Dude, I am an RN

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Well, I sat the first time for this river bottom nightmare of an exam (anybody remember emit otter's jug band christmas?) on Monday and walked out of the place feeling utterly bludgeoned. I truly felt clueless on the majority of the questions both in terms of content and format. It was one of the hardest nursing tests I've ever taken. But, apparently, there was no reason for my premature swan song, as I passed at 75 questions. I never visited this board until I was sure I failed the test and then began searching desperately for a clue. Having now read many of the threads, I realize I should have found this site along time ago. Today, I signed up (hi, nice to be here!) Having passed the exam, I can only advise incipient test-takers what others on this board have advised ad nauseum. I know the test is different for everyone, but I'd nevertheless make sure you are over-prepared for the following kinds of questions:

1) Infection control. Yes! To say there is a lot of infection control probably is an understatement. I was BOMBARDED with these. I am lucky I passed because I was not prepared to answer these questions! I never had ANY questions like this in school, which is ridiculous, and they were not in any of my study materials either! Yet, it is no wonder they have these questions on the exam because this is such BASIC nursing! How can you be safe if you don't know this stuff? In addition, if you've ever been in a hospital, you've probably been on floors in which almost every person has Special Organism Precautions - presumably because caregivers breech the precautions all too frequently. This is causing lots of people to get sick and is costing hospitals patients and the healthcare system a LOT of money. If you've followed the political healthcare debate at all, you know how topical expenditure is. Again, it shouldn't be a surprise that the Boards are chock full of these questions. Anyway, I don't want to preach, the point is this: Know all stuff IC. Knowing now what the exam is like, I would advise everyone about to take the test to read the Standard Precaution (and Contact, Airborne, Droplet) section in the Appendix of your Medical Dictionary. I know Tabers has one. From there, start figuring out which diseases fall into which categories.Which of the following patients with diseases x, y, and z can be roomed together? Do doors need to be closed? Do they need monitored negative air pressure? Do they have to use disposable dishes? Can they share dishes with family members? Bathrooms? How long can vistors stay in rooms? What PPE do both you and they need to wear for disease x, y or z? Surgical mask? Particulate filter? What happens if they need to be transported? etc. etc.

2) Priority questions. It has been said there are lots of these on the test. Guess what? It cannot be said enough: There is! Which patient will you see first? Which intervention do you need to do first? etc.

3) Teaching questions. Holy Smokes! LOTS of these. e.g. Nurse understands teaching has been effective, if patient makes which of these statements? Nurse understands further teaching is needed, if patient says, which of the following? Which of the following should nurse teach patient being discharged to report to the provider? Nurse understands assistant needs further teaching or performed actions correctly when assistant says a, b, c, or d. Familiarize yourself with these formats. Take out your med surg book and look every single care plan given, at the very least. I've found that care plans make a lot of the teaching stuff easily accessible.

4) Client Confidentiality Questions. I had several of these. Nurse knows that which of the following constitutes a breech in confidentiality? You may think a question like this should be easy, that is, until you see the answers listed.

5) Patients condition is X, y or z. Nurse should question which of the following orders? Nurse should clarify which of the following med? I had a handful of these.

6) Cultural Questions! Not prepared for these at all and that's probably why they smacked me with several. One after another in a row. What religious practices need to be incorporated into care for Islamic people? What about for Orthodox Jewish people? Hindu? What are their rituals across the life span? What about their special diets? What about use alcohol? Were I to have to retake, I would learn as much as I possibly can about the beliefs and behaviors of major Orthodox religions AND "ethnic" groups such Hispanic, Chinese. etc. Do you know what "evil eye" is? It wasn't on my test, but it could be on yours.

Anyway, priority, teaching, infection control - you can't waste enough bandwidth reiterating this stuff! It was, for me, as for many others who posted here, the majority of the content. Don't make the same mistake I did, and enter unprepared for these questions. Sure, maybe I am a just a good test taker, maybe I won a dice roll. One thing is certain: I would not chance it and be so unprepared again. The only book I used was a Mosby's. I can tell you this: It was GARBARGE! I seriously think this book left me little more better off than I would have been had I sat for the exam without studying a lick. The content and format of the questions in this book, as I read someone accurately state in another thread, could not have been anymore different than the content and format of the Nclex. I was prepared to throw it away and sign up for Kaplan or NCBSN. Fortunately, I can start looking for a job instead.

