Sample Question #2

  1. OK, here's another one for you.


    A patient returns to a clinic after taking a 7-day course of antibiotic and is still exhibiting signs of a urinary tract infection.

    The initial action of the nurse should be:

    A. Make an appt. for patient to be seen by the physcian

    B. Arrange for the physician to prescribe a different antibiotic

    C. Determine if the patient took the antibiotic as prescribed.

    D. Obtain another urine specimen for a culture and sensitivity.
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  2. 10 Comments

  3. by   Browneyedgirl
    c
  4. by   dsczephyr
    Step 1: Identify the topic of question: UTI
    Step 2: Are the answer choices all assessment, all implementation, or a mixture of both? Use the nursing process and don't pass the buck to another health care professional for what you, as the nurse, need to do now. Words such as 'initial' indicate there is more than one right response, but what is the first thing the nurse does?
    Answer choice (A) is an implementation
    Answer choice (B) is an implementation
    Answer choice (C) is an assessment
    Answer choice (D) is an implementation
    Step 3: Is Maslow applicable? Physical needs are always a priority over psychosocial needs
    Step 4: If all answers are physical, think in terms of the ABC's
    Step 5: If the answers are all psychosocial. think of the outcomes: which would be the desired outcome?
    Step 6: If both are present, use the nursing process.

    Using this process the answer is "C."

    Denise
  5. by   RNIAM
    Okay I am going to go for D here. The reason is it asks for an action, so asking a question I guess is an action but I would think getting a specimen would be a better action?
  6. by   redwinggirlie
    c
  7. by   silvermoon
    C then D then if indicated from C&S results ask the physician for meds prescription.

    We rarely have multiple hope questions in Brit nursing school and if you can rationalise your actions, as long as they are not obvious stupidity, you get a mark.
  8. by   Ortho_RN
    C
  9. by   colleen10
    OK, since it's Friday afternoon and the weather is looking gorgeous I may not be back til Monday.

    The correct answer is "C".

    Options A, B and D should be eliminated because these options move directly to an "intervention" before collecting more data.

    Option D is a form of "assessment" which would be the "initial" action of the nurse.

    I thought these questions were tricky but nothin' is stopping you guys. Please tell me you have a semester of nursing school under your belt because I don't and was a bit stumped on these. I thought the same thing that RN2B did.

    I have learned one good thing by practicing these and that is to assume nothing and don't read too much into the questions.

    I especially enjoyed reading Denises methodology for figuring out the answer and think I'll try it out on some more questions.
  10. by   Mkue
    Another good question !

    Thanks
  11. by   RNIAM
    Thanks..have a good weekend!
  12. by   dsczephyr
    I have realized that I should clarify that my process for this question was for this question alone. I am a graduate nurse (high honors) who is studying for the NCLEX through Kaplan. Kaplan gives some very good strategies for studying for the NCLEX which is based on Bloom's Taxonomy: there are four levels of difficulty in questions - the bottom two are recall/recognition and comprehension. We get these in prerequisites and some in nursing school. They are also on the NCLEX - but are not passing level questions. The upper two levels of questions are application and analysis questions - the critical thinking questions that assume you know the content already. These are the passing NCLEX level questions. What I did for the posted question was to use some of the strategies Kaplan teaches for NCLEX. My own experience with nursing school is that the test questions were a modified version of what I am studying now.

    With the Kaplan review, I have learned not to just jump at what I think is the right answer, but to identify the topic (not always obvious if you get a lot of background information), eliminate wrong answers using a set of strategies, and then to reason out the right answer from what is left using another set of strategies. It's taking a lot of practice, but I am actually beginning to get a lot more right answers than wrong ones using these concepts.

    Identify the topic of the question: it's not always obvious what is being asked.
    Only eliminate answers you know to be wrong in order to find the correct answer.
    Don't use background information unless absolutely necessary.
    Don't read into questions or make assumptions.
    You are always taking care of a patient and NCLEX is about bedside nursing.
    This is not the real world, correct answers are based on the textbook.
    The right answer is within the scope of nursing, don't pass the buck.
    Memorize lab values.
    Take care of the patient first, then the equipment.
    Therapeutic communication is not authoriarian, does not ask yes or no questions, and does not ask why.
    Focus on the patient, not the nurse; correct answer choices are empathetic and reflect the patient's feelings.
    Learn to recognize expected outcomes
    Be able to answer questions about positioning, are you preventing something or promoting something?
    Don't delegate teaching, assessment, or evaluation.
    To establish prioritites: what is the one thing you can do and then go home; or use Maslow if choices include both physical and psychosocial answers - eliminates the psychosocial; for the remaining choices use the ABC's; or are the answers assessments and implementation answers - in this case look for what the question is asking; and/or determine the outcome of your actions - what is the desired outcome?

    I hope this clarifies things. Denise

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