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Key strategies 11

Monitoring the clients 24-hour intake and output would be appropriate for assessing the effects of repeated doses of furosemide. Hourly urine output, however, is most appro-priate in this situation because it monitors the immediate effect of this rapid-acting drug.

Key strategiesRegardless of the type of question, four key strategies will help you determine the correct answer for each question. These strategies are: considering the nursing process referring to Maslows hierarchy of needs reviewing client safety reflecting on principles of therapeutic com-munication.

Nursing process

One of the ways to answer a question is to apply the nursing process. Steps in the nursing process include: assessment diagnosis planning implementation evaluation.

First things firstThe nursing process may provide insights that help you analyze a question. According to the nursing process, assessment comes before analysis, which comes before planning, which comes before implementation, which comes before evaluation.

Youre halfway to the correct answer when you encounter a four-option, multiple-choice question that asks you to assess the situation and then provides two assessment options and two implementa-tion options. You can immediately elimi-nate the implementation options, which then gives you, at worst, a 50-50 chance of selecting the correct answer. Use the fol-lowing sample question to apply the nursing process:

A client returns from an endoscopic procedure during which he was sedated.

Before offering the client food, which action should the nurse take?

1. Assess the clients respiratory status.2. Check the clients gag reflex.3. Place the client in a side-lying position.4. Have the client drink a few sips of

water.

Assess before interveningAccording to the nursing process, the nurse must assess a client before performing an intervention. Does the question indicate that the client has been properly assessed? No, it doesnt. Therefore, you can elimi-nate options 3 and 4 because theyre both interventions.

That leaves options 1 and 2, both of which are assessments. Your nursing knowledge should tell you the correct answer in this case, option 2. The sedation required for an endoscopic procedure may impair the clients gag reflex, so you would assess the gag reflex before giving food to the client to reduce the risk of aspiration and airway obstruction.

Final eliminationWhy not select option 1, assessing the clients respiratory status? You might select this option but the question is specifically asking about offering the client food, an action that wouldnt be taken if the clients respiratory status was at all compromised. In this case, youre making a judgment based on the phrase, Before offering the client food. If the question was trying to test your knowledge of respiratory depression follow-ing an endoscopic procedure, it probably wouldnt mention a function such as giving food to a client that clearly occurs only after the clients respiratory status has been stabilized.

Maslows hierarchy

Knowledge of Maslows hierarchy of needs can be a vital tool for establishing priorities on the NCLEX. Maslows theory states that physio-logic needs are the most basic human needs of all. Only after physiologic needs have been met can safety concerns be addressed. Only after

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