I hate nursing exams

anonymousstudent · Apr 13, 2012

You're just going to have to embrace this and move on. We almost never have to just regurgitate material for testing. That would be very unfair to you. You will never walk into a patient's room and have a simple case where you do x, y, and z and go about your way, performing perfect textbook care. Everything is scattered and jumbled and it's hard to figure out what's important. In my experience, most nursing professors are assuming you already know baseline information you're pulling in from pre-reqs. It's going to be uncommon that they'll just give you questions on normal physiology. They want to know that you can think through a process, identify all of the contributing factors - whether they are important now, later, or never, and provide safe solid care. Those weird questions are the norm.

Get your hands on some NCLEX review books and dig in. Saunders and Davis' (Success books) are excellent. You need to learn how to read and answer questions where you're required to pull in a lot of knowledge from a lot of different sources.

Aurora77 · Apr 13, 2012

I agree with you, OP. By the time I finished nursing school I was so sick of the tests with questions that seem predicated on a nurse's inability to do two things at once. I found them incredibly frustrating. I did finally take the attitude that I could study my butt off and get a B, or I can study a little and not stress and get a B, so why bother? I decided to take the happy route rather than stress.

I've found the real world of nursing to be far different. Things make sense to me and I love my job. Hopefully you can get through the nonsense that is nursing school. It's really worth it, in the end.

grpman · Apr 13, 2012

"Exam questions are almost exclusively multiple choice and either OVERLY simple (i.e. anyone could get the correct answer even without studying) or OVERLY weird (not hard, WEIRD.... as in you don't know what the question is asking.... or the correct answer is missing.... or there are 3 equally correct answers!) I am so sick of not earning the marks I deserve in this course! The exams should be validated by an external reviewer, and then maybe change would occur"

Welcome to nursing school, where weird questions aren't really weird, just not understood. They only seem weird because you haven't learned the nursing thought process to NCLEX style questions. If you are smart enough to get A+'s in advanced org. chem. then you are smart enough to know that your old ways of thinking aren't working. So change.

Secondly, the tests are normally validated through giving them to students. The instructors use statistics to help validate tests just like your science classes. So there won't be any change here.

Thirdly, I can't wait to see all of the instructor/rn responses...prepare yourself.

RNbethy · Apr 13, 2012

We almost never have to just regurgitate material for testing. That would be very unfair to you. You will never walk into a patient's room and have a simple case where you do x, y, and z and go about your way, performing perfect textbook care....

I agree with this, but multiple choice exams do not give us the freedom to use our minds as we would in the real world! In fact, we are forced to chose "x, y or z," even if we would do none of these things in the real world... Why do all exams have to be so heavily weighted on MC? I think nursing schools should utilize less MC and MORE written responses. Yes, the NCLEX exam is MC (it has to be for easy marking...), but that should not mean that all nursing exams have to be MC! Are students learning to study more or study LESS with these types of exams... seems like most students I talk to state "you can't study for a nursing exam!"............ so while exams should not be designed for students to "regurgitate the textbook," they should be designed so students can CONSOLIDATE the knowledge they have!

I will get my hands on those NCLEX books... perhaps I am missing something here....

Aurora77 · Apr 13, 2012

Yes, the NCLEX exam is MC (it has to be for easy marking...), but that should not mean that all nursing exams have to be MC! Are students learning to study more or study LESS with these types of exams... seems like most students I talk to state "you can't study for a nursing exam!"............ so while exams should not be designed for students to "regurgitate the textbook," they should be designed so students can CONSOLIDATE the knowledge they have!
I couldn't agree more. Learning to take nursing school exams or the NCLEX is not so much about what you know, but how to play the game that is the test. I honestly don't know how a person studies for the NCLEX (full disclosure, I passed both my PN and RN boards with the minimum of questions, first try). You either know the material or you don't. You can play the game, or you can't. Learn to play the game and get into the real world. We make sense. And we have cookies. :)

RNbethy · Apr 13, 2012

I couldn't agree more. Learning to take nursing school exams or the NCLEX is not so much about what you know, but how to play the game that is the test. I honestly don't know how a person studies for the NCLEX (full disclosure, I passed both my PN and RN boards with the minimum of questions, first try). You either know the material or you don't. You can play the game, or you can't. Learn to play the game and get into the real world. We make sense. And we have cookies. :)
Thanks Aurora77... This is definitely the best "attitude" to have - to just play the game... However, if you want to further your education beyond the RN level, grades are important. So looking at how these tests are created is vital...
Some might think that I'm wasting my time - but there are some things about nursing education that really need to be revolutionized. Discussion is the first step towards change :) Thanks for your thoughts on this!

