Help with nursing tests/studying technique

  1. Hey guys,

    I used to use this site all the time BEFORE I started nursing school, and I've been in the program almost a year now and I don't think I've used it once!

    But I need help. Badly. So I'm turning to you all for some possible insight/help/support.

    Let me start by saying that I do great in clinicals. I feel so comfortable and have never had any problems. I love it. I know I'll be a, great nurse someday. I'm just frustrated with the lecture portion. (I'm in an ADN program in SoCal).

    Basically... I read, I study, I relisten to lectures, I study with others (which I could, and will do more)... and I'm still not doing well on tests. So frustration. Partly because it's not just me... it's the majority of the students in my class. I am a smart person, I was an A student before this. Obviously there is something to be said about the institution you are learning from when the majority of the class is struggling this much. But that is beside the point right now... There are (some) students who continuously do well on every test. I'd like to be one of them... but I don't know how. I'm at a loss right now as to what I should do differently in terms of how I am learning.

    The first test (fluids/electrolytes), more than half the class failed. Including me. And we were told from semesters ahead of us that that normally happens. I worked my ass off studying for the next exams. Got a C on the second one (diabetes/endocrine). Then PVD/HTN test came along. I studied harder. I walked away from the test thinking I did great. I got a D on the test... that one ****** me off a little. Yesterday we had a test on Musculoskeletal. Walked away from that practically in tears (and I am not a crier), I knew it went poorly. Got another D. A lot of people who were doing great before, failed this one (I think partially due to the fact we had a sub for the main lecture before that test and were not adequately prepared, oh well, c'est la vie).

    Anyway. I need 75% on the final (next Thursday) to pass this class. 75... that sounds do-able, right? Right. Except that I've been basically getting straight Ds on all the other exams (a D in our program is 70-74%, below 70 is an F). I'm aiming high, if I get a 97% I can get a B in the class (slight sarcasm... that's a little overly positive, though possible).

    Can someone please help me? I don't know what to do. I always review my tests, I talked to my instructor, I talked to a counselor, I talked to other classmates. No one has really been able to help me. I obviously need to change my study habits or the way I'm thinking about things in order to be a better test taker. Sometimes I look at the questions during test review and think "wow, what was I thinking when I picked that answer?". Other questions I straight up had no clue about. But I don't have test anxiety either.

    Has anyone experienced this? How do you study? Are there any websites you can recommend to me that have practice tests (I already use Software For Nurses and Lippincott PrepU). Study techniques? Test taking strategies? (I already use the: eliminate two answers and go from there, technique). I just..... need help. I need to pass this class, otherwise I flunk out of nursing school. I'm afraid I'm going to study every spare second I have until this final... and still end up failing. I don't mean to sound hopeless... but I need some hope.

    Any insight you can give me will be helpful.
    Thank you all. <3
  2. 12 Comments

