Writing Multiple Choice Test Items - Part Two

Jan 15, 2009 04:12 PM

by VickyRN

Staff

Here are some examples of questions (concerning diabetes) written at different levels of Bloom's Taxonomy.

Can you see the advancing level of difficulty?

Knowledge question

The nurse is monitoring blood glucose levels for a client who has been newly diagnosed with type 1 diabetes. Which of the following ranges represents a normal fasting blood glucose level?
1. 70-105 mg/dl*
2. 106-125 mg/dl
3. 126-150 mg/dl
4. 151-180 mg/dl

Comprehension question

The nurse is evaluating a client who is diabetic and on insulin. Which of the following statements by the client indicates that the client is experiencing a reaction to insulin?
1. "I am feeling anxious and sweaty."*
2. "I hear a ringing sound in my ears."
3. "I feel drowsy and thirsty.”
4. "I have blurred and yellow vision."

Application question

The diabetic nurse educator is performing a teaching session with a client who has been newly diagnosed with type 1 diabetes. Which of the following statements by the client strongly suggests that the client needs additional teaching?
a. "I will rotate my insulin injection sites to avoid tissue damage."
b. "I will check my blood glucose levels four times daily and keep a record."
c. "If I feel faint or sweaty, it means my insulin level is low."*
d. "It is important to eat my meals and snacks at scheduled times."

Analysis

The client has a serum glucose of 650 with positive serum ketones. The nurse understands it is MOST important to monitor this client's:
a. hydration status.
b. level of consciousness.
c. serum potassium.*
d. breathing pattern.

Something that educators can do to help struggling students with the NCLEX-style questions is to advise them to purchase a good NCLEX review book - One that is broken down into subject matter.

Saunders Comprehensive Review is excellent and I recommend this resource to my students. With a good NCLEX review book, the student can "practice" going through these "higher order" types of questions over and over again. It is important for the student to review each possible answer for each question, along with the rationales.

Additional Resources

Test-Taking Tips

Test-Item Checklist

Taking and Passing Tests - Test Taking Strategies - EXCELLENT resource from fadavis.com

Excellent PowerPoint on Test Taking Strategies for nursing students (also very helpful for nurse educators to review):

http://faculty.ccri.edu/jrichardson/test_takng_strategies2_files/frame.htm

einnasabs · Jan 19, 2009, 05:41 AM

Re: Writing Multiple Choice Test Items - Part Two

thanks for your short but very informative info

*Medic2RN* · Jan 19, 2009, 08:59 PM

Re: Writing Multiple Choice Test Items - Part Two

I used the Saunders during nursing school and for the NCLEX. I highly recommend it too.

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Writing Multiple Choice Test Items - Part Two

Writing Multiple Choice Test Items - Part Two

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