Are you usually nervous before tests? You don't have to be. Here's a checklist of things to do the next time you're feeling nervous about a test.

Before the test

• Talk to your instructor and classmates about what the test will cover.
• Divide your study time over several days instead of trying to review everything the night before the test.
  
• When studying, use all your resources, including your textbook, lecture notes, and completed homework assignments.
  
• Create 3 x 5 cards for each key concept or formula that might appear on the test. Then, use the flash cards to test your memory.
  
• Take a practice test. Find a room that's free of distractions and give yourself a specific amount of time to complete the test.
  
• Try to avoid studying right before the test. Put those notes away and take some time to relax!
  
• Arrive 5 minutes early so you'll be ready when the instructor begins the test. Just don't arrive too early--sitting in an empty classroom or listening to other students' nervous chattering might make you feel anxious.
  

During the test

• Break the tension. If your instructor allows it, get up to ask a question, sharpen your pencil, or get a drink.
  
• Focus on tensing and relaxing muscles in different parts of your body, such as your neck and shoulders. Then, close your eyes and take a few deep breaths.
  
• Calm your nerves by putting the test into perspective. Life will go on after the test is over. Remember that doing your best is sufficient.
  
• Think of something calm and soothing when you feel test anxiety getting the best of you.
  

Source: Student Success for Health Professionals Made Incredibly Easy! by Nancy Olrech, Lippincott Williams & Wilkins, 2008.

When teaching a patient who's been diagnosed with diabetes mellitus, be sure to cover:

• the disorder, diagnosis, and treatment
• the importance of smoking cessation
• medication and potential adverse reactions
• when to notify the healthcare provider
• avoidance of crowds and people with known infections
• avoidance of areas where smoking is permitted
• home oxygen therapy, if indicated
• coughing and deep-breathing exercises
• high-calorie, high-protein diet
• adequate oral fluid intake
• avoidance of respiratory irritants
• signs and symptoms of pneumothorax
• the need for influenza and pneumococcal pneumonia immunizations
• how to access the American Lung Association to obtain additional information
  
• location and contact information for a local support group and local services.

Source: All Things Nursing, Lippincott Williams & Wilkins, 2007.

Among the new drugs recently approved by the Food and Drug Administration:

• RiaSTAP (fibrinogen concentrate [human]) has been approved for the treatment of bleeding in patients with a rare genetic defect known as congenital fibrinogen deficiency.
  
• Savella (milnacipran hydrochloride) has been approved for management of fibromyalgia.
  
• AllerNaze (triamcinolone acetonide), a nasal spray, has been approved for the once-daily treatment of nasal symptoms associated with both seasonal allergic rhinitis and perennial allergic rhinitis in adults and children age 12 and older.
  

Source: Food and Drug Administration.

Worried about passing the NCLEX? The more practice questions you do, the more confident you'll feel. Try these, then review the answers and rationales that follow. Experts recommend taking many practice questions before the NCLEX, so take advantage of review courses, books, and other products to help you succeed and pass the NCLEX. ANSWERS BELOW.

1.	A client's attorney must prove which elements for a professional negligence action?
	1.	Duty, breach of duty, damages, and causation
	2.	Duty, damages, and causation
	3.	Duty, breach of duty, and damages
	4.	Breach of duty, damages, and causation
2.	A nurse asks a nursing assistant to help admit an elderly client diagnosed with pneumonia. Which activity is appropriate for the nurse to ask the assistant to perform?
	1.	Obtain the client's height and weight.
	2.	Obtain an arterial blood gas sample.
	3.	Insert a small-bore feeding tube.
	4.	Assess lung sounds.
3.	Four 6-month-old children arrive at the clinic for diphtheria-tetanus-pertussis (DTaP) immunization. Which child can safely receive the immunization at this time?
	1.	The child with a temperature of 103° F (39.4° C)
	2.	The child with a runny nose
	3.	The child with uncontrolled epilepsy
	4.	The child with difficulty breathing after the last immunization
4.	A pediatrician writes an order for digoxin (Lanoxin), 2.5 mg, for a neonate. A nurse questions the order with the pharmacist and physician taking the call. Which legal standard is most relevant?
	1.	American Medical Association
	2.	American Nurses Association
	3.	American Pharmaceutical Association
	4.	Nurse Practice Act
5.	A physician ordered a urine specimen for culture and sensitivity stat. Which approach is best for a nurse to use in delegating this task?
	1.	“We need a stat urine culture on the client in room 101.”
	2.	“Please get the urine for culture for the client in room 101.”
	3.	“A stat urine was ordered for the client in room 101. Would you get it?”
	4.	“We need a urine for culture stat on the client in room 101. Tell me when you send it to the lab.”

• National Student Nurses Association Annual Convention
  Making it Big: Nursing Students Stepping Up & Stepping Out. April 15-19, 2009, at the Opryland Hotel in Nashville, Tenn.
  
• Nursing2009 Symposium
  May 6-9, 2009, at Disney's Coronado Springs Resort, Orlando, Fla.

Don’t miss these substantive, peer-reviewed features from the January issue of Nursing2009. They'll help you learn about evidence-based practice.

• Putting a stop to dysfunctional uterine bleeding
  By Denise McEnroe Ayers, RN, MSN, and Mariann Montgomery, RN, MSN
  Learn how to search for the source of abnormal bleeding and help your patient get back on track.
  
• Shedding health risks with bariatric weight loss surgery
  By Susan Gallagher Camden, RN, CBN, MA, MSN, PhD
  More and more obese patients are turning to bariatric weight loss surgery, which is proving its worth by decreasing or eliminating dangerous comorbidities of obesity. Here's how to help prepare your patient for surgery and care for her afterward.
  

1. 1 Any professional negligence action must meet four demands--commonly known as the four Ds--to be considered negligence and result in legal action: a duty for the healthcare professional to provide care to the person making the claim, a dereliction (breach) of that duty, the breach of duty resulted in damages, and the damages were caused by a direct result of the negligence (causation).
2. 1 Obtaining the client's height and weight are appropriate actions for the nursing assistant to perform. The other options are the responsibility of the registered nurse or other licensed person.
3. 2 Children with mild acute illness without fever can safely receive DTaP immunization. Children with a temperature of more than 102° F (38.9° C), uncontrolled epilepsy, or serious reactions to previous immunizations shouldn't receive DTaP immunization.
4. 4 Each state has a Nurse Practice Act that dictates a nurse's scope of practice. Each nurse must practice competent standards based on her state's Nurse Practice Act. The American Nurses Association is an organization of nurses that offers credentialing and nursing education. It doesn't set standards of nursing practice. Physicians and pharmacists must practice competency based on the standards established by their professional organizations.
5. 4 This option not only delegates the task, but also provides a checkpoint. To effectively delegate, you need to follow up on what someone else is doing. The other options don't provide for feedback, which is essential for communication and delegation.

Source: NCLEX-RN Questions & Answers Made Incredibly Easy!, 4th edition, Lippincott Williams & Wilkins, 2007.

Allergic Asthma Resource Center Developed in Partnership with the Asthma and Allergy Foundation of America (AAFA)
Despite treatment, many of your patients' asthma symptoms may not be under control. They may have allergic asthma, the most common form of asthma, which is triggered by allergens like pet dander, dust mites or mold. An IgE test is one way to help determine if your patients' asthma is allergic. AAFA, as part of their "What's My IgE" educational program, encourages healthcare professionals and patients to discuss whether an IgE test is appropriate.
Visit the Allergic Asthma Resource Center Now.

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