Critical Thinking Shmitical Thinking

Nurses General Nursing

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So, we have HUGE exams in nursing school & study our little behinds off like CRAZY. By the time we are ready to take our exams we are nearly in a coma from fatigue LOL. Then...ding dong..they test us on stuff that we were NEVER taught, isn't in the book, and wasn't in our notes. BOOOOO. Some is "critical thinking" and the rest..I don't know..my instructors just are not organized and it drives me nuts. They have openly admitted that NO ONE gets an A in their class. UGH.

So anyhoo...can someone suggest a CD or book with NOTHING but TONS AND TONS of critical thinking questions..just TONNNNS? The most important thing is..I need some kind of material that drills me on these questions, and then explains WHY the answer is what it is. I am doing pretty well in nursing school so far..but I have had a few tests that I studied for SOOOO hard & I was given what the instructors label as "critical" thinking. Problem is..they have NEVER EVER EVER gone over this stuff with us. YES- I know you must learn this on your own..but we haven't had REAL LIFE clinical rotations or ANYTHING to base stuff off of.

I'm in an LPN program. Dunno if that helps..but please let me know of a CD or program...book..etc..that has just HUGE amounts of questions I can drill myself with. Thanks :)

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I have critical thinking and clinical judgment from Alfaro-LeFevre.

Havent read much of it but students who struggle with critical thinking in my cohort say it helps them alot.

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"Critical thinking" to some instructors translates to "Don't think too much" for some students. The question may involve a specific disease process or medication or the like, but you may not need any familiarity with those specifics to answer correctly... and conversely, if you DO know the specifics, you STILL might get the answer wrong. Because you might be thinking "What do I know about this?" as opposed to paying close attention to what exactly is the question asking and which answer fits the question best without being completely wrong.

Your brain may be swimming with red flag symptoms, critical nursing interventions, expected lab values, potential complications and the question may actually be much more basic. If the question asks "What does the nurse do to assess the situation?" - only choose answers that have "assessment" words such as ask, look, listen. If the question asks "What does the nurse do first?" consider ABCs and Maslow or for "What does the nurse do next?" consider ADPIE. If the question asks "What nursing intervention does the nurse initiate?" only choose answers that are independent nursing actions unless it specifies a collaborative intervention.

And oftentimes, none of the answers seems spot on and it comes back to what exactly is the question asking and which answer best fits the question without being completely wrong.

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Specializes in Home Care.

Here's a tip:

When you read a question on a test, underline the key words ...figure out right away what the question is seeking. Then look at the answers and eliminate the obvious 2 wrong answers. You're left with 2 answers to choose from.

Here's a sample question from an NCLEX book:

A client with congestive heart failure (CHF) has been advised to follow a low-sodium diet. Which statement by the client indicates to the nurse that diet teaching has been effective.

  1. "If I stop adding table salt, I shouldn't have any problems"
  2. "I need to avoid eating processed foods and canned meats and vegetables"
  3. "I can still use a small amount of table salt in cooking"
  4. "I only have to worry about salty-tasting foods like potato chips"

So the first thing you do is underline the key words as I've bolded above. You need to remember that some questions are "has been effective" and some are "not effective". Then eliminate 3 and 4 because they are least restrictive in a low-sodium diet...these answers also don't give a clear answer of the patient's understanding of what a low-sodium diet is. Then you eliminate answer 1 because answer 2 is the most comprehensive answer that covers hidden sources of sodium.

Get yourself an NCLEX book such as one by Saunders. Use it to study, there are thousands of questions on the cd and you can select questions for different subjects and critical thinking questions. The more you practice NCLEX style questions, the better you'll be at answering them.

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Specializes in Hospital Education Coordinator.

The old fashion way of buying books of questions may work for you. Saunders, Lippincott-Elsevier, Mosby - a lot of options at Books-a-million and online. In my study group each bought one type. Then when we studied a topic (heart for instance) each asked questions to the rest of us about that topic and gave rationales provided in the book. Good luck

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Yes I agree, an NCLEX book. Saunders is great. There are tons you can look through usually at the book store/library to help you decide. Then read through the chapters you are studying in class - helped me alot. I just had to learn how to decipher what the heck they were asking and how to answer it just like itsmejuli explained so perfectly.

