We've had so much contradictory teaching so far. We've been drilled with the RACE acronym, then today we had a test where the correct answer out of the four options within RACE was to pull the alarm. What?? Last time we were tested on this the correct answer was to rescue. Why isn't there any consistency?
Then we had another question on DKA, which we've never covered by the way, on our acid-base exam. Well out of the choices given, two of them were incorrect for sure (i.e., dextrose IV), so it came down to O2 or sodium bicarb. The question focused on their breathing and what collaborative care we would provide. Well, I knew from past reading on my own that HCO3 was a last resort and deemed fairly unsafe in most cases unless the pH was less than 7.00 and special circumstances existed. Cerebral edema, over correction, cardiac issues, and so forth puts bicarb at the bottom of the list of treatment measures. Since we weren't given any ABG values in the question or anything to suggest the patient was in a poor state, I went with O2. Is O2 that helpful? I have no idea. However, the Med-Surg book puts O2 high on the list of initial interventions, then fluid replacement, insulin, and potassium. Well, the instructor wasn't swayed by our reason for picking O2 over bicarb.
This kind of thing happens all the time. Another question we had dealt with Foley placement. We were told in lab not to inflate the balloon prior to insertion, as research had shown that it can cause irritation going in the urethra. On our exam we answered the question dealing with a Foley so as not to inflate the balloon. Well we were marked wrong. Surprisingly, someone found in the book that is does say not to inflate the balloon to test it. Didn't matter, we weren't given the point.
Every week we take a test we argue with the teacher and wonder what the point of all of this is. They keep going on about "critical thinking", but it is way more a game of craps since the majority of our tests have more than one right answer and if you choose a "wrong" one but show the teacher another nursing book (NCLEX review) or the one we've been given that backs up our answer, you're shot down. They will actually say "The book is wrong". Okay, so my Saunders NCLEX review book is wrong??
I missed another one today regarding the defintion of palliative care. They had home care, hospice, and a couple choices that were more acute. I chose home care simply because palliative care is not limited to the dying patient and hospice. That is not the core definition of palliative care, which is often used in treatment of chronic conditions. Well, the teacher seems to think palliative is synonymous with hospice, and that palliative care does not pertain to the maintenance of long-term chronic disorders.
I think nursing school has so many problems in how they "teach", jumping out of sequence regarding topics (e.g., covering ethics and law after physical assessment), preventing the use of medical books to better understand diseases or write papers, giving to little time to skills lab, ect....
We are lucky. In my program there is a standard policy for challenging exam questions. As long as your rationale comes from a reputable up to date source you are given credit for your answer. There have been several times that I have done this and received credit everytime, and I know plenty of other classmates that have too. It really is a shame that some of you are in programs where the ego of the instructor takes prescidence over what is fair and right.
I disagree in the sense that palliative care is not limited to hospice even though too many people seem to think it is the same thing. Home care, rehab, LTC, and other treatment modalities can fall under the guise of palliative care. Just because hospice is considered a palliative form of care doesn't make it exclusive to hospice. A patient receiving continuing care is getting palliative care, whether they're paralyzed and doing fine or dying in 6 months from CA. Palliative Care vs. Hospice Care - Definition
I see what you mean, but that isn't the point. They are teaching people that palliative means hospice, to be used interchangeably. One student even claimed it meant the same thing to me because she had worked in the field as an MSW for a couple years.
I'm fine with missing that question, but it sends the wrong message IMO. People don't seem to understand what palliative means. A schizophrenic on life-long antipsychotic meds is getting palliative care. They simply aren't being cured.
While you are correct about the definition of palliative care, what folks mean when they say palliative care is overwhelmingly end-of-life care. For instance, I've never heard anyone speak of diabetic treatments as "palliative care" although technically they are alleviating symptoms and not providing a cure.
To 2ndyearstudent, that's a pretty offensive thing to say that these nurses aren't good teachers, especially since a LOT of instructors are on this site. While some are better than others, they got an MSN in education in order to do what they do(at least at my school they did). Secondly, don't sit there and generalize about instructors sucking at writing good test questions. Some questions are better than others..and again at my school, each test is approved by the dean prior to being administered. And no...they don't all come from a bank, that I do know. And that's just not smart to say about grade deflation. We've had tests were the average can be in the 60's and someone still gets a 98. The reason that people don't have high scores is because they didn't earn a high score, no one else's fault. A lot of times they justify that by saying "the teacher can't have more than half the class pass, they gotta weed people out". Excuses excuses...
I made it through nursing school without making a single C in a class..while more than half the people I started with failed. They failed because THEY failed, not because the teacher weeded them out.
And to the OP...in the real world, on the NCLEX, and in school, there will always be more than one right answer. And based on the choices given, you might not see the answer you want, but take what you have and go with it.
Pick the answer that will fix the problem. And who cares what the Saunder's book says? Is that a book on your required list? Saunders could have a chapter titled "Everything in nursing school is wrong", that's the problem with having so many outside sources. They will ALL say something different due to different research.
