Wrong info in Kaplan Qbank

I did read that on the tips on taking the exam. I tried to see the question the way it is. One thing I notice is if the choices have it then therefore it isn't implied. So going back to the question, one of the choices was to inform the physician. That means the physician didn't know. If I assumed that the physician already knew it was unsterile then that in itself is creating a story within a story, am I right?

In the NCLEX world, the computer adaptive testing mechanism wants to know which prudent action that you (the nurse) would take. Read: the correct answer is almost never to call the physician.

When assisting with insertion of a central venous catheter, a physician might not necessarily be there to perform the procedure. You might actually be assisting a nurse practitioner, clinical nurse specialist or PA while they're inserting. Anyhow, no nurse in the real world is going to call the doctor to notify him/her that the tip has brushed with the underside of the sterile field.

As a professional who is capable of common sense and critical thought, you are simply going to prepare for another attempt. After all, it is within your nursing judgment to prepare for a second attempt.

What would happen if you called the doctor to notify that the tip brushed the underside of the sterile field? Most doctors would wonder why you are calling in the first place.

In reference to Ozzy84, I would clearly choose the correct answer instead of my choice based on your situation where I am the one performing the insertion but that is creating a whole entirely different situation. In the question, it states the nurse is ASSISTING therefore not doing the procedure.

Also, I have encountered several question in the Qbank where Contacting/informing the physician is the correct answer and it made total sense. An example would be if the dosage had to be adjusted another is by the elimination method. If all other answer do not apply then contacting the physician would be the right answer.

I also used Kaplan, in part, to prepare for NCLEX. Make sure you review the rationales for the questions - it will help you shift your thinking to be able to answer questions in "Ivory Tower NCLEX Nursing Land." I did find a few actual mistakes in their QBank questions, so it is possible that you may stumble across some.

My school also offered us a weeklong Kaplan class and the instructor offered some helpful tips for questions like the one you're wondering about. Don't make assumptions or bring in outside information that is not provided in the question (like assuming the line is being placed by the doctor). She also told us to ask ourselves, "if I can do ONLY ONE thing for this patient/situation, which one thing would I do?" Using that strategy, for me, I would've chosen the answer Kaplan said was correct.

Thank you for the tip.. I'm just so frustrated because I graduated 3 years ago and now I'm trying to take the Boards. I know, Bad move on my part... It's just that I am trying to train my thinking to answer each question correctly but it seems like the questions are not consistent sometimes. I'm guess I'm kinda stressed out.

But I will remember what you told me and I'll keep it in mind when answering.

You're over-thinking it. Even if you (the nurse) are just there to assist with the procedure, you wouldn't ever call a physician to notify him/her that the tip touched the underside of the sterile field. You simply prepare for another insertion, which is a prudent nursing action that is fully within your scope of practice. There is no valid reason to notify the MD.

The reason why I knew it was assisting is because the choice stated NOTIFY the physician of the occurrence. If the choice is worded CALL the physician of the occurrence then obviously the physician is no where near you then yes I would understand why the correct answer is indeed correct.

I think Kaplan really meant to make the correct answer "obtain a new......" it's just that they didn't word the question properly. If you think about it the answer is kinda obvious but if I start to assume the obvious answers then I would make a whole lot of incorrect answers.

I read some other strategies book. Saying that you will do only ONE things that's gonna save patient life. So would you notify md ? What would be outcome? Or if you prep an other set of cath? So patient would not get infected.

Sometimes think of OUT COME.

You're letting the strategies do the thinking for you... Read what the question properly so you will have a good picture of the situation. The question says the nurse is ASSISTING... Are you saying what's best for the patient is to go ahead and prep for for another cath without informing the other medical team of what you obsererved?

As I've said before, I think Kaplan wanted the option to prep for another attempt to be the correct answer but they didn't word the question in a way to have that to be the desired outcome. Don't try to see questions as black and white. Just coz that choice seems like the common correct answer, it doesn't mean you don't have to analyze the question and consider the other choices.