Positive and Negative Event Queries The questions presented on the NCLEX are written to include either a positive or a negative event query. Primarily, the questions are written as positive event queries; however, you need to be prepared for either type. STUDY TIP Student-to-Student One of the first things you should do when reading a test question is identify whether the query is positive or negative. If you do this, then you will look at the scenario in the appropriate context, and this will increase the likelihood of answering the question correctly. Positive Event Queries What Is a Positive Event Query? A positive event query asks you to make a decision and select the option that is accurate or correct with regard to the data presented in the question. How will you know that the question includes a positive event query? Read the question carefully and focus on the query of the question. The query contains words or phrases that indicate the question includes a positive event query. Positive event query: Select an option that is positive or correct! What Words and Phrases Are Commonly Used in Positive Event Queries? Remember to read the question carefully and focus on the query of the question because the query contains words or phrases that indicate the question includes a positive event query. Several examples of queries and sample questions that indicate the question includes a positive event query are listed below. Positive Event Queries: Words and Phrases Early Initial Select all that apply Late First Understands Most likely Immediately Has been achieved Highest Most appropriate Adequately tolerating Best Order of priority Positive Event Queries: Examples of Queries What is the earliest sign of a change in level of consciousness? Which is a late sign of shock? The nurse most likely expects to note which finding? Which individual is at the greatest risk for committing suicide? The nurse plans to administer how many milliliters of medication? What best action should the nurse implement? Which action should the nurse do first? What is the initial nursing action? Based on these findings, the nurse should immediately take which action? Which nursing action is most appropriate? List in order of priority the actions that the nurse should take. The nurse should make which most appropriate response to the client? Which intervention is of highest priority in the preoperative teaching plan? Select all that apply. Which statement made by the client indicates the best understanding of how to prevent transmission of the disease? Which outcome would indicate that the most important goal has been achieved for this client? The nurse determines that the client is adequately tolerating the procedure if which observation is made? Positive Event Queries: Sample Questions SAMPLE QUESTION 1 Case Event: A client with suspected active lung tuberculosis is being scheduled for diagnostic tests. Positive Event Query: The nurse anticipates that which diagnostic test will most likely be prescribed to confirm the diagnosis? 1. Chest x-ray 2. Skin testing 3. Sputum culture 4. White blood cell count ANSWER: 3 TEST-TAKING STRATEGY: This question identifies an example of a positive event query. Note the strategic words most likely. Additional noteworthy words are active and confirm. Focus on the diagnosis presented in the question and the associated pathophysiology to assist in directing you to option 3. Remember that tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, and the demonstration of tubercle bacilli using bacteriology is essential for establishing a diagnosis. It is not possible to make a diagnosis solely on the basis of a chest x-ray, and a positive reaction to a skin test indicates the presence of tuberculosis infection but does not show whether the infection is active or dormant. A white blood cell count may be increased, but it is not specifically related to the presence of tuberculosis. Remember to focus on the strategic words! TIP FOR THE BEGINNING NURSING STUDENT Tuberculosis is an infectious disease of the lung caused by the acid-fast bacillus Mycobacterium tuberculosis. It is generally transmitted by the inhalation or ingestion of infected droplets and usually affects the lungs, although infection of multiple organ systems can occur. It is a major public health concern because of its infectious nature. Because of the presence of the acid-fast bacillus in the lung, the way that the infection is confirmed is by its presence in the sputum. You may have already learned about this disease during your microbiology course, but will learn more about it when you study the respiratory system and infectious diseases. Be sure to learn about this infectious disease. STUDY TIP Scope of Practice As the nurse, you will not be prescribing diagnostic tests, but you must understand preprocedure preparation and postprocedure care and the associated client teaching points. Nurses play an active role in the treatment process of assigned clients and are integral in the management and delivery of quality care. SAMPLE QUESTION 2 Case Event: The nurse is preparing to administer digoxin (Lanoxin) 0.25 mg orally. The label on the medication bottle reads “digoxin (Lanoxin) 0.125 mg per tablet.” Positive Event Query: How many tablets will the nurse plan to administer to the client? ANSWER: 2 tablets TEST-TAKING STRATEGY: Focus on the subject, calculating a medication dose. Note the words plan to administer. Focus on the information in the question and that a dose of 0.25 mg is prescribed. Use the formula for calculating a medication dose to answer the question. Always double-check the calculation and verify your answer. Remember to use nursing knowledge, focus on the information in the case event, and identify what the question is asking (the subject). TIP FOR THE BEGINNING NURSING STUDENT In this question you need to know the formula for calculating a medication dose. You will learn about medication calculations in your fundamentals nursing course. The formula and the calculation for this question are as follows: SAMPLE QUESTION 3 Case Event: Which nursing interventions apply in the care of an infant after a cleft lip repair (cheiloplasty)? Positive Event Query: Select all that apply. 1. Position the child on the abdomen. 2. Observe for bleeding at the operative site. 3. Keep elbow restraints on the infant at all times. 4. Cleanse the suture line gently after feeding the infant. 5. Institute measures that will prevent vigorous and sustained crying. 6. Assist the mother with breastfeeding if this is the feeding method of choice. ANSWER: 2, 4, 5, 6 TEST-TAKING STRATEGY: Focus on the subject, nursing interventions following a cleft lip repair. Eliminate option 3 first because of the closed ended word, all. Next, visualize each intervention, and think about its effect on the surgical repair to assist in selecting the correct interventions. Remember to focus on the subject and the surgical procedure!
