Understanding NCLEX Type Questions

Published

Hi, Can anyone help me with NCLEX questions. I have an exam tomorrow that I have been studying for and while I have been studying and doing several NCLEX questions I seem to be able to get the questions down to two answers and then I pick the wrong one. Perhaps someone can help me understand why choice A is really better than B.

For example Which statement would be an expected outcome for a client experiencing acute pain?

1) Decreased use of medication

2) Will participate in self-care activities

3) Will use relaxation techniques

4) will repeat instructions about medications

I was able to easily throw out 3 and 4 and I picked answer #1 but the answer is #2. The books answer is that if I patient still has acute pain they will not be able to participate in self care activities so that is why the answer is correct. I still maintain 1 is correct but I know w/ NCLEX questions you have to pick the better of the 2. So how do you really do that? To me this isn't really about knowing my stuff but more understanding how to answer a standardized test question.

Another example, the expected outcome for a post-op client who had general anesthesia would be

1) The client will have a urine output of 30 ml/hr or

2)The client will have a pulse ox of 97% on RA.

I was able to determine the other two answers I haven't listed here were wrong but I said the answer was 1 but the book says the answer is 2 since the patient had GENERAL anesthesia. I don't see how 1 is really wrong.

Any tips would be helpful. I feel like at times that I know my stuff but NCLEX exams do not show it (I know others have the same issues). Thanks.

Up Vote Up Vote ×
Specializes in med/surg, telemetry, IV therapy, mgmt.
which statement would be an expected outcome for a client experiencing acute pain?

1) decreased use of medication

2) will participate in self-care activities

3) will use relaxation techniques

4) will repeat instructions about medications

the answer is #2. the books answer is that if i patient still has acute pain they will not be able to participate in self care activities so that is why the answer is correct. i still maintain 1 is correct but i know w/ nclex questions you have to pick the better of the 2. so how do you really do that? to me this isn't really about knowing my stuff but more understanding how to answer a standardized test question.

the question is asking you about an expected outcome. an outcome is a goal. outcomes (goals) are expected results. goals are based upon the (nursing) interventions that are performed for the problem at hand (acute pain in this particular case). a reason (expected result) for giving the pain medication is not that the patient will be able to use less pain medication, but that they will be able to start to do things for himself.

the expected outcome for a post-op client who had general anesthesia would be

1) the client will have a urine output of 30 ml/hr or

2)the client will have a pulse ox of 97% on ra.

i was able to determine the other two answers i haven't listed here were wrong but i said the answer was 1 but the book says the answer is 2 since the patient had general anesthesia. i don't see how 1 is really wrong.

again, you need to focus on the outcome (goal) of anesthesia. in this case you needed to know that a primary goal (expected result) of the anesthesiologist is to keep the patient oxygenated. hence, answer #2 regarding the pulse ox would be the right answer. the anesthesiologist who does the anesthesia has no interest in the patient's urine output.

for a discussion of goals/outcomes, see post ##157 on https://allnurses.com/forums/f50/careplans-help-please-r-t-aeb-121128.html.

Up Vote Up Vote ×

Daytonite wrote "you need to focus on the outcome (goal) of anesthesia. In this case you needed to know that a primary goal (expected result) of the anesthesiologist is to keep the patient oxygenated. Hence, answer #2 regarding the pulse ox would be the right answer. The anesthesiologist who does the anesthesia has no interest in the patient's urine output."

Thank you. Your explanation makes sense. I will try and focus on the goal idea. I like the poin tthat the anesthesiologist doesn't care about the urine's output as much as he would be focused on the patient's lungs and pulse ox.

You always have great advice.

Up Vote Up Vote ×
Specializes in med/surg, telemetry, IV therapy, mgmt.

critical thinking with these questions involves taking the nursing process into account. remember the steps of the nursing process:

  1. assessment (collect data)
  2. nursing diagnosis (determine your patient problem, decide on the nursing diagnosis to use)
  3. planning (write measurable goals/outcomes and nursing interventions)
  4. implementation (initiate the care plan)
  5. evaluation (determine if goals/outcomes have been met)

these questions were questions that fit the nursing process. also, keep in mind that the nursing process is nothing more than a problem solving method. we solve problems every day of our lives using the same process and in the same sequence of steps. nursing just gave it a fancy name and gave us specific rules to follow when performing it. but, it is good, solid rational thinking.

if you have a nclex review book, read the beginning of it where it should discuss the strategy of answering these kinds of questions. the

basic strategy for answering critical thinking (application type) questions is as follows, you must:

  • know and consider the normal anatomy and physiology
  • know and consider abnormal anatomy for the disease in question
  • know and consider the resulting signs and symptoms when the disease occurs and how they proceed from mild to fatal - each sign and symptom can be related back to the pathophysiology of the disease
  • know and consider how the doctor diagnoses and treats the disease in question
  • know nursing interventions for the signs and symptoms you are being asked about
  • know the steps of the nursing process and what goes on in each of the steps and consider how they are affecting the question you are being asked
  • know and consider the principles behind the actions being done - there are many kinds of principles: principles of nursing, principles of biology, principles of chemistry, principles of physics, etc.
  • read the stem of the question carefully and answer that because the test makers try to trip you up by distracting you with conflicting information they give you in the answer choices that sounds good but has no relationship to what the question is asking for
  • ask yourself "why" a patient is experiencing some sign or symptoms to get at the underlying problem. nursing like other disciplines treats the problem/signs and symptoms.

you should also review the information on this thread:

Up Vote Up Vote ×

Just wanted to add that there is a great book out there called, Fundamentals Success by Nugent and Vitale that is just a book of NCLEX type questions with the rationales.

I have found it very helpful to go over tons of rationales to questions so that I can put the information together with the nursing process. Just a thought.

Up Vote Up Vote ×

Thanks to everyone who share their knowledge.I am still processing for Nclex and I am started reviewing,I am already nervous.

God Help us test takers...

Mommy Tata

Up Vote Up Vote ×
+ Join the Discussion