Test Taking StrategiesTHINKING IS THE HARDEST WORK THERE IS, WHICH IS THE PROBABLE REASON WHY SO FEW ENGAGE IN IT. -HENRY FORD

Left-Hemisphere versus Right-Hemisphere Brain Processing

Left-Hemisphere Right-Hemisphere

Rational Problem-solving strategies and logical sequencing.

Main ideas to establish relationships that can be abstracted as the foundation for intuitive problem solving.

Rational learners break down situations into components and look for universal rules and approaches that can be applied in all situations.

First learns from content and experience then applies and analyzes principles

Examinations

1. Must be approached as learning opportunities.

2.Review before turning in.

3. Identify key concepts: -”What is happening?”

-”What should I do?”

Remember: If all your energy is spent on defending your response, then your mind is not open to different perspectives, which ultimately limits your learning.

Critical Thinking Requirements

Identify assumptions.

Use a method to collect and organize information.

Validate the accuracy and reliability of collected information.

Determine the significance of collected information.

Determine the inconsistencies in collected information.

Identify patterns of patient responses.

Identify stressors and common responses to stressors.

Identify gaps in information.

Determine relationships in given information.

Identify actual problems and patients who may be at risk.

Establish priorities. (Maslow’s)

Patient-centered realistic measurable goals with time frame.

Identify appropriate nursing actions.

Evaluate outcomes.

MASLOW’S HEIARCHY OF NEEDS

Knowledge is a treasure, but practice is the key to it

Applying Critical Thinking

Think of it this way:

“We cannot stand in the same river twice, because water rushes away as new water takes its place and the rushing water changes the river bed. The decisions we make today may not fit circumstances that change tomorrow.”

IN OTHER WORDS; NO CLINICAL AND PATIENT SITUATION WILL BE EXACTLY LIKE A PREVIOUS EXPERIENCE.

One different factor in a situation can change the entire landscape of the situation.

Components of a Question

1. Item

2. Stem

3. Option

4. Correct Answer

5. Distractors

Item

The entire MCQ

Objective

STEM

This is first part of the item that asks the question.

Key words: FIRST, INITIALLY, BEST, PRIORITY, SAFEST AND MOST

These words occasionally are emphasized by an underline, italics, Boldfaced, or CAPITALS.

Positive polarity words: Understand, apply or differentiate correct information

Negative polarity: Contraindicated, further, unacceptable, least, NOT, never, least, avoid. These identify interventions that are unacceptable.

Option

The second part of the item

Possible responses

Options can be a sentence (Before performing a procedure, what should nurse do 1st? Collect the equipment for procedure, position pt. for procedure, explain procedure to pt., raise the bed to highest position)

Completes the sentence begun in the stem (The RN understands that the primary etiology of obesity is? Lack of variety nutrients, glandular disorder prevents weight loss, caloric intake that exceeds metabolic needs, psychological prob that causes overeating)

Can be an incomplete sentence (which nursing intervention is common when caring for all pts. w infections? Donning a mask, wearing a gown, washing hands, discouraging visitors)

Just a single word (What is the nurse doing when formulating a nurse dx? Planning, assessing, analyzing, implementing)

Correct Answer

There is one BEST correct answer

Distractors

Remaining answers which house incorrect answers

Designed to make you doubt and distract you away from the correct answer.

Step 1: Identify the KEY CONCEPT being tested

What is happening?

What should I do?

Need to: RERAME, CRITIQUE AND EVALUTATE STEM

ANSWER BEFORE LOOKING AT CHOICES

A patient has just returned from the operating room with a Foley catheter, IV line, and oral airway & is still unresponsive. Which nursing assessment should be made first?

1. Check the surgical dressing to ensure that it is intact.

2. Confirm the placement of the oral airway.

3. Observe the Foley catheter for drainage.

4. Examine the IV site for infiltration.

KEY CONCEPT: Priority of care for the unresponsive patient

Key words that answer What is Happening?

Postoperative patient

Oral airway

Unresponsive

Key words that answer What should I do?

Assessment

Should be made first

Question being asked: What assessment takes priority when caring for an unresponsive postoperative patient with an oral airway?

ANSWER: Confirm placement of oral airway

The abc’s of life support, which refer to Airway, Breathing and Circulation, thus maintaining an airway takes PRIORITY.

Falls under Maslow’s hierarchy of needs with physiological needs; BREATHING.

Explore The Consequences Of Each Nursing Action In Each Alternative

ASK MANY DIFFERENT QUESTIONS:

Is the action safe?

Is the action unsafe?

Is the statement true?

Is the statement false?

Is this a fact?

Is this an inference?

2. Avoid reading into the Question; do not rewrite the question Ask yourself:

Did I read additional information into the stem of question?

Did I have difficulty deciding among the options because I would have done something completely different?

Did I delete an option because my experience was different from the patient situation presented?

Did I view the question in light of a more sophisticated level of curricular content than that being tested?

Did I view the patient scenario in more depth than necessary?

Change the Focus of the Question

To explore additional situations using MCQ is to change one of the key facts in the stem of the question in order to alter the focus of the question.