Anyway, do what you will and best of luck to everyone!

Dude, I am an RN! I hope as we continue into the future, I can be of help to those of you who are looking.

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Whoa,you just gave me a load of information,you are the type of person I need to encourage me with my studying because right now I am no where from been prepared as I am about to retake the exam the second time, so I really need some help to tackle this exam once and for all.

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:ancong!:

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Whoa,you just gave me a load of information,you are the type of person I need to encourage me with my studying because right now I am no where from been prepared as I am about to retake the exam the second time, so I really need some help to tackle this exam once and for all.

First things, first: You graduated nursing school. I don't know what your school was like, but if it was anything like mine, it was not easy. Only half the people I started with graduated with me. IOW, you have the base of knowledge required to pass the test. If you didn't, you wouldn't be eligible to sit for it. Remember that!

Second, there is no point in trying to study every single little thing, it's tempting but don't. The best advice I can give is to know the base knowlege and HOW to study. I said this above. If you know, for example, that Graves disease, revs the metabolism up, hypothyroidism downshifts the body, the BASICS, then you will have a much better chance at guessing the correct symptoms for each even when the symptoms presented are not the most obvious ones. This way, you don't need to remember FORTY-FIVE different symptoms. Glance at them but don't spend too much time doign that.

It's the same thing, for example, with spinal injuries. You don't need to know every single little last thing. For example, you could spend forever studying the nuances in outcomes among injuries at various points in the Cervical spine, but don't! Don't get hung up on the fact that C3 is where the phrenic nerve branches off (lower injuries put people on vents anyway) or where other certain nerves branch off the column. Chunk large portions of the spine together: C1-4 will affect breathing, probably even 5 and six to a lesser extent, heck just throw the whole cervical spine in there with breathing. Most C injuries are Quads. End of Cervical. Below that you start getting into Para. Know this stuff! Know the basics of C, T, S injuries. Know where bladder and bowel control starts to become affected. Know upper motor and lower motor disease. Know central cord syndrome, posterior cord, anterior cord, brown sequard. etc. Decerebrate, Decorticate. Know spinal autonomic hyperreflexia, the basics of spinal shock (hypotension, and unlike other shock, BRADYcardia), then promptly move on to the next topic!

The notes for my spinal injuries slides from school are probably >30 pages long single spaced. The information I just outlined for you is the core base knowledge that will give you the ability to correctly answer almost any spinal question, and, while it sounds like a lot, it can actually be condensed to a single PAGE and memorized in an hour or two, even much less if you are somewhat familiar with it. Most of the spinal stuff above, is basically just a handful of definitions.If you are worried about being prepared for content, you've got to start thinking about topics this way. And remember, spinal and endocrine are two of the more complicated topics. If you can do this with these, you should be able to tackle the rest even easier.

Definitely know your infection control. Cannot be stressed enough. Practice priority questions. Practice teaching questions, as I said above. Know cultural stuff just to make sure you don't answer one or two correctly to be bombarded with several in a row.

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:ancong!:

Thanks!

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Thanks for the information that you posted I will keep in mind all of these because my reading was becoming overwhelming and I have been reading chapter by chapter and forcng myself to understand every bit of it.But now I will take my time to understand think in general rather than breaking it into bits and pieces.

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Specializes in school nurse, SNF, peds.

CONGRATS wow that is quite a bit of information I am taking my test next month and after reading your post ohh my god I am so thankfull to you for writting all this very very very helpfull THanks a MILLION God bless you. RN:nmbrn::tinkbll:

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In my excitement I totally forget to say CONGRATULATION!!!!!!!! you deserve the best..:yeah:

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Obviously you know more than you "think" you know. Great job and Congratulations! Although I'm not an RN student and have no (at least immediate) plans to become one, I will tell you that if I were, your post would be very inspirational to me in content as well as context. Even though I'm just taking the CNA test on Friday, what you've written is inspirational because it speaks to the notion that each of us has a certain subconscious level of knowledge that we just need to trust when there's no one there telling us what to do.