  3. by   ArrowRN
    I'm in a BSN program started 3 months now and I experienced a lot, partly due to the learning curve but sound like you past that stage. I failed my very first test. My problem was not with knowledge and lack of studying, it was interpretation of NCLEX style questions. I am really statical type and had a hard time figuring out the correct answer when all the answers are correct.In nursing they want the best answer based on the given senario, not based on book knowledge. That is why they emphasize critical thinking. If your school uses NCLEX style questions in test (questions that begins like "The nurse knows"...or The nursing student understands that...) then you need a NCLEX review book to help you. I brought a Review and Rationales book and after I read testing strategies on the first few pages and practiced what you look for, I had no problem passing other tests. I even passed one test recently that I honestly did not study for. If you are 1 year in the program and your instructors haven't given you some sort of feedback on how to proceed I'd get an NCLEX book, many people swear by Saunders, I got it I don't really like it. I like the Mosby's Comprehensive review and the Review and Rationales series I really liked.
    Getting A's don't matter in the nursing program. Join the student nursing association, and participate in volunteering in the community if you can , it's stuff like that will look good on your resume and help you get employed when you are done.
    Last edit by ArrowRN on Mar 30, '13
  4. by   VickyRN
    Test taking for NCLEX-type questions is a skill. The Saunders Comprehensive NCLEX Guide has helped many students to succeed. It costs about $40 but is worth every penny. Last time I was there, Barnes & Noble was carrying this book. If you do buy this product, please make sure it is the NCLEX guide with the questions broken down into subject material (not just all clumped together, which would be worthless for your present situation). (You may have to tear off the outer plastic, to look inside the book before you buy.) Then, practice, practice, practice! Make sure you look at ALL the answers to the questions (distracters as wll as the correct answer) AND the rationales (as to why the answer is or is not correct). This aids immensely in understanding the content material, as well as increasing your test taking skills!
  5. by   ArrowRN
    VickyRN do you think it is was a bad idea for me to get a NCLEX book so soon because the standards are changing like next week and I do not know if publishers will be updating their books.
  6. by   CT Pixie
    The passing level is changing, not the content of the NCLEX. The content in the NCLEX books are all pretty much the same.
  7. by   nurseprnRN
    OP, this is a common problem in people who have always studied well for prereqs and other sorts of fact-based testing and then come up against nursing. You cannot memorize your way into successful critical thinking. That's not to say you can't memorize facts-- you'll need facts to support your decision-making-- but knowing how nurses decide, prioritize, and plan is a different kind of thinking requiring knowledge about nursing. I know this is sort of a "duh" thing to be saying, but still. Here's another thread on "thinking like a nurse" How do you think like a nurse?

    And here's a little vignette that may help you refocus. You are quite clearly intelligent, well-spoken, and thoughtful, and you correctly deduce that you need to be completely changing your approach. You need to understand rationales for why we do what we do.
    Perhaps an example will help explain what "thinking like a nurse" means.

    1). You are working in an outpatient setting and a woman who is well-known to you comes in with yet another set of injuries from her husband in a fit of rage. She says she will not leave him, she loves him, he is so sorry, gave her flowers, and promises he will never do it again. What do you say to her?

    (two of the four answers are totally wrong, so you can eliminate them ... so you have to choose between these two)
    a. "And yet you are here again. Let's try to think of a way to keep you safe."
    b. "The research shows he will do it again, and it could be worse next time. You have to leave him."

    Both look like "good" answers. Both are factually true and contain a second phrase. Which to choose? Well, we know (or will know) that the nurse's job is not to direct care but to help the person along the path to wellness using specific kinds of interventions. Which one of these answers does that? Right, A, because the nurse does not deny the patient's decision (patients are allowed to make bad decisions even if we don't like them) but points out a fact known to the patient ("And yet you are here again") and then offers to engage her in a way for her to make choices about how to plan a way to improve her health (".. a way to keep you safe"). The patient can then discuss options along those lines-- how to recognize the cycle of abuse, how to see when his behavior is beginning to escalate, keep a bag packed, have a cell phone, keep a little money for travel, know the women's shelter hotline phone by heart, how not to internalize his abuse as her own fault, whatever....

    While choice B is factually true (he probably will beat the crap out of her again, and it likely will escalate), it denies her feelings and desires (she loves him, she has decided not to leave him), and tells her what to do (even though she has already said she won't). So it will make the patient shut down and not hear another word the nurse says. She's not going to leave him. Saying this offers her nothing she can use. It does not recognize the ultimate nursing value of patient autonomy and does nothing to take the patient along the path towards health.
  8. by   BSNbeDONE
    When all else fails, for the non-NCLEX-style questions, use simple word association. Identify the key term, then select an associated word or two in the answer to help that choice stand out on the exam.
  9. by   rachaelbennett
    Let me just start by saying Fluid and Electrolytes are difficult for many to understand. Everyone has their way of remembering or understanding these topics. I think that teachers make tests in different styles as well and they might differ from the way students get it. Do you know what I mean?
    I am 5 weeks away from finishing my first semester in an RN program. My test taking skills have changed drastically! The thing that helps me the most is not freaking out about the exam. I know it sounds stupid easy but it really does help. If you go in scared and anxious you won't do as well on your exam.

