New nursing student

Published

Hello everyone.:wink2: My name is Quinda and I'm a 1st year nursing student. This is the moment I've been waiting for. It took me two years to get to this place. I'm sooo excited! This is my third week of lectures, lab and clinicals. It is sooo much until it's not funny but in my heart I'm determined. I've learned that anything worth having is worth working for. I've done my vs check off and passed! Now I'm working on my head to toe assessment in the upcoming weeks. My only challenge is the test. I have a test on this Tuesday and my only challenge is how will they word it. I've heard of the many stories of how nursing tests are not like the norm. It basically involves a lot of critical thinking. Just wanted some good sound advice from anyone that will help me pass my test on this wee. Take care!

RNnTrainin, how are you today? Well I took my first test, and it wasn't bad at all. Everything that she lectured on, was on the test. Unfortunately I want know my grade until next Wednesday. I have to be on edged until then. I wanted to see what you would put for this question, it was on our test: Out of 4 things that was listed, a nurse had to put down the abnormal one. This is for a 79 year old man. The abnormal one was either: yellow jaundice, decrease skin turgor, hair loss or hearing loss. Which one would you have picked? I choose the yellow jaundice because with age some people will likely have hair loss and some hearing loss. I got stuck between skin turgor and yellow jaundice. I really took a guess on this one. Let me know what you would have done. Take care and thanks for the encouragement!

I am sure you are right. With age, the skin gets drier and less elastic, hearing loss is a normal change, hair loss is normal as well. So, yellow jaundice is the only one that is abnormal. Can't wait to hear what you made....how do you think you did?

Up Vote Up Vote ×

Yeah, jaundice is definitely abnormal. It means bilirubin and metabolic wastes are building up in the blood. Not good.

Decreased skin turgor is something that is not uncommon with the elderly. Their skin is thin and fragile and it has less elasticity than those who are younger.

Up Vote Up Vote ×

Thanks RNnTrainin. I don't know why that one threw me for a loop. I'll let you know as soon as I hear something. Thanks again!

Up Vote Up Vote ×

So their skin turgor decrease because they don't drink as much water or liquid and that makes them dehydrated, right?

Up Vote Up Vote ×

It could be from dehydration, yes, but think about all the old people you know. They have wrinkles, the skin on their hands tent, they have saggy cheeks. Their skin is loose. Decreased skin turgor.

Up Vote Up Vote ×

Which one would you have put?

Up Vote Up Vote ×

Okay, I got you now. So skin turgor should have not been the answer but the jaundice should have. That was the abnormal. You made it real plain. Boy do I really appreciate this.:)- I have to switch desk here on my job and I'll get right back to you. Thanks.

Up Vote Up Vote ×

Hello RNnTranin.:)- How are you today? I still haven't received my grade yet but I found out the the class average was 82. I made two 100's on two test that I had. My next test is on this coming Tuesday and it's on the nursing process, documentation, diagnostic test, and two other things I can't remember right now. I believe you have already taken a somewhat type of test. What are the important highlights of the nursing process? I understand documentation but the nursing process is a little hard for me to focus on. Any advice would be appreciated. Thanks.

Up Vote Up Vote ×
Specializes in med/surg, telemetry, IV therapy, mgmt.
what are the important highlights of the nursing process? i understand documentation but the nursing process is a little hard for me to focus on. any advice would be appreciated. thanks.

sorry to highjack the thread, but i post and talk about this information all the time. the nursing process is a tool as well as being all about problem solving. it consists of 5 steps.

here are websites that explain the nursing process:

this is my analogy of the steps of the nursing process to the real world:

