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chicken1 425 Views

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    HangInThere likes this.

    I'm a Freshman I student in an ADN program. I'm getting really frusterated with what I feel are some poorly written test questions. I get the idea that the test questions are supposed to mimic the NCLEX by having the 'critical thinking', judgement-based questions, but I think some of the questions that I've gotten wrong this semester have logical fallacies that make the question invalid. I want opinions from you guys: are these really bad questions, or am I just 'over-thinking' them, as my instructors tell me?

    Question #1:

    Your client tells you he is feeling pain in a location different from where it started. You know his type of pain is....
    a. referred
    b. viseral
    c. radiating
    d. cutaneous

    I picked 'c', and was wrong. The answer given by the teacher is 'a', referred. My impression of referred pain is that pain is not felt at the site of tissue damage, but is felt in a different 'referred' would be the correct answer if the question read ...'Your client tells you he is feeling pain in a location different from the site of tissue damage. But, the way the question is written, 'it' refers to pain, and it is true to say that radiating pain is pain that is felt in one location, and then is felt in a different location (as it radiates from one location to the next).

    Question #2

    What is the surgical classification for cataract removal?
    a. major
    b. urgent
    c. restorative
    d. cosmetic

    I don't think any of these answers are correct, so the question is invalid. The instructor's answer was 'c', restorative. While cataract removal does result in restored vision, the definition for restorative surgery is that is 'restores function or appearance to traumatized or malfunctioning tissues'; cataract removal does not restore function to the damaged tissue, it removes the tissue and replaces it with an artifical lens. Therefore the classification pertaining to purpose should be 'ablative', or 'ablative and transplant'. I picked 'b', urgent, thinking it was the best answer out of those provided, even though I understand that cataract surgery is better classified as an elective surgery.

    3. You are teaching a patient about ways to induce sleep. You will be sure to teach him that...
    a. a cup of warm, regular tea before bed will help him sleep.
    b. a glass of red wine promotes deep and REM sleep
    c. as you age, the length and quality of REM and deep sleep decrease
    d. physical activity prevents falling asleep

    Again, I think there is not a fully correct answer. C is the only completely true statement, but I would NOT teach my client that if my purpose is to teach about ways to induce sleep because it is not fully relevant to the teaching topic and would obsure the main messages that the patient should learn. I picked 'd', figuring that although physical activity may help promote sleep if it is moderate and well bedfore bedtime, it can also prevent sleep if it is to the point of fatigue or too close to bedtime.

    4. Which of the following statements, if stated by your client, would show understanding of the fecal occult test?
    a. I must use a 1-2" piece of formed stool
    b. I will complete the test over a three day period.
    c. I will wait until my cycle starts to do the test.
    d. I eat red meat on a daily basis.

    The instructor gave the correct answer as 'a'. I had eliminated this choice because it is true to say "You do not have to use a 1-2" piece of formed stool for the fecal occult test, instead, you can use 15 mL of liquid stool. I picked 'b' instead, because the test can be completed over three the Hemoccult test directions say to do. Instructor said it's better to do it over three consecutive stools, which may be true....but I think the question is invalid as written because of the logical error in using the word 'must' in choice 'a', rather than 'can'.

    5. A nurse monitors a patient's vital signs and assesses his IV medications for 15 mintues. The nurse does not acknowledge or speak to the patient or the patient's spouse while she is in the room. Which behavior is the nurse best demonstrating?
    a. discourtesy
    b. unprofessionalism
    (c and d were nonsense answers that I can't remember)

    I picked 'b', unprofessionalism, while the instructor's correct answer is 'a', discourtesy. The book lists the 'elements of professional communication' as consisting of 'courtesy', 'use of names', 'trustworthiness', 'autonomy and responsibility', and 'assertiveness'. The instructor says discourtesy is the best answer because it it most specific. I think unprofessionalism is a better choice because the nurses behavior in this situation fails to be courteous, to use names, to build trust, and to promote patient autonomy; therefore, unprofessionalism encompasses all the failures in her communication which 'discourtesy' unneccessarily limits the boundaries of the behavior. In either case, I think this question is arbitrary and could have been made a valid question by simply asking 'Which behavior is the nurse most specifically demonstrating?'

    Again, am I over-analyzing or do the questions have inherent flaws? Am I misunderstanding the material somehow? Any input is appreciated. As an 'A' is a 93, there is not much room for error on these tests....and I'm debating whether I should try to formally petition a few of these questions if I end up with a 91 or 92 in the class.....