Been out of school for a while? Not sure where to start studying for the NCLEX? So what do you do? Get yourself several different resources and start studying right away? Right? No bad idea. A lot of the biggest issues for many test takers that often become repeat test takers is that they are not aware of this fundamental secret to passing the NCLEX.

Disclosure: There are some affiliate links below and I may receive commissions for purchases made through links in this post, but these are all products I highly recommend. I won’t put anything on this page that we haven’t verified and/or personally used or vetted.

Here’s a small breakdown of the correct order to studying. Now if you have already mastered specific areas then you can skip certain steps but if it’s been 6 or more months since you have been out of school, you’re probably going to need to go through the whole thing.

#1- Understand anatomy and physiology

Anatomy and physiology has everything to do with you having a basic understanding of what each of the 11 body systems does, what are their appropriate functions, what organs do they house and what lab values are associated with them.

#2 Learn the pathophysiology of diseases

Once you know the normal it becomes a lot easier to master more disease processes and not confuse the two. The pathophysiology is all about how the disease WORKS. This is important because you can’t answer priority questions well if you don’t understand what’s truly going on inside of the body.

#3-Know the appropriate medical treatment

Now that you understand how the disease works, know you can understand how to start TREATING the disease using the correct medical treatment such as pharmacological therapies. This is important since medication errors are one of the third leading causes of death in the United States. You can combat this by making sure you understand medication administration well.

#4- Safety prevention and psychosocial issues

You got your medications down? Great. Next is now prioritizing how to keep your patient SAFE by studying safety risks, standard precautions and more. With safety, also comes mental health concerns that affects your patient’s judgment. Now you want to prioritize how to keep your patient from harm as well as harm from others.

#5- Reducing emergencies and complications

One more thing is being able to now know the appropriate nursing interventions based on ALL the above needs, delegation, and assessing for potential harm from at risk complications and how to prevent them.

#6- Identifying basic needs

Your patient is a person and with that being said, you need to be able to identify what are all their basic physiological needs and how are those needs DIFFERENT because their diagnosis or disease process.

These are all the appropriate topics you need to learn, in this order to set yourself up to pass the NCLEX the first, next and LAST time.

If you want to gain more insight and understanding, then you can learn more about our NCLEX prep courses where we will walk you through it all here


Here are some free comprehensive nclex questions for you to practice with. Questions are ideal for both NCLEX-RN and NCLEX-PN

An elderly patient is found lying on the floor of his hospital room. The patient was on fall precautions. Which of the following actions is most appropriate for the nurse to take first in this situation?

  1. Assess the patient for any injuries
  2. Notify the patient’s physician
  3. Ask another staff member to assist you to get the patient back into bed
  4. Ask the patient why he tried to get up without assistance

Correct Answer: 1

Using the nursing process, the first action the nurse should carry out is to completely assess the patient for injuries and any other changes in their condition in order to provide any nursing interventions that may be needed, such as applying pressure to bleeding, immobilizing a possible broken joint, etc. The nurse should definitely notify the patient’s physician, however it is not the first action that should be taken. The nurse should also seek assistance for help in getting the patient back into bed for the safety of both the patient and staff, but this is not the first action that should be taken either. Finally, it is always important to determine why the patient got out of bed without assistance in order to implement new interventions that may help to prevent future falls, but it is not the initial action the nurse should take.

A staff registered nurse (RN) is preparing to insert an IV for patient that has been ordered to have morphine 10mg IVP. Using time management skills, which of the following actions should the RN take first?

  1. Enter the room and perform hand hygiene
  2. Explain the procedure to the patient
  3. Mentally go over the procedure when collecting supplies before entering the room
  4. Eject excess medication from the prefilled syringe

Correct Answer: 3


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The initial action the RN should take is to mentally think over the procedure to ensure that she has all of the supplies that are going to be needed, this way she will be able to avoid wasting time by having to make more trips to get supplies. Hand hygiene should be performed upon entrance to the room; this should not be the very first action. The RN should explain the procedure to the patient immediately prior to performing the task and inserting the IV, this should not be the first action. Once the IV is inserted and patent, the RN should eject/waste any excess medication from the prefilled syringe if needed, so the patient receives the correct amount, so this would also not be the first action.

An RN on a medical-surgical unit is in charge of making nurse-patient assignments at the beginning of the shift. Which task should the nurse delegate to the licensed practical nurse (LPN)?

  1. Instructing a patient on how to perform wound care
  2. Obtaining vital signs on a patient who is 2 hours post-operative after a cardiac catheterization
  3. Administration of 1 unit of fresh frozen plasma (FFP)
  4. Developing a care plan for a newly admitted patient

Correct Answer: 2

It is within the scope of practice of the LPN to monitor a patient who is 2 hours post-op after a cardiac catheterization, so she can get their vital signs and record them. The RN is responsible for any patient education, whereas an LPN can only reinforce patient education. The RN is responsible for administering blood components; it is not within the scope of the LPN. The RN is the one responsible for developing a care plan for a new admission to the unit, whereas it is within the scope of practice for an LPN to only suggest additions to the care plans.

As a nurse, you are preparing to transfer an adult patient who is 72 hours postoperative from surgery, back to a long-term care facility. Which of the following should you include in the transfer report? (Select all that apply).

