Scenario Test Questions

jenrninmi, MSN, RN · Oct 21, 2004

Hopefully I can help here:

How about ABC's?

Airway

Breathing

Circulation

Does this help? Anyone have any other suggestions?

Altra, BSN, RN · Oct 21, 2004

These "application" or "critical thinking" questions are what will be on the NCLEX. These questions are the core of nursing judgement. They're very difficult at first, but should get easier with time.

The suggestion above - always remember your ABCs - is an excellent one. Physiologic needs always come before psychosocial needs. If one of the possible answers is "notify the MD" that's usually not the answer - there's usually some other nursing action or assessment that can be done first.

The best suggestion I can give you is to read the "case studies" or "critical thinking exercises" at the end of your chapters - these are great examples of putting the information in that chapter into real, practical use.

It gets better - I'm amazed at what I can now think through, that would have simply looked like mumbo jumbo to me a year ago. :)

manna, BSN, RN · Oct 21, 2004

Welcome to the wonderful world of nursing school tests! :chuckle

The other two posters had good advice... ABCs, get familiar with Maslow :)

Have a good feel for what the norms on VS (and later on lab values) are so that you'll know when you find an unusual number that there's a red flag.

sabRN2b05, BSN, RN · Oct 21, 2004

Welcome to the wonderful world of nursing school tests! :chuckle
The other two posters had good advice... ABCs, get familiar with Maslow :)
Have a good feel for what the norms on VS (and later on lab values) are so that you'll know when you find an unusual number that there's a red flag.

I agree with all suggestions so far! And if there's an answer that says "assess" or "take VS" - that's usually the answer at my school.

lisamc1RN, LPN · Oct 21, 2004

I have my first exam like this tomorrow. I'm a bit nervous, but I hope I have a handle on it. I've been prioritizing and noting what comes first for everything we've learned. We've discussed Maslow, ABC's, and ADPIE. Our instructor has told us that if we remember these, then we should be able to pass the test without too much difficulty. I hope she's right. Good luck!

purplekath · Oct 21, 2004

We get sooooo many of these! I usually go through the case study with a highlighter and highlight all the relavant bits and symptoms, disregarding anything that's a red herring (they love to throw those in there). You'll become a hawk-eye before too long...look for words like "paralysis, labored breathing, pressure injury, poor skin turgor etc" and highlight those.

Then write them all into a list and start giving them numbers for priority. Remember that your first need is OXYGEN...so anything that impairs that (eg: breathing, airways, circulation etc) will be your first port of call. If there is nothing like that, think BRAIN...any kind of weird thing that could be caused by a problem in the brain, or after surgery where they might have sewn a nerve etc. When you have your number one priority, make that your first "assessment" and figure out what kind of assessment to do. Eg: If your patient comes out of surgery and is suddenly unable to move her lower body, then you'll do a neuro exam. If your patient is a long-term smoker who is coughing up sputum, then a respiratory assessment. If she's got a poor colour, maybe a cardio.

Then go down your list and figure out all the other priorities in order. You will begin to make natural connections that you hardly have to think about. If there is immobility, think "pressure injury". If there is poor skin turgor or any kind, assess for dehydration or over-hydration. Bloating, flatus, diarroeah, constipation - elimination needs must be met.

Further down the list, look at stuff that your pt has in situ - IDC, IVT, NGT etc...all that will need to be cared for. And of course vitals are always on there - how often will depend on what your priorities are and what has been compromised.

After that it is "comfort care"...washing, making beds, keeping the area accessible and tidy, ensuring social/emotional needs are addressed etc.

Then you can just put it all together in a document and hand in! And better still, if you've got it on your computer it can all be cut and pasted into a careplan in order of priority. Then you'll just have to fill in the blanks for goals, rationales etc.

stressgal, RN · Oct 21, 2004

ABC's.

Also do not forget about autonomy. That was a big one on our first quarter tests.

Good luck!

KRVRN, BSN, RN · Oct 21, 2004

With so much emphasis in school about assessing for and treating pain, always remember that pain control comes after ABC's.