NCLEX - The Kaplan Decision Tree

NCLEX - The Kaplan Decision Tree

Presentation by Mary Ann McLaughlin MSN, RN

Step Five: What is the outcome of each of the remaining answers?

Additional NCLEX Strategies

• This isn't the real world.
• You always have an order.
• Don't "pass" the buck.
• Take care of the patient/client first, and then the equipment.
• Memorize lab values.
• Communicate therapeutically.
• Learn to recognize expected outcomes.
• Learn to answer positioning questions.
• Don't delegate assessments, teaching, or evaluation.
• Pay close attention to words such as "first", "best", or "initial". These words indicate priority.
• Never use the word "why" when asking the patient a question.
• Only choose the answer, Notify the physician, if the situation is emergent and the physician is needed immediately.
• "Most appropriate" indicates that there may be more than one correct response.
• Determine the outcome of each answer choice. Is it desired?
• If the topic is not obvious from the stem of the question, look at the answer choices to determine the topic of the question.
• If the question says "Teaching has been successful" we are looking for a correct answer.
• Rephrase the question in your mind.
• Do not offer false reassurance.
• Do not ask yes/no questions.
• Never leave the patient.
• Comma, comma rule.

(Kaplan Instructor Manual, 2007).

Determine the outcome of each answer. Is it desired?

Select the correct answer.

Trap: Don't select answers that "sound" right.

Step Four: Are all answers physical?

Step Three: Does Maslow fit?

No: Proceed to Step 5.

Yes: Apply ABC's.

Trap: Don't automatically select respiratory answers.

Step Two: Are the answers assessments or implementations?

No: Are all answers physical? Proceed to Step 4.

No: Are all answers psychosocial? Proceed to Step 5.

Yes: Eliminate psychosocial answers. Do the physical needs make sense? Apply ABC's.

Trap: Physical needs take priority over psychosocial needs.

Which of the following tasks is appropriate for the nurse to delegate to an experienced nursing assistant?

• Obtain a 24-hour diet recall from a patient admitted with anorexia nervosa.
• Obtain a clean catch urine specimen from a patient with a urinary tract infection.
• Observe the returns from a continuous bladder irrigation for a patient with a urinary tract infection.
• Observe a patient newly diagnosed with diabetes mellitus practice injection techniques using an orange.

Are answers all assessment or implementation? Yes. Proceed to Step 3

A mix of assessments and implementations? Read the stem to determine if you should assess or implement. Select the correct answer.

Trap: Is validation required?

Step One: Can you identify the topic of the question?

Yes: Proceed to Step 2

No: Read answer choices for clues. Identify the topic of the question. Proceed to Step 2.

Trap: NCLEX "hides" the topic of the question.