Guys, we spend so much time on diabetes, CHF, COPD, etc. But some of the less common conditions have really dangerous complications, and NCLEX loves testing what the nurse should recognize FIRST.
A few worth knowing. Esp if you’re doing prioritization questions.
1. Guillain-Barré syndrome (GBS)
Weakness starts in the legs and moves upward. Reflexes disappear. Often happens after a GI or respiratory infection.
Big danger? Respiratory failure. Monitor vital capacity, breathing, and swallowing. SpO₂ can look normal even when respiratory muscles are getting dangerously weak.
2. Myasthenia gravis
Ptosis, double vision, difficulty swallowing. Weakness gets worse w activity and improves w rest.
If the pt suddenly can’t swallow, cough effectively, or hold their head up, think myasthenic crisis. Airway and respiratory assessment come FIRST.
3. Thrombotic thrombocytopenic purpura (TTP)
Low platelets + hemolytic anemia, often w schistocytes. May have confusion, renal problems, or fever.
This one is a true emergency. Urgent plasma exchange is the key treatment. And btw, platelet transfusions are generally avoided unless there’s life-threatening bleeding.
4. Hemolytic uremic syndrome (HUS)
Child has bloody diarrhea, then develops pallor, low platelets, and decreased urine output.
Think acute kidney injury. Monitor BP, electrolytes, urine output, and renal function. Antibiotics and antimotility drugs should be avoided in suspected STEC infection.
5. Malignant hyperthermia
Pt under anesthesia develops rising end-tidal CO₂, tachycardia, muscle rigidity, and metabolic acidosis.
Here’s what ppl miss. HIGH FEVER CAN BE LATE.
Stop triggering anesthetic agents, call for help, give 100% O₂, and prepare IV dantrolene.
6. Stevens-Johnson syndrome (SJS)
Recently started a med such as lamotrigine or allopurinol. Now fever, painful rash, blisters, mouth sores, maybe eye involvement.
Not a simple drug allergy. Stop the suspected med, notify the provider immediately, assess airway and fluids. These pts can deteriorate very quickly.
7. Kawasaki disease
Persistent fever, strawberry tongue, red eyes, cracked lips, rash, swollen hands/feet.
Major concern is coronary artery aneurysm. IVIG + prescribed aspirin are standard treatment. Yes, aspirin in a child. This is one of the important exceptions.
8. Pheochromocytoma
Severe episodic HTN, headaches, sweating, palpitations.
Remember the med sequence. ALPHA blockade before BETA blockade when both are needed. Beta blockade first can cause a serious hypertensive crisis.
9. Heparin-induced thrombocytopenia (HIT)
Platelets drop over 50%, usually 5–10 days after heparin exposure.
The scary part is thrombosis, not just bleeding. With intermediate/high clinical suspicion, stop ALL heparin, including flushes. Anticipate a non-heparin anticoagulant.
10. Meningococcemia
Fever, petechiae or purpura, hypotension, confusion. Can progress to septic shock and DIC really fast.
Droplet precautions, immediate escalation, prompt IV antibiotics, and sepsis management. Do NOT wait for the rash to spread.
A lot of NCLEX prioritization comes down to recognizing which pt is deteriorating, even when the initial findings look pretty ordinary.
Also, dont memorize these as just disease names. Connect the symptoms to the actual complication and the FIRST nursing action.
Which rare condition did your nursing school barely teach? Curious what ppl are actually seeing in clinicals lol.

Hi! For my fellow NCLEX repeat takers, would you guys be interested in starting a group chat where we can support, motivate, and help each other through the process? I feel like it would be nice to have people who genuinely understand what we're going through!

hi! i have 15 days remaining til my exams, should I focus more on cheat sheets or crash course Videos? pls help yo girl out

Hi guys! Currently processing my Form 2F and ipapadala ko pa lang via DHL.

Ask ko lang, when did you guys start getting Qbanks or enrolling sa review center? Nag-wait ba kayo until may ATT na?

Medyo worried ako kasi sabi mahirap daw maka-secure ng slot, kaya baka sayang yung review materials if 3 months lang validity and matagal pa before makapag-NCLEX.

Would appreciate any advice!

Nursing school has a way of making good students doubt everything they know.

I know that chair. Just like you, I was failing class exams and changing answers I had right.

My test anxiety was so severe I took my class exams in a private room with special accommodations.

My problem was not the next app, the next question bank, or another ten hours. My problem began when doubt got loud enough to move my hand.

Work the tool already in front of you with more honesty, for every question you miss, ask yourself one question. Did I get it wrong because I did not know it, or because fear talked me out of what I knew?

If you did not know it, study that one small piece well. If you knew it and fear moved you, more content is not the cure.

One small habit stood between my doubt and my hand. It has a name, the 3-Second Rule, taken before any answer is allowed to change.

