Critical thinking questions in job interviews

RNLola035 · Mar 12, 2009

When I've gone on interview I've had to determine the diagnoses, such as Stroke, MI, CHF, Stroke, Hypo/Hyperglycemia, Diabetic ketoacidosis, Renal failure, Sepsis, Hemmorhage

Know what the signs/symptoms are, what you your assessments are going to be...what are your interventions..if you would call the doctor and what orders do you anticipate from the doctor like meds, tests, diets,etc.

I was asked what kind of juice I would give to a Renal Diabetic patient

A patient is having chest pain..What do you do?

I had a question that required me to know what you would teach a patient if they had COPD

Another asked about the antidote for coumadin

Here's one specific scenario I remember:

YOU have just gotten off from a break, you enter the lobby where there is a transporter who is transporting a patient up to the 6th floor, which is a stroke unit. Just as you are about to get onto the lobby elevator the patient says to you "I just don't feel right." What are your first steps? What is your assessments? What are your interventions? (It was something like that anyway)

Good luck! You are in my thoughts!

cruisin_woodward · Mar 12, 2009

As a new grad, I was given scenarios if 8 pts, which ones would I attend to first...prioritize and delegate.

mediatix8 · Mar 12, 2009

From my experience, they do not go into real detailed questions of how you would handle real specific situations. From my experience, they have asked real simple questions pretty much like the once you described. I.e. what do you do if you find a patient not breathing, blue, etc. I wouldn't kill yourself trying to think of different questions they might ask but rather think of good, simple answers. Many of the same solutions apply to different scenerios. And I think you might get yourself all nervous if you start thinking too much, seriously. I think the MOST important thing they are looking for is that you, especially as a new grad if you are, are going to get in as much help as possible if a pateint is in real trouble. They are looking that you are not going to be a liability case, not getting any help, panicking and running around looking for a nasal cannula when the patient is dead and on the floor. If they use words like "blue" "unresponsive" "not breathing" they want to hear that you will call a code blue. You can't go wrong calling a code blue on a patient who is unresponsive and lying on the floor. They know that the more people are involved the better the outcome, even if the person is breathing and does have a heart beat. Even if they are breathing, if they are on the floor and you seriously can't wake them up, something is obviously wrong- just call a code blue or a rapid response (a step below a code blue but where the charge nurse, resp. therapist, ICU nurse respond... even if the hospital does not have this particular code you can always call these people for help individually at anytime). Anyone would rather you be more safe than sorry. I think they would hate to think of you trying to handle a real critical situations all by yourself as a new employee and new grad. I think that is what they are really looking to hear you say first and foremost in your answers- more important than some detailed explaination of...I don't know...interpretiations of ABG level results and the clinical signs and symptoms of metabolic acidosis.

So to answer any code blue type questions they may have, think of code blue type solutions and make a list. Check ABC's. Call code blue (you can still call it even if they are breathing... as long as you consider it a critical situation). Perform CPR, if applicable. Have someone get crash cart. Apply crash cart. Pretty much the ER doctor and ICU nurse that comes to these things run the show. I wouldn't state that in an answer but I would say something like assist ER doctor, ICU nurse in their recommendations for further care, gathering supplies they need. Set up suction device, check vital signs, perform an accucheck, esp. if pt is a diabetic. This is done at some point on any diabetic patient during a code. Just think simple. This really isn't a hard question so don't make it into a 10 page essay.

If they truely give you a scenerio that you know you know you can't call a code blue for because it isn't serious enough, I would still at least tell them you would get the charge nurse involved because as a new grad and or new employee, you really need a second opinion and a little help when something goes wrong. And again I wouldn't try to come up with different questions as a prep but start making a list of different solutions that you can later apply to any question. It's the same ol solutions for all kinds of different questions. For example, for anything respiratory related: check vital signs, apply O2 or advance the O2 they have such as putting on a nonrebreather, get resp therapy involved- they may draw ABG's, check the medications they are on to review for any potential reaction, set up suction, get charge nurse involved, call MD. For anything cardiac or potentially cardiac related: check vital signs, put them on tele if they aren't on it all ready, get a STAT EKG, labs for cardiac enzymes and a BMP, mag, apply o2, get charge nurse involved, call MD. There is obviously a lot of overlap with the cardiac and respiratory solutions.

