i feel like a failure BIG time

NurseLoveJoy88, ASN, RN · Oct 31, 2008

Practicing nclex style questions helped me in fundamentals and even now ! I used to answer at least 100 questions before the exam... and I scored A's and B's !

lilo2010 · Oct 31, 2008

I'm 1st semester NS also!I agree about NCLEX book or disk! Our fundamentals book came with a disk that had nclex type questions for every chapter! I go over & over them before each test! It has really helped! Good luck to you!

Kevin RN08 · Oct 31, 2008

If you're puting in too much time you could be doing more harm than good. If you got in to NS you are obviously a good student, unlike English, History, or Biology "knowing everything" isn't always a good thing... or atleast studying everything isn't. Preread (skim) the entire chapter(s) before class, then focus your studying to the points of the lecture by re-reading those areas. Limit your study time to 2-3 hours a day and take some time for yourself (RELAX). Over studying is just as bad as not studying for many.

Yours is a common feeling among Nursing Students, learning what the question is asking is, argueably, one of the hardest things in NS. Personally, Fundamentals was the hardest class for me but it is the foundation of the next 2 years.

Here is a thread that has a ton of good advice https://allnurses.com/forums/f205/i-m-panicking-339301.html#post3165935 , specifically read Daytonight's post and use her links. SHE IS THE MASTER.

Finally, meet with your instructor to review the tests, she may quiz you, fine you know the material. Let her (or him) know what your thought process was/is.

And finally, here are some test taking strategies:

From Saunders, "Strategies for Success for the NCLEX-RN Examination", I faithfully review (the only studying on test day) them on test day just as a reminder and to take my mind off of all of the "what is this ...?", "did you study that ...?" chatter that comes with test day. Then I close my eyes, take deep breaths and go to the beach until the tests are being passed out.

1. Avoid reading into the question

2. Look for key words like Early, Late, Best, First, Initial, Immediately, most likely, least likely ...

3. Prioritize using ABCs and/or Maslow's hierarchy.

4. Identify true or false response questions. "... it is determined the pt needs reinforcement of discharge instructions if he states" is looking for a false or negative statement.

"What action would the nurse take next?" is looking for a true or positive statement.

5. Theraputic communication questions always focus on the pt, pt's family, feelings, concerns, anxieties or fears.

6. Eliminate similar options. If options are pursuing the same idea both can be eliminated. The ONE correct option frequently is the one that is different.

7. Eliminate options with absolute words like all, always, every, must, none, never.

8. Look for the umbrella option. Thats the one answer that is more general and encompasses other correct responses that are provided.

9. Use guidelines for delegation and assignment making questions.

There is a more indepth list of these principles in the Saunders Comprehensive Review (4th Ed in Ch. 5).

By the way is it South Dakota State or San Diego State?

YSB82 · Oct 31, 2008

I am a first semester NS also, I have this book: Fundamental's Success, it is amazing!!!! it is a book with fundamental's questions in a critical thinking way, they give you the correct anwser and the rationals, it has also a cd with more questions and NCLEX style questions, I have done really good in my exams, you should buy it and use it....Good Luck and don't give up!!! :up:

Dianacabana · Oct 31, 2008

IMHO, learning to think like a nurse is completely different than any other career (except other areas of medicine). I have a BA in Biology and still I scratch my head sometimes trying to figure it out.

Practice questions are really helpful to see how you can apply the knowledge from your text and lecture. I too like Fundamentals Success--the rationales are great. Do you do the practice questions that come with your text? Usually there is a web site for the text/publisher with more questions. We also received the ATI book which contains excellent synopses of the different areas covered in Fundamentals...plus more practice questions. I do have an NCLEX book but I find these other resources more helpful at this point.

Good luck to you!

Daytonite, BSN, RN · Oct 31, 2008

see the weblinks and information on this sticky thread:

https://allnurses.com/forums/f50/looking-test-taking-stratagies-224581.html - looking for test taking strategies

also, the basic strategy for answering critical thinking (application type) questions is as follows, you must:

know and consider the normal anatomy and physiology
know and consider abnormal anatomy for the disease in question
know and consider the resulting signs and symptoms when the disease occurs and how they proceed from mild to fatal - each sign and symptom can be related back to the pathophysiology of the disease
know and consider how the doctor diagnoses and treats the disease in question
know nursing interventions for the signs and symptoms you are being asked about
know the steps of the nursing process and what goes on in each of the steps and consider how they are affecting the question you are being asked
know the sequence of priorities of needs as per a guideline such as maslow's hierarchy of needs
know and consider the principles behind the actions being done - there are many kinds of principles: principles of nursing, principles of biology, principles of chemistry, principles of physics, etc.
read the stem of the question carefully and answer that because the test makers try to trip you up by distracting you with conflicting information they give you in the answer choices that sounds good but has no relationship to what the question is asking for
ask yourself "why" a patient is experiencing some sign or symptoms to get at the underlying problem. nursing like other disciplines treats the problem/signs and symptoms.

