Stupid Test (Rant)

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Today we had our second exam of the semester. The very first question was about the chain of infection:

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We have been taught that this "chain" is like a cycle that can begin or end at any point.

Anyway... The question was (multiple choice) Which of these is the proper sequence for the chain of infection?

A. (something wrong)

B. (wrong order)

C. Susceptible Host; Causative Agent; Reservoir; Portal of Exit; Mode of Transmission; Portal of Entry

D. Causative Agent; Reservoir; Portal of Exit; Mode of Transmission; Portal of Entry; Susceptible Host

Well, I wound up getting the "correct" answer (which they claim was "D") but it still really bothers me.

I said to my instructor while taking the test "these are both correct" to which she replied "well, you'll just have to use your critical thinking skills." :angryfire

Using my critical thinking skills I decided that they usually began with the causative agent when listing them. But I did still spend about 15 minutes on that question. I was sure that "D" must have the wrong order or something and that they wanted to make sure that we understood that the chain could begin or end at any point.

After the test was over, I complained about that question again. My instructor said that "D" was "more right" because "we treat sick people, so you want to trace it back to the causative agent."

Which didn't make a whole lot of sense to me. I told her that I didn't think that option C was any "less right" since prevention is stressed to us, you would want to break the chain at the susceptible host.

I went back to work and complained about this poorly worded question and I heard from another nurse that I needed to use my "critical thinking skills." :angryfire

I am sure that she thought I was just whining and wanted to weasel another point out of the test, but that is not the point! I did answer it "correctly" - I am just frustrated with the fact that neither answer was better than the other! Especially when they reinforced to us the fact that it can begin or end at any point!

IF answer "D" was in fact a "better" answer, could somebody explain to me how it is?

Thank you for letting me rant.

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I would say D would be better only because you would want to know what infected the person, so that you could maybe stop the chain via contacting the health dept., etc. I dunno. Just a guess. Looks like some of the questions on my exams. Just makes you wonder sometimes which way the wind was blowing huh!

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wouldn't want to offend anyone

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This question is assuming that the causative agent was transmitted from one person to another. Although both look correct, we were taught in micro that to show the "flow" you would always start with someone already infected with the causative agent.

Obviously in a real world scenario this would not be how it works, since the chances of knowing where the causative agent began would not be the case, which our professor also pointed out.

I definitely agree with you that it was a poorly worded question and definitely debatable if your instructor did not emphasize that you should begin with the causative agent.

Hey at least you got it right and can move on!! :coollook:

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At my school we were taught that it begins with the "agent".

You also have to think of other diseases that cannot be communicated person to person, such as a Tetorifice or an something that comes from an animal (acting as the reservoir) like perhaps Rabies (I don't think rabies can be transferred human to human, or if it does most people don't give it to each other).

Also, note how all the other steps (Reservoir, Portal of exit, mode of transimission) are related to the agent, not the host.

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The reason I would go with D is because the stem of the question asked for the chain of "infection". In other words we are all susceptible host (who have yet to be infected) but an infection can only be attributed to a causative agent (microbe) so that would be the 1st step in the chain, eventually the microbe moves on till it finds another "susceptible host".

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Specializes in Rehab, Step-down,Tele,Hospice.

Although I agree its good practice for NCLEX, and I'm glad you got it right, it was a stupid question, the wording was very confusing, contradictory to say the least. Gosh ain't nursing school grand?

Lovin every minute of it!

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I don't understand...If you got it right, then why are you angry? Why did you pick that answer (that turned out to be, indeed, the right answer)? Apparently, out of the other choices, it was the BEST answer, right? Isn't that what nursing tests are all about. Good answer, better answer, BEST answer.

Congrats on picking the BEST one!

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The reason I would go with D is because the stem of the question asked for the chain of "infection". In other words we are all susceptible host (who have yet to be infected) but an infection can only be attributed to a causative agent (microbe) so that would be the 1st step in the chain, eventually the microbe moves on till it finds another "susceptible host".

Wow! That really made sense. Thank you!

And thank you all for you kind responses. I know that everyone I have bothered with this has said that I should not complain because I got it right... but whenever I get an answer wrong, I want to know why so that I don't repeat the mistake and if I happen to get an answer right I want to be able to understand why that was the correct answer, so that I will know it in the future.

Again, thank you all for your replies. :)

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