Taking notes isn't the only way to increase learning in the classroom. You'll need to do things in addition to taking notes in order to increase your learning potential. Get the most out of class by focusing on:

• information presented in handouts
• key terms or ideas the instructor writes on the chalkboard
• concepts the instructor emphasizes during the lecture
• any questions raised by classmates and your instructor's responses to those questions
  
• your own opinions and thoughts about material presented by the instructor
• material that isn't covered in the textbook
• the instructor's teaching style
• the instructor's introductory and summary statements (given at the beginning and end of each lecture).

Knowing your personal learning style can give you an advantage in the classroom. Being aware of how you learn can help you increase the amount of information you understand and remember. By using a variety of learning techniques, you can accommodate your learning style. As a result, you'll have better communication with your instructors.

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

• Thickening and calcification of valvular tissue
• Increased pressure in the left atrium
• Pulmonary hypertension and left atrial hypertrophy
• Right ventricular failure
• Narrowing of the mitral valve opening results

Source: Straight A's in Medical-Surgical Nursing, 2nd edition, Lippincott Williams & Wilkins, 2007.

Good documentation should offer legal protection to you, your patient's other caregivers, and the healthcare facility.

Admissible in court as a legal document, the medical record provides proof of the care received by the patient and the standards by which the care was provided. Medical records typically serve as evidence in disability, personal injury, and mental competence cases. They're also used in malpractice cases, and how and what you document--or don't document--can mean the difference between winning and losing a case, not only for you but also for your employer.

For the best legal protection, make sure your documentation shows that you not only adhere to professional standards of nursing care but also follow your employer's policies and procedures--especially in high-risk situations.

Source: Complete Guide to Documentation, 2nd edition, Lippincott Williams & Wilkins, 2007.

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 nurse is preparing to bathe a client who has been hospitalized for emphysema. Which nursing intervention is correct?
	1.	Remove the oxygen and proceed with the bath.
	2.	Increase the flow of oxygen to 6 L/minute by nasal cannula.
	3.	Keep the head of the bed slightly elevated during the procedure.
	4.	Lower the head of the bed and roll the client to his left side to increase oxygenation.
2.	A 56-year-old client with heart failure is allergic to sulfa-based medications. Which type of diuretic should be used cautiously?
	1.	Osmotic diuretics
	2.	Thiazide and thiazide-like diuretics
	3.	Potassium-sparing diuretics
	4.	Carbonic anhydrase inhibitors
3.	Which condition most commonly results in coronary artery disease (CAD)?
	1.	Atherosclerosis
	2.	Diabetes mellitus
	3.	Myocardial infarction (MI)
	4.	Renal failure
4.	Which blood test is used first to identify a response to human immunodeficiency virus (HIV) infection?
	1.	Western blot
	2.	CD4+ T-cell count
	3.	Erythrocyte sedimentation rate
	4.	Enzyme-linked immunosorbent assay (ELISA)
5.	An elderly client with pneumonia may appear with which symptoms first?
	1.	Altered mental status and dehydration
	2.	Fever and chills
	3.	Hemoptysis and dyspnea
	4.	Pleuritic chest pain and cough

• 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 6-10, 2009, at Disney's Coronado Springs Resort, Orlando, Fla.

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

• An upward trend in motorcycle crashes
  By Joan M. Pirrung RN, APRN-BC, MSN, and Pamela Woods RN, CEN, BSN, SANE-A
  Is your team ready to manage the care of a patient who has complex injuries from a motorcycle crash? Follow this case study to make sure you're up to speed on this increasingly common cause of trauma.
  
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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.

How Proper Documentation May Reduce Your Lawsuit Risk
Good documentation can help you defend yourself in a malpractice lawsuit, and it can also keep you out of court in the first place. You have to make sure it's complete, correct, and timely. If it's not, it could be used against you in a lawsuit.
Download the Special Report Now.

1. 3 The elasticity of the lungs is lost for clients with emphysema, who can't tolerate lying flat because the abdominal organs compress the lungs. The best position is one with the head slightly elevated. The rate of oxygen delivery shouldn't be increased or decreased without an order from the physician. Increasing oxygen flow in a client with emphysema may also suppress the hypoxic drive to breathe. Positioning the client on his left side with the head of the bed flat would decrease oxygenation.
2. 2 Thiazide and thiazide-like diuretics are sulfonamide derivatives, so their use should be used cautiously in clients allergic to sulfa-based medications. Osmotic, potassium-sparing, and carbonic anhydrase inhibitor diuretics can be safely administered to these clients.
3. 1 Atherosclerosis, or plaque formation, is the leading cause of CAD. Diabetes mellitus is a risk factor for CAD but it isn't the most common cause. Renal failure doesn't cause CAD, but the two conditions are related. MI is commonly a result of CAD.
4. 4 The ELISA is the first screening test for HIV. A Western blot confirms a positive ELISA test. Other blood tests that support the diagnosis of HIV include CD4⁺ and CD8⁺ counts, complete blood counts, immunoglobulin levels, p24 antigen assay, and quantitative ribonucleic acid assays.
5. 1 Fever, chills, hemoptysis, dyspnea, cough, and pleuritic chest pain are the common symptoms of pneumonia, but elderly clients may first appear with only an altered mental status and dehydration due to a blunted immune response.

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

In the February 2009 edition of LWW American Nursing Student eNews, an error was made in the Patient Teaching: Emphysema article. The introductory paragraph stated, "When teaching a patient who's been diagnosed with diabetes mellitus...," when it should have stated, "When teaching a patient who's been diagnosed with emphysema..." We regret the error and apologize for any confusion it may have caused.

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