Exams...how to trust yourself? your instinct?

Hi all.

Say there is a question dealing with diabetic adults and diet. Like so, we all know they need to watch their sugar and their carbs...yet what about the answer about them eating regular meals...to me, both is right...one 1 hand I know they must watch their diet and their intake of sugars and carbs yet also know they should eat a specific meal at a specific time and have snacks. How do you choose the best one? I have come to a point where I can sort of understand prioritization and what to watch for, but what about those subtle questions?

I can understand your frustration -

The approach I take is to look at the worst case scenario: What could happen if I don't discuss sugar compared to what could happen if I don't discuss eating regular meals?

I would reason that if I don't tell the patient to watch his sugar intake, he might choose poor options at his meals, which might result in high blood sugars...

On the other hand, if I don't tell him to eat regular meals and he is taking either insulin or some other hypoglycemic, then he might be at risk for hypoglycemia... Regular meals also help to regulate appetite, so if he is only eating once a day... he might be more inclined to make poor choices and reach for a sugar fix.

This is why I would choose the regular meals option.

However....

like you, I would probably sit there and question myself over and over (and I would probably ask myself, "is this really what the test maker wants me to choose?", but I would end up choosing this option because it will lead to the best outcome overall)

In the real world, I would just choose both of these options - they are both important but on an M/C exam... we don't have that luxury...

It's also too bad that on an M/C exam, we can't explain our rationale...

Honestly, I have to give myself a limit. I take a test and only allow myself to change 2 answers per test when I go back through to review it. I second guess myself alot and 90% of the time, my first answer is correct, so I have to give myself that limit.

Also, I agree with what the previous poster said about considering the worst case scenario. When you're answering questions, think through safety and ABCs first, then through Maslow, then consider what could happen with each of the answer choices you think could be correct.

Do you read the rationales of the NCLEX questions? That is the key. Read it, make a note of it and apply it. You can find tips to answering these questions in the NCLEX subforum but it is tricky. For example, people say that "pain won't kill anyone" which is true, and they often tell you to treat it last if you have other issues. BUT I noticed that a lot of questions I got involved pain and something else- for example, pain is affecting the patient's breathing (hurts for them to deep breathe), then YES it is a problem and needs to be priority. Point is, those tips are quite one dimensional and I only figured this out by reading rationales. Trust me, there is a method to this madness. Once you figure out the patterns and keywords, you will breeze right through these questions. I did not know what half of NCLEX was asking me, but because I knew how to answer NCLEX-style questions, I easily passed even though I was "guessing".