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Good Lord

Posted

Specializes in ICU.

hey guys, I'm 27 years old and a Paramedic transitioning to RN. So I go in the other day to take this ATI transition test, Fundamentals- fine, Child-no problem, Maternal newborn- BOMB. Jeez louise, despite not having a uterus or kids I managed to do fine on the interventions, foundation and all that. I did terrible on the Comfort portion during labor. They had questions about rhythmic stroking of the lower back for pain and there was one i was particularly confounded by:

Which statement shows that your client understands the amnio procedure

1. bs

2. bs

3. I understand i will have to drink 3-5 glasses of water prior to the procedure......hmmmm

4. I understand my bladder will need to be empty for this procedure

I know that most places prefer their bladder to be full while doing the ultrasound to find the bladder but then want it to be empty during the actual amnio to prevent puncture. So what do they want to hear? It didn't specify at what point the client was making these statements.

Beyond that I had trouble with the episiotomy care, etc. I went in thinking that i was going to receive questions about how to manage emclampsia, breech presentations, etc and instead it was waaaaaay more touchy feely than I had expected. Anyone else ever have this problem? How did you resolve it?

DuluthMike

Specializes in ICU, ED, PACU. Has 6 years experience.

A full bladder is required for the ultra sound that will guide the needle. If we empty the bladder we cannot have an ultra sound and cannot guide the needle.

BloodyMedic

Specializes in ICU.

and i understand the logic behind that. But unfortunately ATI disagrees and that's the test I'm taking. I answered that she should have a full bladder and I was wrong. ATI says it should be empty to prevent puncturing it. Again, that's not my answer, that's ATI's

DuluthMike

Specializes in ICU, ED, PACU. Has 6 years experience.

They would be wrong.

From Mayoclinic.com

Before the amniocentesis, you can eat and drink as usual. Your bladder must be full before the procedure, however, so drink plenty of fluids before your appointment. Your health care provider may ask you to sign a consent form before the procedure begins. You may want to ask your partner or another close contact to accompany you to the appointment for emotional support or to drive you home afterward.

BloodyMedic

Specializes in ICU.

again, I agree. But what am I supposed to do? I mean, one question isn't going to pass or fail anybody but what if there are more like that? Shoot man, i can show you in the book where it says it. Its in the ATI Maternal-Newborn book page 290- Critical Thinking Exercises. If its an ATI test and the ATI book says so, then I guess I have to answer that way. Idk, this is all pretty ridiculous. "you have a pregnant female who's exhibiting tachycardia, hypertension, and swelling of the hands and face; What phase of coping is her partner likely to be in?" I'm sorry, maybe its the paramedic in me, but WHO CARES? Wouldn't your first priority be to make sure homegirl doesn't scramble her brains seizing from eclampsia first??? And then, ya know, maybe we can give whoever a little pep talk later? I just don't understand any of these questions. Its like they could care less how to treat patients, its all about how their "social support group" is feeling. Again, way too touchy feely with little emphasis on actual care. I just dont get it.

Good lord. Where do you need to take this? Im a first semester student and I dread flowery ambiguous stuff like this.

Full bladder for an ultrasound, empty bladder for an amnio to prevent bladder perforation... Thats what I always learned :icon_roll

DuluthMike

Specializes in ICU, ED, PACU. Has 6 years experience.

Full bladder for an ultrasound, empty bladder for an amnio to prevent bladder perforation... Thats what I always learned :icon_roll

How does one guide the amnio needle with no ultrasound?

I hate hearing that. I'm tempted to enroll in nurse school with a B.S. in other stuff and having previously worked as a paramedic. When I was in medic school I hated OB. It's just not interesting to me. I guess nurse school involves more weirdness.

hey guys, I'm 27 years old and a Paramedic transitioning to RN. So I go in the other day to take this ATI transition test, Fundamentals- fine, Child-no problem, Maternal newborn- BOMB. Jeez louise, despite not having a uterus or kids I managed to do fine on the interventions, foundation and all that. I did terrible on the Comfort portion during labor. They had questions about rhythmic stroking of the lower back for pain and there was one i was particularly confounded by:

Which statement shows that your client understands the amnio procedure

1. bs

2. bs

3. I understand i will have to drink 3-5 glasses of water prior to the procedure......hmmmm

4. I understand my bladder will need to be empty for this procedure

I know that most places prefer their bladder to be full while doing the ultrasound to find the bladder but then want it to be empty during the actual amnio to prevent puncture. So what do they want to hear? It didn't specify at what point the client was making these statements.

