Monthly Archives: July 2011

Test Taking Tips

Exams in nursing school differ from traditional paper & pencil types. They’re computerized, timed & can only be progressed forward. They are also formatted for higher level of thinking, requiring the use of analytical and application critical thinking skills. It’s quite an adjustment for those of us who like to double check over their exams, especially when one question triggers an answer to a previous question. The most challenging questions, from experience, are those where all the answers are right but you have to choose the “most right” answer & communication-type questions. It’s important to know how to think & prepare for these exams. Here are some basic tips straight from Strategies for Test Success: Passing Nursing School and the NCLEX Exam.

I. Cover the answer choices & read the question. Read EVERY word

II. Look for key words.

  • For words such as initial, best, priority or most important:Photobucket
    i. ABCs (Airway, Breathing, Circulation) are a priority ALWAYS (when applicable)
    ii. Maslow’s Hierarchy of Needs: 1st physiologic, 2nd safety, 3rd emotional support; pain.
    iii. Consider preventive measures (example: manage pain early before it gets worse)
    iv. Do least invasive first
    v. Remember the Nursing Process ADPIE –  Assessment → Diagnosis → Planning → Implementation → Evaluation. ASSESS first. If you have enough information, DO something.
  • Look for superlative/inclusive words such as all, every, never, none, each.
  • If the question is about the patient, the answer should be PATIENT CENTERED
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  • Therapeutic communication: no opinions, closed-ended questions, you want to explore feelings & address emotions

III. How you you restate the questions?

IV. Look for negative words: except, need additional info, lacks understanding, etc.

V. What do you think the answer may be? You are not focusing on the question?

VI. When you uncover your answers, read the choices for content only. Refrain from saying “yes” or “no” until you have read the four choices.

VII. Do NOT look for the right answer. Eliminate the ones you know are incorrect. When you have two choices left, return to the question. Remember the key words.

THINK: How will the nurse use this information in the clinical setting?

Teach yourself the information. Review, did you include all the key points?

When doing the NCLEX practice questions, use these:

1. What are the key words?

2. What is the question asking?

3. What do you think the answer is?

4. Is this a priority question? Does Maslow apply (physiological, safety, psychosocial)?

5. Look for comparable answer; they both can’t be correct.

6. Eliminate the answers you know are wrong. Look at key words.

Don’t forget to practice, practice, practice!

Content derived from Saunders Strategies for Test Success: Passing Nursing School and and the NCLEX Exam, 2nd Edition.

Intro to Math for Medications

Medication math involves simple algebra and competence in certain formulas and conversion rates that you will be required to know for the exam, which you need to make a 90%+ in order to pass (in our program at least). Here, I’m just going to go through the basic info you will need. KNOW THESE:

CONVERSIONS:

  • 1 teaspoon = 5 mL
  • 1 tablespoon = 15 mL
  • 1 ounce = 30 mL (therefore 1 ounce also = 2 tlbs or 6 tsps)
  • Roman numerals – V(5), X(10), XV(15)
  • 1 kg = 2.2 lbs
  • 1 grain (gr) = 60 mg; 65 mg for Tylenol
  • 1 L = 1000 mL
  • 1 mg = 1000 mcg
  • 1 gm = 1000 mg

ABBREVIATIONS:

  • AC = before meals
  • PC = after meals
  • PRN = as needed
  • q2h, q4h … = every 2 hours, every 4 hours
  • BID = twice daily
  • TID = 3x daily
  • QID = 4x daily
  • IVPB = intravenous piggy back
  • mcg = microgram VS mg = milligram
  • tabs = tablets

ADDITIONAL FYI:

  • Always LEAD with a ZERO. Never TRAIL with a ZERO.
    – 0.5 or 5 ✔ (correct)
    – .5 or 5.0 × (wrong)
  • Round to the nearest tenth when calculating for most medication problems, unless specified otherwise
  • Round to the nearest hundredth when calculating for drugs to be administered in a TB syringe (<1mL)
  • Round to nearest whole number for drops (gtt/min) & IV pumps (mL/hr)
  • For pills & tablets, make sure you answer is either a whole number or halves.
  • Insulin is only given in units.
  • Make sure all of your answers are label appropriately (tabs, mL/hr, mg, etc)

FORMULAS:

  • The easiest way, for me, to calculate simple drug dosages is through Ducks Have Quacks (Hurrrr??). You’ll learn the origin of that but it’s simply DESIRED/HAVE x QUANTITY = X (amount)
  • For an IV infusion when using a pump: amount to be given (mL)/time (hours)
  • For an IV infusion without a pump: amount (mL) x drip factor (gtt/mL)/T(hr) x 60 min

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Let’s try one out for fun. Basically your math exam will have a series of 20 questions, with a couple of pages of medicine labels on the back to refer to. Here’s an example of a test question:

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Here’s an example of the medicine label that you will read in order to get the information needed to solve this question:

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First thing you would do is LABEL. What are we looking for here? TABLETS! So label like so:

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Now, determine what formula you are going to use. We’re simply looking for “how many tablets per dose”. We can use the DHQ formula, but let’s double check. We have our D “desired” (375 mg), we have our H “have” (250 mg – from the drug label) & we have our Q “quantity” (1 mL – which is usually the case, unless otherwise specified). Now set up our equation & solve:

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Now double check your answer again. It’s in tablets so 1.5 is an acceptable number. Congratulations! You (most likely) just got first taste of medication math!

Again, this is just a small example of what to expect once you get closer to the math exam. You’ll learn more through practice. I highly encourage you to practice frequently. Take advantage of the opportunity!

Image Source.