  1. Patient’s vital signs on the day of admission
  2. Patient’s medical diagnosis
  3. Type of anesthesia that was used
  4. Patient’s advance directive status
  5. Any needs for special equipment

Correct Answer: 2, 4, 5

The nurse giving transfer report should only include information that is pertinent and that the following nurse at the next facility will need in order to provide the best care. Vital signs on the day of admission are not pertinent, rather the most recent vital signs would be. The type of anesthesia that was used is not pertinent for the transfer report at this point either, unless there were complications. What the patient has been diagnosed with is pertinent in order to adjust care, along with the code status of the patient, and if there is any special equipment that the long-term facility will need in order to provide the best care.

An RN is attending an interprofessional conference for a patient who has sustained a recent C6 spinal cord injury. The patient was a construction worker. Which of the following members of the healthcare team should also participate in planning care for this patient? (Select all that apply).

  1. Psychologist
  2. Vocational counselor
  3. Speech therapist
  4. Physical therapist
  5. Occupational therapist

Correct Answer: 1, 2, 4, 5

The patient will need the assistance of a psychologist in order to adapt to any psychological impacts the injury has caused due to being so active immediately prior to the accident and all that being taken away so quickly. The patient will also need assistance from a vocational counselor in order to explore any options for reemployment in the future. A speech therapist will not be needed because speech and/or swallowing problems will not be anticipated for this patient. A physical therapist will need to attend the conference because they will be the ones to assist the patient with mobility skills and help to maintain muscle strength. Finally, an occupational therapist will also be needed so the patient can learn how to perform their activities of daily living again with possible deficits.

The RN has taken over care for a patient and their condition is declining. Upon reviewing their medical records, the nurse notices that the patient’s do not resuscitate (DNR) order has expired. Which of the following actions should the nurse take in this situation?

  1. Anticipate that CPR will be initiated should the patient go into cardiac arrest
  2. Call the physician to determine whether the order should be reinstated immediately
  3. Assume that the patient does not want to be resuscitated and take no action should cardiac arrest occur
  4. Write a note on the front of the physician order sheet asking for the DNR to be reordered

Correct Answer: 2

The nurse should immediately call the physician in order to determine whether or not the order should be reinstated, which is the action that should be taken to ensure the patient’s wishes are carried out. Without a current DNR order, the nurse must initiate emergency resuscitation, which most likely would not be consistent with the patient’s wishes. In addition, without a current DNR order, writing a note on the physician order sheet will likely delay resolving the problem at hand.

A newly licensed nurse is preparing to start an IV. Which of the following sources should the nurse use in order to best review the procedure and the standard at which it should be performed?

  1. A more experienced nurse
  2. Web site explaining the task
  3. State nurse practice act
  4. Institutional policy and procedure manual

Correct Answer: 4

The policy and procedure manual will provide instructions on how to perform the procedure that is consistent with established standards; therefore the nurse should use this resource first. A more experienced nurse on the unit may not perform the task according to the policy and procedure. A web site may not provide consistent information in order to correctly do the task. The nurse practice act identifies a scope of practice and other aspects of the law, but it does not set standards for performing a task.

A nurse observes a nursing assistant reprimanding a patient for not using the urinal properly. The nursing assistant threatens to put a brief on the patient if he does not use the urinal more carefully next time. Which tort is the nursing assistant committing?

  1. Assault
  2. Battery
  3. Invasion of privacy
  4. False imprisonment

Correct Answer: 1

Assault is conduct that makes a person fear that he or she will be harmed. Battery is the actual physical contact without a person’s consent that could possibly cause harm. Invasion of privacy is the unauthorized release of a patient’s private information. False imprisonment is when a patient is restrained against their will, including use of both physical and chemical restraints, and refusing to allow a patient to leave a facility.

A nursing assistant reports that the blood sugar of a patient was 58 mg/dL a half hour before lunch. The patient’s morning blood sugar was 285 mg/dL. The patient is observed to be asymptomatic at this time despite their low blood sugar result, plus the next dose of insulin is scheduled to be administered at this time. Which of the following actions should the nurse take first?

  1. Phone the laboratory in order to obtain a STAT serum glucose level
  2. Recalibrate the glucometer and recheck the blood sugar
  3. Inform the nursing assistant to go ahead and give the patient 120 mL of orange juice
  4. Administer the insulin as ordered

Correct Answer: 2

Due to the blood sugar being 285 mg/dL just a few hours prior to this reading, it is unlikely that it has dropped to 58 mg/dL at this time. Therefore, the first thing the nurse should do herself should be to recalibrate the glucometer and obtain another reading before taking any other actions. Calling the laboratory to obtain a STAT serum glucose level may be unnecessary right at this moment and could even add cost to the patient’s care. The nurse should refrain from allowing the nursing assistant to give the patient orange juice because it is unlikely that the blood glucose is low enough at this time. Also, before administering insulin, an accurate blood sugar reading needs to be obtained.

A nurse finds out that a patient was administered an antihypertensive medication in error. Arrange the following actions in the appropriate order that the nurse should follow in this situation.

  1. Complete an incident report
  2. Notify the risk manager
  3. Monitor the vital signs
  4. Call the patient’s physician
  5. Instruct the patient to remain in bed until further notice

Correct Answer: 3, 5, 4, 1, 2

In this situation the nurse should first monitor the patient’s vital signs to see how the medication has affected the blood pressure. Then, the nurse should educate the patient to remain in bed in order to prevent falls should they get up and experience any dizziness. Next, the nurse should phone the physician and explain the situation with the most recent blood pressure value. Once the physician is notified, the nurse and complete an incident report that is very thorough and accurate. Finally, the incident should be reported to the risk manager.

A community is experiencing an outbreak of meningitis, and hospital beds are in urgent need. Which of the following patient should the charge nurse recommend for discharge?

