Client Needs Subcategory Implementation of a Lesson Plan using The 2016 Test Plan for NCLEX-RN® Success Elizabeth Moxley, PhD, RN, Larry Maturin, MSN, APN, ACNS-BC, CEN, CCRN, Kristin Rakstang, MSN, RN ABSTRACT TEST PLAN LESSON PLAN Summary: The National Council of State Boards of Nursing (NCSBN)1 NCLEX-RN® licensure examination measures the mastery of current content essential for safe, entry-level nursing practice. Familiarity with the 2016 NCLEX-RN® Detailed Test Plan2 and its applicability to the nursing curriculum guides educators and improves the likelihood of student success on the NCLEX-RN®. Methodology: A Lesson Plan was developed implementing a Client Needs Category from the 2016 NCLEX-RN® Detailed Test Plan2. The Client Needs Category Physiologic Integrity; Subcategory, Physiologic Adaptation; Related Content, Medical Emergencies; and Activity Statement, Perform Emergency Care Procedures.2 Knowledge, Skills and Abilities statements3 specific to this Activity Statement2 are integrated into didactic instruction4 according to Bloom's Taxonomy5 in the paradigm: 'introduce, recall, refresh, review’.6 Teaching strategies incorporate D.A.R.T. SIM technology,7 to facilitate EKG rhythm analysis and emergency treatment, resuscitation, oxygenation, defibrillation and transcutaneous pacing on a low-fidelity manikin, thereby integrating the didactic learning domain5 with the clinical setting by integrating knowledge and assessment skills, and evaluation of care using simulation. Creative teaching strategies encourage content synthesis. Conclusions and Implications: The 2016 NCLEX-RN® Detailed Test Plan2 is a resource for educators to assist students with NCLEX-RN® success1. A Lesson Plan illustrates the integration of Test Plan content into the curriculum using innovative teaching strategies. Lesson plans from other Client Needs Categories have implications for entry-level nursing practice. Review of anatomy, physiology and pathophysiology of the cardiovascular and pulmonary system and perform a complete Client Assessment. Physiologic Integrity Physiologic Adaption Medical Emergencies Perform Emergency Care Procedures Assessment of presenting symptoms and history; demonstration of physical examination to include Vital Signs, and consideration of appropriate patient-specific Oxygen Delivery Systems. Client Needs Subcategory Client Needs Category Related Content Activity Statement Systematic approach to understanding and interpreting Basic Cardiac Rhythms, including atrial, junctional, and ventricular dysrhythmias, rate, rhythm and interval (PR, QRS, QT) interpretation and prioritization of blocks, and prioritize treatment during a medical emergency. KSA Statements CLIENT ASSESSMENT MEDICAL EQUIPMENT VITAL SIGNS OXYGEN DELIVERY SYSTEMS BASIC CARDIAC RHYTHMS MEDICATIONS RESPIRATORY GUIDELINES DOCUMENTATION PROCESSES EMERGENCY CARE PROCEDURES PROFESSIONAL RESOURCES ADVANCE DIRECTIVES ETHICAL PRINCIPLES Application of nursing diagnoses to care, including short and long term goals, testing and diagnostic procedures, respiratory guidelines and Medication administration. Stepwise procedure for the use and application of the 5-lead and 12-lead EKG and Cardiac Lead Placement, emergency respiratory equipment and Respiratory Guidelines. LESSON PLAN OVERVIEW Course Structure: Didactic content: Care for the client requiring Emergency Care Procedures, (Cardio-pulmonary Resuscitation, Respiratory Support, Automated External Defibrillator), medication calculation, EKG interpretation, diagnostics, nursing interventions, synthesis and evaluation. Lesson Plan Pedagogy: A lesson plan using The Client Needs Category, Physiological Integrity, is demonstrated in didactic content using the paradigm 'introduce, recall, refresh, review.’6 The material will be introduced during class lecture; and pre-lecture quizzes, in-class minute writing and interactive discussion facilitate recall of information. Refreshment of content involves the use of case studies and a “flipped classroom” with integration of the nursing process; and review of content occurs by writing or “mapping" out material presented in didactic instruction from memory and brief presentations or student-led content review and summary. 6 Knowledge, Skills and Abilities (KSA) statements3 are integrated throughout content.  Materials and Equipment: *D.A.R.T. EKG Simulation (D.A.R.T. SIM) technology7 is educational software that facilitates EKG rhythm simulation, defibrillation, cardioversion and transcutaneous pacing of a low-fidelity manikin. Discuss and document presenting signs and symptoms, medical history relevant to respiratory and circulatory systems, and Emergency Care Procedures, emphasizing client impact, followed by a no stakes post-test. 2 Relevance of client education topics and care coordination with consideration for Advanced Directives, based on unfolding case study and a review of Professional Resources. Case review to consider Ethical Principles based on client situation; written application with group presentation with role play demonstrating scenario; bioethicist guest speaker. Create Evaluate Analyze Apply Understand Remember References National Council of State Boards of Nursing (NCSBN). https://www.ncsbn.org/nclex.htm Accessed June 13, 2016. The NCSBN publication, 2016 NCLEX-RN® Detailed Test Plan Item Writer/Item Reviewer/Nurse Educator Version. https://www.ncsbn.org/index.htm. Published 2015. Accessed June 13, 2016. The National Council of State Boards of Nursing (NCSBN). Report of findings from the 2014 RN nursing knowledge survey (vol. 63). https://www.ncsbn.org/7384.htm. Published 2015. Accessed May 29, 2016. Hinkle JL, Cheever, KH. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing (13th edition). Philadelphia, PA. Lippincott Williams & Wilkins; 2010. Anderson & Krathwohl, D. R. (2001). A Revision of Bloom’s taxonomy: An overview. Theory into Practice, 41(4), 212-218. Brown PC, Roedieger HL, McDaniel MA. Make it Stick: The Science of Successful Learning. Harvard University Press; 2014. D.A.R.T. SIM. http://ecg-simulator.com. Published 2016. Accessed June 13, 2016.