Those small choices carried me from failing class exams to passing the NCLEX on my first try.

The fuller story sits pinned at the top of my profile.

When you look at your wrong answers, what do you hear most?
"I need more content," or "I need to trust what I already know"?

I took my Nclex today on Saturday , it cut off at 95, I’m just wondering do I really have to wait till Monday or Tuesday to know my results or have any of you found out on Saturday/ Sunday. I’m just curious I’m not gonna do any of the tricks I’ll patiently wait i just want to know when I should check.

Update I passed, received my results on Sunday morning!

Hi everyone! I’ve been lurking here for the past month, and I wanted to share my experience in case it gives someone reassurance during NCLEX prep.

This is only what worked for me—everyone studies differently and needs a different amount of time to feel ready.

I graduated from my accelerated BSN program on 8/17, received my ATT on 9/3, and took the NCLEX on 9/29. During nursing school, I earned Level 2s on my ATI proctored exams and got a 79.5% on my ATI Comprehensive Predictor, with a 97% predicted probability of passing. I felt well prepared by my program, but I still wanted additional time to review after graduation.

Take It When You Feel Ready

A lot of my classmates tested within one to two weeks after graduation. I am naturally more risk-averse, so I chose to give myself about a month.

I had someone encourage me to test earlier, but I trusted my gut and picked the date that felt right for me. Seeing classmates test and pass before me was exciting, but it also made it easy to compare myself. I had to remind myself that everyone is on their own timeline.

There is no prize for taking the NCLEX first. Take it when you feel prepared—not when someone else thinks you should.

What I Used

I took one week off after graduation, then mainly used UWorld for its questions and rationales. I also used Mark Klimek lectures, Dr. Sharon’s prioritization videos, NCLEX Crusade’s 7-Day Review, and a few shorter last-minute review videos.

If I had to do it again, I would mainly use:

• UWorld
• Mark Klimek
• Dr. Sharon’s prioritization videos

I found UWorld especially helpful because I focused more on understanding the rationales than finishing every question. I did not take detailed notes on every missed question—I read the explanations carefully and trusted that repeated practice would reinforce the concepts.

My Study Approach

I tried UWorld’s daily schedule at first, but it felt overwhelming. Instead, I usually did 85-question tutor-mode sets on days I was not taking a CAT.

I completed about 81% of the QBank, averaged about 75%, and completed five CATs. All of my CATs shut off at 85 questions, with high predicted passing probabilities. Looking back, I probably did not need to take five CATs, but they helped me feel comfortable with the format.

The day before my exam, I reviewed lightly, reread some Mark K notes, and completed only 30 tutor-mode questions. I did not want to overwhelm myself right before test day.

Test Day and Final Advice

My exam was at 8:00 a.m. I ate breakfast, got coffee, arrived early, and only reviewed familiar notes that morning. I was anxious, but breathing exercises, prayer, and trusting my preparation helped me stay calm.

I took a break around question 60 to use the restroom and drink water. If you need a break, take it—it helped me reset and refocus.

I found that careful reading, prioritization, safety, and clinical judgment were important skills to practice during preparation. Slowing down, identifying what a question is asking, and avoiding overthinking helped me throughout my study process.

My exam shut off at 85 questions, and I found out two days later that I passed!

Be kind to yourself while studying. Take breaks, get out of the house, and remember that you already made it through nursing school. You are more prepared than you think.

Airway, breathing, circulation first. Always.

Then: is this actual or potential. An actual problem beats a risk for.

Then: is it acute or chronic. New shortness of breath beats long standing shortness of breath.

Then: is it unstable or stable. A changing value beats a bad value that has not moved.

Maslow comes last, and only once nobody is physiologically unstable. Safety before belonging, belonging before esteem.

Two that override everything. A pt who cannot maintain an airway. And anything u did that is still going in, so an infusion u started and an error u are mid way through outrank a pt who is waiting.

When two options are both physiological, pick the one that kills sooner. Airway kills in minutes, circulation in minutes to hours, and a potassium of 6.8 before a haemoglobin of 7.

Same style of question, free, on RNExamRoom. No sign up.

These are not the reference range. The number where u stop charting and pick up a phone.

K+ under 2.5 or over 6.5. Arrhythmia at both ends.
Na+ under 120 or over 160. Seizure at the low end, and correcting either too fast does its own harm.
Glucose under 40 or over 500.
Ca2+ under 6 or over 13.
Mg2+ under 1 or over 4.
Platelets under 20,000. Spontaneous bleeding.
Hgb under 7, which is the usual transfusion threshold in a stable pt.
INR over 5 on warfarin.
pH under 7.2 or over 7.6.

The exam asks these as which result do u report first, and the answer is the one that kills soonest. Potassium and glucose move fastest.

Report it, and document who u told and when.

Free bank on RNExamRoom if u want to drill this one.