gradRN2007, BSN, RN · Nov 1, 2008

laogirlinsd

think like a care plan, you will eventually hate those too but only really need them in school, becomes second nature when you start working

critical thinking is not like anything else...and never change an answer

it gets easier and forget about the a's, they don't care if you have all c's when you take the nclex, just pass and relax

you will do fine

Daytonite, BSN, RN · Nov 1, 2008

let me add something else. learning to think critically is a skill just like learning how to tie your shoes, learning to ride a bike, learning to drive, and learning to take a blood pressure. it's a mental skill. just like other skills it requires practice to master. i tell you that i got better at it over the years. it wasn't until i had been an rn for several years that i probably started seeing how things were making more and more logical sense. a great deal of critical thinking skill relies on what you know. factual information has to be applied to these questions you are presented with on tests. the problem is that you aren't told which information you need to pull out of the logic hat. the instructors who make these questions sometimes base them on what they saw in their own practice as nurses and it stuck in their minds. the nclex won't be subjective like that. it is ultra fair.

all you need to do is pass so you can graduate and take your licensing exam (nclex). unless you need the gpa to move onto another nursing degree, no employer that i ever heard of is going to care about your grades--only that you have a license. grades are highly subjective and almost everyone in the world knows that. that license is the great leveler.

none of your learning is ever a waste. i suggest that you make an appointment with your instructors for office time to sit and ask them to personally review the critical thinking with you for the problems you missed on your tests. if they won't do it, ask them if you can sit with one of the other instructors in the program because you need to learn where you are erring. go to the dean of the department if you get a negative response. they owe this to you and they are obligated to help you when you seek this help. you need to be shown the subtleties between the answers you are choosing and the right answers so you can understand where your logic has failed so you can correct it.

outside of purchasing a nclex study guide, there are a couple of ways to access free nclex style questions for practice. check to see if your nursing textbook has an online companion website--most do these days. there are often nclex type questions on these websites by chapter of the book. you usually need an access code to get into the website. it may have come with your textbook. bug your instructors or the bookstore where you purchased the book for the access code because part of the price you paid for that book was access to the website. you can also get practice questions on these two websites:

http://www.learningext.com/students/qofweek.asp - question of the week. every monday a question from the online nclex-rn examination course from ncsbn and it's answer is posted here on this page.
http://www3.us.elsevierhealth.com/cgi-bin/mosby/cdonline/saxton/question - mosby's question of the week from mosby's comprehensive review of nursing. also has archived questions that you can access.

Natingale, EdD, RN · Nov 1, 2008

Theres a book fundamentals success which contains how to think critically and practice questions for every unit you learn in 101. It has NCLEX based questions.

The biggest thing with critical thinking is learning how to differentiate an inference, or opinion from FACT. Some people throw in a "well if the patient.." ..Stop right there. It doesnt say WELL the patient is.. You have to look at what the question is asking you, and answer it. Period. Its tough for a lot of people, they dont expect everyone to get A's since we're all used to just memorizing and spitting the information back.

Keep practicing those questions and you'll build your confidence up in no time. Good luck to you!

Serlait · Nov 1, 2008

I don't mean to sound rude or disrespectful, but I'm wondering if English is your first language? The only reason I say this, is that a very dear friend is one year ahead of me in NS, and her first language is Russian. She really struggled a lot at first, and she felt that part of it was a language barrier, although she is completely fluent in English. And like you, she did very well in clinicals, and is an extremely intelligent person. She went to tutoring and all, but then she found another person who spoke Russian who had completed the program, and they were able to help her connect the dots somehow. The Russian tutor was able to help her see how to study and what the question was looking for. Since she was tutored by that person, she's done great. Hang in there. Just get over this hurdle, then on to the next. Don't tell yourself that you're a failure or you'll start to believe it. If you want this, go get it. Use ANY resource you can get your hands on.

Could someone post an author for the Fundamentals Success book mentioned please? I'm intrigued. And it is so true, it's not like thinking like A&P, it is on another level. But I guess when a life is in your hands, you better be able to think critically.

laogirlinSD · Nov 1, 2008

Everyone, thank you for all your replies and suggestions. After failing the first test i went out and brought more books than what was required of me. I got the fundamental book most of you mentioned. I can answer those questions on the fundamental book with no problems. English is my second language. I am at San Diego State University school of Nursing. I have set up appointments next week to go see people from the school to see where i went wrong with the exams. I do study alot. That's all i do. I took my kids out trick or treating yesterday and i feel so guilty b/c i wanted to study. How can i not study, I have 2 tests coming up again in 3 weeks. On top of that i have clinicals, care plan, and journal among other things to do. Not to mentions my kids (4 of them) and other responsbilites.

Again, thanks you to all. I have been hurt, step on, depressed all that you can think off, but this is the first time ever that my spirit has been shot down. It's coming back and i will surivive. I will look into all the suggetions. I have printed out the suggestions. Thank You!