Nurses thinking multiple choice?

Sleepyeyes · Dec 2, 2002

Since a bowel obstruction is an emergency, I probably would've chosen that because that might mean a necrotic bowel, which is really a compromise in Circulation, and ABC's always get the right-of-way.

Sometimes, difficulty swallowing can lead to difficulty breathing and in that case, Airway would be compromised and would then take precedence. But they didn't SAY "difficulty breathing' so ....

Tricky question though, eh?

Point is, that's how I finally resolved how to do those questions. ABC's..... in order. What's being compromised, and how urgent is it?

Sleepyeyes · Dec 2, 2002

PS I would've challenged that one....

After all, how do you think they do swallow studies?

On the other hand, how long can a bowel be obstructed before necrosis and the Pt needs a major surgery?

Dr. Kate, BSN, RN · Dec 2, 2002

Test taking is an art, no question about it. The question as you describe it was ambiguous at best. Among other things I would want to know how many people got the question wrong/right.

Sometimes the best you can do is put the question in the context of what content you're being tested on at the moment. When that doesn't work remember you always start with the ABCs, airway, breathing, circulation. If the airway is obstructing or obstructed it wins the priority contest. If the Pt isn't breathing that wins.

As far as multiple choice tests, not only are they preferred by instructors who have to grade piles of tests, but the NCLEX is multiple choice and you have to be able to deal with them to pass it. The point in making two answers almost equally correct is a way to push you toward more critical levels of thought. Ultimately nursing school is about teaching you to think. A well contructed test can do that as well as any lecture.

Unless you have been told specifically that you cannot query the instructor once the test has started, there is nothing to stop you from asking during the test for clarification of a question.

kimmicoobug · Dec 2, 2002

After reading that, I would have chosen difficulty in swallowing. Note, here, I am a student and take these multiple choice tests aaaalllll the time. Here is my rationale, think safety, safety, safety. Patient is at risk for aspiration and swallow precautions must be enforced. The question is a shallow one, but I think maybe you read too much into it. Yes, a bowel problem would be an important, but what is going to kill you first, choking on too thin liquids and getting aspiration pneumonia or constipation. That is my reasoning. Mario, you will get the hang of this. You are just in your first quarter and you will adapt to taking these tests. Good luck, and let us know how you did for the quarter.

mario_ragucci · Dec 3, 2002

I apologize for bugging out. My advisor just called me and told me I got 43:50 correct!!!!! That is 86% !!!!! When i got the call, I just about jmped out of my skin. Now I have the confidencei need in knowing that I can retain and think correctly about nursing data. I can remember all the ones I answered wrong. My first summary exam score was 74%, so I was really scared of not passing. Thank you for being here; I had no where else to turn for solace as I sat near my phone awaiting the call with my exam results.

All thats left now is to stay cloistered in my apartment with my books and ACE the final on 09 Dec !!!!! I asked my nurse manager for 2 vacation days next week because I was schedualed to work the weekend before my final and she said yes. I asked her before I got the 86% today. Why was I so afraid? I can do it...and now I know i can.

I want to give praise and thanks and love to my: clincal instructor, lab instructors, lecturers, manager and co-workers who are all great and wonderful women!!!! And especially to allnurses.com....MY ROCK!

2banurse · Dec 3, 2002

:confused: But Mario...did you ask your instructor about that question?

:confused: Don't keep us in suspense!

mario_ragucci · Dec 3, 2002

No - we go over the actual test on Wednesday. So, I don't know exactly which ones I missed, but you know how everyone huddles around after tests like this and coughs up the questions. I still can't believe i got an 86%. I have to be humble, because I know how utterly bugged out I was when i got a 74%. My advisor called me just like she did today, and i immediately began openly weeping after i hung up the phone.

2banurse · Dec 3, 2002

Well, congratulations on your 86%! And on Wednesday, don't forget to let us know (especially those of us following your footsteps!).

kimmicoobug · Dec 3, 2002

Mario, Congratulations. Sounds like you did pretty well! Was this a difficult test for your class? Do let us know about that question. I actually asked one of my first year friends about that question and he had the same response as you. Good luck on your final.

SusanRN2004, RN · Dec 3, 2002

Could it be that difficulty swallowing would be something a nurse could do something about and the bowel thing is a medical problem that would only be handled by a Doctor? I know I got tricked on a question before because some things are a nursing diagnosis and some are medical....I am only a student...just a thought...

mattcastens · Dec 3, 2002

Originally posted by SusanRN2004
Could it be that difficulty swallowing would be something a nurse could do something about and the bowel thing is a medical problem that would only be handled by a Doctor? I know I got tricked on a question before because some things are a nursing diagnosis and some are medical....I am only a student...just a thought...

Ah yes ... I remember that trickiness. Just wait until you get into the "real world" and your orientation tests expect you to correctly anticipate medical orders and procedures. :devil: That's when you'll point out that the "correct" answer is medically oriented, not nursing oriented, and the response will be, "Yes, but you need to be able to understand the medical thinking to effectively nurse." While this is true, it also takes some brain re-training after the brainwashing of nursing school. Have fun.