1、STUDY SKILLS EXTRA HELP SESSION,Test Taking Strategies For Success,Critical Thinking Applied to Test Taking,Educational Domains Components of Multiple choice questions Cognitive level of Nursing questions,Educational Domains,Nursing as a discipline includes three domains Affective Domain: concerned
2、with attitude, values and development of appreciation. Ex. The nurse quietly accepting a patients statement that there is no God without imposing personal feelings. Psychomotor Domain: concerned with manipulative or motor skills Ex. Is the nurse administering an IM. Cognitive Domain: concerned with
3、the recall, comprehension, development and application of knowledge and skills. Ex. The nurse clustering collected data, and determining its significance.,Components of a Multiple Choice Question,Each item (multiple choice question) has two parts: Stem: part that contains the information topic, para
4、meters, asks the question Option: one or more possible responses,Cognitive Levels of Nursing Questions,Four types Knowledge: - recall Comprehensive: - understanding the meaning and intent of remembered information Application: emphasis is on remembering understood information and utilizing it in new
5、 situations Analysis: emphasis is on comparing and contrasting a variety of elements of information,The Race Model : The Application of Critical Thinking to Multiple Choice Questions,R: Recognize the key words in the stem Recognize what information is in the stem Recognize who the client is in the s
6、tem Recognize what the topic is about A: Ask what is the question asking? Ask what are the key words, that indicate a response Ask what the question is asking me to do C: Critically analyze the options in relation to what is asked in the stem Critically scrutinize each option in relation to what is
7、asked Critically identify a rationale for each option Critically compare and contrast the options E: Eliminate as many options as possible Eliminate one option at a time,Critical Elements of a test question,Key words (early-late, immediately, postoperative period) The client (the client in the quest
8、ion) The issue (Problem or subject the question is asking) The type of stem (positive or negative),Eliminate incorrect options (1-5),Distracters Avoid misreading test questions1. Separate the case scenario and stem, identify the client, the issue and type of stem2. Identify Key words3. Avoid reading
9、 into the questionsa. Restate question in own wordsb. Eliminate any option which include “new” information that was not give in the case scenarioc. Avoid misinterpreting disorders (review carefully; focus on areas of difficulty),In preparing to give a client a bed bath, the nurse would:,A. Place the
10、 bed in the lowest position B. Expose the top side of the body, washing and drying quickly, then doing the same on the posterior side C. Gather all articles necessary for the bed bath and place them where they will be within easy reach of the nurse during the bath D. Use firm, scrubbing strokes to r
11、emove dirt and bacteriaAnswer: C,The nurse is preparing to give a morning medication. The first nursing action in this activity is to:,A. Read the label B. Check for the right dose C. Wash the nurses hands Check for the right timeAnswer: C,A client who has right sided weakness needs to be transferre
12、d from his bed to a wheelchair. In transferring the client, the nurse must remember to:,Keep the client at arms length while transferring him Bend at the waist to get down to his level Maintain a straight back and bend at the knees. Try to transfer the client alone, before determining the help is ne
13、ededAnswer: C,4. Client A and Client B are sitting in the day lounge. The nurse has medication to administer to client A. When the nurse enters the lounge, Client B says to the nurse “I see you found me to give me my pills” The best nursing response would be:,“I dont have any pills for you, Client B
14、” “Let me check your identification armband, and I will check to see if you are supposed to receive any pills “Client A, I have pills for you to take, but none for Client B” “Client A, would you please take these pills”Answer: B,The nurse must lift a heavy object which is found in the hallway. Which
15、 is the best approach when the nurse must lift a heavy object?,A. Lift the object at arms length so all of the arm muscles are being used. B. Bend from the waist, using a wide stance, so that the leg muscles of the body are used C. Maintain good body alignment and use the large muscles of the body D
16、. Bend at the knees and use the large leg muscles when lifting the objectAnswer: C,Choosing between the two best options,Identify the global response 1. Global response: is a general statement which includes correct idea form other options Practice steps: (6-8)a. Identify critical elementsb. Evaluat
17、e stem: Positive or negativec. Eliminate options that do not match the stemd. Compare remaining options- look for global response option,A client returns with a foley catheter after surgery. In providing catheter care, which is the best nursing approach?,Preventing infection and maintaining a patien
