Fundamenmtals Of Nursing Help!!!

rayofsunshine · Sep 10, 2005

I know EXACTLY how you feel!!! I just finished my first week of class and I am SCARED! There's so much to know. I'm so excited though.

I am in my first semester of ADN nursing. The fundamentals of nursing class is killing me!!!! I read everything, answer all the questions, look up all the word definitions and do my workbook. Where did the questions come from on this test was my question as I read the first page. I didn't do good on the test at all. I have readall test taking skills and followed those too. The questions were the least signifiant in useful information.

Bonnie Nurse · Sep 11, 2005

One of the most difficult things you encounter in nursing school is the "critical thinking question". Sometimes you know what the question concerns and sometimes you just don't have a clue. Here are a few tips i can think of off the top of my head:

1. Unless the question is a straightforward patho question or something like it, ask yourself, "what is the risk to the patient here and what answer best addresses that potential risk?" You may find that you can follow your ABC's priority for these. You will want to add safety as the next one in that sequence. Patent airway first, breathing next, circulation next, and then safety.

2. if you are unsure of the first priority action of the nurse and assessment is one of the answers among several others that have the nurse DOING something, then pick assessment as your first action. A good example of this is when you see a crazy rhythm on the monitor. Beginning CPR and calling the code team is NOT your first action! Assessing the patient is the correct option here. Believe me, it's very embarassing to call a code on a sleeping patient!

3. if there are 3 democrats and one republican among the answers, pick the republican. This happens when you notice that about 3 of the answers are just different versions of the same answer, while the fourth option is very different from all three. The very different answer is probably the one.

4. read the question with all the answers covered up and take a highlighter and highlight the stem of the question, or the most important words. Next uncover the first option and rate it as no way or maybe. Uncover each answer in the same manner. You will end up with two maybes. Now consider them in the light of what the risk is to the patient or in the light of the facts you know about the situation. You will always have two best answers, and you will have to choose the best.

Here's an example:

Question: The nurse is caring for a client who has been taking diuretics on a long-term basis. A fluid volume deficit is suspected. Which assessment finding would be probably during the physical assessment with a client with this condition?

a. increased hematocrit

b. increased blood pressure

c. poor skin turgor

d. decreased central venous pressure

Okay, first off you should highlight the important words. Diuretics, long-term basis, fluid volume deficit, assessment finding, physical assessment.

Now uncover option 1. Does increased hematocrit fit this client with fluid deficit? Fact: hematocrit increase is found with fluid volume deficit. So this option is still in the running, but it MAY NOT BE the best one for this question.

Now option b: Increased blood pressure. Well, no way. Fluid volume loss would decrease pressure. So this one is ruled out.

Now option c: Would it make sense for someone with FVD to have poor skin turgor? Yes. Might be the answer.

Now option d: Would a client with FVD have lowered central venous pressure? Yes so this one might be the answer also.

Now let's consider the ones we haven't ruled out: increased hematocrit, decreased central venous pressure, and poor skin turgor. Well now we have a problem. These would all be true for someone with fluid volume deficit. BUT NOW GO BACK TO THE QUESTION!! The question stated that this would be an assessment finding during the physical exam. The answer most likely to be found during a routine physical exam performed with eyes, ears, and stethoscope would be the poor skin turgor. Now do you see what I mean?

Hope this helps.

shukry · Sep 13, 2005

One of the most difficult things you encounter in nursing school is the "critical thinking question". Sometimes you know what the question concerns and sometimes you just don't have a clue. Here are a few tips i can think of off the top of my head:
1. Unless the question is a straightforward patho question or something like it, ask yourself, "what is the risk to the patient here and what answer best addresses that potential risk?" You may find that you can follow your ABC's priority for these. You will want to add safety as the next one in that sequence. Patent airway first, breathing next, circulation next, and then safety.
2. if you are unsure of the first priority action of the nurse and assessment is one of the answers among several others that have the nurse DOING something, then pick assessment as your first action. A good example of this is when you see a crazy rhythm on the monitor. Beginning CPR and calling the code team is NOT your first action! Assessing the patient is the correct option here. Believe me, it's very embarassing to call a code on a sleeping patient!
3. if there are 3 democrats and one republican among the answers, pick the republican. This happens when you notice that about 3 of the answers are just different versions of the same answer, while the fourth option is very different from all three. The very different answer is probably the one.
4. read the question with all the answers covered up and take a highlighter and highlight the stem of the question, or the most important words. Next uncover the first option and rate it as no way or maybe. Uncover each answer in the same manner. You will end up with two maybes. Now consider them in the light of what the risk is to the patient or in the light of the facts you know about the situation. You will always have two best answers, and you will have to choose the best.
Here's an example:
Question: The nurse is caring for a client who has been taking diuretics on a long-term basis. A fluid volume deficit is suspected. Which assessment finding would be probably during the physical assessment with a client with this condition?
a. increased hematocrit
b. increased blood pressure
c. poor skin turgor
d. decreased central venous pressure
Okay, first off you should highlight the important words. Diuretics, long-term basis, fluid volume deficit, assessment finding, physical assessment.
Now uncover option 1. Does increased hematocrit fit this client with fluid deficit? Fact: hematocrit increase is found with fluid volume deficit. So this option is still in the running, but it MAY NOT BE the best one for this question.
Now option b: Increased blood pressure. Well, no way. Fluid volume loss would decrease pressure. So this one is ruled out.
Now option c: Would it make sense for someone with FVD to have poor skin turgor? Yes. Might be the answer.
Now option d: Would a client with FVD have lowered central venous pressure? Yes so this one might be the answer also.
Now let's consider the ones we haven't ruled out: increased hematocrit, decreased central venous pressure, and poor skin turgor. Well now we have a problem. These would all be true for someone with fluid volume deficit. BUT NOW GO BACK TO THE QUESTION!! The question stated that this would be an assessment finding during the physical exam. The answer most likely to be found during a routine physical exam performed with eyes, ears, and stethoscope would be the poor skin turgor. Now do you see what I mean?
Hope this helps.

Bonnie thanks for the tips.