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Saturday, July 21, 2007

How to Choose the Right Answer using ADPIE nursing strategies (Test Taking Strategies)

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Which part of the Nursing Process: Assessment; Analysis; Planning; Implementation or Evaluation?

Next, Decide the Order of Priority

First you must decide what part of the nursing process the question is connected with:

ANALYSIS - is the process of identifying potential and actual health problems. Most identify pertinent assessment information and assimilate it into the nursing diagnosis. Prioritize the needs that have been identified during analysis.

Some common words that are associated with ANALYSIS questions:
diagnose; contrast; compare; analyze; order; prioritize; define; classify; catagorize; synthesize; sort; arrange;


ASSESSMENT- consists of a collection of data. Baseline information for pre and post procedures is included. Also included the recognition of pertinent signs and symptoms of health problems both present and potential. Verification of data and confirmation of findings are also included. Assess a situation before doing an intervention.

Some common words that are associated with ASSESSMENT questions:
observe; gather; collect; differentiate; assess; recognize; detect; distinguish; identify; display; indicate; describe;


PLANNING - Involves formulating goals and outcomes. It also involves various members of the health care team and the patient's family. All outcome criteria must be able to be evaluated with a specific time frame. Be sure to establish priorities and modify according to question.

Some common words that are associated with PLANNING questions:
rearrange; reconstruct; determine; outcomes; formulate; include; expected; designate; plan; generate; short/long term goal; develop;


IMPLEMENTATION - Addresses the actual/direct care of a patient. Direct care entails pre, intra and postoperative management, preforming procedures, treatments, activities of daily living. Also includes the coordination of care and referral on discharge. It involves documentation and therapeutic response to intervention and patient teaching for health promotion and helping the patient maintain proper health.

Some common words that are associated with IMPLEMENTATION questions:
document; explain; give; inform; administer; implement; encourage; advise; provide; perform;


EVALUATION - Determines if the interventions were effective. Were goals met? Was the care delivered properly? Are modification plans needed. Addresses the effectiveness of patient teaching and understands and determines in proper care was offered. Evaluation can involve documentation, reporting issues, evaluates care given and determine the appropriateness of delegating to others. Most significantly, it finds out the response of the patient to care and the extent to which the goals we met.

Some common words that are associated with EVALUATION questions:
monitor; expand; evaluate; synthesize; determine; consider; question; repeat; outcomes; demonstrate; reestablish;

After determining what part of the nursing process the question is concerned with, next focus your attention on determining the category of priority:

Safe and effective care environment is always first. Patient safety is related to the proper preparation and delivery of nursing techniques and procedures as part of the nursing practice. It relates to every aspect of the delivery of care.

Physiologic integrity is the ability to provide competent care Information that may be described as traditionally medical- surgical and pediatric nursing falls into this category. Specific questions in this area can be related to many direct-care aspects of nursing practice. The importance of this area is highlighted because it is one in which planning, implementation and evaluation of care needs can easily be identified and tested. Physiologic integrity is always a slight lower priority than safety unless it involves airway, breathing and circulation. "ABC's" always comes first!

Psychosocial integrity tests the knowledge about a patients response to a disease or disorder. An understanding of stress, anxiety and ways to cope are essential. This is a lower priority the physiological integrity.

Health maintenance deals with health promotion, health teaching, disease prevention and assessment of risk factors for health problems. Normal growth and development is a major theme in this category. This however, is a low priority.

In Summary, when choosing the right answer for you NCLEX exam question
1) ask yourself, "what part of the nursing process is this question dealing with: analysis, assessment, planning, implantation or evaluation? and
2) Remember to prioritize your choices: safety always being first,
3) physiological integrity,
4) psychosocial integrity and health maintenance always has the lowest priority when choosing an answer.

Other tidbits:

  • avoid choices with the answers "all" "always" "never" or "none". Nothing is ever a definite in Science.
  • look for answers that are different. If three answers say the same thing but in different words, choose the answer that is different.
  • when given choices that are pharmacologically based or non pharmacologically based, choose the non pharmacological intervention. It is more often then not, the correct answer.



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