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NCLEX- Hot Spot

Hot spot questions require more than basic nursing content.  You must have a very good understanding of anatomy and physiology and pathophysiology.  This type of question asks you to put information on a chart, graph or a table using the mouse.  Visualization works best with this type of question. Close your eyes and imagine the area of the body that they are describing. What are the structures? What is the function?  What is the condition that is related?
 
Sample question:
 
Your client is in labor.  The health provider palpates the uterine fundus finding small parts on the right side of the uterus and a curved section on the left side.  Where would you put your stethoscope to hear the fetal heart beat? 
 

 First begin by imagining the abdominal area - the umbilical is the midpoint -  Right side    Midpoint              Left side

                                                                                                              A                      .                     B
                                                                                                              C                                            D      
Next determine which position the fetus is lying in -LOA
Now reword the question - If the fetus is in the LOA position where would you listen to the fetal heart rate?
The answer would be D - the point of maximum intensity (PMI) in the LOA position.
 
This picture should have come to mind - A - the point of maximum intensity for fetus in the ROP
C - the point of maximum intensity for fetus in ROA
B - PMI for fetus in the LOP
LOA - left occipital  anterior                 LOP - left occipital posterior
ROA - Right occipital anterior               ROP- Right occipital posterior
 
By visualization and recalling your anatomy you would be able to respond to this question. The important thing to remember about this question is where the fetus is lying no matter what letters are being used.  The fetus is lying in the left anterior position.
 
Happy exam
 
Dr. Harriette

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