Frustrated after exam grade...the way the questions are asked..

katia0203 · Mar 12, 2012

This sounds like my school. The profs are trying to get you ready for the NCLEX I'm assuming. The questions on that exam are going to have 2 answers that are both right, and it is your job to pick the one that is best. Sometimes it's hard because you know you would possibly act in a different way than what the answer is, but you have to answer how they want you to. Ask yourself: which action is the most efficient? which one will make things quicker and smoother? which problem is the most important one to fix out of the ones listed? It can be tough to get used to, but by the time you're in your last semester the format of the questions will be familiar and you will have a better idea of how to answer them. Good luck to you!

kh321 · Mar 12, 2012

Get an NCLEX book and do questions! I was the same way. I knew my material but could not for the life of me pass the tests. I started doing NCLEX practice questions and my grades got better. Good luck.

anonymousstudent · Mar 13, 2012

Saunder's NCLEX review book

Davis' Med Surg Success

You can't just know the material, it's never that easy. And it's going to become more and more abstract. You have to practice lots of questions to get the hang of how to filter out when 2 seem right - 2 are always going to seem right, because there's a good chance they both are right, just not what you should do FIRST.

LemonIndiscretion · Mar 13, 2012

Welcome to nursing :) I am not mean I'm trying to be helpful. Tweak your study habits and you'll do better next time. Some classes you'll get and A one or two you'll get a C, sometimes its the teacher sometimes it you. If Its just not your thing, no big deal just do your best. Maybe you're under more stress than you think, try working less hours that was my problem my sophmore year. Take care.

nurseprnRN, BSN, RN · Mar 13, 2012

it's not that you have to choose between two arbitrarily right answers, it's that only one of those answers is the right one for a nurse with a good working knowledge of nursing process to do. this is a very hard concept for nursing students to grasp, because it is not like anything else they ever studied. but that's what you need to learn in nursing school, along with the science and other factual stuff to support your practice of nursing.

i'll give you an example.

a patient/client who has been admitted to the hospital after spousal abuse tells you that "he's really sorry now, brought me flowers, swears he'll never do it again, says he loves me." she has previously disclosed that he has abused her before, but this was the worst episode. she is talking about going home. what does the nurse say? (i'll eliminate the two obviously-wrong answers)

1. "and yet he has done and said this before. before you leave, let's think of a plan to keep you safe."

2. "abusers always say this, it's part of the cycle of abuse we discussed before. it is probably dangerous to go home with him."

now, there is a correct answer, and only one. i know that #2 is factually correct, and it's something that anybody on the street would tell you.

but you aren't just anybody, you're the nurse. once you say that, you deny her feelings, cut off future conversation and support with her, eliminate any chance of a therapeutic relationship with her, and have not helped to bring her along the road to health. any well-meaning but nontherapeutic person could do that.

but ... you are the nurse.

#1 is the only answer. she has the right to make her own decisions, even if the nurse does not agree with them.

the therapeutic response, the best response a nurse can give due to the nurse's education, restates the patient's words, recognizes her right to choose, and by giving her a tool to protect herself, moves her along the path to better health (safety). that is what the nurse does, as opposed to the well-meaning lay person.

this is nursing. (and btw, this has nothing at all to do with the medical plan of care. nursing is an autonomous discipline.) it is a higher concept than "common sense," and that is why it is sometimes hard for students to grasp.

heartnursing · Mar 14, 2012

GrnTea

That was a great explanation

BeenThereDoneThat74, MSN, RN · Mar 15, 2012

This is what I tell my students: It's great that you know everything; that you can recite my powerpoints verbatim. But imagine yourself in a clinical situation: are you going to stand there, when the poop hits the fan, and say "Mr Jones, I know the pathophysiology of Crohn's disease, and that you have skip lesions of inflammation and erosion throughout your colon ", or that a positive (fill in the blank) sign is indiciative of (fill in the blank)? Sure, you need to know that. But you also need to know what to do when the poop hits the fan. You need to know when to assess BEFORE calling the doctor. You need to know what to say to a patient based on what they are saying to you. You need to know how to make decisions, not just memorize every sign and symptom and medication. Applying what you know and making decisions are what it is really about.

Do not fret, you and everyone else goes through this. It is a blow to your ego. It takes time to learn the test-taking process. Coming from the other side, I ask for this favor: listen to your instructors, regarding rationales. Oftentimes, students justify in their own minds why their answer is right. It becomes a tit-for-tat, nit-picky argument, because of what the student thought the question was asking. Reading the stem of the question, and understanding what the question really means is a huge obstacle to overcome. Good luck!

Double-Helix, BSN, RN · Mar 15, 2012

The nursing profession is situational. Every day at work you have to make decisions based on the situation you are presented with. It's not about knowing facts and spitting them back out for the test. This is one of the biggest problems that nursing students have when transitioning from general classes to nursing classes. Just reading the book and learning the information isn't going to be enough. You have to apply it to your practice. Situational questions are the #1 type of question you will see on the NCLEX and on future tests.

They are harder questions than just knowledge. I wish that our nursing school tests just asked me the definition of the trachea or the symptoms of an MI, but they didn't. They ask you what you would do if a patient presents with chest pain or dyspnea. Not only do you have to know the definitions and information, but you have to take a step further and know how to use that information in clinical practice.

My advice would be, after you read a section in your text, think about the disease or intervention that you just read about. Ask yourself, or make a list of what you would do if you had that patient in clinical. How would they present (signs and symptoms), what interventions would you be using to treat them? What medications would you use? What would you want to avoid? What emergencies could present and how would you respond? What are you going to teach the patient/family about the condition?

If you make a list of the answers to these questions, you will have a good understanding of not only the medical definition and patho of the disease, but you will also understand the nursing implications and how you would need to treat a patient with this condition. This will really help you when you are given situational questions.

mssjez · Mar 15, 2012

I am very pleased to see that nurses and professors are also providing input. It allows a great constructive thread in response to something every student nurse goes through and it makes sense. Knowing and understanding information are two different things. You can know every disease the class has gone over but being able to understand the information is what allows you to help your patient. Not every disorder that comes through the door will be exactly the same, have the same comorbid symptoms, react the same to meds, etc. Using all of the extraneous information that varies from patient to patient is how you provide the best care for that specific patient and it's what makes a great nurse.

maccheese · Mar 15, 2012

These are all great responses. I am in my first semester too and EVERYONE in my class has struggled in reconstructing our thinking. We're getting it though. Especially if we want to pass these tests.