  1. 70 year old admitted 24 hours prior with pneumonia and dehydration
  2. 65 year old female who sustained a fall with a hip fracture, who is schedule for hip replacement the next day
  3. 50 year old with type 2 diabetes admitted for rotator cuff surgery
  4. 58 year old male admitted 12 hours ago with angina and a history of CABG 1 year ago

Correct Answer: 3

This patient is stable and can be safely discharged at this time. The 70 year old patient is unstable and at risk for complications such as fluid volume deficit and cannot be safely discharged. The 65 year old patient is also unstable, and discharge would place her more at risk for causing further damage to her hip. Finally, the 58 year old is at risk for a cardiac event, discharging him would not be safe at this time.

A nurse is educating a patient who is taking iron supplements about what other foods aid in its absorption into the body. Which of the following food choices made by the patient would indicate that they understood the teaching?

  1. Green beans
  2. Orange juice
  3. Milk
  4. Baked potato

Correct Answer: 2

Vitamin C aids in the absorption of iron, and orange juice is a great source of vitamin C. Green beans, milk and baked potatoes do not aid in iron absorption.

A nurse is caring for a patient who routinely takes warfarin (Coumadin). Which of the following food choices should the nurse advise the patient to limit in their diet?

  1. Ice cream
  2. Broccoli
  3. Orange juice
  4. Chicken

Correct Answer: 2

Broccoli is a green leafy vegetable and is a good source of vitamin K. The patient should avoid excess consumption of vitamin K because in excess it has a negative response to the effects of warfarin. Ice cream, orange juice and chick do not effect coagulation.

A nurse is teaching a nutritional class on minerals and electrolytes. Which of the following food sources would provide the best amounts of magnesium when consumed?

  1. Canned soup
  2. Yogurt
  3. Nuts
  4. Tomatoes

Correct Answer: 3

Of the foods listed, nuts are the best source of magnesium and should be included in the diet if needed. Canned soup contains sodium, yogurt would be a good source of calcium, and tomatoes are a good source of potassium.

Which of the following clinical findings are associated with hypothyroidism?

  1. Diarrhea
  2. Increased heart rate
  3. Decreased metabolic demand
  4. Weight loss

Correct Answer: 3

Hypothyroidism will most likely decrease the metabolic demand of your body, making all the processes slower than normal. Diarrhea, increased heart rate and weight loss would most likely be signs of hyperthyroidism.

Which of the following medications should the nurse be aware of that decreases the body’s rate of metabolism?

  1. amitriptyline
  2. prednisone
  3. somatropin
  4. levothyroxine

Correct Answer: 1

Amitriptyline is a tricyclic antidepressant used for treating depression and decreases that body’s rate of metabolism. Prednisone is a glucocorticoid that is used for suppressing the immune system and inflammation; therefore it increases the metabolic rate. Somatropin is used as a growth hormone and increases the metabolic rate. Levothyroxine is used for the treatment of hypothyroidism and increases the metabolic rate.

A nurse is calculating BMI for a number of patients. Which of the following BMI results indicates an overweight patient?

  1. 27
  2. 30
  3. 24
  4. 32

Correct Answer: 1

Overweight is defined as an increased body weight in relation to height, indicated by a BMI of 25 to 29.9. Obesity is an excess amount of body fat indicated by a BMI greater than or equal to 30. Normal/healthy weight is indicated by a BMI of 18.5 to 24.9.

A nurse is teaching a nutritional class to a group of females. Which of the following should the nurse include as risk factors for developing osteoporosis? (Select all that apply).

  1. Obesity
  2. Cigarette smoking
  3. Family history
  4. Inactivity
  5. Hyperlipidemia

Correct Answer: 2, 3, 4

Cigarette smoking may increase the risk of osteoporosis. Also, osteoporosis tends to run in families and tends to occur more in those who are inactive. Weight-bearing exercises should be discussed as primary prevention measures to decrease their risk. Weight loss, instead of obesity, can lead to a decreased intake of dietary calcium and vitamin D leading to development of osteoporosis. Hyperlipidemia is not a risk factor.

You are caring for a patient who has a urinary tract infection (UTI). The patient reports pain and a sensation of burning upon urination, along with cloudy urine with an odor. Which of the following would be your priority intervention as the nurse?

  1. Offer a warm sitz bath
  2. Administer an antibiotic
  3. Encourage increased fluids
  4. Recommend to the patient they should drink cranberry juice

Correct Answer: 2

The greatest risk to the patient at this time is injury to their renal system from the UTI. Therefore, the most important intervention would be to give an antibiotic ASAP. Offering a warm sitz bath and encouraging increased fluids will provide only temporary relief. In addition, drinking cranberry juice may help to prevent a UTI in the future.

You are admitting a patient with a kidney stone. Which of the following findings would you expect to note in your assessment?

  1. Bradycardia
  2. Nocturia
  3. Bradypnea
  4. Diaphoresis

Correct Answer: 4

Diaphoresis is a manifestation that is noted with a patient with a kidney stone. Other symptoms you will see would be the opposite of the other choices and would include: tachycardia, oliguria, and tachypnea.

During your completion of discharge instructions with a patient who has passed a calcium oxalate stone, which of the following food choices should you instruct them to avoid in the future? Select all that apply.

  1. Red meat
  2. Black tea
  3. Cheese
  4. Whole grains
  5. Spinach

Correct Answer: 2, 5

Both black tea and spinach contain calcium oxalate and should be avoided for prevention of this type of kidney stone. Red meat, cheese, and whole grains contain magnesium ammonium phosphate and do not need to be avoided in this situation.

You are providing instructions to your patient prior to a mammogram. Which of the following should you instruct your patient to avoid prior to their procedure?