Beyond that I had trouble with the episiotomy care, etc. I went in thinking that i was going to receive questions about how to manage emclampsia, breech presentations, etc and instead it was waaaaaay more touchy feely than I had expected. Anyone else ever have this problem? How did you resolve it?

K.P.A.

Specializes in mental health. Has 2 years experience.

Our program has plus minus grading. A+ is 97+ percent. It's like winning the lottery because that top 3% of the grade is buried in the noise of error and opinion. It's not worth the stress of worrying about.

We don't get A+'s in our program, but I have learned to improve my grade by regurgitating opinion. It's all about having the right answers for the tests and the correct ones when you hit the street.

Your diatribe about eclamptic homegirl had me laughing. You're right on. I will say I am having to learn to be more empathetic. . . especially when it isn't an emergency.

CrufflerJJ, RN

Specializes in ICU. Has 5 years experience.

again, I agree. But what am I supposed to do? I mean, one question isn't going to pass or fail anybody but what if there are more like that? Shoot man, i can show you in the book where it says it. Its in the ATI Maternal-Newborn book page 290- Critical Thinking Exercises. If its an ATI test and the ATI book says so, then I guess I have to answer that way. Idk, this is all pretty ridiculous. "you have a pregnant female who's exhibiting tachycardia, hypertension, and swelling of the hands and face; What phase of coping is her partner likely to be in?" I'm sorry, maybe its the paramedic in me, but WHO CARES? Wouldn't your first priority be to make sure homegirl doesn't scramble her brains seizing from eclampsia first??? And then, ya know, maybe we can give whoever a little pep talk later? I just don't understand any of these questions. Its like they could care less how to treat patients, its all about how their "social support group" is feeling. Again, way too touchy feely with little emphasis on actual care. I just dont get it.

Welcome to the weird, wonderful world of NCLEX-style questions, where you have to choose the least crappy answer from the 4-5 crappy answers listed below. Once you get the hang of that, you'll still find yourself pounding your head against the wall from some of the odd freakin' questions & "correct" answers.

One extra credit question (about a 8 year old boy hurt in a car accident) from my Peds class was:

The parents stay at the bedside constantly. The mother says to you, "I am so afraid my baby is not going to make it and it's all my fault. If I had just been watching the traffic closer, maybe this never would have happened." She weeps as her husband tries to console her. How can you therapeutically respond to her?

Yes, therapeutic communication is a useful thing, but it shouldn't get in the way of taking care of business. But that's reality talking, not NCLEX.

Then there was the frustration about a question on one of my Peds instructor's tests....

It was related to fecal (occult/hidden) blood testing in peds. To rule out GI bleeding, you have to base that decision on the fact that 3 separate stool samples (from 3 separate poops) are free of hidden (occult) blood. The "correct" answer was something along the lines of "take 3 simultaneous samples." My frustration hinged upon her use of the word "simultaneous."

Now when somebody says to take 3 simultaneous samples, wouldn't you think they mean that you should take all 3 samples at the same time???

Nooooo, silly me. I didn't choose that answer, since I knew the "real" answer involved 3 SUCCESSIVE stool samples (3 separate samples, taken from 3 separate poop samples). Of course, that wasn't an option on the test, so I chose the closest thing. Wrongo!

When the class was asking why her answer was "correct", since simultaneous isn't the same as successive or sequential, she got a wee bit defensive & said "I'm not going to argue with you...I think we're getting bogged down in semantics here."

Yeah, semantics. You know...choosing the right word, so the question MEANS what you say...Silly, I know, to expect that the prof knows the meaning of the freakin' word she uses.

Just nod your head dumbly like a good little student, keep moving forward, and smile. SMILE, darn you...SMILE!!.:D

God I hate that phrase: "therapeutic communication".

CrufflerJJ, RN

Specializes in ICU. Has 5 years experience.

God I hate that phrase: "therapeutic communication".

AragornSkywalker - it sounds like you have some concerns about the phrase "therapeutic communication."

:D:D:D:D (can you tell I've been practicing, or maybe it's just a NCLEX flashhback)

Edited by CrufflerJJ