Nurses thinking multiple choice?

  1. 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.
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  2. 38 Comments

  3. by   Sleepyeyes
    Since a bowel obstruction is an emergency, I probably would've chosen that because that might mean a necrotic bowel, which is really a compromise in Circulation, and ABC's always get the right-of-way.

    Sometimes, difficulty swallowing can lead to difficulty breathing and in that case, Airway would be compromised and would then take precedence. But they didn't SAY "difficulty breathing' so ....

    Tricky question though, eh?

    Point is, that's how I finally resolved how to do those questions. ABC's..... in order. What's being compromised, and how urgent is it?
  4. by   Sleepyeyes
    PS I would've challenged that one....

    After all, how do you think they do swallow studies?

    On the other hand, how long can a bowel be obstructed before necrosis and the Pt needs a major surgery?
    Last edit by Sleepyeyes on Dec 2, '02
  5. by   Dr. Kate
    Test taking is an art, no question about it. The question as you describe it was ambiguous at best. Among other things I would want to know how many people got the question wrong/right.
    Sometimes the best you can do is put the question in the context of what content you're being tested on at the moment. When that doesn't work remember you always start with the ABCs, airway, breathing, circulation. If the airway is obstructing or obstructed it wins the priority contest. If the Pt isn't breathing that wins.
    As far as multiple choice tests, not only are they preferred by instructors who have to grade piles of tests, but the NCLEX is multiple choice and you have to be able to deal with them to pass it. The point in making two answers almost equally correct is a way to push you toward more critical levels of thought. Ultimately nursing school is about teaching you to think. A well contructed test can do that as well as any lecture.
    Unless you have been told specifically that you cannot query the instructor once the test has started, there is nothing to stop you from asking during the test for clarification of a question.
  6. by   kimmicoobug
    After reading that, I would have chosen difficulty in swallowing. Note, here, I am a student and take these multiple choice tests aaaalllll the time. Here is my rationale, think safety, safety, safety. Patient is at risk for aspiration and swallow precautions must be enforced. The question is a shallow one, but I think maybe you read too much into it. Yes, a bowel problem would be an important, but what is going to kill you first, choking on too thin liquids and getting aspiration pneumonia or constipation. That is my reasoning. Mario, you will get the hang of this. You are just in your first quarter and you will adapt to taking these tests. Good luck, and let us know how you did for the quarter.
  7. by   mario_ragucci
    I apologize for bugging out. My advisor just called me and told me I got 43:50 correct!!!!! That is 86% !!!!! When i got the call, I just about jmped out of my skin. Now I have the confidencei need in knowing that I can retain and think correctly about nursing data. I can remember all the ones I answered wrong. My first summary exam score was 74%, so I was really scared of not passing. Thank you for being here; I had no where else to turn for solace as I sat near my phone awaiting the call with my exam results.
    All thats left now is to stay cloistered in my apartment with my books and ACE the final on 09 Dec !!!!! I asked my nurse manager for 2 vacation days next week because I was schedualed to work the weekend before my final and she said yes. I asked her before I got the 86% today. Why was I so afraid? I can do it...and now I know i can.
    I want to give praise and thanks and love to my: clincal instructor, lab instructors, lecturers, manager and co-workers who are all great and wonderful women!!!! And especially to allnurses.com....MY ROCK!
  8. by   2banurse
    But Mario...did you ask your instructor about that question? Don't keep us in suspense!
  9. by   mario_ragucci
    No - we go over the actual test on Wednesday. So, I don't know exactly which ones I missed, but you know how everyone huddles around after tests like this and coughs up the questions. I still can't believe i got an 86%. I have to be humble, because I know how utterly bugged out I was when i got a 74%. My advisor called me just like she did today, and i immediately began openly weeping after i hung up the phone.
  10. by   2banurse
    Well, congratulations on your 86%! And on Wednesday, don't forget to let us know (especially those of us following your footsteps!).
  11. by   kimmicoobug
    Mario, Congratulations. Sounds like you did pretty well! Was this a difficult test for your class? Do let us know about that question. I actually asked one of my first year friends about that question and he had the same response as you. Good luck on your final.
  12. by   SusanRN2004
    Could it be that difficulty swallowing would be something a nurse could do something about and the bowel thing is a medical problem that would only be handled by a Doctor? I know I got tricked on a question before because some things are a nursing diagnosis and some are medical....I am only a student...just a thought...
  13. by   mattcastens
    Originally posted by SusanRN2004
    Could it be that difficulty swallowing would be something a nurse could do something about and the bowel thing is a medical problem that would only be handled by a Doctor? I know I got tricked on a question before because some things are a nursing diagnosis and some are medical....I am only a student...just a thought...
    Ah yes ... I remember that trickiness. Just wait until you get into the "real world" and your orientation tests expect you to correctly anticipate medical orders and procedures. That's when you'll point out that the "correct" answer is medically oriented, not nursing oriented, and the response will be, "Yes, but you need to be able to understand the medical thinking to effectively nurse." While this is true, it also takes some brain re-training after the brainwashing of nursing school. Have fun.
  14. by   hoolahan
    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!!!

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