  1. Deodorant
  2. Multivitamin
  3. Sexual intercourse
  4. Exercise

Correct Answer: 1

Application of deodorant or powder can cause a shadow to appear when the mammogram is done. Taking a multivitamin, having sexual intercourse, and exercising does not alter accuracy of a mammogram.

You are reviewing the medical record of your patient with premenstrual syndrome (PMS). Which of the following medications are used to treat PMS? (Select all that apply).

  1. fluoxetine
  2. spironolactone
  3. ethinyl estradiol/drospirenone
  4. ferrous sulfate
  5. methylergonovine

Correct Answer: 1, 2, 3

Fluoxetine is an SSRI that is used to treat the emotional symptoms of PMS (irritability & mood swings), plus it can also treat physical symptoms. Spironolactone is a diuretic that can reduce bloating and weight gain that accompanies PMS. Oral contraceptives that contain drospirenone help to reduce symptoms of PMS. Oral iron supplements are only used to treat anemia related to dysfunctional bleeding and methylergonovine is used to treat postpartum hemorrhage.

It is up to you to provide support to your patient who has a recent diagnosis of endometriosis. You should reinforce to your patient that which of the following conditions is a complication of endometriosis?

  1. Insulin resistance
  2. Pelvic inflammatory disease (PID)
  3. Infertility
  4. Vaginitis

Correct Answer: 3

Infertility is a complication because overgrowth of endometrial tissue can block the fallopian tubes. Insulin resistance is a complication of polycystic ovary syndrome, vaginitis is usually caused by an infection, and PID is caused by an infection of the pelvic organs.

The nurse is assessing a patient who has a cast on his arm due to a compound fracture. Which of the following findings is an early indication of neurovascular compromise?

  1. Pallor
  2. Paralysis
  3. Paresthesia
  4. Pulselessness

Correct Answer: 3

Paresthesia is an early sign of neurovascular compromise that may even suggest compartment syndrome. Pulselessness, paralysis and pallor are late signs, all of which suggest compartment syndrome.


Becoming a nurse is definitely a journey. Depending on the career path that you choose to take, there can be some hurdles to finally becoming and succeeding as a nurse. Inside this article, we will discuss eleven different resources that you must obtain to succeed as a nurse.

#1- Accredited nursing programs with high NCLEX passing rates

One of the mistakes many aspiring nurses make before they even start their journey is not doing the necessary research required so they can be positioned for success later. It’s so important that you honestly take the time prior and review and research all the nursing schools that you want to attend and make sure they have great passing rates; ideally 80-90% and above. Don’t look at the cost to attend the program, focus on if people are even successful with becoming a nurse. Trust me, it will save you thousands of dollars in the long run. I have seen people who have wanted to say money on attending a really low cost program without doing all their research, but ended up paying for it later with years and years without a nursing license that will make them money. Do the research so you don’t suffer later.

Disclosure: There are some affiliate links below, but these are all products I highly recommend. I won’t put anything on this page that I haven’t verified and/or personally used.

#2- Funding plan to pay for education

You want to make a decision early on exactly how you’re going to even pay for your nursing education. Are you going to work and pay out of pocket? Loans? Scholarships? Grants? Evaluate this now so it doesn’t stress you out later. You can check out Juno for more funding opportunities.

#3- Study partners or a community

Nursing is not meant to be done alone. You need some kind of support system with ideally fellow classmates to study with, so definitely make friends while you are in your program. You can also check out our community called, NCLEX Prep for Success on Facebook where we have thousands of students who range from nursing students to nursing graduates. Learn more here.

#4- Easy nursing books

Let me tell you, the thing that really saved my life in nursing school was easy to digest nursing books. Nursing is very complicated to learn so I needed books that could break everything down a lot more easier for me. One of the books I recommend are the cheat sheets codes by Picmonic. It’s available here on Amazon.

For additional nursing books, you can read my entire article here called, “Top 3 NCLEX Review Books”.

#5- Study tips

Did you know that there are multiple different ways to study effectively? And the reality is that nursing is something takes a lot of intention effort to completely learn it. This is why you need to leverage specific study tips that will help you to master what you need to know when it comes to really understanding nursing. You can visit our blogs, “7 Incredible Nursing School Study Tips For Success” or “3 Easy Tips To Learning Nursing“.

#6 – Tutor help

One of the things that helped me when I was taking my prerequisites in nursing was a tutor. I do recommend a tutor if you feel like you’re really struggling to learn the material on your own. We provide NCLEX coaching, which you can learn more by attending our webinar here or for other subjects, you can visit Wyzant Tutoring which has hundreds of tutors.

#7 -NCLEX Prep Help

So hears the reality, the number of people NOT passing the NCLEX exam is slowly rising year after year. This includes new graduates as well as repeat test takers. I did the math and in 2016, there was about 63,000 graduates who didn’t pass their exam. However now in 2020, there was about 96,399 graduates who did not pass their exam in total. This is definitely alarming and concerning. If you want us to help you to pass your test, watch our free webinar called, “How To Pass The NCLEX!” here

#8- Finding a good nursing job

Yes there is an abundance of nursing jobs but the challenge is having the right experience and credentials to get your ideal job. A great place to start when it comes to looking for jobs is

#9- Mentor

What is a mentor? A mentor is someone who has already gotten to where you want to be and can help guide you along the way to help you achieve your goals. Find your mentor. Ask around. Talk to coworkers. It’s very important. Mentors can also come in the form of books, youtube channels and more. You can follow our Youtube channel here at

#10- Scrubs and shoes

You definitely need a good pair of nursing scrubs and uniforms. It can honestly make a big difference when it comes to working on the job. You can visit our Amazon site here for a list of nursing scrubs and shoes that we recommend.

