Kaplans Decision Tree Please Help!

[katiejean]

I have the Kaplan book and I've heard so much talk about the decision tree so I looked it up and I'm having a hard time understanding it. For an example, I tried using it to answer questions on Saunders cd-rom and it lead me to the wrong answer on the question below.

A client has a AV fistula in place in the right upper extremity for hemodialysis treatments. When planning care for this client, which of the following measures should the nurse implement to promote client safety?

1. Take blood pressures only on the right arm to ensure accuracy.

2. Use the fistula for all venipunctures and intravenous infusions.

3. Ensure that small clamps are attached to the AV fistula dressing.

4. Assess the fistula for the presence of a bruit and thrill every 4 hours.

Decision Tree

STEP 1: Can you identify the topic of the question?

YES proceed to Step 2.

STEP 2: Are the answers assessment or implentations?

A Mix of Assessments and Implentations > Read stem to determine if you should assess or implement. > Select correct answer.

WELL the stem tells me "which measure should you IMPLEMENT" so that that would automatically eliminate answer 4... but that I come to find answer 4 is the correct answer.

Where did I go wrong with this?? Everyone says the decision tree is so helpful and I want to understand it please help!

[brownbook]

Maybe "everybody" thinks this decision tree is great!!!! However two people don't think it is so great, you and I. Makes no sense to me. Obviously number 4 is correct. You are over thinking the problem and answer. Maybe the decision tree is for people who think differently from you and I? Try to not get bogged down in the details!!! Reminds me of math problems, some people look at a math problem and can figure out the answer, "see" the answer, in their head, it just makes sense to them. Others have to break it down into minute step by step details to get the answer.

[shoegalRN, RN]

I took Kaplan and passed boards with 75 questions in under 2 hours (could have been done in one hour, but took my time).

The decision tree does NOT work on each and every question, but I did find it helpful on majority of my questions I got on boards. Some you just have to KNOW. Obviously, #4 was the correct answer.

[naipeee]

4 is the right answer!--- check for bruit all the time if your patient has AV fistula..

[naipeee]

... and also--- you have to think about each and every answer-- for your patient's safety... you don't wanna do answer 1 and 2 coz that is not a safe implementation to do... and number 3 doesn't make any sense at all...

i was having the same problem too coz i used kaplan review.. i graduated in kaplan college and all they have for us was saunders and kaplan complete... when i was doing the review inside the classroom-- i thought it was easy to follow the decision tree coz the kaplan lady was using it on every question she gave us and i fully understood how to use it... BUT-- when i was doing the questions myself (QT and QBANK)-- i was like "what the fudge is going on".. i kept getting the wrong answer and i'm using the technique..and so from there i read the rationales and it stucked into my head -- after a loongg practicing of each question.. i never even used the decision tree anymore... i noticed that the questions are knowledge based and you realy have to know the topic itself to get to the right answer and for you to eliminate wrong answers as well..

hope this helps.. i know the feeling :-) but practice more questions everyday till u get used to it coz i am:D.. goodluck!! i knoow you'll make it!!