Question for educators

[MEDICJOHN]

Can someone explain to me why nursing questions are set up how they are? When a question could simply ask "Which of these is incorrect regarding Lupus?" the question will be "The nurse understands that client needs further instruction when the client states which of the following regarding Lupus?"

I don't see how such long, wordy questions have anything to do with our medical training. Yes, we all need basic communication skills. And I truly do well with these ridiculous questions. Yet I still don't understand the purpose of making them so elaborate when our knowledge could be assessed in a much more direct way.

Does anyone have an answer?

[Nurse SMS, MSN, RN]

I am not an educator, but the way it was explained to me is that life itself and active clinical duties won't be in a "which of these is incorrect" format. It will be in watching and listening for clues on what an appropriate response is. It teaches to notice detail, to pick up on subtleties and trains the brain to think beyond "yes, no" answers. So often in medicine, the answer is not correct or incorrect. It is often what is the best option/likely to do the least damage, what is most important or highest priority in a given scenario, etc.

Asking "which is incorrect" is a simple, knowledge based question. Asking you to scope for clues, find them and then act on them is a different pathway in the brain. It develops critical thinking skills.

[anonymous1919, LPN]

The questions are set up the same way NCLEX questions are. In order to answer the questions you have to have good critical thinking skills and know the subject in depth. It's to prevent people from just memorizing facts and getting them to understand what they are reading.

[Sendana]

The poster above me is correct in stating that nursing school questions are presented that way in order to help prepare you for NCLEX. The better question is probably why NCLEX questions are so convoluted. I believe the answer to that is probably that NCLEX is written by a gaggle of overeducated Ivory Tower-dwelling knuckleheads with fancy degrees. Also, NCLEX (like nursing school), is structured to make it easy for people to fail. The wordiness of the questions increases how hard you have to work to extract pertinent information from them, thus making them more difficult to answer, no matter how well you know the material.

[MEDICJOHN]

I agree w/ you Sendana. So many times classmates have missed questions based on one word or phrasing and NOT whether they know the material. I honestly think it's a bunch of crap and yes, designed to make ppl fail.

[elkpark]

If people are misreading questions or failing to pick out the most pertinent information in a question, then they don't know the material well enough. And NCLEX-style questions are a walk in the park compared to real-life nursing practice and dealing with human beings, which are full of contradictions, hidden and convoluted info, etc., etc., etc.

I agree with RN2BDFW and lindsayisxblonde -- the point is not so much to assess your knowledge of the info as it is to assess whether you can apply that knowledge appropriately to clinical situations and think critically about real-life scenarios. Simple "assessment of knowledge" questions are the lowest level of Bloom's taxonomy and way below the level at which nursing students need to be functioning intellectually. It is pretty much assumed, if you got into nursing school in the first place, that you are capable of memorizing facts. What matters is how effectively you can apply and synthesize those facts.

[anonymous1919, LPN]

the point is not so much to assess your knowledge of the info as it is to assess whether you can apply that knowledge appropriately to clinical situations and think critically about real-life scenarios. Simple "assessment of knowledge" questions are the lowest level of Bloom's taxonomy and way below the level at which nursing students need to be functioning intellectually. It is pretty much assumed, if you got into nursing school in the first place, that you are capable of memorizing facts. What matters is how effectively you can apply and synthesize those facts.

This!

And people have totally failed out of nursing school because of NCLEX type questions, no offense to them, but if they can't critically think or aren't capable of understanding and applying nursing theory in a clinical setting, they shouldn't be nurses. So the questions served their purpose appropriately. Sounds crappy, but it's neccessary.. you don't want a bad nurse taking care of you or your family members.

[JBudd, MSN]

The key thing here is not what you know about lupus, because you are expected to know about lupus. What is being asked is how the nurse is going to assess the pt's knowledge; and what the nurse will do about it. Its called a higher level question, building on basic knowledge and going a step beyond.

In the real world, it isn't just right/wrong decisions, its assessing someone else's understanding/compliance/ability. NCLEX and nursing questions often have more than one "right" answer, but we want the "best" answer. For instance, how do you treat fever?

Given a choice of anti-pyretics, tepid baths, fan in the room, etc. Which will you choose first? If its a liver failure pt, can't do the Tylenol can you? All the choices work, but what is best at this time for this pt? Sometimes we don't "treat" the fever, low grade ones help kill infections.

[kids]

The wordiness of the questions increases how hard you have to work to extract pertinent information from them, thus making them more difficult to answer, no matter how well you know the material.

Just like trying to extract the "pertinent information" from a patient in the real world.

[Sendana]

Just like trying to extract the "pertinent information" from a patient in the real world.

You'll notice I didn't decry the format of the questions, or their purpose, just offered a reason for why they are so convoluted. I've also seen questions that are simply incoherent; over the past couple of years, my faculty has thrown out probably five dozen or so questions that they thought were stupid beyond belief, even though they were "official" NCLEX-style questions supposedly written by experts.

My experience with actual patients has been that the vast majority are so uneducated about their bodies and health-related matters that they don't know what they don't know. Trying to extract "pertinent information" from them beyond vague reports of symptoms is like asking a blind person to describe the color blue. That's fine, I suppose, because it's our job to interpret those symptoms, but if you're arguing that NCLEX-style questions represent anything resembling the reality of patient interaction, you are wrong (but probably not in a bad way). Talking to or assessing an actual patient is far more complicated and difficult than answering an NCLEX-style question.