How long does it take to get the "Critical Thinking" aspect?

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I just finished my first round of exams in my first quarter of nursing school. I studied by behind off and I thought I aced my Patho test. I got my grade and it was a low B. I took my Fundamentals exam and I couldn't believe how tough it was. I totally wasn't expecting that. I felt like I got blindsided. I ended up getting a C, but we need a B to go on in the program. They teachers keep saying that these test are different and the critical thinking process throws everyone off, but that we'll get it eventually. So, I'm wondering if anyone else is experiencing "first exam shock" and for those that already went through it...is the second exam better? Do you really start to understand this "critical thinking" that instructors always talk about?

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Specializes in Psychiatry.

With critical thinking exams, there are usually TWO "right" answers. It all boils down to choosing the "most right" answer.

My first critical thinking quiz in my nursing program: 4 correct/15 possible. Whoops.

3 years later I graduated summa cum laude and have a fulfilling career as a hospice nurse.

You'll get there. The first years is ALWAYS the toughest.

Hang in there, :nurse:

Diane, RN

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

i don't want to discourage you too much, but it will take years to get good at critical thinking. it took me a long time to realize exactly how the nursing process figured into all the critical thinking and i try to explain to students in a way that i hope you can all understand. at least understand it better than i did as a student. there is a lot of information that goes into making decisions and you haven't even touched the tip of the iceberg yet. the application type questions you are given on exams are focused, however. there are certain key points that you must know and pull from your mind in order to get to the correct response. the advice for these kinds of questions is given in the first few pages of most nclex preparation books. this is it scaled down:

  • 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.

more information is assembled on this thread that you should look at: https://allnurses.com/general-nursing-student/looking-test-taking-224581.html - looking for test taking strategies

from time to time test questions get posted and the critical thinking discussed on allnurses. i keep a list of the threads. you might want to look at some of them. there are several websites that post nclex questions and some give you insight into the critical thinking that goes into the correct answer.

previous allnurses threads:

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Wow!!! Thanks so much for all the info DaytoNite!!! I really appreciate it and I looked some over and they were exactly what I was talking about!!! Thanks again!! And thanks Diane for your encouragement!! :)

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