Fundamental of Nursing

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hello,

does anyone have any good advice or words of wisdom on this?

i am a cna in nursing school. i am starting to look at things differently in the hospital setting, so i am making baby steps to becoming a nurse. what i am having trouble with is the critical thinking and answering the good, better, best questions correctly. it seems like i am always finding the better answer, but just not the best answer. how do i make that next step & start thinking like a nurse?

thanks.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

see the advice and weblinks on this thread: https://allnurses.com/forums/f50/looking-test-taking-stratagies-224581.html - looking for test taking strategies

many times these are what are called application type questions which involved pulling knowledge of a number of different subjects into answering correctly. what makes this complicated is that you are not told what subjects to consider in answering. in general, consider:

  • the medical disease involved, it's normal pathophysiological progression and the signs and symptoms associated with the pathophysiological changes. learn the progression of symptoms as they go from mild to serious to fatal. this helps you determine priorities of care.
  • know the medical tests and treatments that the doctor is going to order. know which tests and treatments fit which each sign and symptom (again this helps determine priority if you get asked which to get done first). some of these tests and treatment will impact the nursing care you will give.
  • know the steps of the nursing process. there are five of them. know which order they come in and what goes on in each step: assessment, determining problems, planning care, implementation and evaluation. each step of the nursing process is a link in a chain; ask yourself if the question is placing you in one of the link of events on the chain of the steps of the nursing process and what would be logically happening on that step.
  • there are many kinds of principles behind nursing actions (i.e., principles of asepsis, principles of osmosis, infection process, etc) that you need to know and sometimes pull into determining the answer to a question. this is where you sometimes cannot discount the science or math you learned before. something as simple as heat coagulates protein helps you to know that it is the underlying principle of steam sterilization in the killing of bacteria.
  • read the root or stem of a multiple choice question very carefully. i've read some of the instructors manuals on how to write these questions. they deliberately give you answer choices designed to distract you from what was originally asked because it naturally draws your attention to it. a mediocre student or a student who isn't thinking will opt for these distractive answer choices. if you've done your reading and studying you should be putting two and two together. nursing involves a process of logical thinking, not guesswork. if you are narrowed down to two possible answers, try to figure out from the stem of the question if pulling in knowledge of the nursing process or the disease process is going to help you make your final decision.
  • think about previous test questions you missed and why you missed them. teachers use the same techniques that "gotcha" to answer incorrectly before over and over again which is why you should always review your tests when you get them back and correct your reasoning for picking wrong answer choices.
  • bottom line. . .you always have to be thinking "why". why would this situation a question poses be happening to the patient? why would the doctor order some particular treatment? why would a nurse do what a question is asking? why? why? why? answer that, and you are closer to answering the question correctly.

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Specializes in IMCU.

You should search some of the threads on this site. They cover it in a number of places. Peek at:

https://allnurses.com/graduate-nurse-forum/nclex-prioritizing-109143.html

Also, review the rationales of the answers. If, when you read them, you go "oh yeah I see why that is the best answer" fine. If not ask your professor to explain.

Be glad they are asking this type of question early one -- it helps you prep for the type of questions you will get on the NCLEX.

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Specializes in ICU.
hello,

does anyone have any good advice or words of wisdom on this?

i am a cna in nursing school. i am starting to look at things differently in the hospital setting, so i am making baby steps to becoming a nurse. what i am having trouble with is the critical thinking and answering the good, better, best questions correctly. it seems like i am always finding the better answer, but just not the best answer. how do i make that next step & start thinking like a nurse?

thanks.

you might try picking up a nclex study book such as kaplan or saunders. those books often explain why a certain answer is the "best."

don't feel bad - learning how to "read" nclex-style questions is a big step in nursing programs. these questions are often vastly different from the usual "memorize & regurgitate for tests" type of question you may have had in your prereq courses.

it is frustrating to be able to rule out the worst choice, then get stuck deciding between the remaining choices. you've got to learn how to not read too much into the questions. like i said, give the nclex study books a try.

you'll get it down - it just takes time & whacking your head against the wall enough.:D

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I came from the same boat, and you don't realize how things are different now that you are in school and you look at things in a whole new light. I used to think as a benefit from my hospital experience but now that I am so close to the end and while I was going through the transformation...I realize that it kind of hurt me in the long run. To be a RN or real nursing as I like to put it you got to do the book time...Saunders is a great resource and the more questions I do the better I have gotten to it. Another tip, is to take yourself out of the scenario and you what have seen....you have probably heard this a lot, don't understimate the power of knowledge...and critical thinking...they will always be back and might as well master it now.

Good luck!

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I started out as a CNA also and now am in my 2nd year of nursing school! Don't get discouraged! I think the critical thinking element of nursing school is one of the most difficult to master. What text book are you using? Our program requires Potter & Perry's Fundamentals of Nursing. This text came with a companion website and CD that offers NCLEX style questions for each chapter. You can set up a quiz for each chapter separately or choose several chapters at once. I found these practice questions invaluable. They all have rationales as to why a certain answer is the "best". I try to go through at least 25-50 NCLEX style review questions per day. This really helps me get in the "mode" of the types of questions that are on our tests. I have seen an improvement in my grades since doing this. I also have a Saunders NCLEX review book that came with a CD as well. My best advice is to just practice these types of questions over and over! Eventually, it will just start to click and you will be able to answer the questions with less difficulty. Good luck! Please let me know if I can answer any other questions or concerns about nursing school for you!

Michelle Willerford

Elselvier Student Ambassador

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