Large percentage failing nursing school exams, why?

alovelymother · Oct 27, 2012

We never get a study guide. We are told it the syllabus which chapters every unit contains and anything we learn within those weeks is fair game.

melmarie23, MSN, RN · Oct 28, 2012

anything from pervious semesters would, to me, seem as fair game. One would assume that students wouldnt just forget things that they previous were taught. Nursing isnt just GI, or respiratory, or cardiac....its everything. Nursing is not just ED, OB, med/surg, ortho, onco, neuro, ICU, tele...its everything. Nursing knowledge is cumulative. The NCLEX tests you on cumulative knowledege and covers all areas and aspects of nursing.

DaniDoll · Oct 28, 2012

Nursing knowledge is cumulative.

I agree with this. Even in the first semester of nursing school you will notice questions on exams coming from anatomy/physiology and pathophysiology which could be some time ago depending on the individual.

gatoraims RN · Oct 28, 2012

Seems fair to me. Our instructors informed us, after a few people complained about material on the test, that anything from previous semesters is testable material. They are prepping us to be nurses and to pass the NCLEX. Anything can be on the NCLEX even stuff you have never heard of. I think it is fair.

loriangel14, RN · Oct 28, 2012

The things you learned in previous semesters are the foundation for what you are learning now.They should not have to review it with you. You are suposed to know it. They will not reteach everything each semester.

hodgieRN · Oct 28, 2012

Believe me, I know what you are saying. Nursing exams can seem difficult, vague, or unrelated. Nursing instructors have the right to prepare and test how they see fit as long as it follows proper guidelines. Instructors giving you study guides was a plus, but it's not a requirement. I always liked it (of course) when they told us what to study but I did get professors that said "your study guide is reading chapters 1-3." That's free game! The problem is that math, A/P, bio, etc is it's very cut and dry...there's one answer and that's it. With nursing, there can be 3 correct answers but the "rightest" option is the one that answers the question. It's the difference between knowing how to solve a math equation vs having to apply your critical thinking skile by eliminating answers that don't fulfill the question. It can be very confusing or frustrating. The NCLEX is all about testing your ability to pick out the right answer among the trick answers on top of medical knowledge. But to answer you question, you can help your chances of picking the right choice by knowing the question....

An 80 year old male complains of chronic chest pain during an office visit. He has a history of high blood pressure, diabetes, high cholesterol, syncope, and coronary stent. He complains that his chest pain increases with activity. He recently required an increase in his cholesterol medication. His vital signs are HR 118, B/P 169/85, resp 16, oxygen sat 94%. The doctor has decided to prescribe a calcium channel blocker. How would you measure its effectiveness?

A) A decrease in blood pressure

B) His chest pain has subsided

C) A decrease in heart rate

D) His cholesterol level was 203

Well...Calcium channel blockers (CCB) do decrease HR...so this is true. CCB do decrease blood pressure...so this is true. The cholesterol level doesn't answer anything. His chest pain subsided....what does that have anything to do with CCB's....they decrease HR and B/P. But the answer is (B). CCB are vasodilators. Angina occurs when the coronary arteries are spasming, so a CCB that stops chest pain is correct because.....................that is what the question was asking! It didn't matter that he had an increase in cholesterol meds. His vital signs are irrelevant. Having angina with activity doesn't matter. A decrease in heart rate could decrease the demand for oxygen consumption, but he had chronic chest pain that only increased with activity; not manifested with activity. A decrease in blood pressure isn't going to to anything for chest pain. And you didn't need to know what a normal level of cholesterol was or whether or not a CCB affects cholesterol levels at all. All that mattered was that this guy had chest pain, the doc gave a CCB, and that chest pain subsided. This addresses the question of effectiveness to his pain...not the effectiveness the medication itself.