    I usually come to class 10 min early and try not to talk to any other students until after the test (they might make you more scared or confuse you). After the test I write down what I didn't expect to be on the test and everything else i can remember about the topics questioned. This gives me a study guide for the mid-term and final.

    Also I have changed the way I study as well. I don't study to memorize I study to understand! Another simple thing but your mentality about studying has to change. This was hard for me and still is.

    Also study a little every day... I mean EVERY day. 15 min if you can! It reinforces.

    Do you have a skills lab? A place to study all of your hands on skills? Go there! You might be a visual learner!

    Hope this helps
  10. by   luvnlfe,LMT
    See this post from pinterest on how to break down the questions. Pinterest also has some great mneumonics and study aids that may help.
  11. by   pinksapphire
    I am in my 3rd semester and I have found the following to be extremely helpful when studying for exams in Nursing School.
    1) Review lecture power points and class notes
    2) make Concept Maps
    3) Read text books (or at least topics I am not clear on)
    4) Practice NCLEX style questions (My favorite book is Lippincott's NCLEX-RN Review and my favorite iPad app is NCLEX QB)
    5) Get a good night's sleep and eat a good breakfast before the exam

    Also if your course/program offers test reviews prior to the exam make sure you participate. These made a huge difference in my grades.

    Best wishes!
  12. by   peacelover
    It's tough to find the best way to study I know..

    For me, the way to recall data on testing was to create as many links between the info that I could. So as you read the chapter don't paraphrase and rewrite what you are reading. My study sheets often were 1 or 2 pages for 30 plus pages of reading. lots of arrows and boxes that linked things together but not a bunch of rewritten textbook info

    Ask yourself who/what/when/where/why questions about the topic as you go through it.
    Why does the patient have the disease?
    What makes it worse or better?
    Why are they seeking treatment now? What will the doctor do to help treat it?
    What will you need to do as the nurse to support the patient during treatment?
    What meds will you give? What labs will you watch?
    What s/s mean something bad is happening in your patient and you need help quick?
    How will your nursing care change for this patient? What will you do to keep them safe?

    So if you were looking at CHF then asking yourself questions would get you to one of the possible treatments(what will doc do to help?) giving the patient Lasix to decrease fluid.

    Ask yourself those questions about Lasix...

    What does Lasix do? (Diurese via the loop of henle)
    How will this help the patient? (decrease fluid volume so heart doesnt have to remove it since pump is failing)
    What lab should I watch?(Potassium..right? What does being hypokalemic mean for your patient? Will you need to plan some nursing interventions to keep them safe? uhm, yes you will right?)
    What will I monitor in patient?(Orthostatic hypotension, Ringing in ears, weight gain, I/O)
    What interventions will I do based on what I need to monitor above?(get up slowly please mister patient, tell me if your ears ring, measure pee and weight)
    What is the worst case symtpom I need to report STAT? (pulmonary edema, right?)

    So then circle back and 'drill-down' in each of these questions..why is K+ being lost? Will you replace it? What should the lab vaue be? Why does it cause ectopy?

    In all your study remember to focus on what keeps your patient safe, yes?

    It takes a minute to get used to studying this way. try it on one concept in your next test and see if you do better with those questions. Best part is that you will remember it when you get into the patients room instead of just for the test then forgetting it.

    Sorry to ramble, you can do it!

  13. by   AndreeRN
    I also found some great testing tips and reference materials for Agency Nurses. This site provides sample questions to some to the leading test providers out there.
  14. by   classicdame
    F&E eats everyone's lunch. Having said that, I believe that practice, practice, practice is a key to success. You need to understand the rationales in order to "think like a nurse". Reviewing test questions, especially with 1-2 classmates, might be of help, so each of you can rationalize out loud. If your computer lab has practice tests, use that resource. It does no good to continue a practice that is NOT working, so change some aspect of your study routine till you find the right fit. Good luck and let us know what worked for you.