18、t catheter and drainage system Keeping the collection bag above the level of the bladder Using soap and water to clean the perineal area Maintaining a closed system without any kinks in the tubing Answer: A,While getting a elderly client who is very weak out of bed and into a wheelchair, the best nu
19、rsing approach initially is to:,Lock the wheels of the bed Position the equipment to provide the safest transfer that is possible for the client Align the wheelchair as close to the bed as possible, to prevent the client from falling to the floor Remove the leg support on the wheelchair on the side
20、closest to the bed Answer: B,In a long-term care facility, the nurse finds an elderly client on the floor. After having the client examined by the physician, the most important nursing action is to:,Call the family and ask them to stay with the client Provide for the safety and protection of the cli
21、ent Apply wrist and leg restraints to prevent the client from falling from the bed Obtain an order for medication to sedate the client Answer: B,Choosing between the two best options cont.,Eliminate similar distracters 1. There is only one correct answer. If two options say the same thing or include
22、 the same idea, neither can be correct Practice steps: (9-13)A. Review the questions: identify the critical elementsB. Narrow your choices C. Use the similar distracter strategy and look for the option that is different,One of the most important nursing actions in the care of the elderly is to:,Avoi
23、d drying agents when providing skin care Encourage the client to perform as many activities of daily living as possible Gently apply moisturizing lotions to pressure areas Apply powder to moist folds in the skinAnswer: B,A newly diagnosed adult diabetic is doing a return demonstration of the proper
24、technique for insulin injection. He draws up the correct dose of insulin using the proper technique, but when he is ready to inject the needle, he hesitates and says, “Im not sure I can do this.” Which response by the nurse would be best initially?,“Ill show you again how to inject the needle.” “Ill
25、 inject the needle for you this time.” “Youre doing fine so far. Give it a try” “Why are you so nervous? Do you need help?”Answer: C,An obese client had been placed on a high-protein, low-calorie diet by his physician. Which nursing action is most appropriate?,Explain to the client the he will have
26、to change his eating habits Explain the importance of exercise when dieting Explain to the client what types of foods are permitted on a low calorie, high protein diet Tell the client that if he doesnt stay on this diet he will continue to gain weight Answer: C,A client tells the nurse that his last
27、 name is not spelled right on his identification bracelet. The appropriate nursing action is to:,Tell the client that as long as his medical record numbers are correct, the mistake is not a problem Ask the client for the correct spelling, and change his name in his chart. Notify the admitting office
28、 of the error and obtain correct identification bracelet for the client Notify the physician of the error Answer: C,A client is admitted to the hospital for evaluation of inadequate circulation to her lower extremities. The doctor orders a tub bath at the clients request. In assisting the client wit
29、h her bath, which nursing action would be unsafe?,Place a rubber mat on the bottom of the tub Fill the tub approximately half full When the client steps into the bath, ask her if the water is the right temperature for her Obtain all the necessary supplies and place them within easy reach of the clie
30、nt. Answer: C,Answering Communication Questions,Use test question logica. Identify the clientb. Identify the issue/problem/feelingc. Identify the type of stem B. Eliminate distracters (14-21)1. Correct answers have a therapeutic responsea. Therapeutic communication tools: being silent, offering self
31、, showing empathy, focusing, restatement, validation/clarification, giving information, dealing with the here and now2. Communication blocks are the distracters. Communication blocks prevent therapeutic communicationa. Communication blocks: giving advice, showing approval/ disapproval, using clich a
32、nd false reassurance, requesting an explanation, devaluing clients feelings, being defensive, focusing on inappropriate issues or persons, places clients issues on hold,Answering Communication Questions cont.,Using communicationa. Address the clients feelings Client- centered responsesb. Analyze the
33、 introductory statement1. Physical problems are addressed first2. Use the nursing process: is more information needed?3. If the client is upset, feelings must be address first,An elderly male client is admitted to the hospital. His son asks the nurse what he should do concerning his fathers hearing