Was your RACE question asking what would you do FIRST? Or just asking what a letter meant? You never gave any info
To 2ndyearstudent, that's a pretty offensive thing to say that these nurses aren't good teachers, especially since a LOT of instructors are on this site. While some are better than others, they got an MSN in education in order to do what they do(at least at my school they did).
I don't think it's offensive to say that good nurses aren't necessarily good teachers. Teaching is a skill set unto itself, and, unfortunately, higher education doesn't always recognize that fact. The nursing profession at least acknowledges it by providing a course of study to become a Certified Nurse Educator, but not every nursing professor is required to have a CNE to teach in a nursing school. I think it's great that your school does require it, but it certainly isn't a universal policy.
OP, I think regarding the majority of your concerns, you are dealing with instructors who neither write their own tests nor select exam questions that they coincide with the points they stress. They just sound like lazy educators to me.
Palliative care is not limited to hospice care. Hospice care is meant specifically for those approaching the last stages of life, while palliative care is appropriate for any stage of a serious illness. The goal of palliative care is to relieve the pain, symptoms and stress of serious illness - whatever the prognosis.
And to the OP...in the real world, on the NCLEX, and in school, there will always be more than one right answer. And based on the choices given, you might not see the answer you want, but take what you have and go with it.
Pick the answer that will fix the problem. And who cares what the Saunder's book says? Is that a book on your required list? Saunders could have a chapter titled "Everything in nursing school is wrong", that's the problem with having so many outside sources. They will ALL say something different due to different research.
Was your RACE question asking what would you do FIRST? Or just asking what a letter meant? You never gave any info
Actually there will some key word or phrase that will make one answe right and all the others wrong - also, something that confuses some students in my class are questions about what you would do 'first'. There might be 4 answers in which two have nothing to do with what's being asked and then two that are steps you would take sequentially while performing the task - but they won't be the first, second or third ones. They may be the sixth and ninth. The one you would do first is the sixth one (in context of the question - it's the first you'd do of the answers given, even if not the actual first step of the given task starting to perform it).
And to the OP...in the real world, on the NCLEX, and in school, there will always be more than one right answer. And based on the choices given, you might not see the answer you want, but take what you have and go with it.
Pick the answer that will fix the problem. And who cares what the Saunder's book says? Is that a book on your required list? Saunders could have a chapter titled "Everything in nursing school is wrong", that's the problem with having so many outside sources. They will ALL say something different due to different research.
Was your RACE question asking what would you do FIRST? Or just asking what a letter meant? You never gave any info
The RACE question was a "what would you do first" type with the four choices. Pull the alarm was priorty over rescue...
I understand what you are saying about more than one right answer and picking the best one. We've been told that over and over again, but the questions we get aren't that straight forward. Like the one about inflating the balloon on the Foley. That was just a bad question and plain wrong according to our book and latest research. Yet, we were still told that is too bad. That is like teaching nursing students to use Thorazine or Risperdal, then testing us on a first line treatment and marking us wrong when we answer Geodon or Abilify in the maintenence of a psychotic disorder.
Not to mention, how are we supposed to learn and prepare for the NCLEX if using a Saunders book or other review book along with our teaching gives us conflicting data? If two sources say two different things, then you are gonna go into the NCLEX not having a clue how to answer. I want to learn nursing, but I need to pass the NCLEX to work as a nurse!
yep this is why i quit nursing school and switched to a major that had some consistency and well...logic
Yeah, and if I were younger and in a different place I would do the same. I'm actually doing very well and much better than a lot of my classmates, however, I just find the process more than aggravating.
Another example is with one instructor telling us that crackles and rales are two different things. So now, those in the class concerned about details think that a difference exists between the two terms. In reality, in 1977 the American Thoracic Society and American College of Chest Physicians decided to make crackles the only term as standard nomenclature and advice against using rales or even crepitations in the US. Too many clinicians, nurses, and resp workers were making a distinction between rales and crackles. Rale in just the French term for rattle, but in the clinical sense, the sounds are the same. Obviously, you have fine and coorifice, but my instructor wanted us to think that crackles were fine and rales were coorifice.
I have noticed though that even some doctors and other ancillary personnel think a small difference exists. Seriously though, 1977 and people are still using "rales"?
Not to mention, how are we supposed to learn and prepare for the NCLEX if using a Saunders book or other review book along with our teaching gives us conflicting data? If two sources say two different things, then you are gonna go into the NCLEX not having a clue how to answer. I want to learn nursing, but I need to pass the NCLEX to work as a nurse!
Lol go peak into the NCLEX forum and see the thousands of threads about conflicting books and sources, and how books say the opposite of what is taught in school. Saunders will say the opposite of Kaplan, ATI, Hurst, among tens of others. No 2 books will be the same. I'll tell you from my experience...the NCLEX was VERY straight forward and it was easy to pick out what they did or did not want.
thatpasunshine
91 Posts
We are lucky. In my program there is a standard policy for challenging exam questions. As long as your rationale comes from a reputable up to date source you are given credit for your answer. There have been several times that I have done this and received credit everytime, and I know plenty of other classmates that have too. It really is a shame that some of you are in programs where the ego of the instructor takes prescidence over what is fair and right.