AND

Identify the next best option that answers the question.

Which is associated with a physiological need of a patient with a colostomy? 1. Disturbance in body image

2. Inadequate nutrition

3. Lack of knowledge

4. Skin breakdown

“Physiological” modifies the word “need” and is the CLUE in the STEM Therefore the correct answer is 4

SKIN BREAKDOWN

Change physiological to psychological within the stem

Which is associated with a psychological need of a patient with a colostomy?

1. Disturbance in body image

2. Inadequate nutrition

3. Lack of knowledge

4. Skin breakdown

Now the ENTIRE focus has changed

Correct answer is now 1 – Disturbance of body image

CLUE in the STEM is NOW:

PSYCHOLOGICAL

Cognitive Levels of Nursing Questions

1. Knowledge

2. Comprehension

3. APPLICATION

4. Analysis (synthesis and evaluation)

Knowledge Questions

Require you to recall or remember information.

Commit facts to memory

Expect you to know: terminology, facts, classifications, principles

What is the expected range of a radial pulse in an adult?

1. 50-65 BPM

2. 70-85 BPM

3. 90-105 BPM

4. 110-125 BPM

To answer correctly you have to know the range of an adult radial pulse

70-85 BPM is within the expected range of 60-100 in an adult.

To Increase your knowledge

Memorize

Use Alphabet cues

Use Acronyms

Acrostics

Mnemonics

Memorize

Use of repetition

Facilitate by using lists, flash cards or learning wheels

Alphabet Cues

CAB’s

3 P’s of diabetes: Polyuria (U)

Polydipsia (T)

Polyphagia (H)

Acronyms; word formed from letters of a series of statements

Infection remember the word INFECT:

I: Increased P/R/WBC

N: node enlarge

F: function impaired

E: erythema, edema and exudate

C: C/o pain

T: Temperature ↑

Acrostics: phrase or motto where first word prompts memory for rest Studying fat soluble vitamins remember motto:

“ALL DIETERS EAT KILOCALORIES”

A, D, E, AND K ARE FAT-SOLUABLE VITAMINS

Mnemonics: similar to acrostic except not q word is r/t piece of content

“There are 15 grains of sugar in 1 graham cracker” therefore

15 grains = 1 gram

HDL and LDL

Happy cholesterol and lousy cholesterol

COMPREHENSION QUESTIONS

Must understand the information

Commit facts to memory – as well as – translate, interpret, determine implications of the information, consequences and effects.

I.e.) A nurse uses the interviewing technique of clarification when interviewing a patient. What is the nurse doing when this communication technique is used?

1. Paraphrasing the patient’s message.

2. Restating what the patient has said.

3. Reviewing the patient’s communication.

4. Verifying what is implied by the patient.

You have to know:

Clarifying is a therapeutic tool that promotes communication between the patient and the nurse (knowledge) & you must explain why or how this facilitates communication (comprehension).

ANWER IS 4

4. Verifying what is implied by the patient.

CLARIFICATION IS A METHOD USED TO VERIFY THAT THE PATIENTS MESSAGE IS UNDERSTOOD AS IT IS INTENDED

CAN BE USED TO GAIN MORE INFORMATION WITHOUT INTERPRETING THE ORIGINAL STATEMENT.

***APPLICATION QUESTION***

Requires you to show, solve, modify, change, use or manipulate information.

May be theories, technical principles, rules of procedures.

Test ability to use information that has been taught.

I.e.) A nurse is going to assist a heavy patient higher in bed. What should the nurse do to prevent self injury?

1. Keep the knees and ankles straight.

2. Straighten the knees while bending at the waist.

3. Place the feet together and keep knees bent.

4. Position the feet apart with one foot placed forward.

Answer: Must know & understand principles of good body mechanics4. Position the feet apart with one foot placed forward.

Both actions provide a wide base of support that promotes stability; placing one foot in front of the other facilitates bending at the knees, which permits the muscles of the legs, rather than back, to bear the patient’s weight.

ANALYZE Information

Interpret a variety of data, recognize commonalities, differences and interrelationships among presented ideas.

Learn to discriminate

Differ3enciate the significance of information

I.e.) BLOOD PRESSURE

First you will memorize the normal range (knowledge)

Then you develop an understanding of what factors influence and produce a normal blood pressure (comprehension)

Then you identify a particular patient situation that necessitates obtaining a BP (application)

Now differentiate among a variety of situations to determine which has the highest priority for assessing the BP (analysis)

Analysis promotes higher acuity thinking

Identify those differences:

Causes of hypertension each ↑ for different reason Infection (↑ in metabolic rate)

Fluid retention (causes hypovolemia)

Anxiety (constricts the blood vessels)

PRACTICE TEST TAKING

Reinforces learning

Identifies learning

Understand and grasp concepts

Identifies nursing interventions

Applies principles

Analyzes information

Applies critical thinking skills

By Arthur Guiterman

“ BOTH MINDS AND FOUNTAIN PENS WILL WORK WHEN FILLED, BUT MINDS, LIKE FOUNTAIN PENS, MUST BE FILLED.”