34、problem. The nurses best response to the son is:,“As people get older, they tend to have hearing problems” “Your father will need to be seen by a specialist” “I would ask your father how he feels about his hearing loss” “What kind of hearing problem does you father have?” Answer: D,A client is in ho
35、spital because of severe weight loss and refusal to eat. The physician orders the insertion of a NG tube for feeding. The nurse find the client with the tube removed. The client tells the nurse the he “doesnt need that thing”. The most appropriate nursing response is:,“You shouldnt have done that! N
36、ow I have to put it down again.” “Why did you pull that tube out? Do you want to die?” “Tell me what you dont like about the tube” “Your doctor is going to be really upset with you for doing this” Answer: C,A female client is schedule for cardiac bypass surgery in the morning. She says to the nurse,
37、 “I dont think Im going to have the surgery. Everybody had to die sooner or later” The most therapeutic nursing response is:,“if you dont have the surgery, you will most likely die sooner.” “There are always risk involved with surgery. Why have you changed you mind about the operation?” “Cardiac byp
38、ass surgery must be very frightening for you. Tell me how you feel about the surgery” “I will call you doctor and have him come in and talk to you Answer: C,A male nurse has received a doctors order to catheterize one of his female clients. The client says, “Im not going to allow a male nurse to cat
39、heterize me.” The nurses best response is:,“Your doctor is a male. Would you let him catheterize you?” “Ive done this many times with no problems.” “You can explain to your doctor why the catheter wasnt inserted.” “You appear to be upset. Let me find a female nurse to help with this procedure.”Answe
40、r: D,A male client is admitted to the hospital for surgery after finding a lump in his right testicle. He asks the nurse, “Do you think that the doctor will find cancer?” The most appropriate nursing response is:,“ Most lumps found in the testicle are benign.” “It must be difficult for you not to kn
41、ow what the doctor will find.” “I think that you should discuss this with your doctor.” “It might be, but the doctor wont know until the surgery is performed.” Answer: B,A client is admitted to the hospital with abdominal pain. She overhears her doctor and her nurse discussing cancer of the liver. L
42、ater, she says to the nurse, “Having cancer of the liver must be a terrible thing.” Which is the best nursing response?,“Yes, it is a terrible disease.” “What made you think about cancer of the liver?” “Any kind of cancer is terrible, but you cant live without a liver.” “Yes. A client on this floor
43、has it and it is very said for everyone.” Answer: B,The nurse is teaching a female client about self breast exam. The client tells the nurse that she doesnt understand why she is being taught this, since she doesnt plan on doing it anyway. The best response by the nurse is:,“Self breast exam is taug
44、ht to women in order to detect any lumps or changes in the breast which can be an early sign of cancer, because early treatment had a higher rate or cure” “Youre right. If you dont plan on doing the exams, then I dont need to show you how to do it.” “If you dont plan on doing the exam yourself, then
45、 you should have your doctor do it at your annual check up.” “You have the right to do whatever you choose. It is your body.” Answer: A,A confused elderly female client has wet herself and is standing in the hospital corridor in a puddle of urine. She has trouble getting to the bathroom in time. She
46、 looks ashamed. She says to the nurse, “I want to go outside for a walk now.” What is the most appropriate response by the nurse at this time?,“Before we go for a walk, perhaps we can make a list that will help you make your bathroom trips easier.” “Right now, let me wipe up the urine on the floor,
47、and lets get a change of clothing. I am sure that this problem is upsetting for you.” “This had been a problem for you. Lets see if we can find a solution together.” “Wetting yourself is very upsetting, Yes, lets take a walk.” Answer: B,Priority setting questions (22-27),Decision making questions in
48、volving setting priorities. Common words used in priority setting test question are:1. Initial response2. Essential nursing action3. Vital considerations4. Immediate attention5. Priority nursing action6. Best Nursing judgment7. Most important,Priority setting questions cont. (22-27),Priority-setting
49、 guidelinesa. Nursing process Assessment received priorityb. Maslows Hierarchy of needs ABCsc. Communication theory Tools and feelingsd. Teaching/Learning theory Motivation is key,A client, 21 years old, is admitted to the hospital because of extreme weight loss. It is noted on the admission assessm
50、ent that the client believes that she is overweight at 88 pounds. What aspect of care should the nurse consider her first priority?,Assessing the clients nutritional status. Obtaining a psychiatric consult Planning a therapeutic diet for the client Talking to the family members to find out more about the client self conceptAnswer: A,
