What is the method for success in nursing exams????

NurseguyFL · Mar 23, 2007

The problem you are having with the exam questions may be related to all those NCLEX books that you are reading. They may be helpful for passing NCLEX, but what you really want right now is to pass the instructor’s exams. I would put the NCLEX books aside and take a second look at the instructor’s previous exams. Were the exam questions consistent with the material covered in class and in the text? If you can recognize a pattern in the types of questions on the previous exams then that should give a clue on how to prepare for the next one. If, for example, the instructor likes to ask a lot of questions about pathophysiology then focus more on that. If she likes to ask a lot of questions about nursing interventions then focus more on that. If she is taking the questions from a test bank (as many nursing instructors do), then your textbook is a better study resource than the NCLEX books. If she is the type of instructor who makes up his/her own questions, class notes and the textbook are still a better resource than the NCLEX books.

Re your I&O question. The question doesn’t actually state that the IV infusion began at 1500, but we will assume that it did. If the IV is going at 125ml/hr then between 1500 and 1700 the patient received 250mls.

At 1700 he is given a 500ml bolus, which is supposed to run only for 1 hour. So, by 1800, the patient would have received 750ml. But he voids 50.

The doc wants the IV to be slowed back to 125ml/hr at 1800, and it runs at that rate until the end of the shift at 2200. So, that’s 125ml times 4hours, which is 500mls between 1800 and 2200. The patient voided an additional 70mls during that time.

The total IN would be 750+500. The total OUT would be 50+70.

Daytonite, BSN, RN · Mar 23, 2007

When it comes to answering multiple choice question which are of an application type and require using critical thinking and logic, you have to focus on the root of the question and what it is asking. Instructors will deliberately write answer choices that will attempt to "distract" you from the correct answer by giving you additional information in these answer choices that may have nothing to do with the question at hand. So read them very carefully. You have to be very watchful for this! Always go back to the original stem of the question to see if the answer choice is giving what is being asked. Also, with multiple choice and critical thinking questions you sometimes need to figure out where in the nursing process the question falls, so you need to know the steps of the nursing process and what goes on in each of the steps. The one thing that causes a lot of confusion is "assessment". There is the step in the nursing process of assessment, but there are also nursing interventions in the step in the nursing process of planning that involving assessing the patient's condition. It needs to be clearly defined in your mind that during the planning and implementation stages of the nursing process that assessment means monitoring, evaluating or observing the patient's already known or anticipated change in condition. This is quite different from assessment to collect data at the beginning of the nursing process. Prioritizing nursing interventions is something you will get from those NCLEX books of yours. Those books are very good about listing nursing interventions in the order of priority. There are just some things you have to do before others and, unfortunately, that has be learned by memorizing them if you are having trouble associating them with the pathophysiology going on. Sometimes the best way to prepare for exams is to pretend to think like the instructor and think up the kinds of questions you might get asked and how you would answer them. Do this as a group or with another student. Talk to your cat or dog or to the walls in your house. Do it out loud. We retain and remember way more when we speak things out than we do when we read silently to ourselves. This is proven fact.

Regarding your math question. . .I am getting a different answer than what NurseguyFL gets.

At 1500 a client is receiving 1000 ml of IV fluids at 125 ml/hr. At 1700 a 500 ml fluid challenge is ordered to run for 1 hr. In the last 2 hrs. the client has voided 50 ml of urine. At 1800 the physician orders to return to the previous infusion rate. At 2200 the client voids 70 ml. What is the client's total input and total output for that shift.

First of all a shift, in my experience, lasts for 8 hours and goes from 3pm to 11pm (1500 hours to 2300 hours). So, based on that you go through the problem sentence by sentence and break this problem down, like this. . .

Intake

:

1500 to 1700 (that's 2 hours) @ 125mL = 250mL infused

1700 to 1800 (that's 1 hour) @ 500mL = 500mL infused

1800 to 2300 (that's 5 hours) @ 125mL = 625mL infused

Total for the 8-hour shift (250 + 500 + 625)

1375mL (intake)

Output

:

Voided 2 hours into the beginning of the shift = 50mL

Voided at 2200 = 70mL

Total voiding for the 8-hour shift (50 + 70)

130mL (output)

MySimplePlan · Mar 25, 2007

Talk to your cat or dog or to the walls in your house. Do it out loud. We retain and remember way more when we speak things out than we do when we read silently to ourselves. This is proven fact.

:yeahthat:

I 'reteach' what I am trying to learn to the imaginary class that is beyond my kitchen table. Think "A Beautiful Mind" and you've got an idea of me talking to a bunch of people that aren't there. I try to speak clearly and with confidence, just as if I had to really go up there and recite what I interpret the concept to be. That solidifies it in your mind. It really does work. I know I probably look and sound like a big dork, and I would probably be mortified if someone saw me, but what the heck.It works for me, and with the fail rate in my current class, I'm pulling out everything I can do.

For me, Dork = RN :specs:

meandragonbrett · Mar 25, 2007

Determine what is being asked in the question. Reading the questions has a lot to do with doing well on exams. Always remember the order of the nursing process...Assessment is key. Always remember your ABC's when it comes to interventions. And last but not least, don't forget Maslow's needs. Good luck!