How do you know you've done enough

Can't really help you with time or amount of study, but in exams i think logically. Assess plan implement and evaluate. Look at all the problems that are going on with the patient, and what systems are involved. The indications for their diagnosis and what your care plan should incorporate.

You'll get to the point where it's second nature to think "like a nurse". I found when I was in nursing school that reading case studies and nursing journals really helped me to see how to apply that kind of thinking. Now I'm back in school and find that I'm overthinking my tests in my pre-reqs, and having a difficulty seeing a multiple choice question for just a multiple choice question! Sometimes you just can't win.

I never feel like I've done enough.

I answer questions....lots and lots of questions. It has been especially helpful in med surg. Even though the questions may be harder or easier than the material presented in class, they allow me to think. That, in turn, prompts me to look over my notes and read a little more in my books.

"Thinking like a nurse" is something that comes with time and practice. It's starts with the most minute thing like remembering to carry alcohol swabs with you all the time to delegating patient care based on acuity. Time, practice, and patience.....

Something that really helps me in taking exams is to practice NCLEX questions. Some textbooks have an online portion where each chapter has 10 or so NCLEX questions with answers and rationale for those answers. Practicing those questions will help you think like a nurse and better-evaluate the questions on the exams. Plus, it's early prep for NCLEX!!

Also, try not to be stressed out. When you're stressed out sometimes your brain doesn't work as well (in my experience).

Good luck, and just try your best. Don't beat yourself up over a grade that is less than you would like. You'll score higher next time!

I just wanted to reiterate the other posts saying to do lots of practice questions. Use the disk that came with your book, and check to see if your book has a website with additional questions. And take the time to read all the rationales, even for the questions you got correct.

May I ask how much you're studying now?

I do 2+/- hours a day with Sundays off, Monday test or not, it's the day I get to just hang out with my wife maybe watch some football and drink a couple beers.

The two biggest lessons I've learned are not to "over study", I was puting in 40-50 hours a week (it's a full time job right?) and come test time I froze, becoming brain dead; and FOLLOW THE SYLLABUS! I was so preoccupied with "learning everything" I wouldn't master the stuff that mattered for the class (test).

My school provided a handout from Saunders, "Strategies for Success for the NCLEX-RN Examination", I faithfully review them on test day just as a reminder and to take my mind off of all of the "what is this ...?, did you study this ...? chatter that comes with test day.

1. Avoid reading into the question

2. Look for key words like Early, Late, Best, First, Initial, Immediately, most likely, least likely ...

3. Prioritize using ABCs and/or Maslow's hierarchy.

4. Identify true or false response questions. "... it is determined the pt needs reinforcement of discharge instructions if he states" is looking for a false or negative statement.

"What action would the nurse take next?" is looking for a true or positive statement.

5. Theraputic communication questions always focus on the pt, pt's family, feelings, concerns, anxieties or fears.

6. Eliminate similar options. If options are pursuing the same idea both can be eliminated. The ONE correct option frequently is the one that is different.

7. Eliminate options with absolute words like all, always, every, must, none, never.

8. Look for the umbrella option. Thats the one answer that is more general and encompasses other correct responses that are provided.

9. Use guidelines for delegation and assignment making questions.

There is a more indepth list of these principles in the Saunders Comprehensive Review (4th Ed in Ch. 5).