Rant. Questions are killing me!

[broughden]

So as new nursing students we keep getting told time and again, "Dont read into the question."

Ok fine.

We had a question recently:

"A Native American patient has been refusing to take their medication or attend treatment, which of the following would be a proper nursing response?"

A. Something outrageously not right

B. Something also clearly not right

C. Enlist the help of a family member, to discover if their are traditional healing practices the patient may be more receptive too.

D. Recommend to the provider that the patient be referred for a consult with a social worker.

To me C was clearly not right because, discussing the patient's diagnosis and health status without permission to a 3rd party (even if its family) is a clear violation of HIPAA. While we should respect the patient's culture and beliefs, discussing his diagnosis with an outside party is still a violation.

In D we are bringing the patient's lack of compliance to the provider's attention and using a collaborative team effort (social worker) to help address and overcome the patient's concerns with both the medication and treatment.

So I answered D.

We were told the answer is C. I questioned, "How is this not a clear HIPAA violation? We were told not to read into the questions. The question doesnt state, s/he gave you written permission to discuss their care with a 3rd party."

Response: "It doesnt state you werent given permission either."

Oh so Im supposed to be able to guess when they do and dont want me to read into questions, and in which way Im supposed to be able to read into the question.

Thats about as clear as mud.

[broughden]

Well in the NCLEX and testing world, things are perfect, so yes, the family would be visiting. Again, reading into the question too much. Don't try and apply what happens in the real world. The NCLEX is the "perfect nursing world". This means that you would have family to talk to, supplies at easy access.

When I read the question, my first thought was C because, one this is not something you would delegate to someone else. Remember, you have to assess first before you can recommend. You are assessing patient history and cultural beliefs in answer C.

But thats my point! LOL

You say Im reading into the question but IMO everyone else is by assuming things about the family we havent been told in the question....

Like they are there.

Like the patient gave us permission to speak to them.

The question doesnt say they are there. It doesnt say the patient is okay with us contacting them. We are being asked to assume all these things.

You cant say, "Dont read into the question."

While also saying, "Hey assume all this crap we havent stated."

[cin808]

LOL. I just saw a nursing school meme with a picture of a bowl of oranges. The caption read: which of these oranges is the most orange? The answer: the orange one.

[cin808]

I absolutely agree with you. I often feel that not enough information is being provided with some of the questions.

[WanderingWilder, ASN]

You are assuming that family is even visiting in C. Again I would have to assume something that is not given in the answer or question.

I understand your point on D. Simultaneously though I feel the provider should immediately be told a patient is not following their medication nor even their treatment. Rather than "hoping" a more traditional medicine approach may finally get them to take it.

If you call the provider they are going to ask you why the patient doesn't want to do the treatment. You need to find out the why before calling them, because what are they suppose to do about it if they don't know the why. They aren't going to come to the floor to find out.

I get the questions suck and are vague but the nclex is written the same way and you can't challenge those questions so you have to learn how to answer them.

[RNNPICU, BSN, RN]

But thats my point! LOL

You say Im reading into the question but IMO everyone else is by assuming things about the family we havent been told in the question....

Like they are there.

Like the patient gave us permission to speak to them.

The question doesnt say they are there. It doesnt say the patient is okay with us contacting them. We are being asked to assume all these things.

You cant say, "Dont read into the question."

While also saying, "Hey assume all this crap we havent stated."

When I was preparing for the NCLEX, a professor once told us... You have to imagine with each question that consents are signed, waivers are done, etc. The NCLEX wants to assess your critical thinking and your ability to demonstrate your knowledge of the nursing process.

Let's go back to that question with the answer C.

"A Native American patient has been refusing to take their medication or attend treatment, which of the following would be a proper nursing response?"

You eliminated two answers and are now left with two choices.

Choice C - Enlist the help of a family member, to discover if their are traditional healing practices the patient may be more receptive too.

This response involves that you as the nurse provide an intervention. This answers is having you do a further assessment on your patient. Nothing in the scenario above states that the family is not visiting.

D. Recommend to the provider that the patient be referred for a consult with a social worker.

Although this may be a good response. You could only do this after further assessment of the family dynamics, furhter assessment on your part.

I realize the way NCLEX asks questions can be infuriating, but you can't think of a typical day in the hospital. It does go back to the nursing process

Assessment

PLan

Intervene

Evaluate

also then the ABCs

[LovingLife123]

It's a cultural question. C is the correct answer. It's not a HIPAA violation to discuss cultural beliefs regarding medicine with the family.

On NCLEX you will have cultural belief questions.

[Mrs.D., BSN]

You are assuming that family is even visiting in C. Again I would have to assume something that is not given in the answer or question.

I understand your point on D. Simultaneously though I feel the provider should immediately be told a patient is not following their medication nor even their treatment. Rather than "hoping" a more traditional medicine approach may finally get them to take it.

