NCLEX Wednesday #6
Rather than present strategies for general questions on the National Council Licensure Examination, we’re focusing on a common theme you’re sure to encounter: Patient positioning. The NCLEX covers a breadth of information, and the specific questions are always changing, but positioning always pops up—at least as an answer, if not in a question. For more general NCLEX study tips, be sure to read last week’s post, which complement the following four.
1. Study the Positions
Nurses constantly have to position patients, which is why related questions appear so frequently on the NCLEX. As you’ve learned, each patient position is done for a very specific reason—and you should study all of them. When presented with these types of questions you need to remember clearly what each position accomplishes, so you know what you’re trying to promote or prevent with the positioning.
2. Think about the Purpose
When questions deal specifically with a position, read them carefully. Ask yourself why this position is important for the client, and what is the nurse trying to accomplish by placing the client in a particular position? For instance, if you are caring for a laboring client whose fetus experiences a variable deceleration, you should first turn the client to her side to increase cord blood flow to the baby. This should be done before more invasive measures such as a vaginal exam, increasing IV fluid, or giving the client oxygen. Paying attention to what the problem is and why a certain position could solve it will help guide you to the correct answer.
3. Pay Attention to the Patient
Just because positioning options appear doesn’t mean that’s the solution. Evaluate whether positioning is important to the care of this particular patient—and if so, remember that some positions can exacerbate rather than solve the issue. For example, a client with a severe head injury should be placed with the head of bed elevated at 30-45 degrees (decreases intracranial pressure) and not the Trendelenburg position (increases intracranial pressure and can cause more brain damage).
4. Err on Least-Invasive
Positioning is often considered the least invasive measure a nurse can take (see scenario in tip 2) and it is easy and can be done quickly. Though you may suspect a scenario will require additional treatment, focus on the immediate needs. Doing the least invasive thing first is often the correct answer.
Happy studying, and see you with more NCLEX study tips next week!
– Cheryl Armstrong, MS, RN
– Britt Baer, RN, MSN-HCSM, SANE
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