Quizzed in Clinical

A doctor asked me the location of a cancer one time. My clinical preceptor was extremely proud I answered right away because I guess his medical student didn't answer properly (I guess that doctor is kind of strict). Clinical instructors may ask about the medication information prior to administration.

Really know the medications your patient is on. I can't remember the specific example, but the patient was on a med that was mostly for Psych but also helped with neuropathy. It was important to know WHY I was giving that med. if you do your med cards after your care plan, it will help to answer these types of questions. It is also common to be quizzed on post op procedure complications, which you should also be able to look up beforehand. Hope this helps. Sometimes you will not know the answer, if that is the case than just say so and then state that you will go look it up. This should not be a common occurrence though.

For me it has mostly been about meds. You REALLY need to know why you are giving each med, it's side effects, possible adverse reactions, route, dosage, etc.

One nursery nurse I worked with is famous for asking each student what 3 meds (1 ointment and 2 IMs) are always given to a newborn, why, when, etc. If the student can't answer all of the questions they are not allowed to do any hands on that day (a huge bummer for those who really want to spend the day holding babies).

My med surg instructor really loved to ask about the patho of diseases. I had a patient with CKD whose labs (almost every single one) were out of range. She absolutely loved it when I was able to tie most of them to the CKD. That being said, there were definitely some I didn't know. But because she could see that I had tried to figure it out and wanted to learn she happily explained them instead of getting mad that I didn't know.

Bottom line (in my experience and observation at least)- if your patient is assigned to you the day before (most of ours were) research them and their conditions, meds, etc as thoroughly as possible. Look in their chart, get all their meds, labs, read all the notes you can. Go in and talk to the patient, if allowed, to get a feel for their current situation. As long as your instructor knows that you are willing to give a good strong effort and have some critical thinking skills (or are trying to develop them) you will be okay :)

As stated above, you MUST know about the meds that will be administered to your patients.

Can someone give me some examples of how they were quizzed during clinical? Have you ever been wrong or not known the answer? I hear a lot of stories about bad experiences people have had with instructors. How often did this happen with your program?

I can count on being quizzed every single clinical in the RN program I'm in at Harrisburg Area Community College. What we are quizzed on varies but is guaranteed to include knowing the following:

★ All of the non PRN medications the patient is on

★ For each of the scheduled medications during the time frame of clinical, know the drug classification, method of action, contraindications, side effects, parameters (if applicable), assessment and safety considerations, and WHY is the patient on the medication.

★ Relevant lab values AND trends as well as how the lab values might correlate to the patient pathophysiology and medications; AND if we have to make changes to any medications (i.e. hold, call the doctor, alert the primary RN, etc.) based on current labs.

★ Various info on the patient(s) we are assigned from chief complaint, past medical history, pathophysiology, etc.

While we are guaranteed to be quizzed by our clinical instructor, there are times we will be quizzed by the staff at the clinical location (these quizzes are generally not planned, and are very random). I.e. one time I was quizzed by a respiratory therapist in terms of what impacts O2 saturation readings, how to use a peak flow meter, am I aware of how reimbursement works for respiratory therapy and various areas... another time I was quizzed by a doctor concerning VQ mismatch.

Yes, there are times I am caught off guard (even when I plan to have the right answer -- we don't know about our patient assignment(s) until a few minutes after we arrive on site), and don't have to look up anything, other times I should know the answer, but don't. A few times, I thought I knew the right answer, and gave the wrong answer.

Thankfully, almost all of the clinical sites are teaching hospitals with very patient staff; and, I've been blessed by Jesus with very intelligent, wise, and patient clinical instructors who don't punish those who do their best, but get stuff wrong.

What I do recommend to make clinicals flow as smoothly as possible is as follows:

★ Have a grab-and-go bag you pre-pack with everything you will need for clinical at the ready.

★ Stay up to date with learning pharmacology; this should be ongoing and will be extremely helpful come NCLEX time.

★ If you know the floor you will be on in advance, try to get a handle on the common chief complaints, pathophysiology, etc. that you might come across.

★ ASK questions, ask questions, ask questions. Three semesters in (4th coming up this fall), and the feedback I get regularly from clinical instructors is they appreciate that I have no fear to ask questions of them, of staff, etc. I've also found jumping in to share ideas -- even if they are wrong -- is helpful; if the idea(s) et all are wrong, I get instant feedback to make corrections (rather than maintaining wrong information in my head).

I get quizzed in clinical all the time. Here's how to prepare:

Look at your patients chart and piece together a story of what is going on from that info and the info you get from your assessment. Hint: if your patient is coherent, ask questions.

In your story, include the following:

How did patient wind up in hospital?

What is chief complaint?

What is medical diagnosis?

What are meds:

List each and what each is for, along with side effects

Lab results?

Imaging?

Procedures scheduled or recently completed?

Past medical/surgical history?

While you are looking in the chart you will see words you don't know. Google them or use a database. Learn everything about this patient that you can.

Do this and you will be well prepared. If the instructor asks something you don't know, you can safely admit it, because you are prepared.

You're going to be quizzed on a lot of different things. What is important to remind yourself is not only to be prepared for anything but if you don't know something, admit it.

A huge thing I've learned that has impressed my instructors and employers immensely was admitting when I didn't know and stating I would find out though. Nurses who don't admit when they don't know can be dangerous. We can't know everything. Don't be hard on yourself if you get something wrong or don't know. Admit to it, learn from it, and prepare to have it happen again at some point.

You're in school to learn and your in clinical to apply what you learn. No instructor should ever make you question your worth if you get a question wrong. They're to help you learn. As long as you try and work hard, no one can fault you for not knowing. Please don't be scared about that. Having a wrong answer doesn't ruin your day.

However, if you're completely unprepared, know nothing about your pathology or labs, and are clueless as to what medications the patient is on and why--- you're going to have a bad time.

I want to reiterate what Scrubs n Sirens and Invitale and PMBAbraham have said and to reinforce lab trends and current labs and interventions. This was super important in my nursing school clinicals.

Plus hold perameters, in case that wasn't mentioned. Oh, I see it was!! That's a lot of stuff to know, but at my school, you might get written up or dismissed if you don't know these things.

Most, if not all the pop quizzes that happened during my clinical were based on medications. Why are you giving this medication, what do you want to watch for (in terms of S/S, lab values, potential reactions, etc), what are other things to consider (allergies, contraindications, etc), etc.

The "quizzes" I had in clinical were mainly just verbal back & forth. Instructor asks something and we throw answers out. Questions typically surround the patient(s) we're caring for. We need to know the patho, meds, labs, and priority nursing actions etc.

Add me to the "meds" answer. We didn't really get quizzed first semester in clinical much but my instructor definitely asked a lot of med questions.

Great answers everyone!