NCLEX Test-Taking Strategy Tip

Tip #9: Evaluate all of the options in a systematic manner.

After you understand the question, read all options carefully. Remember, distracters are designed to be plausible to the situation and thus to "distract"
you from the correct answer. All the options may be correct, but only one will be the best answer.

Example: A client has just returned to his room from the recovery room after a lumbar laminectomy and is in stable condition. In considering possible complications the client might experience in the next few hours, what nursing action is most important?
1. Monitor vital signs every 4 hours.
2. Assess breath sounds every 2 hours.
3. Evaluate every 2 hours for urinary retention.
4. Check when he last had a bowel movement.

All of these options are plausible for the situation. However, consider that this is the client's operative day, he is currently stable, and the question is asking for complications he might encounter in the next few hours after lumbar laminectomy. Options 1 and 4 are not appropriate at this period of postoperative recovery; vital signs should be checked more often, and constipation can be more effectively addressed at a later time - eliminate these from consideration. Option 2 would be appropriate if respiratory problems were anticipated; however, there is no indication of respiratory compromise. (Remember, don't always select airway-related answers.) The correct answer is 3, because this is a common problem in the immediate postoperative period after a lumbar laminectomy.

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