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Thanks for the information that you posted I will keep in mind all of these because my reading was becoming overwhelming and I have been reading chapter by chapter and forcng myself to understand every bit of it.But now I will take my time to understand think in general rather than breaking it into bits and pieces.

Definitely do. Forget about Reductionism! If you try to know everything you only will wind up knowing nothing. There is a reason why great notes are put into outlines! Once you can structure information into general categories, the rest of the information, if you even need to know it, will fall easier into place on its own. If you keep this in mind, I think you will do well.

Aside from this there is test taking strategies. I am hesitant to advise people to forgo courses that teach you these, even though I didn't take advantage. If you need the reinforcement and confidence boost, then by all means go for it. A great instructor can be really inspiring and rally you to the task. But, at the end of the day, I'm not convinced that these are a magic bullet. You already know that "client needs further teaching", means eliminating the true answers. They only tell you (ah-ha!) what you already know. You already know that you need to eliminate wrong answers. You already know that the nursing process (AAPIE), Maslow, ABCs, and, intuitively should know, that acute vs chronic, expected complications vs unexpected complications (etc) should inform how you answer questions. You should already know that you should slow down, calm down, and put yourself in the driver's seat instead of letting the test writer dictate how you react. You should already know that you should read each answer as if it could be the answer before you just eliminate it - consider each in the context of the question.

I'm not sure that anyone needs to drop several hundred dollars to have these things explained to them. I just don't believe these strategies are the magic bullet that can seal the deal, much less esoteric information that you should shell out lots of money for.

If you need to brush up on the basic test strategies, you can learn most of them through books, that are, as I learned after I thought I failed, available for free on Google books. Some pages omitted from each. But, if you read enough of these free pages from books, you should get the idea. What's omitted from one, is covered in another. I even found a Kaplan book that had hardly any pages omitted from it for free on google books. I can give people the link, at request.

Others are free to disagree with my POV; I'm hesitant to be controversial. What works for one person may not work for another and you should do what you think is best for you. But, at the end of the day, I believe that your core basic knowledge is what will see you through. Learn it, trust it, don't look back. Remember, you graduated nursing school. You belong among Registered nurses. You wouldn't be sitting for the exam if this wasn't true.

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CONGRATS wow that is quite a bit of information I am taking my test next month and after reading your post ohh my god I am so thankfull to you for writting all this very very very helpfull THanks a MILLION God bless you. RN:nmbrn::tinkbll:

Thank you. I wish you the best.

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Obviously you know more than you "think" you know. Great job and Congratulations! Although I'm not an RN student and have no (at least immediate) plans to become one, I will tell you that if I were, your post would be very inspirational to me in content as well as context. Even though I'm just taking the CNA test on Friday, what you've written is inspirational because it speaks to the notion that each of us has a certain subconscious level of knowledge that we just need to trust when there's no one there telling us what to do.

Yes, Trust. I think that is key. Once you stop trusting yourself and your body of knowledge, you are at the mercy of the test and each and every question just gets more nerve wracking, and your answers less thought through. You'll just start taking emotional hunches. Don't. Slow down. Relax. Read each question thoroughly. Subject each answer to the context of the question. Don't assume any are wrong until you've at least thought about each for a few moments. I didn't do this for every question, but I tried to. It's easy to get swept away in the anxiety of it all and I did a few times. But, each time I saw this happening, I slowed down, and tried to trust myself.

My objective when I went in was framed by the fact that I knew I had SIX HOURS to complete this thing. With that in mind, I took my jolly time and was determined to give everything I had to the first 75 questions. It took me an hour and half to finish 75 questions, maybe almost two hours, I'm not sure. I realized within the test that when I tried to hurry, I would only wind up reading each question five times. I caught myself doing this a few times. That's when I knew I needed to take a breath, and slow down. This way you'll understand the question the first time and, ironically, you'll actually spend less time on it by slowing down then if you tried to rush. I have also tried to remind myself, in school and on this test, that some of the best test takers in my school wound the clock down every time. The kids who scored in the 90s were mostly (not all) the last to leave the room.

Thanks for your comments. May you pass your exam with flying colors!

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