#11- Overcoming nursing burnout

It’s true. There are nurses who are burned out everyday from their job. But then there’s also thousands of nurses who have been working 10-20 years and love what they do. The issue is all about work life balance. Make sure to always take time for you so you don’t become the former.


To med surg or not to med surg? That is the question.

While you were in nursing school, did people often tell you that MUST start on a Medical Surgical floor once you finish school?

Did they emphasize how important it is to start on this floor and without it you stand very little chances of becoming successful?

Well I am here to tell you that this is completely untrue. Medical Surgical nursing is a good floor for many new graduates but however it is not necessary for your success.

If you are fortunate enough to already know what type of specialty you want to go into once you finish nursing school then please by all means do it. Follow your PASSION.

Nursing is not an easy career so if you can find something about it you already enjoy then go with your gut. Your passion will lead to your success.

The reason why Medical Surgical nursing is usually recommended is because it provides a general foundation of what nursing is. You pretty much see everything on this kind of floor. You work with post op patients, patients with chronic illnesses, elderly patients from skilled nursing facilities, rehab patients, young patients, bariatric patients, patients with psychiatric problems, and sometimes you deal with emergencies for patients in rapid response or code blue situations. Nearly everything you can imagine.

Medical Team Working On Patient In Emergency Room

Medical Surgical nursing is the floor that will teach you the most about time management and prioritization. If you don’t know what interests you the most in nursing, a Medical Surgical floor is a great stepping stone to help reveal to you what this may be. You will also gain many hands on clinical skills from working in this area of nursing as well as critical thinking skills. Thus making this the traditional floor for new graduates.

The reason why I am not advocating it as a requirement to start your career is because it’s not for EVERYONE. There are many nurses who will already know during their rotation that it’s not the specialty they want to do and some who will be forced to during a difficult economy.

My overall best recommendation is that if you can find a hospital with a great residency program in the specialty you enjoy, take it. Do not put it aside because of the negative stereotypes you’ve heard during nursing school.


With so many questions regarding what one should study for the NCLEX, I thought it would be a good idea to take particular areas of study and highlight some of the disorders associated with them. Today, I would like to share with you five pediatric disorders you need to know for the NCLEX.

Disclosure: There are some affiliate links below, but these are all products I highly recommend. I won’t put anything on this page that I haven’t verified and/or personally used

1. PYLORIC STENOSIS IS VERY COMMON AMONG INFANTS.Pyloric stenosis is a narrowing of the opening (pylorus) from the stomach to the small intestine. anatomical locations the pylorus. stomach of the human. Vector illustration for biology, scientific, and medical use.

Normally, food passes easily from the stomach into the first part of the small intestine through the pyloric sphincter. With pyloric stenosis, however, the muscles of the pylorus are thickened, which prevents the stomach from emptying into the small intestine properly.SymptomsThe most obvious sign of pyloric stenosis is projectile vomiting. Because the pyloric sphincter is restricted, anything the infant tries to swallow comes back up. Pyloric stenosis is most commonly seen in infants aged 1-5 weeks, but may be seen at up to six months of age. Other symptoms include weight loss, persistent hunger and irritability.DiagnosisDiagnosis can be by physical exam, initially, and then other tests, as indicated. Physical signs include dehydration, a swollen belly, or an olive-shaped mass when feeling the upper belly. Usually the first imaging test is an abdominal ultrasound. A barium x-ray will reveal a swollen stomach and narrowed pylorus. Blood tests will reveal an electrolyte imbalance related to vomiting.Treatment Options and PrognosisIf the physician feels surgery is necessary, a pyloromyotomy may be performed. During this procedure, an incision is made in the muscles of the pylorus to create a larger opening. If the infant cannot be safely put to sleep for surgery, an endoscope with a balloon attached may be used to widen the pylorus. Prognosis for this disorder is good, as infants can usually resume small feedings within a few hours after surgery

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2. HIRSCHPRUNG’S DISEASEHirschsprung’s disease is a birth defect (nerves are missing from parts of the intestine). Constipation. illustration represent the human intestine (large and small). Vector diagram for biology, scientific, and medical use.Hirschprung’s disease is a congenital disorder that researchers believe is related to flaws in DNA instructions. It is thought to develop during the early months of pregnancy. As a fetus develops, nerve cells are created throughout the entire digestive system. These nerve cells are known as ganglion cells. One of their roles is peristalsis of the digestive system. In a baby with Hirschsprung’s, the nerve cells stop growing at the end of the large intestine, just before the rectum and anus. Others may have an absence of these cells in other parts of the digestive system, as well. Because the nerve cells are absent, this means that the body cannot sense when there is waste present that needs to be expelled. This results in constipation and may lead to bowel blockagesor perforations.SymptomsHirschsprung’s disease affects about one in every 5,000 newborns. A child who has another congenital defect may be more likely to have Hirschsprung’s. Parents who carry the gene, especially mothers, , may pass it on to their children. Symptoms usually begin within the first 6 weeks of life, with some symptoms occurring as soon as 48 hours after birth. Symptoms include a swollen abdomen, no bowel movements, chronic constipation, diarrhea (possibly bloody), and green or brown vomitus. Older children may also experience extreme fatigue and growth issues.Diagnosis and TestsA contrast (barium) enema can be used to allow the physician to see which areas of the colon are affected. An abdominal X-ray may show a blockage. Rectal biopsies may be performed, if the physician prefers. Anorectal manometry test inflates a small balloon inside the rectum to see whether the muscles of the area respond. This test is done only on older children.TreatmentHirschsprung’s is a very serious condition. If it is found early it can almost always be cured by surgery. One surgery option is a colectomy.During a colectomy, the part of the intestine missing the nerve cells is removed. The remaining intestine is then connected directly to the anus. Another option is an ostomy surgery. With this option, the affected area of the intestine is removed and the remaining intestine is routed to an opening in the abdomen. In children, the ostomy is usually a temporary measure until a colectomy can be performed.

