How to pass a nursing class?

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Okay y'all, I am in my 2nd semester of a 4 semester program. I did fairly well in the first semester and I do know "my stuff" during clinical. I have gotten very good marks and comments on my work in clinical. But these darn NCLEX style questions on exams are messing me up! I know the content, I do practice questions, watch videos, discuss content with other students in the class, and I STILL don't do so hot on the exams. We are halfway through the semester and I'm riding a 77 in my NUR 112 now and only have 2 more exams and a final exam to go until the end of it. So that means I have to make at least an 83 on the remaining exams to pass with an 80. It's not out of reach by no means but I just don't understand where I am going wrong with these exams! I think I may be second guessing myself too much, or maybe reading too much into the questions on exam day. I have a LOT riding on me to graduate nursing school on time. And if I fail it, I am not only failing nursing school but I am failing myself, my husband, my family, and everybody that has supported me throughout this time. I have put a too much time (and by time I mean YEARS), heartache, tears, and money to get my pre-reqs, entrance testing, equipment, etc. for me to fail now. I am 27 years old and I will be almost 29 if I graduate on time. I am holding off on starting a family, buying a car, and building a house until after I graduate nursing school. We are struggling now paying bills because I am not working while I am in school because I keep telling myself and my husband that it will be worth it in the end when I graduate and start working. I have constant nausea, headaches, depression, all because of this. I really just don't know what else I can do to help myself with these exams. My school is supposedly one of the most difficult ADN programs in the state because of its 100% pass rate on the NCLEX every year for the past several years. They implemented a new type of learning/teaching called Contextual Learning last year. The second year students started with 60 and are now down to ~25 left for the graduating class (that's if everybody passes this semester). My class has already lost around 15 students out of 60 and about to lose a lot more because of these difficult exams. Before last year they were graduating at least 40 a year but now its down to averaging 25 a year! It makes me sick. I need any advice you can give me, please. I am desperate!

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Specializes in Critical Care, Education.

Heck, no stress there - right?? Seriously, OP, I can feel your pain radiating through your post.

In terms of 'difficulty, I think it is probably very difficult to compare schools. The curriculum is standardized to meet accreditation requirements. That grading scale is pretty standard. The attrition rate you mentioned is unfortunate, but not unusual either. Have you utilized all the academic resources that your school provides? Tutors, extra labs, etc? Have you made an appointment with your instructor to discuss strategies for improving your chances of success?

As strangers here on AN, we can provide encouraging 'attagirl' messages, but there is little likelihood that any of us could provide you with a magical intervention. That has to come from you and those who are closest to your situation. I am sure your hubby knows how hard you are working - hours of study you are putting in. Open up to him about your stress and fears so he can provide you with the support and reassurance you need. Seek assistance from your healthcare provider re: physical stress symptoms.

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As far as resources go, I have extra reference books, extra Powerpoint presentations the instructors give us to look at, videos, studying with fellow students, other experienced nurses, education websites, plus more. I had a friend in class give me a website to take practice NCLEX exams on and she said that it has helped her with test taking. I'm going to go talk to one of my instructors tomorrow about how I can improve and be successful with the program. I guess I just needed to vent because of all this stress that I have. There is nobody that knows what other nursing students are going through except for people who are going through it or who already have gone through it. If I do make it through I am going to need some serious counseling and hope that my hair grows back! I don't think I mentioned that my hair was falling out too! The bad part about it is I KNOW the material going into exam day but I screw up on those NCLEX style questions somehow. It's like "all answers are right but you are probably still wrong" type answers lol. I think I just need to work on the NCLEX style questions and reading the questions and answers thoroughly and not add anything to them in my head. Thanks for your response.

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I don't see one thing that indicates you have contacted your faculty for help. The one reason that students mess up on NCLEX questions is because they can't separate the factually correct answers from the best nursing answers. The challenge of learning to think like a nurse is huge. Here's something I posted elsewhere on that:

I counseled a student who was dead certain sure that a number of her exam questions had TWO correct answers and she was being unfairly penalized because her faculty wasn't giving her credit for her choices. There were, to her mind, TWO "best answers." Alas , she was wrong on every single one. Perhaps an example will help explain what "thinking like a nurse" means.