you are driving along and suddenly you hear a bang, you start having trouble controlling your car's direction and it's hard to keep your hands on the steering wheel. you pull over to the side of the road. "what's wrong?" you're thinking. you look over the dashboard and none of the warning lights are blinking. you decide to get out of the car and take a look at the outside of the vehicle. you start walking around it. then, you see it. a huge nail is sticking out of one of the rear tires and the tire is noticeably deflated. what you have just done is step #1 of the nursing process--performed an assessment. you determine that you have a flat tire. you have just done step #2 of the nursing process--made a diagnosis. the little squirrel starts running like crazy in the wheel up in your brain. "what do i do?" you are thinking. you could call aaa. no, you can save the money and do it yourself. you can replace the tire by changing out the flat one with the spare in the trunk. good thing you took that class in how to do simple maintenance and repairs on a car! you have just done step #3 of the nursing process--planning (developed a goal and intervention). you get the jack and spare tire out of the trunk, roll up your sleeves and get to work. you have just done step #4 of the nursing process--implementation of the plan. after the new tire is installed you put the flat one in the trunk along with the jack, dust yourself off, take a long drink of that bottle of water you had with you and prepare to drive off. you begin slowly to test the feel as you drive. good. everything seems fine. the spare tire seems to be ok and off you go and on your way. you have just done step #5 of the nursing process--evaluation (determined if your goal was met).

another profession that utilizes a form of the nursing process (although they would not call it the nursing process) is police investigation. think about it. a crime is committed. a detective must investigate, or assess, the facts of the case before making a decision and arrest. this would parallel to a nurse making a nursing diagnosis. what happens after that is the suspect gets arrested and goes into the justice system where interventions (planning) and implementation occur from then on.

if you have difficulty remembering the nursing process, put it in terms of a flat tire or a crime. there are plenty of examples of this process in use. it is not exclusive to nursing. but, note that there is an established order of succession to the performance of the steps in doing it. go outside the steps and you risk tainting the final results. why? because this process is extrapolated from the field of science. break protocol and all resulting data and decisions are considered suspect. and that leads us to the subject of critical thinking. this is what critical thinking is all about--following the logical sequence of the nursing process. from hereon in, the nursing process is your friend for solving all problems. it works for everything: flat tires, mrs. jones' fever, the chest tube that bubbles continuously and that stupid rooster that wakes me up with his crowing at 3am.

the steps of the nursing process applied to care planning are:

  1. assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
    • a physical assessment of the patient
    • assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease
    • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
    • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.
    • https://allnurses.com/forums/f205/medical-disease-information-treatment-procedures-test-reference-websites-258109.html - medical disease information/treatment/procedures/test reference websites

[*]determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)

  • it helps to have a book with nursing diagnosis reference information in it. there are a number of ways to acquire this information.
  • your instructors might have given it to you.
  • you can purchase it directly from nanda. nanda-i nursing diagnoses: definitions & classification 2007-2008 published by nanda international. cost is $24.95 http://www.nanda.org/html/nursing_diagnosis.html
  • many authors of care plan and nursing diagnosis books include the nanda nursing diagnosis information. this information will usually be found immediately below the title of a nursing diagnosis.
  • the nanda taxonomy and a medical disease cross reference is in the appendix of both taber's cyclopedic medical dictionary and mosby's medical, nursing, & allied health dictionary
  • there are also two websites that have information for about 75 of the most commonly used nursing diagnoses that you can access for free:

[*]planning (write measurable goals/outcomes and nursing interventions)

  • goals/outcomes are the predicted results of the nursing interventions you will be ordering and performing. they have the following overall effect on the problem:
    • improve the problem or remedy/cure it
    • stabilize it
    • support its deterioration

    [*]interventions are of four types

    • assess/monitor/evaluate/observe (to evaluate the patient's condition)
      • note: be clear that this is assessment as an intervention and not assessment done as part of the initial data collection during step 1.

      [*]care/perform/provide/assist (performing actual patient care)

      [*]teach/educate/instruct/supervise (educating patient or caregiver)

      [*]manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)

[*]implementation (initiate the care plan)

[*]evaluation (determine if goals/outcomes have been met)

good luck on your test.

Up Vote Up Vote ×
Specializes in None.

Hi everyone,

This is the first time I am on this page. I just registered. It may be feel good to read many of the discussions. I am in my first semester of nursing school at what was suppost to be a "good" nursing school but I am so disappointed. I really want to be a nurse. I come from a family of nurses so I feel I know what nursing is all about. I have done shadowing and volunteering in hospitals etc. I was a 3.85 student freshman and sophomore years. Now barely making it. I do not like my professors. I am thinking of transferring to another school. Has anyone tried to do that? How hard is it? So much of what we need to learn is online to be taught to ourselves --like medication calculation. We do not get much clinical practice. They lecture us in skills but we don't have time to practice. AFBlue

Up Vote Up Vote ×
+ Join the Discussion