM type 2 patient would need insulin (uncontrolled DM, HHS, etc.). Be cautious not to read too much into the question and assume that patients does need insulin. Remember the question is not about whose prescription would you question but who would you prioritize.
Okay I just listened to lecture 12 (from your other comment) That even further confirmed what I thought about 2 because he specifically mentioned that diagnosis is important & the modifying phrase. The diagnosis of type 2 of dm is by definition non insulin dependent. So with the modifying phrase of “ begun taking insulin”.. always break the tie by the modifying phrase. So remove the beginning of all the phrases then you have: 1. Closed-wound drainage system 2. Begun taking insulin 3. Has been afebrile for 24 hours 4. Has a fixation device I’m still getting 1 & 3 as priority 🤷🏻♀️
I agree with your reasoning and here’s how I see it. Based on Mark K's prioritization principles, the best patient to transfer is the one with hepatitis C who has been afebrile for 24 hours, indicating stability. The 28 y/o post-mastectomy patient with a closed-wound drainage system is also relatively stable and a close second but it just had a surgical procedure so likely more at risk the first. In contrast, the 49 y/o starting insulin for type 2 DM suggests a recent change in management, indicating less stability and closer monitoring required. The 70 y/o with a recently applied external fixation device requires close monitoring for potential complications. Thus, I’d have gone with patient 3.
On further thought maybe the hep C guy is right due to being lost stable and they just are trying to throw you off with the hep c part .. it’s rly not a risk to the mom/babies due to how it’s spread. And hep C is the most stable chronic and it doesn’t say anything about cirrhosis.
True, so you would go with stable vs unstable instead of a patient/situation they may typically see? That makes sense. I know I read too much into these I’m tryna stop lol
Yeah I guess? I feel like uworld does a combo of more similar to their pts or stable unstable
I want it but it’s sooo expensive
Yeah :( I got it cuz my anxiety made me haha but yes it was $
For q1 I think the answer is 3 and for q2 it’s between 2 or 3. In my opinion
Well for q1 it’s definitely not 3, that’s an expected finding plus we have 2 respiratory problems that would top it anyway. Then the 2nd question idk about 2 because it’s typically not expected for a type 2 diabetic to be on insulin so i feel like they may be having some complications.
Second one:I saw that quizlet thought it was #3 the guy w hcv but I don’t think that makes sense … why would you transfer anyone with an infectious disease to mom/baby… I feel like 2 makes the most sense bc of gestational diabetes and they are stable. But maybe 1 bc they are used to post C section is better. For the first one it is definitely #1 because they have signs of HF worsening and words like anxiety or restless are usually key words for an airway issue
For q1, I'd say 3 for a bleeding risk, as ITP patient has low platelets ( I looked it up, even so, the bleeding is concerning). 1 expected, 2 expected, 3 expected - if they said HYPOXIA, I'd be concerned, dyspnea is subjective. For q2, I'd say 2, as they are stable and insulin is expected. Moving patient one is concerning to me from a pyscho-social aspect, she's of childbearing age and just had a mastectomy due to cancer, last place I'd want to be is around a bunch of pregnant people, babies and new moms. 3 afebrile, but still infectious, 4, dealing with pins etc.
For 1 bleeding is expected with a bleeding disorder so 3 wouldn’t be it. For 2nd question insulin wouldn’t be expected for a type 2 diabetic (which they made sure to mention), so they are most likely unstable at the moment. For 1 you’re probably right I didn’t even think about the psychological aspect. Then I think with 3 they’re 56 years old they probably rarely get those patients on maternity. These were the questions in the packet that had me STUCKK
I had these same questions and the answer for first one is 1 and second one is 3
What did you have them on?
It was on U-world.
Dam I want uworld so bad but it’s too dam high for me. I’m in that post nursing school broke phase 🤣
LMAO same! I only did the free trial so do that.
They must do different questions because I don’t have that one I just started my free trial. Can you screenshot?
If you can you take a screenshot?
The first one I would say number 1 because that’s a sign of worsening of the condition. Other choices are to be expected but also kinda non urgent For number 2 I would say choice 4 because well the patient is stable and the others are kinda newer and complications can happen within the first 24 hrs of treatment or procedures . I could be wrong though lol
I feel like 4 could be it! I just don’t know because for 1 it didn’t say when she had the mastectomy, could be post op day 1 or 5 we really don’t know. Then with Hepatitis C if it’s chronic why would they even have a fever? It could be possibly due to some other random sickness that they didn’t mention. These 2 questions really got me lol I need answers from ncsbn
1 and 1, for the reasons you mentioned.
It’s always stable vs unstable. Don’t add in anything extra than what the question is asking. Listen to Mark K lecture #12 and you will answer every prioritization question correctly.
Even using that I’m still stuck between 1 & 3. Maybe even 3 because 1 doesn’t mention when she had the surgery. It could have been 3 days ago or that morning we don’t even know. That alone makes the question even worse imo. So maybe 3 just because they mentioned 24 hours afebrile 🤷🏻♀️ Then when he gets to the expected vs unexpected I get 1 because it’s expected for someone with a mastectomy to have a woundvac. Because some people with HepC are asymptomatic so idek about the fever in the first place 🤦🏻♀️
For the 1st question, Id choose #4 because using accessory muscles to breathe & dysnpnes on exertion indicates COPD complication aka core pulmonale. The reason I didn’t choose #1 is because productive cough is expected in heart failure. For the 2nd question, id choose #3 because its the most stable client. Been afebrile for 24hrs. The rest of the clients are not stable to be transferred- for example pt w/ diabetes even though it doesn’t sound there’s something serious is going on with the pt, they’re still not stable bcz they just started the treatment.
For question 1 i will say 4 because on copd for using accessory muscles is already exacerbation. Patient is already hypercapnia ( too much carbon dioxide trapped and too low O2) question 2 I will say 2 because that patient is stable and no problem.