Anyone one of those choices could be argued. The reason I am telling you this is b/c you can't change what the instructor puts on the test, but you can change how you attack a question. All nursing exams are trick questions. All of them. It sucks. But it is trying to evaluate your critical thinking skills. So, if you see a question that does not relate to the exam, there is a reason why it's on the exam, even is it doesn't make sense or there are things that you haven't learned yet (which will happen, btw) Sometimes, it doesn't even matter why it's there. If it's something from a past exam, the teacher isn't trying to pull your chain...she throwing a curve ball for you to critically think. You have to dissect it's nature (not over think the question, but find out what is it asking me. Can you alter your state of thinking with just respiratory and switch to GI. The NCLEX does this constantly! Some questions don't even have an answer! You have to pick the one that's MOST true. Even our ICU certification exam is like this. My advice is look at the questions in two parts. The medical side and then "how is this trying to trick me" side. Study your work and understand the A/P, patho, medication stuff and then study as "how could this be used in a way to confuse me." Sometimes (and I mean sometimes) you can answer question by only reading the first and last line! Maybe a curve ball was the entire point...which is fair b/c medicine is not one answer. It's about paying attention to detail (and that is critical!)...attention to detail. You won't be able to brush up on everything for an exam. It's impossible. But you will be able to answer any question if you pay attention to the question and give detail in the answer. It's about strategy. People get 68s b/c they aren't attacking the question. It happens in every class. A critical thinking exam is a different beast when compared to a science, math, or history class. Pretend you are interrogating the question, "This doesn't add up. Something stinks!" "Why are questions set up this way...why are they worded this way." The right answer is there. You can say, "It's not that one, it's that one, this kinda make sense and it's true, but this one does in fact answer the question...I might not fully understand it, but it answers the question and that's what matters. Now there are questions that are easy and right to point. And they're awesome when it happens! But to answer your last question, no matter how much you believe that the instructors just want to see you fail, they don't. They are trying to teach you how to think critically.

Sorry for the book! I just wanted to explain that there is more than just black and white. I hope this helps :)

KR14CCRN · Oct 29, 2012

Everything you learn is building on everything you have already learned. Anything from previous classes is fair game as far as your instructors see. When you take care of a heart patient you also have to assess the other areas, right? Everything ties together and one system can affect the next. Your instructor is only trying to get you to see the big picture, think critically, and be prepared for anything, because that is the real world of nursing.

Stephalump · Oct 29, 2012

On our exams everything covered throughout the program is testable. We don't get review sheets or study guides. We get the list of objectives they want us to be able to do for the unit, but its not particularly helpful because its basically everything in lecture and readings. If you were being asked something not even covered in lecture/reading so far, then I surely would complain, but if thus the case I'm sure the instructors would be receptive.

Nursing school is hard!

Sadala, ADN, RN · Oct 30, 2012

We get a list of chapters we'll be covering in the exam, but... its seldom accurate, and in fact, ?'s are pulled in from material in other classes (and not just other chapters). The fun goes on...

Esme12, ASN, BSN, RN · Oct 30, 2012

I have a question on the legitimacy of testing in nursing school. Maybe someone can help me out with advice. I am in 3rd semester of nursing school have passed all exams up until my first exam in med surg this semester. In fact only 5 people passed the exam out of 31 people and the class average was a 68. On the second exam it seemed more fair however there were two specific questions like respiratory ques (such as breath sounds) on the GI test that we had no idea would be on the test. The focus was GI. Would it be safe to say that this is being unjust and risking points of students on exams? Can teachers do this or should they give us a review sheet hinting of what to brush up on from previous semesters so we do not risk points that could have been answered correctly if we knew to brush up? From what I can remember, every semester before this one our teachers gave us a study review sheet a week before the exam esp if it contained material from previous semesters and currently the teacher we now have is stating anything is fair game from previous semesters. So how do we study things that have no relation to our exams? Where is the focus?

You are well into your education....unlike other disciplines....nursing continues to use all of the knowledge base everyday. Patients are multifaceted with multiple co-morbidities. So...... your GI bleed with a history of Crohn's can have a history of asthma or COPD with pulmonary hypertension.

All of your knowledge from day one will be needed and used every day in the care of your patients. I know this may sound harsh but your patients will not come with a study guide....THIS is what makes nursing so challenging.

Now do I think there is something amiss when that may fail a test....yes. Someone isn't on the right page or teaching the right material.

classicdame, MSN, EdD · Oct 30, 2012

the questions are probably from a question bank. They have probably been tested for validity and reliability to avoid bias and other pitfalls. That said, when you are a practicing nurse you will have to recall things from WAY BACK. Nursing is an identity, culture and language. It is all inclusive and you have to be totally focused. So yes, the tests are "fair". BUT, I hated them myself when I was in nursing school.