Prepare for your little one today by ordering some important baby formula so you always have enough in stock through this link here.

Want to learn more? Get access to colorful, visual video tutorials that will teach you all about fetuses grows inside of the uterus and what you need to know through our partner here.

Disclosure: There are some affiliate links below and I may receive commissions for purchases made through links in this post, but these are all products I highly recommend. I won’t put anything on this page that I haven’t verified and/or personally used.

3. REYE SYNDROMELiver, pancreas, gallbladder and spleen detailed drawing on a white backgroundThis is a rare but serious disease that causes swelling in the liver and brain. It is most often seen in children and teenagers recovering from a virus. One main risk factor for Reye syndrome is taking aspirin or other salicylates. Doctors recommend that children and teenagers recovering from viral infections should avoid taking aspirin.SymptomsWhen Reye syndrome occurs, cells in the body begin to swell and build up fats. Blood sugar levels drop and ammonia and acid levels rise in the blood. This can cause trauma to various organs, especially the liver and brain, where severe swelling may occur. In children less than 24 months of age symptoms may include diarrhea and tachypnea. In older children and teenagers, early symptoms may include ongoing vomiting and unusual fatigue. Left untreated, symptoms become more severe and include irritability, confusion, hallucinations, seizures, or loss of consciousness.Diagnosis and TreatmentThere is no specific test to diagnose Reye Syndrome. However, screenings such as urine and blood tests may be performed, as well as screening for disorders involving fatty acids. Other tests may include spinal taps, liver biopsies, or CT scans. Also, there is no single treatment that will stop Reye Syndrome. However, doctors can do some things to make sure it is managed. They can also try to prevent more severe symptoms and see that brain swelling is held down. These steps include: Diuretics to help rid your body of sodium and water (decrease edema), IV fluids, Vitamin K to assist with clotting, platelets, and plasma when liver bleeding occurs.

How well a person recovers from Reye Syndrome and the chances of long-term brain damage depend upon the extent of swelling of the brain and how long the syndrome is left untreated.

4. TRACHEOESOPHAGEAL FISTULA AND ESOPHAGEAL ATRESIAIllustration of male stomach anatomyTracheoesophageal fistula (TEF) is a condition in which a fistula connects the trachea to the esophagus. Food and saliva pass through the fistula into the trachea and can get into the lungs. This can make a child cough or choke and lead to lung infections or pneumonia. Esophageal atresia (EA) is a condition in which the esophagus does not form completely. Usually there is an upper and lower portion of the esophagus, each of which has a closed end. A baby with EA cannot eat or drink by mouth because there is no way for food or liquid to travel from the mouth to the stomach.Although TEF and EA are two different disorders, they are most often seen together. TEF/EA is not thought to be inherited, but are considered congenital disorders. About 1 in 4,000 children are born with TEF, EA, or both. Approximately one third of these children are born prematurely.SymptomsSymptoms usually include coughing or other respiratory symptoms. These symptoms are especially obvious during feedings. When both TEF and EA are present, the symptoms are usually obvious shortly after birth. Symptoms include difficulty breathing and coughing or chokingwhile trying to swallow.OptionsMost TEF/EA babies will require surgery soon after they are born. One option, esophageal anastomosis, occurs when the surgeon opens each closed end of the esophagus and connects those ends together to form one uniform structure. Another option, a thoracotomy with fistula ligation is a surgical procedure in which the surgeon gains access through the pleural cavity to the esophageal fistula and performs a ligation. This allows there to be a separation between the trachea and esophagus, as should occur in a healthy body. Without surgical complications or post-operative difficulties, prognosis is good.

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Phenylketonuria (PKU) is an inherited disorder that results in increased levels of the amino acid, phenylalanine, in the blood. High protein foods are the main source of phenylalanine. Left untreated, PKU can cause phenylalanine to build up to harmful levels. This can result in serious health issues, including intellectual disabilities.SymptomsSymptoms of PKU may be mild or severe. The most severe form of the disorder is known as “Classic PKU”. Infants with Classic PKU may, actually, appear normal until they are at least a few months old. Without treatment, permanent disabilities including seizures, delayed development, behavioral problems, and psychiatric disorders may occur. Side effects of excess phenylalanine in the body may also include amusty odor of the skin or urine. Children with classic PKU are, also, likely to have skin disorders such as eczema and may have more fair skin and hair colors.When Mothers Have PKUPediatric patients born to mothers who have PKU and uncontrolled phenylalanine levels have a significant risk of intellectual disability. This is because of fetal exposure to high levels of phenylalanine. These infants may exhibit low birth weight and slower growth. Other characteristics include cardiac issues, microcephaly, and behavioral issues. . Women with PKU and uncontrolled phenylalanine levels also have an increased risk of pregnancy loss.Side Note:Remember, no one has the exact same test. Whether you have one pediatric question or one hundred, remember…. You’ve got this! Now, go rock the NCLEX like the nurse you were born to be!!!