RNbethy · Apr 13, 2012

" the tests are normally validated through giving them to students. The instructors use statistics to help validate tests just like your science classes. So there won't be any change here."

How is the content validity assessed? Sometimes it feels like the tests are not comprehensive enough and important areas are being missed. Are the tests reviewed by a review board prior to writing the tests? To ensure adequate coverage of ALL important content? Are all the questions reviewed for grammar and accuracy?

Furthermore, shouldn't the tests be validated (somewhat) BEFORE administering them to students? After they are administered, the results might provide further evidence of the test's validity... but we need to know the tests are valid PRIOR to administration! Also, even if there is a standard bell curve, are enough students earning As/A+s on the exam?

HouTx, BSN, MSN, EdD · Apr 13, 2012

There are many different ways to determine the reliability and validity of test items - and many types of reliability and validity that can be assessed.

The basis of a bell curve is a norm referenced measure.. in which each individual is compared to the performance of others who have taken the same test. However, NCLEX is a criterion referenced test, in which each individual is measured in terms of achieving a set of standard outcomes. So, you're basically comparing apples and oranges. If you want to improve your understanding of the overall process, you may want to focus on refining your deductive reasoning skills... reaching a conclusion based upon applying a set of general principles or hypotheses (AKA critical thinking).

It is frustrating to move into nurse-land if you're used to hard science. And I agree that it is very difficult to construct a multiple choice test item that actually reflects higher order thinking. One of the underlying issues is the fact that not all nursing faculty have an adequate background in the discipline of education. Although a graduate degree in nursing is required to teach, that degree probably did not include curricula related to psychometrics or program evaluation. Hopefully, the school is providing this expertise and/or continuing education for faculty.

Chances are, the tests you are taking contain items that have been used with prior classes. Because of the dramatic increase in cheating over the last decade or so, schools no longer use the exact same test but they are likely to have a test bank of items which are used to create each test. Depending upon the work that has been put into analyzing each item,they may even have a "difficulty index" assigned so that the instructor can make sure that there are sufficient 'easy' and 'hard' questions on each test.

Seas · Apr 13, 2012

What is your school's NCLEX pass rate , OP?

RNbethy · Apr 13, 2012

What is your school's NCLEX pass rate , OP?

Our school's pass rate is 99-100%. However, I'm not just concerned with passing an MC exam... I'm concerned with the style of questions and whether these MC exams really challenge us to study and learn everything comprehensively... Bottom line is they DON'T. It's fine to have an MC exam for the NCLEX, but it's ridiculous to rely on MC so much for EVERY single nursing exam! I don't think this is teaching us to know our stuff INSIDE and OUT.

RNbethy · Apr 13, 2012

There are many different ways to determine the reliability and validity of test items - and many types of reliability and validity that can be assessed.
The basis of a bell curve is a norm referenced measure.. in which each individual is compared to the performance of others who have taken the same test. However, NCLEX is a criterion referenced test, in which each individual is measured in terms of achieving a set of standard outcomes. So, you're basically comparing apples and oranges. If you want to improve your understanding of the overall process, you may want to focus on refining your deductive reasoning skills... reaching a conclusion based upon applying a set of general principles or hypotheses (AKA critical thinking).
It is frustrating to move into nurse-land if you're used to hard science. And I agree that it is very difficult to construct a multiple choice test item that actually reflects higher order thinking. One of the underlying issues is the fact that not all nursing faculty have an adequate background in the discipline of education. Although a graduate degree in nursing is required to teach, that degree probably did not include curricula related to psychometrics or program evaluation. Hopefully, the school is providing this expertise and/or continuing education for faculty.
Chances are, the tests you are taking contain items that have been used with prior classes. Because of the dramatic increase in cheating over the last decade or so, schools no longer use the exact same test but they are likely to have a test bank of items which are used to create each test. Depending upon the work that has been put into analyzing each item,they may even have a "difficulty index" assigned so that the instructor can make sure that there are sufficient 'easy' and 'hard' questions on each test.

I'm not talking about NCLEX per se... I'm concerned with our nursing exams, from semester to semester... Criterion-referenced test or not, I think some people should achieve an A on the test... (if no one is achieving excellence, there's a problem here, especially if people taking the test study HARD, KNOW THEIR STUFF, and are good at critical thinking)... but it seems pretty well next to impossible to achieve an A on the test! There's something fishy going on here. 120 students cannot all be bad critical thinkers. I also did quite well in my clinical rotations on "critical thinking," and I have taken a LOT of tests that made you THINK so much harder than these nursing exams...