jla623 · Mar 12, 2009

From my experience, they do not go into real detailed questions of how you would handle real specific situations. From my experience, they have asked real simple questions pretty much like the once you described. I.e. what do you do if you find a patient not breathing, blue, etc. I wouldn't kill yourself trying to think of different questions they might ask but rather think of good, simple answers. Many of the same solutions apply to different scenerios. And I think you might get yourself all nervous if you start thinking too much, seriously. I think the MOST important thing they are looking for is that you, especially as a new grad if you are, are going to get in as much help as possible if a pateint is in real trouble. They are looking that you are not going to be a liability case, not getting any help, panicking and running around looking for a nasal cannula when the patient is dead and on the floor. If they use words like "blue" "unresponsive" "not breathing" they want to hear that you will call a code blue. You can't go wrong calling a code blue on a patient who is unresponsive and lying on the floor. They know that the more people are involved the better the outcome, even if the person is breathing and does have a heart beat. Even if they are breathing, if they are on the floor and you seriously can't wake them up, something is obviously wrong- just call a code blue or a rapid response (a step below a code blue but where the charge nurse, resp. therapist, ICU nurse respond... even if the hospital does not have this particular code you can always call these people for help individually at anytime). Anyone would rather you be more safe than sorry. I think they would hate to think of you trying to handle a real critical situations all by yourself as a new employee and new grad. I think that is what they are really looking to hear you say first and foremost in your answers- more important than some detailed explaination of...I don't know...interpretiations of ABG level results and the clinical signs and symptoms of metabolic acidosis.
So to answer any code blue type questions they may have, think of code blue type solutions and make a list. Check ABC's. Call code blue (you can still call it even if they are breathing... as long as you consider it a critical situation). Perform CPR, if applicable. Have someone get crash cart. Apply crash cart. Pretty much the ER doctor and ICU nurse that comes to these things run the show. I wouldn't state that in an answer but I would say something like assist ER doctor, ICU nurse in their recommendations for further care, gathering supplies they need. Set up suction device, check vital signs, perform an accucheck, esp. if pt is a diabetic. This is done at some point on any diabetic patient during a code. Just think simple. This really isn't a hard question so don't make it into a 10 page essay.
If they truely give you a scenerio that you know you know you can't call a code blue for because it isn't serious enough, I would still at least tell them you would get the charge nurse involved because as a new grad and or new employee, you really need a second opinion and a little help when something goes wrong. And again I wouldn't try to come up with different questions as a prep but start making a list of different solutions that you can later apply to any question. It's the same ol solutions for all kinds of different questions. For example, for anything respiratory related: check vital signs, apply O2 or advance the O2 they have such as putting on a nonrebreather, get resp therapy involved- they may draw ABG's, check the medications they are on to review for any potential reaction, set up suction, get charge nurse involved, call MD. For anything cardiac or potentially cardiac related: check vital signs, put them on tele if they aren't on it all ready, get a STAT EKG, labs for cardiac enzymes and a BMP, mag, apply o2, get charge nurse involved, call MD. There is obviously a lot of overlap with the cardiac and respiratory solutions.

Excellent post! I wish I could give you like 20 thankyous. You have no idea how much this helps me. :yeah:

I was just worried about either being too vague or rambling on so much that they think I am a cocky, know-it-all new grad (which I am not!). As long as I can get it all out without getting too nervous and stumbling on my words, I think I'll be okay.

Aneroo, LPN · Mar 12, 2009

When in doubt, check policy/procedure or your preceptor/charge/doctor.

Ivanna_Nurse, BSN, RN · Mar 12, 2009

When in doubt, check policy/procedure or your preceptor/charge/doctor.

Excellent piece of advice. :) Ivanna