For the NCLEX exam, it is important that you not only just know the different organs in the body but you really understand how it relates to the role of the nurse.This is the main general point to mastering the body systems on the exam.In this article, I will discuss six major organs you must know for the NCLEX exam.

Disclosure: There are some affiliate links below, but these are all products I highly recommend. I won’t put anything on this page that I haven’t verified and/or personally used.


It’s important that you understand not only what the brain does but the purpose of each lobe and how it effects the patient if it is damaged.Main Role: Maintains the neurological and mental health of the patients. Effects coordination and balance, speech, ability to swallow.Abnormalities in the brain would need to monitor their level of consciousness. Ex: autonomic dysreflexiaTHE HEART

For the heart, you need to understand how blood flows through the heart, what is the electrical conduction system and what are some common heart conditions.Main Role: Pumps blood through the circulatory system by rhythmic contraction dilation.Abnormalities would need to monitor fluid balance, heart rate, tissue perfusion, etc.THE LUNGS

For the lungs you need to understand oxygen exchange, and how are the lungs effected when the patient has certain lung diseases or problems.Main Role: Where gas exchange takes place at the alveolar level so the patient can breathe normally.Abnormalities in the lung would require the nurse to monitor respirations, lung sounds, ABGs, etc.For visual help, visit our partner Picmonic which breaks down anatomy and physiology visually.

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When it comes to the liver, you want to know the purpose of the liver and what are all the enzymes or lab values it houses.Main Role: Metabolizes and excretes everything that comes in and goes out of the body. Also houses the clotting factors and fatty acids.Abnormalities would need to monitor electrolyte levels, clotting factors, skin color (jaundice).THE KIDNEYS

For the kidneys, you want to make sure you not only know what they do, but also their corresponding lab values, acid base imbalances and how the body responds when they are damaged.Main Role: Filters blood of metabolic wastes, regulates acid base concentration, maintain electrolyte balance. Abnormalities would need monitor labs (BUN/Cr), electrolytes, urinary output.THE PANCREASThe pancreas is a very important organ in the body and is one many test takers overlook and don’t really understand.It’s important that you understand not only it’s function but also how it changes the health of the patient when it is damaged. One great example is with diabetes mellitus.Main Role: Secretes hormones and digestive enzymes including insulin.Abnormalities would need to monitor intake and output, glucose levels, etc.Thanks for reading!


It absolutely saddens me when I see other future nurses take their exam over and over again which causes them to lose their confidence and ability to become a great nurse. I DO NOT want to see that happen to you. I am here to help bridge that gap. I will outline the mistakes you MUST AVOID so you can take and pass your NCLEX exam the first time or if this isn’t your first time, the next time. So take your time and read this WELL and if you need to, read it over and over again.

Best of luck!


One of the biggest mistakes that significantly reduces your chances of passing the NCLEX is purposely waiting a long time to schedule their NCLEX test date. How long is too long? Anything greater than four months from the time you graduated your program is too long. Take it as soon as you comfortably feel you can take the exam. The sooner you take the test, the greater your chances are of passing.


Do you know how you best learn? How you best retain information? Are you a kinesthetic learner? Audio learner? Because what works for me, may not work for you.


Let’s say Susan may be able to take several practice tests over and over again and get a 100% on her exam while Joann may need to listen to audio tapes of the same test material over and over again to get a perfect score.

I recommend you figure out what your learning technique is and then apply it immediately to your study habits. This will help guarantee you success. Even if you did not pass the first time around, you can start applying this idea right now. How do you find out your learning technique? Well think about what has worked for you in the past. What techniques have you been successful with? You can always also Google it. There are hundreds of quick sources online to help you quickly determine your specific learning style.



There’s a huge difference between taking a bunch of practice questions on flash cards or in a book versus sitting down and taking an actual practice test in a test like scenario/environment. Practice questions are wonderful; they’re a great study guide. However, before you take your NCLEX exam, you should sit down and take a practice test, preferably on a computer. And if you can, do this more than once. You do this method so it will teach you how to take the NCELX. It will teach you how to answer questions in a test environment.

Mistake #4


Guess how long you have to take the NCLEX exam? FIVE HOURS!! That’s a very long time to take a test. More than enough time actually. Knowing this, you can rest easy so that you take your time to select the right answer.

You can double check your answers; you can exhaust your scratch paper and go over your math before you hit submit. However you can’t go back. So there’s absolutely no reason to rush through your exam. You can take your time and be sure.

Mistake #5


When it comes to your priority questions particularly, the ABC rule will be your best friend.

A for Airway

B for Breathing

C for Circulation

When you can’t decide between two answers, always go with the selection that addresses the higher rule first.

EXAMPLE: You get a question and you have it down between two answers

Scenario 1: Says treat the patient with minimal bleeding from the surgery site on post op day 1 or your CNA just told you your newly trach patient is behaving anxiously, go with the trach patient; that’s airway.

Scenario 2: The other answer is circulation. Sounds like a trick question because it’s using the word “anxiously” which some might interpret as a psychosocial issue, but the test wants to see if you’re competent enough to recognize this as a sign your patient is not doing well.

IMPORTANT TIP: Every time you get a priority question, you should first identify which ABC rule applies, then select the higher rule.


Struggling to pass your NCLEX exam? Here is a list of 21 different things you can do to increase your chances of passing.

