General studying advice?

[manchmal]

This is a general question, and I'm really curious how successful students answer it. I'm a first year, first quarter student (with a degree in humanities, and another in publication design -- totally different style of learning), and I just took my first test. Didn't do fabulous on it (not awful, but not great). Exams are modeled after NCLEX questions, so there's no general knowledge stuff...it's all synthesis/application. And so...I read and took notes on the book, practiced questions, re-listened to lectures, did the study guides, and knew that stuff backwards and forwards, but I'm having a very hard time converting the info (data) I read in the book into something I can apply when I have to answer questions that require me to prioritize and make judgment calls.

So my questions:

1. How do you study? Does making decisions and analyzing test questions become more intuitive after a while?

2. How do you prioritize care between patients and between symptoms on the same patient?

I know Maslow's hierarchy, but sometimes you'll have two critical problems on a patient, and then I get stuck about which to do first. I know airway, breathing, circulation come first, but...does anyone have any other insight into how they prioritize what to do first, second, third, etc.?

[Daytonite, BSN, RN]

see the information on this thread: https://allnurses.com/general-nursing-student/looking-test-taking-224581.html - looking for test taking strategies

i always advise that students as part of the critical thinking take these factors into account in every question:

• 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, i cannot stress this enough. there are five of them: assessment, determining problems, planning care, implementation and evaluation. one of the most confusing is assessment because it is step #1 of the nursing process and the word "assess" is also frequently used in nursing interventions which are part of step #3 of the nursing process which is the planning step. assessing as an intervention is not quite the same as the full-blown assessment you do when you first encounter the patient in order to plan care; it's more of a monitoring/evaluation/observation thing when it's an intervention. each step of the nursing process is a photograph, a link in a chain; another link later on may be appropriate as well, but ask yourself if that is what the question is asking of you.
  
• 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 and contribute more information to the root of the question to deliberate confuse you. a mediocre student or a student who isn't thinking will opt for the most easily distractive answer. if you've done your reading and studying you should be putting two and two together. nursing is 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.
  
• bottom line. . .you always have to be thinking "why". why would this be happening to the patient? why would the doctor order this? why would i do this? why? why? why? answer that, and you'll probably answer the question correctly.