1). You are working in an outpatient setting and a woman who is well-known to you comes in with yet another set of injuries from her husband in a fit of rage. She says she will not leave him, she loves him, he is so sorry, gave her flowers, and promises he will never do it again. What do you say to her?

(two of the four answers are totally wrong, so you can eliminate them ... so you have to choose between these two)

a. "And yet you are here again. Let's try to think of a way to keep you safe."

b. "The research shows he will do it again, and it could be worse next time. You have to leave him."

Both look like "good" answers. Both are factually true and contain a second phrase. Which to choose? Well, we know (or will know) that the nurse's job is not to direct care but to help the person along the path to wellness using specific kinds of interventions. Which one of these answers does that? Right, A, because the nurse does not deny the patient's decision (patients are allowed to make bad decisions even if we don't like them) but points out a fact known to the patient ("And yet you are here again") and then offers to engage her in a way for her to make choices about how to plan a way to improve her health (".. a way to keep you safe"). The patient can then discuss options along those lines-- how to recognize the cycle of abuse, how to see when his behavior is beginning to escalate, keep a bag packed, have a cell phone, keep a little money for travel, know the women's shelter hotline phone by heart, how not to internalize his abuse as her own fault, whatever....

While choice B is factually true (he probably will beat the crap out of her again, and it likely will escalate), it denies her feelings and desires (she loves him, she has decided not to leave him), and tells her what to do (even though she has already said she won't). So it will make the patient shut down and not hear another word the nurse says. She's not going to leave him. Saying this offers her nothing she can use. It does not recognize the ultimate nursing value of patient autonomy and does nothing to take the patient along the path towards health.

If this rings a bell, then you have your work cut out for you. Your faculty, believe it or not, wants you to pass and succeed. If you are missing things like this, it's because, probably, you need some help learning to think like a nurse. My daughter is a professor (not of nursing) and had this up in her office:

"Office hours.

No one comes in again.

Perhaps they'll all fail."

GO to office hours, every week, twice or three times a week if you have to. Get them to explain the rationales behind the correct answers of the questions you got wrong. Believe me, they want to help you but they will not seek you out. Part of learning to be a nurse is learning how to learn things and get help as a grown-up on your own. Go.

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I feel your pain. What you described was exactly what I was going thru...except I am a bit older, had 4 kids to support and when I went PRN during my last year of school we lost our health insurance and to top it all off 3 months before graduation my husband lost his job. The stress was unforgiving. We were financially hurting very badly. As if nursing school was not stressful enough, the added stress of wondering how we were going to pay bills or even buy groceries was unbearable. I also suffer from depression, anxiety and chronic migraines. With no health insurance, I no longer had my medications to get me through it all. When my kids got sick, we had to wait until a Saturday to take them to a free clinic. It goes on and on...

With all my stress I couldn't focus either and my grades were declining. What helped me the most was utilizing our school's councilor. I met with her every day an hour before class. She also helped me with tutoring because she was a nursing instructor as well.

Long story short, I did graduate (12/14/12) and I did pass NCLEX (2/4/13) even with all that going on in my life...and you can do it too! Utilize all resources available. Where there's a will, there's a way.

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Just and update here. I went and talked to an instructor after class yesterday about my exams and grade and she gave me a pep talk about how I can make up for those 3 points and pass this class and graduate on time. She isn't the type to give out compliments but she said that she sees a great nurse in me and that I shouldn't give up. She said that she would help me in any way possible so I set up some appointments for tutoring with her and to help me pass these exams. Thanks for everybody's input on this topic!

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@julz68- I know this is an old thread - I was just wondering how you were coping as a new nurse with depression & migraines? Do you have less stress now that you are out of school?

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Not quite out of school yet. I still have 2 finals ro get through this week and then pinning ceremony is May 14. But I feel confident that I will be walking across the stage next week! I actually invested in a NCLEX style question book and my grades went from failing to making As and Bs :). I can't believe I am almost done! I made it through!

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