Decision Tree:
This walk-through provides test-taking strategies to determine the correct answer for the different types of questions you will encounter on the NCLEX-RN exam. These strategies are based on the Kaplan Decision Tree (DT) algorithm, a technique that provides a process to determine the correct answer for NCLEX-style questions.
This is a Priority Question.
Priority questions use words such as most, best, first, immediate, etc.
STEP 1: Can you identify the topic of the question?
STEP 2: Are the answer choices assessment or implementation?
Assessment vs. Implementation
- Determine if the client has a history of prostate enlargement. Assessment
- Insert an indwelling urinary catheter. Implementation
- Monitor the client's daily weights. Assessment
- Assess the client's blood pressure. Assessment
When there is a mix of assessment and implementation answers, ask if further assessment or validation is needed. Is assessment or assessment validation needed? Yes, the client's diagnosis is noted in the stem, but there is no information about the client's current condition. Eliminate #2. Move to Step 3.
STEP 3: Apply Maslow: Are the answer choices physical or psychosocial?
Maslow
1. Determine if the client has a history of prostate enlargement. Physical
3. Monitor the client's daily weights. Physical
4. Assess the client's blood pressure. Physical
Because a mix of physical and psychosocial answer choices does not exist, answer choices cannot be eliminated at this step. Move to Step 4.
STEP 4: Are the answer choices related to ABCs?
ABCs
1. Determine if the client has a history of prostate enlargement. N/A
3. Monitor the client's daily weights. Circulation
4. Assess the client's blood pressure. Circulation
When there is a mix of ABC and non-ABC answer options, ABC answers take priority if they make sense with the topic. The topic is circulation, as the client with prerenal AKI will have experienced or is experiencing reduced blood flow to the kidney secondary to poor cardiac output or hypovolemia; therefore we need a circulation answer. Eliminate #1. Move to Step 5.
STEP 5: What is the outcome of each of the remaining answer choices?
Evaluate the outcome(s)
3. Monitor the client's daily weights. This will provide the nurse with information about the client's condition over a period of time, but will not provide information about the "here and now." Eliminate.
4. Assess the client's blood pressure. This will assist the nurse to determine whether the client is stable in the "here and now" and whether the client's blood pressure is adequate for renal perfusion.
Select the best choice:
Is #4 the correct answer? Yes, prerenal AKI is due to a lack of blood flow. The nurse must ensure adequate perfusion to the kidneys.
Does #4 make sense? Yes, this ensures the client's current circulatory status is adequate.