Good luck

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"for some teachers critcal thinking means dont think to hard" i totally agree, heres an example from one of my exams

A nurse walks in on a patient's family member performing a religious ritual at the the patients bedside. At the end of the ritual the family member cracks an egg open and leaves it under the patient's bed in a pan. As a nurse you should

A. notify maintenance and ask them to clean up the egg

B. tell the family member that they are not aloud to place the egg under the patients bed

C. leave the egg under the bed

D. tell the patient that this ritual will not do anything for their health

the correct answer is C because as a nurse u have to respect the beleif and culture of ur patients. So if the patient beleives that having an egg under their bed will make them better, then leave the egg under the bed. My classmates and I always seem to over analyze our test questions, maybe for mistrust of the teacher (shes trying to trick us into chossing the worng answer LMAO) or just over active brains during testing. We now have our own euphenism when it comes to over analyzing things "just leave the egg under the bed":D

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Specializes in Operating Room.

When I started the actual nursing program, I went out and bought a few NCLEX books..why? Because, NCLEX questions are all about critical thinking. I bet you find that the questions that are on your nursing exams are structured much in the same way. These books also provide rationales for the answers..

Someone ahead of me in the program suggested I do this and it helped tremendously.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

when the instructors refer to critical thinking they are referring to a number of different things that have to be considered when answering questions:

  • the medical disease involved, it's normal pathophysiological progression and the signs and symptoms associated with the pathophysiological changes. learn the progression of symptoms as they go from mild to serious to fatal. this helps you determine priorities of care.
  • know the medical tests and treatments that the doctor is going to order. know which tests and treatments fit which each sign and symptom (again this helps determine priority if you get asked which to get done first). some of these tests and treatment will impact the nursing care you will give.)
  • know the steps of the nursing process, i cannot stress this enough. there are five of them: assessment, determining problems, planning care, implementation and evaluation. one of the most confusing is assessment because it is step #1 of the nursing process and the word "assess" is also frequently used in nursing interventions which are part of step #3 of the nursing process which is the planning step. assessing as an intervention is not quite the same as the full-blown assessment you do when you first encounter the patient in order to plan care; it's more of a monitoring/evaluation/observation thing when it's an intervention. each step of the nursing process is a photograph, a link in a chain; another link later on may be appropriate as well, but ask yourself if that is what the question is asking of you.
  • there are many kinds of principles behind nursing actions (i.e., principles of asepsis, principles of osmosis, infection process, etc) that you need to know and sometimes pull into determining the answer to a question. this is where you sometimes cannot discount the science or math you learned before. something as simple as heat coagulates protein helps you to know that it is the underlying principle of steam sterilization in the killing of bacteria.
  • read the root or stem of a multiple choice question very carefully. i've read some of the instructors manuals on how to write these questions. they deliberately give you answer choices designed to distract you from what was originally asked. a mediocre student or a student who isn't thinking will opt for the most easily distractive answer. if you've done your reading and studying you should be putting two and two together. nursing is a process of logical thinking, not guesswork. if you are narrowed down to two possible answers, try to figure out from the stem of the question if pulling in knowledge of the nursing process or the disease process is going to help you make your final decision.
  • bottom line. . .you always have to be thinking "why". why would this be happening to the patient? why would the doctor order this? why would i do this? why? why? why? answer that, and you'll probably answer the question correctly.

there is also a thread in the student forums that you should look at: https://allnurses.com/forums/f50/looking-test-taking-stratagies-224581.html - looking for test taking strategies

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I must go to a completely different school than you guys lol. My exam questions are definitely not that easy. Your examples are close, and you get the gist of it, but I get some hardcore questions. They word them poorly IMO & they give 4 answers, 2 of which could be correct. I obviously go ahead with process of elimination..but I cannot tell you how many times there have been "ties".

I'm in the top of my class and it baffles my brains sometimes. I would hate to think how the middle or bottom of my class feel :eek:

Thanks everyone

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