What's metalearning? The prefix meta means something that is aware of itself and refers to itself. Metalearning is a process where you ask yourself questions to become aware of your own motives, understanding, challenges, and goals.

In metalearning, you ask yourself a series of questions:

• Why am I reading or listening to this? In the metalearning process, you briefly state your purpose for studying certain material. Your purpose and goals set the stage for your study time.
  
• What's the basic content of this material? Preview material before you read. For long or complex material, translate your preview into a chapter map or outline. You also might want to write what you know about the topic and what you'd like to know or think you will know once you're done studying.
  
• What are the orientation questions? Orientation questions give background information on a topic or concept by asking about definitions, examples, types, relationships, or comparisons. The purpose of using orientation questions is to see how many questions you can ask about the material and how many answers you can find.
  
• What's really important in this material? Identify information you should focus on, ignore, or just skim. As in planning ahead, this helps you figure out where to spend your time. If you can't decide whether something is important or whether it should be skimmed or ignored, assume it's important.
  
• How would I put this information in my own words? Putting things in your own words is called paraphrasing. Paraphrasing helps you understand concepts better and identify gaps in your learning right away. Make sure you can put unique terminology for each subject into your own words.
  
• How can I draw the information? Visual learners can get a lot out of drawing the information they're studying. Representing information in pictures is very useful for building understanding.
  
• How does the information fit with what I already know? If you already have a solid foundation of knowledge about a topic, you can learn new things about that topic more easily.
  

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

Use the PQRST mnemonic device to obtain more information about your patient's pain. Asking these questions elicits important details about his pain.

Provocative or Palliative

• What provokes or worsens your pain?
• What relieves the pain or causes it to subside?

Quality or Quantity

• What does the pain feel like? Is it aching, intense, knifelike, burning, or cramping?
  
• Are you having pain right now? If so, is it more or less severe than usual?
• To what degree does the pain affect your normal activities?
• Do you have other symptoms along with the pain, such as nausea or vomiting?
  

Region and Radiation

• Where is your pain?
• Does the pain radiate to other parts of your body?

Severity

• How severe is your pain? How would you rate it on a 0-to-10 scale, with 0 being no pain and 10 being the worst pain imaginable?
  
• How would you describe the intensity of your pain at its best? At its worst? Right now?
  

Timing

• When did your pain begin?
• At what time of day is your pain best? What time is worst?
• Is the onset sudden or gradual?
• Is the pain constant or intermittent?

Source: Nursing Facts Made Incredibly Quick!, Lippincott Williams & Wilkins, 2006.

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.	Which characteristic is expected for a client with paranoid personality disorder who receives bad news?
	1.	The client is overly dramatic after hearing the facts.
	2.	The client focuses on self to not become overanxious.
	3.	The client responds from a rational, objective point of view.
	4.	The client doesn’t spend time thinking about the information.
2.	Which term describes an effect of isolation?
	1.	Delusions
	2.	Hallucinations
	3.	Lack of volition
	4.	Waxy flexibility
3.	Which health finding is expected in a client who chronically abuses alcohol?
	1.	Enlarged liver
	2.	Nasal irritation
	3.	Muscle wasting
	4.	Limb paresthesia
4.	A nurse notes a change in voice and mannerisms of a client with dissociative identity disorder (DID) after he learns that his wife has filed for a divorce. Which nursing intervention is most appropriate?
	1.	Avoid discussing the client’s feelings.
	2.	Force the client to discuss his feelings.
	3.	Offer encouragement to the client that he’ll be able to cope with the divorce.
	4.	Encourage the client to verbalize his feelings about the divorce.
5.	A client with an ileostomy tells the nurse he can’t have an erection. Which pertinent information should the nurse know?
	1.	The client will never regain functioning.
	2.	The client needs an abdominal X-ray.
	3.	The client has no problem with self-control.
	4.	Impotence is uncommon following an ileostomy.

• Association of Women's Health, Obstetric and Neonatal Nurses Annual Convention
  June 27-July 1, 2009, at the San Diego Convention Center in San Diego, Calif.
  
• Emergency Nurses Association 2009 Annual Conference
  October 8-10, 2009, at the Baltimore Convention Center in Baltimore, Md.

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

• Acute ischemic stroke: Not a moment to lose
  By Julie Miller, RN, CCRN, BSN, and Janice Mink, RN, CCRN, CNRN
  Be prepared to assess your patient’s condition and intervene within the narrow therapeutic window for fibrinolytic therapy.
  
• How to protect yourself after body fluid exposure
  By Andine Davenport, RN, COHN-S, and Frank Myers, CIC, MA
  Injured by a contaminated needle? Don’t panic. Instead, follow this evidence-based advice to reduce your risk of contracting a bloodborne disease.

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1. 3 Clients with paranoid personality disorder are affectively restricted, appear unemotional, and appear rational and objective. Clients with histrionic personality disorder are overly dramatic in response to stress. Clients with narcissistic personality disorder focus on themselves and don’t spend time thinking about bad news. Clients with an obsessive-compulsive personality disorder are preoccupied with the fear of becoming very anxious and losing control.
2. 2 Prolonged isolation can produce sensory deprivation, manifested by hallucinations. A delusion is a false, fixed belief that has no basis in reality. Lack of volition is a symptom associated with type I negative symptoms of schizophrenia. Waxy flexibility is a motor disturbance that’s a predominant feature of catatonic schizophrenia.
3. 1 A major effect of alcohol on the body is liver impairment, and an enlarged liver is a common physical finding. Nasal irritation is commonly seen in clients who snort cocaine. Muscle wasting and limb paresthesia don’t tend to occur with clients who abuse alcohol.
4. 4 Encouraging a client with DID to verbalize his feelings will help him cope with his anxieties. Forcing the client to discuss his feelings can increase his level of anxiety. Avoiding discussion of feelings doesn’t reduce anxiety and avoids the issue. Offering encouragement that the client will be able to cope with the divorce gives false reassurance and can erode the client’s trust in the nurse.
5. 4 Sexual dysfunction is uncommon after an ileostomy. Psychological causes of impotence should be explored. An abdominal X-ray isn’t indicated for sexual dysfunction. An ileostomy can change a person’s self-control, making sexual functioning difficult.

Source: NCLEX-RN Questions & Answers Made Incredibly Easy!, 4th edition, Lippincott Williams & Wilkins, 2008.

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