rationale problem

[adamsmom]

Had a very bad day. I to a 73 on a test and lousy on a quiz. Our school goes by points. We need so many by the end of the semester so I have plenty of time to get more points.

I did a blueprint sheet on my test that shows that my main problem is the rationale of either the question or the answer. Of course I found the 2 but mostly choose the wrong one.

Any suggestions? A instructor suggested to stop memorizing so much and make sure I understand why.

[Lisa CCU RN, RN]

What your instructor said is right.

[Jolie, BSN]

What your instructor said is right.

This is so true, but understanding the rationale for nursing interventions is VERY difficult for someone with little to no patient care experience.

I attended my nursing program as a 19-year old with absoutely NO healthcare experience. I am a very good memorizer, so I did well, but it wasn't until I had a year or two of actual RN experience under my belt before it all came together, and then memorization was no longer necessary.

I would suggest that you make certain you have a good understanding of the pathophysiology of any condition that you are being tested on. From there, move on to understanding the pharmacology of the medications involved. Then study pre-written care plans and quiz yourself on the rationale for the nursing interventions suggested.

Do you still work in a nursing home? If so, ask your charge nurse to spend 5 or 10 minutes a shift with you discussing a patient whose condition you don't understand. Ask for permission to review the H&P, physician and nurse's notes, labs, radiology studies, and MAR. Try to formulate nursing diagnoses that apply to your patient's medical diagnosis (COPD, pneumonia, sepsis, etc.), and sketch out a brief care plan including rationales for your nursing interventions. It will get easier, and make more sense each time.

Good luck!

[kimber1985]

When you get down to two answers, reread the question. What is the question really asking you. Underline words like always, never, best, first.

I have thought I have bombed test and have done well because I have learned to be a good test taker. Practice with a NCLEX book. Sometimes the previous answer is in the next question. When you are studying or memorizing, ask yourself "what is the question here?" The question is never what is the normal Digoxin level, the question is what do you do when you give Digoxin and why are you giving it. You have to vertically and horizontally understand the material and how it interacts.

[Daytonite, BSN, RN]

Sometimes the choice between two answers lies in prioritizing your interventions. You need to know Maslow's Hierarchy of Needs. Sometimes the choice is simply in figuring out where the situation falls within the nursing process itself and proceed from there. You need to know the steps of the nursing process. A really, really good NCLEX review book that lists out the pathophysiology, signs and symptoms and nursing actions is also a good thing to have. These books tend to list things in order of increasing severity and intensity when it comes to symptoms. You need to know those sequences to help you determine the seriousness of any symptoms you are given in questions.