Can anyone explain the logic behind nursing exam questions?

The answer is SIMPLE. potassium imbalances the most important of the choices.

potassium imbalances = cardiac irregularities,

K+ would be my answer, but it also has to be given how much out of balance in relation to the condition of the patient and the other electrolytes. The tests are trying to get you to think in terms of a whole as well as foster critical thinking. It's easy to regurgitate information, I used to do it all the time in school, but the ability to think things through and to notice subtleties is something that I think every nurse needs. Is it fair? Probably not. Does it make you think on your feet and try and look at the big picture with these questions? Probably so. It's that or they just don't like us very much.

That question is NOT simple, and IMO very, very stupid. I hope that isn't for real.

What do they mean by "imbalance" -- hypo, or hyper? Yes, hyperkalemia can be deadly -- but so can hypo/hypernatremia (cerebral edema, coma), and severe acidosis of any type (metabolic, respiratory) is a recipe for a code. To answer this question they would need to give you lab values and have you choose which one is the furthest out of range.

I haven't been in a basic nursing program for awhile but I can tell you that some schools have gone to asking NCLEX-style questions on exams. It is to get you thinking about priority setting and what your first plan of action would be according to the nursing process (think ADPIE).

I could use help with this also. Waiting on midterm grade & hoping I passed the exam. I know the material & my lab values inside out, but I have no idea how well (or badly ) I may have done.

I find the questions are written oddly, and designed to make you choose the wrong answer. I read each question very carefully, and read it 3 times before choosing my answer. Even then I find them still tricky, 1 word may be the difference between a right & wrong answer. I do practice NCLEX questions every day & find them very straight forward compared to our school exams.

Fingers crossed!

Sometimes I think the questions simply aren't fair, and some instructors are better than others about writing questions that don't require their specific frame of reference to figure out the correct response. I have also experience the feeling of doing poorly on an exam that I studied much more for than previous exams, and sometimes I think all of the excess knowledge plays against me because it makes me look for answers based on recognition of terms and procedures rather than using my critical thinking skills.

Practice, practice, practice. It gets better with time, seriously.

Got 60% and this one counts for 30% of my grade. Not sure what to do at this point.

Make a meeting with your instructor for a time to go over your answers with her personally. Schedule a 30-45 minute session so that you have time to actually go through each question you missed and find out the rationale behind why the right answer was correct.

That question is NOT simple, and IMO very, very stupid. I hope that isn't for real.

What do they mean by "imbalance" -- hypo, or hyper? Yes, hyperkalemia can be deadly -- but so can hypo/hypernatremia (cerebral edema, coma), and severe acidosis of any type (metabolic, respiratory) is a recipe for a code. To answer this question they would need to give you lab values and have you choose which one is the furthest out of range.

so right in this. any one of the conditions could have been lethal or debilitating, depending upon degree. if no degree is specified the question is invalid. sure, K is the easiest scale to fall off of and into death, but the question still stinks.

I am not a straight A student but I have learned a LOT about how to answer HESI / NCLEX-style questions.

First of all, you have to know the patho of diseases and you have to know about electrolytes and how they affect the body if it is hypo or hyper.

Secondly, I think you need to learn HOW to read and answer questions. I have a Kaplan book that is a test taking how-to book. One thing that really helped me is to look at how the question is asked and WHAT the question is asking. Is it a nursing intervention question or an assessment question? It is very easy to misread a question and answer it incorrectly. It is also pretty easy to read too much into a question. I was guilty of that a few times.

Make sure you are meeting with instructors after tests so you know what questions you are missing and why. That helped me soooo much and it really made me a better test taker.

good luck!

m

Thanks! I did meet with my instructor after our 1st test, and knew that I was making the error of not reading the questions and all of the options carefully enough. I thought I had done just that but obviously not! Am meeting with my prof tomorrow to see where I went so wrong. Also scheduled some private tutor sessions which will hopefully help.

The question does not have enough information to be answered consistently. Meaning each student will interpret the question differently and many will get is wrong because they did not "see" the question the way the author intended. Let's say the ph was 6.3 and the K 5.7. Acidosis would be the priority. Does the question mean, if one of these was out of the norm, which would have priority? Or, if they all were out of norm, which would have priority. Obviously severe alterations of any of the choices could kill you. I realize I'm just venting on the poor quality of test questions...

Read the question through once and look at the answers. Then read the question again and underline the key words and what the question is asking. Then eliminate the obviously wrong 2 answers. Read your underlined words/phrase again and look at the 2 remaining answers and select the right one.

Here's a really good example from the Saunders cd:

A nurse monitors the respiratory status of the client being treated for acute exacerbation of chronic COPD. Which of the following assessment findings would indicate a deterioration in ventilation?

a. cyanosis

b. rapid, shallow respirations

c. hyperventilated chest

d. coorifice crackles auscultated bilaterally

Hyperventilated chest and cyanosis are common in people with chronic COPD so eliminate those right away.

If you read through the question quickly you'd be tempted to select D. You need to read the question again, its asking about "deterioration in ventilation" so the answer is B.

Do not sit there and keep looking at the question and answers and telling yourself that all of the symptoms apply to COPD. Concentrate only on what the question is specifically asking, don't try to justify anything.

This is how I do exams and it works well for me.