No. There is no assumption. The answer specifically says that the family is available to ask. There is also no assumption on whether it's a hipaa violation because the option says you can talk to them. If it were a hipaa violation, then you wouldn't be able to talk to them.

You need to use what is in front of you that is offered, and not what you read into the question.

I'm sure plenty of students could give you an excuse as to why they believe D is correct-all different reasons, however, it is not. It clearly, is not. It would behoove you to learn why. You will see many more questions set up this way. It would be smart to learn how to answer them.

I understand that you are frustrated. You are not alone and we have all thought these things. However, if you just keep staying angry and repeating all of the excuses as to why you think you are are correct, when you are not, you will not be able to learn how to master these types of questions.

Good luck to you.

[Mrs.D., BSN]

But thats my point! LOL

You say Im reading into the question but IMO everyone else is by assuming things about the family we havent been told in the question....

Like they are there.

Like the patient gave us permission to speak to them.

The question doesnt say they are there. It doesnt say the patient is okay with us contacting them. We are being asked to assume all these things.

You cant say, "Dont read into the question."

While also saying, "Hey assume all this crap we havent stated."

Okay, I can put it another way. Even if C is not the ideal answer (which it is, but it does take time to understand this and I'm confident that you will get it someday), D is an incorrect answer. It would never be the correct option.

I know you say you need to talk to the provider about A, B, and C... but you are not doing that by choosing D. You are only telling the provider that the patient needs a consult. You cannot assume that when you speak with the provider you will say a million things because in this answer, you say only one thing: patient needs a social worker. You, as the skilled and resourceful RN, have not addressed the problem presented in the question if you choose option D.

Learning the incorrect options for process of elimination is a good skill to learn, as well.

[Mrs.D., BSN]

LOL. I just saw a nursing school meme with a picture of a bowl of oranges. The caption read: which of these oranges is the most orange? The answer: the orange one.

I love that meme and have referenced it often. It sure does seem that way, but you will get it! Lol

[nursinglove30]

Lol I am really enjoying this thread cause I had a classmate who used to get very upset with these kind of tricks in questions. His outbursts and complaints were hilarious. Unfortunately he dropped out in the middle of second semester. But yes the answer is C based on what everyone before me said and also remember Nursing is holistic not just medical. In critical thinking when left with two answer choices look at Nursing process; priorities, safety, holistic care, being neutral when answering pt concerns. It can be frustrating but that's The nursing model.

[Mrs.D., BSN]

Lol I am really enjoying this thread cause I had a classmate who used to get very upset with these kind of tricks in questions. His outbursts and complaints were hilarious. Unfortunately he dropped out in the middle of second semester. But yes the answer is C based on what everyone before me said and also remember Nursing is holistic not just medical. In critical thinking when left with two answer choices look at Nursing process; priorities, safety, holistic care, being neutral when answering pt concerns. It can be frustrating but that's The nursing model.

I'm not saying this is OP AT ALL (venting online is different than freaking out in public), but...

I used to hate the next class after exams when students would fight questions. Laaaaaaaawd those girls would get red in the face! Embarrassing themselves to get 1 or 2 points while learning nothing. Sometimes the teacher would throw out questions if 50% got them wrong, but if most people got it right, and those loud ones got it wrong, they would STILL fight it. It made me so aggravated to have to sit through. It was always the same people too. I know they were just high-strung and stressed, but it happened all. through. school. I wished they would just go to the teacher after class or join a study group to get answers. None of them were bad students, either, where they may have been desperate for the passing point. I dunno. I'd just roll my eyes for days with my study partner.

[broughden]

I'm not saying this is OP AT ALL (venting online is different than freaking out in public), but...

I used to hate the next class after exams when students would fight questions. Laaaaaaaawd those girls would get red in the face! Embarrassing themselves to get 1 or 2 points while learning nothing. Sometimes the teacher would throw out questions if 50% got them wrong, but if most people got it right, and those loud ones got it wrong, they would STILL fight it. It made me so aggravated to have to sit through. It was always the same people too. I know they were just high-strung and stressed, but it happened all. through. school. I wished they would just go to the teacher after class or join a study group to get answers. None of them were bad students, either, where they may have been desperate for the passing point. I dunno. I'd just roll my eyes for days with my study partner.

I dont fight anything. Some professors will toss out questions, on their own, if a certain percentage miss it. But beyond that fighting it leads nowhere other than to, "Im the professor, thats why."

I just rant here semi-anonymously, to relieve stress, get feedback and learn something in the process.

Ive stopped ranting on my own facebook page because while my RN, NP and MD friends give me great feedback....the rest of my cohort are certain the nursing school will see my posts and throw me and/or any of them who respond (or click like) out of the school.

So AN gives me an outlet.