Nurses thinking multiple choice?

[mario_ragucci]

I'm a first year NS and quarter one is drawing to a close. Do all RN's love and cherish multiple choice tests for all tests of knowledge. Today, the comletion of my labs culminated with a successful IM shot. My clinicals are complete. But the dad burn multiple choice summary II exam today and the Final next Monday are making me bug out. Ok - I can respect A,B,C,D and one answer is truly the best, but some questions can't be one right answer ifI am supposed to think about the question.

For example, one question on todays test asked whats more important/immediate, and the 2 best answers were: difficulty swallowing or bowel obstruction. So I went with BM because the question didn't mention the person was eating. And if you can give a PT thickened liquids and check for aspiration. But if perastasis is obstructed, then I understand you can die. The right answer was difficulty swallowing, but because the question didn't mention the PT was eating or drinking, I ruled it out.

Did any nurses struggle and have self-doubt r/t multiple choice question mega exams. Did any nurses come close to flunking out of a program if their scores were close to passing? Did it take you awhile to get those dad burn tests? I remember facts and information satisfactorily. I know I can be a great nurse. These exams, with the multiple choice describing PT scenarios can go 2 ways, and are not a reflection of my knowledge or understanding. I am having a nervous breakdown waiting for my results today, and next week will be twice as hard because there are 100 questions that are from the entire quarter. I have been doing my studying, but if you have a bunch of them curve questions, I could get tripped. Did yall get straight A's through your 2 year time? Thank you for letting me ask you.

[hoolahan, ASN, RN]

Matt...cool pic!!!

Mario...wooohoooo!!!!! Good for you.

That is exactly the way state boards will be, so get used to it. There are always two right answers, but yu have to choose which is more right. That was tricky. I would have said diff swallowing b/c like others have said, that is one a NURSE can treat, aspiration precautions, etc...

I have also learned another trick about mult choice ?'s. Reda it so you see what they want for the answer. Example, an example of collaboration is 1. The nurse deciding the pt will be given a Kosher diet b/c he is Jewish (Did she ask him if he wanted a Kosher diet? 2. The discharge planner ordering a bedside commode for a pt upon discharge (did she find out if there was a BR on the 1st floor?) 3. The pt tells the nurse he would like to see his grandson before his surgery, and the nurse arranges for a visit.

Clearly #3 is the only one in which there was any interaction between the pt and the nurse, so it is the answer. Don't read "into" the question, but the question asks which of these is an example of collaborating? #1&2 are one-sided decisions, so they are out.

BTW, be glad they are only 4 choices, how about those moronic ones which have four choices, THEN have a) 1,2,&4 b) 2,3 & 4 c) 1,3 &4, d) none of the above? THOSE are the really rotten ones!!!

[katieRNlove]

Mario, I am currently a second year NS and i can totally relate to you. The one thing I can give you is that at least for me the 2nd year is better. I also was pulling my hair out because of mult. choice questions when there were 2 right answers, then my psych prof gave me an article about test taking and it helped me out alot, if i can find it i will post it. Heres another one, i don't know if it's like this where anyone else goes/went to school, but my whole first year we learned in knowledge based form and then all of our tests were application! Did that bother anyone else??

[opalmRN]

Mario,

Congratulations, you must be feeling a bit relieved.

If you want my vote, I too would choose the difficulty swallowing as #1 priority. Now please excuse this cause it is rather crude but if I learned one thing in EMT class it was the A,B,Cs. And as "some" students use this to remember the importance, "If they're blue they're through." Point being if you can't maintain an airway, don't bother splinting the leg or doing just about anything else.

Now if the question had said swallowing vs profuse bleeding my choice would have been different.

Anyway enough of this, enjoy your triumph!

c

[acaringnurse]

GREAT JOB MARIO!!!

[oldgirl, RN]

Remember-AIRWAY,AIRWAY,AIRWAY. Difficulty swallowing could lead to aspiration, or maybe it indicates swelling that may compromise respiration. I remember on our exams, if airway was involved in any way, that was the right answer. Those multiple choice questions can be really nasty!

[mario_ragucci]

See? I know about ABC being a priority, no doubt. But the question didn't specify if the PT ws actually eating anything, or drinking anything. So I figured the statement to be null because aspiration must require someting to aspirate, right? My advisor said that there is saliva that could be aspirated, but I blocked bowel is matter of fact. Had the answer read "Pt has trouble swallowing and is drinking water" I would have went for it. How do you stop a person who has trouble swallowing from aspirating their own saliva????? :-(

There was also a question about a jewish mother and circumcision which I thought was wigged out. Ethics and values.

There was a mom-favoring question about where peds should recieve the most cc's IM injection. I chose dorso glutleal, but the moms all knew it is rectus femoris. How was I supposed to remember that? Dag nab it!

[Tweety, BSN, RN]

I'm glad you passed the test.

I can't stand it when they all are correct, and you must choose the priority, or which would you do first. Sometimes the most obvious to me isn't the correct answer.

[kimmicoobug]

Mario, even if the patient isn't stated to be eating or drinking, dysphagia precautions are still very important. Yes, a person could aspirate on their own saliva. In fact, one of my elderly patients last year was their because of aspiration pneumonia and had to be watched closely because of her profuse saliva.Suctioning would be an option for a patient who has a lot of saliva and is at risk.

I also agree with a previous poster who said second year is easier. It is, at least for me.

[CMERN]

Mario..CONGRATS!!!! I ditto Oldgirl...in these K questions ( i call em that because iether of 2 answrs could always be oKay, but only ONE is CORRECT) . as Oldgirl says..Airway...ABC's are big deal forever on.(NCLEX)....ABC's will lead ya right in assessment every time also, cause long as that patients breathing you can come up with all kinds of Diagnosis,and interventions...first second he aint breathing NOTHING ELSE MATTERS>!!!! You got it..KEEP UP THE GREAT(hard) WORK:)

[Peeps Mcarthur]

Mario,

In my soon-to-be-former program, Maslow's Hierarchy takes precedence over everything. Since the first need is oxygenation, aspiration risk, or if you prefer the more corect scientific observation, ventillation perfusion mismatch;)

In the real world I think that absent bowel sounds will get more attention than a patient having "trouble swallowing", since there are many simple interventions.

I think its real BS to tell us not to assume while reading questions, and then present us with questions like yours that force us to assume the patient's nutritional intake.

If your pt was on a tubefeed, for example, the question would be moot.

[WashYaHands]

Mario, look at it this way, you knew the answers to the questions that you got right and now you'll not forget the correct answers to the questions you got wrong. It's all part of the learning process, my friend. You did a good job on the test. Keep up the good work.

Linda

[researchrabbit]

THe thing to remember about multiple choice, is GO WITH THE FIRST ANSWER THAT CAME TO YOU. Circle the number if you think you may need to rethink it and come back after you've already finished the other questions.

And personal opinion, I think multiple choice is just plain wrong for nursing...you have to pull the answers out of your head when you are with your patients. You may have your own PERSONAL multiple choices, but you have to know what your choices are.

And yes, I know it's harder to grade and harder to do. :)