  1. Study with a partner
  2. Create a study plan
  3. Take notes when you listen NCLEX trainings
  4. Study nearly everyday
  5. Use visual aides
  6. Go to the library
  7. Keep your vision in front of you
  8. Don’t talk to negative people
  9. Join study groups where they post updates about the exam
  10. Attend a review class
  11. Study your weak areas
  12. Study anatomy and physiology
  13. Study pharmacology first
  14. Create flash cards
  15. Create audio flashcards
  16. Identify the pathophysiology of each disease pattern
  17. Use comprehensive books to supplement your learning
  18. Get tutoring
  19. Ask people to help you
  20. Keep a list of keywords
  21. Learn multiple strategies


Do you struggle with really grasping and understanding medical surgical nursing? I know I did. I am going to use this article to hopefully really help you to better understand how to learn and retain your understanding of medical surgical nursing.

Let’s get started.

The very beginning of really grasping med surg is making sure you really first understand the basics. A lot of times, the reason why you are struggling to retain different areas in med surg is because there are some holes in your foundation of the fundamentals behind nursing. Here are some examples of what I mean by this.

Fluid and Electrolytes

Part of really understanding medical surgical nursing is that you need to first grasp how fluid and electrolytes work. You want to know and learn different concepts such a osmosis and diffusion. This also ties into microbiology as well which is the study of microorganisms. Understanding fluid and electrolytes involves the movement of particles through the cell. When you understand this, it helps you to better understand why we do or do not do certain nursing interventions.

Anatomy and Physiology

This is SO essential. Anatomy and physiology is key towards really understanding medical surgical nursing. If it has been a long time since you have finished nursing school, then this is usually one of the first areas many nursing graduates forget. When you know and memorize the anatomy and physiology of the different organs of the body then this makes it easier for you to grasp pathophysiology which is the study of the disordered physiological processes associated with disease. Some ways you can improve in this area is to start by reviewing and studying the function for all the 11 systems in the body. You want to study their normal function(s) as well as also the lab values associated with each of them, the normal processes in the body associated with each of them and the major organs where these processes occurs.

This is a great picture below that illustrates the anatomy of the muscles located in the neck.

Once you learn these neck muscles and how they work then it will help you to better understand neurological disorders that such as a stroke or injury in the brain that destroys or damages one of the cranial nerves which influences the movement of these neck muscles. And if that movement of that neck muscle is damaged or other muscles associated with it, then this means they’re going to likely have problems swallowing, breathing or other functions that muscle does. This then influences what type of nursing care you should anticipate to give to your patient which is medical surgical nursing.

One tool I recommend that is very helpful with understanding anatomy and physiology is Picmonic.

You can watch the video below, called “How To Understand Medical Surgical Nursing!” to learn all about them.

With Picmonic, you can sign up for free today and get a 20% off discount!

Look At The Process

Another thing I will mention that makes medical surgical nursing so difficult is the fact that honestly you can not learn it from just memorization only. You have to understand that it is much more abstract and for this reason, you need to focus on looking at the process.

For example if I am trying to really learn and grasp diabetes mellitus, I need to first understand what glucose is and how it is broken down in the body.

Then once I learn this, I need to learn the anatomy and physiology of the pancreas which is where insulin is stored.

And we know that beta cells produces insulin inside the pancreas.

islets of Langerhans and diabetes mellitus type 1.

Once we grasp this, then we can understand that the beta cells are destroyed which is the cause of type 1 diabetes mellitus.

So if the beta cells are destroyed then this means there is not enough insulin to break down the glucose which results in high levels of glucose also known as hyperglycemia.

Do you see that?

Once of the reasons why you may be struggling to really grasp med surg is that you are missing steps. You are either trying to learn everything at once which is making it complicated for you or you not simplifying the steps enough for you to really memorize it.

Additional Recommendations

Sometimes books can also be helpful as well with grasping medical surgical nursing.

To see a list of books I recommend, visit

I hope you found this helpful.

If you need more help understanding medical surgical nursing, you can also receive access today to our free NCLEX Prep Mini Course by visiting

Thanks for sharing!


Today we are bringing some important facts to you. I recently did some research and I wanted to share with you the top five lowest NCLEX passing rates by states within the past year.

#5- Florida – We all know about Operation Nightingale and the recent scandal that took place with so many nursing schools with the state of Florida being one of the central locations. But it looks like it is definitely reflecting and showing in the NCLEX passing rates. Let us remember this is in the past year so one can only imagine what the numbers will look like once the Next Generation NCLEX arrives next month.

#4- Maryland – This one surprised me a little bit. I’ve been speaking with a number of individuals via Zoom who graduated from a nursing school in Maryland and they still haven’t passed many years later. it’s kind of scary because they often are not aware that they are not the only one.

#3- New York – Now one of the things that really separates New York from all the other states within the country is that they have an unlimited number of tries graduates can take the exam. Which means that test takers are more inclined to taking the exam even with little preparation which could naturally affect the passing rates.

#2- New Mexico – Now I honestly don’t know too much about New Mexico to really comment on why these numbers are happening in this state. However though with an only 77% NCLEX passing rate, it takes #2 on our slots.

#1- Virgin Islands – The number one state we have on our list with the LOWEST passing rate is the Virgin Islands, which does count as a state in one of our 50 states for those who don’t know. I have talked to SEVERAL people in the Virgin Islands that haven’t passed their test yet and you want to know one of the major things I have noticed that prevents them from passing? Not understanding the content. The life expectancy and conditions is wildly different than the U.S which can put them at a disadvantage.

Now if you fall under one of these states or you know someone who does or some of the other states I didn’t get to mention, it’s important that you get help QUICKLY.

The NCLEX is changing next month permanently and there’s nothing you or I can do about.

You have to prepare for the change with the right information, presented in a way that makes sense to you so you can pass.

These are all things that I teach in depth inside of our School of the NCLEX Refresher Course.