ID10T NS questions....... ***VENT***

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I swear if I hear one more NS instructor use "you need to use critical thinking!" to justify their poorly worded question....I'm gonna go postal! :devil::devil::devil::devil::devil::devil:

Here is the question:

Your client is a 48 hr postpartum breastfeeding mom. She asks you,"What birth control methods are available to me?"

A. diaphram

B. condom

C. mini-pill

D. abstinence

This was Q#3 on our test. A student goes up for clarification...and sitting right in front of ye ol teacher, I state, I have a problem with that question as well...it does not contain enough data. She disagrees....so I state,"hmmmm...is she asking about for tonight or 6 weeks from now?!?!?!" Her reply? "SHHHH!!! There is a test going on!!!" Then she states to the class....if you don't get the answer right away....you are thinking too hard!

OH REALLY!?!?!?!?!?!?!? :uhoh3::uhoh3::uhoh3::uhoh3::uhoh3::mad::mad::mad::devil::devil:

1. If she is asking about tonight.....obviously D.

2. If not....then we "assume" she means after 6 wk check. A is not a good choice because a diaphram has to be refitted every 10 lbs of weight loss. Then B, C *and* D are POTENTIAL options.

Classmate answered C. Her rationale? The mom is breastfeeding. The mini-pill only has progesterone so that is the answer. (Knowing this school and this teach...her thinking might match theirs).

The only problem with C is you have not been given the following: age of mom, cardiac hx, hx of HTN(?), smoker???? So until you know that, mini-pill is not the obvious answer.

Now this teacher always says "READ THE QUESTION!!!!!!!" OK, I *did*. The patient asked what is AVAILABLE to me......

D...yep, that available.

C...yep, available....advisable...dunno

B...yep, available....

A...available but not advisable.

Don't have the answer yet. Thought I would shoot it out to all you folks first.

BTW, day class averaged in the 60's on this test (80 is passing). Our eve class averaged 83. What torqued many of us is we ALL felt great after the test like we all got As. Imagine our shock when we were in the 70's or low 80s!!!!!!

I can't even fathom seeing the teacher yet.

(BTW, on this one, I answered D)

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This is why I have a love-hate relationship with m/c questions. Sometimes it helps cause you know it as soon as you see the right answer, and other times it's a ridiculous question with multiple right answers. At least if it was short or long-answer I could justify my response. With m/c you're often required to read the instructor's mind and this is a perfect example.

I can think of several ways to justify basically each different response, depending how one wants to think about the question. My gut response after reading just the question would have been "there are several options...". Helpful, right? lol!

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Our instructors in critical care have told us not to read into the question and pick your answer according to exactly what they ask and if they don't provide that extra information you mentioned don't factor that in. I would have picked C because the mom is breastfeeding. I think teachers believe we can read their minds and know what kind of mood their in when they make these tests!! I think they should use nclex questions from books and they would probably make more since! Just my two cents!

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Specializes in ICU.

Wow thats nuts. It is such a poorly worded question.

Aren't they all available to this patient really?! But which would you suggest - I would have gone with C.

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The problem I see with going for C is as I stated above.....

Imagine the same question but info is provided....

Pt. 39 yo

Smoker 2 pk/dy

Hx HTN

Would you STILL recommend the BCP?

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Even if you dont read anything into the question, just take it at its face value... the answer is everything. All forms are available to her, not just the 4 listed. Even regular bc pills are available if she really wants them. Certainly there is no reason she cant simply abstain, esp at 2 days pp. Diaphragm and condoms are also options to anyone. Yeah, I have a real problem with this question!

The problem is that you *have* to assume there is more info in order to choose just one of the options provided. The question is what info should you assume the teacher is expecting you to glean from this cryptic question.

All tests are psych tests... quizzing you on your ability to read your prof and figure out what is in their head!

I have to assume C as well, as the prof is probably testing your recollection of the safety of regular bc pills while bfing. And I assume that mini-pill was specifically mentioned as an alternative to regular bc pills during bfing. She just made the rest of the question garbage.

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BTW.... simple FYI....

My mother was an OB nurse (for part of her nursing career)....35 yrs exp....Masters....

I asked her that question on the way home...

Her answer: Abstinence.

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FYI to all that responded......

The answer WAS abstinence.

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These types of questions are SO FRUSTRUATING! My instructor does these types of questions as well and while I love nursing school...I can't seem to pass our instructor's tests. They are SO VAGUE! Good luck to you and I hope this gets better!

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I would have answered D as well, because of the 48 hours. Never is it going to be recommended that a woman have sex 48 hrs postpartum. These type of test questions are tough, and I find that usually my first response is the right one. D was my first response, but when I read into the question, I had the same thought process as you did, and tried to rationalize all the other answers, which may have changed my answer to C if I thought too much about it. Go with your first instinct on these, it's usually right. I can't tell you how many times I changed my first answer, and ended up getting it wrong. It's frustrating!

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Specializes in Maternal - Child Health.

I agree that it is a poorly-worded question.

What is "available" implies what can the patient obtain at this time. The answers would include condoms and abstinence, since she can obtain both on her own.

The mini-pill and diaphragm would require prescriptions/fittings, which no reputable healthcare profider would authorize at 48 hours postpartum.

The question should have been worded, "What birth control is advised for me?"

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I agree with the fact that it's a very poor question, however, in one of our test taking strategy seminars, we were taught to underline key points in the question. The main key point I see is that the mom is "48 hours" post partum. They wouldn't put that detail in there if it didn't pertain to the answer. Therefore, abstinence is what I would have chosen also. Obviously 48 hours after childbirth, she'd need to remain abstinent. The reason this question is so difficult to answer is because as nursing students, we over think the question and read it the way we WANT it to read instead of the way it's actually written. Don't assume information that isn't offered in the question. To the OP, your point about the mini pill is actually awesome critical thinking.

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