Hi, sftbllgrl34654, and welcome to allnurses!
Nursing school exams are very different from exams in other classes because the questions expect you to draw upon your knowledge of other subjects as well as the nursing. Before you got into nursing classes you also had to take some pre-requisites, and although those classes are behind you, you are still expected to know the information from them.
Also, when you are learning about the diseases with body systems as you are now for substance abuse, liver, and endocrine you not only need to learn about the signs and symptoms of the diseases in these categories, but what the
medical AND
nursing interventions are as well. Something that took me many years to understand is this: signs and symptoms are the manifestations of the underlying pathophysiology that is going on in a disease. Know how the pathophysiology proceeds from the mildest symptoms to the fatal ones--that's how your list of not-so-bad to critical symptoms is determined. Then, I realized that all interventions (treatments, medications) that are done by both the doctors and us nurses are almost always aimed at these symptoms. Sometimes the doctors will aim a treatment at the underlying cause of the disease as well. Therefore, the key to answering many problems involving a disease has to do with knowing the underlying pathophysiology and treatments for it. It might sound kind of simple, but it encompasses a lot of information. Yet, each disease is it's own separate entity and it's uniqueness lies in it pathophysiology.
For endocrine the biggie to learn is diabetes. You need to know the difference between Type I and Type II and their treatments. Diabetes is a big comorbidity among today's population of patient's so you have to this disease inside and out. Type II is almost running like an epidemic these days with people being diagnosed with it right and left. I was diagnosed with it 3 years ago. There are plenty of websites about it including lots of information on the National Institute of Health (
http://www2.niddk.nih.gov/), a U.S. government sponsored website. Alcoholism is also a big problem and its effects on the liver in long term abusers is dramatic. You need to know the signs and symptoms of cirrhosis.
After your past tests you should have taken the opportunity to review the questions that you missed if only to figure out where you went wrong in answering the questions. This kind of debriefing is critical in helping you to prepare for future tests. Nursing school tests generally have what are referred to as critical thinking, or application type questions. These same kinds of questions are also on the NCLEX licensing exam.
You must:- know normal anatomy and physiology
- know abnormal anatomy for the disease in question
- know the resulting signs and symptoms when the disease occurs and how they proceed from mild to fatal - each sign and symptom can be related back to the pathophysiology of the disease
- know how the doctor diagnoses and treats the disease in question
- know nursing interventions for the signs and symptoms you are being asked about
- know the steps of the nursing process and what goes on in each of the steps
- know the principles behind the actions being done - there are many kinds of principles: principles of nursing, principles of biology, principles of chemistry, principles of physics, etc.
- read the stem of the question carefully and answer that because the test makers try to trip you up by distracting you with conflicting information they give you in the answer choices that sounds good but has no relationship to what the question is asking for
- ask yourself "why" a patient is experiencing some sign or symptoms to get at the underlying problem. Nursing like other disciplines treats the problem/signs and symptoms.
There is a sticky thread on the student forums on test taking that you should look at as well. It has some pretty good links to information on taking tests:A good NCLEX review book will also help you focus on the most important information to be studying in the subjects you are being tested over. However, you also have to allow for the subjective quirks of the instructor. Every instructor will base some questions on their own past experiences and what they feel is important. That is something you have to psych out from listening carefully to their lectures.
You are not alone is having problems getting the passing grades on your first nursing tests. This is a common problem and your question is one that is often asked on the forums. Good luck on your next test.
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