Statistics for Adult Medical Surgical Nursing Quiz
Eight individuals took this quiz, and out of the eight quiz
takers, all persons passed. The quiz was taken a total of nine times, as one
person took the test twice, scoring 100% both times. The average score for the
quiz was 94%. The average time spent taking the quiz was two minutes and twenty
one seconds. Five of the quiz takers scored 100% on the quiz, two people scored
86% and one person scored 71%. All questions in this quiz were weighted equally
for scoring purposes.
Question Revisions
The three questions that need to be looked at specifically
in this analysis are numbers 3, 6, and 7. Number 3 was chosen because it makes
the student read the question, analyze, and critically think to apply the
answer. In order to critically think through this question, the student must be
able to understand the rationale between anticoagulation, a possible hemorrhage,
and the fact that taking aspirin and a nap instead of seeking medical attention
immediately would be contraindicated. The question is reverse application
because it forces the student to read the question which actually asks the
student to pick the incorrect response from the patient. The
current format of the NCLEX-RN examination included alternative format
questions, and critical thinking questions that force the student to apply
critical thinking skills in order to answer the question (Herrman and Johnson,
2009). The stem of this question could be modified to ask the question in a
clearer manner with less opportunity for confusion. Maybe presenting a scenario
as I did in the first two questions might help the students put the question
into perspective.
You are a medical surgical
nurse who is discharging a patient who is newly prescribed Coumadin for a
diagnosis of atrial fibrillation. Which statement made by the patient after receiving
their discharge teaching would alert you that the discharge teaching has not been effective, and further teaching
with this client is necessary?
A. “If I notice that I have a bruise that is
three inches or bigger and continually gets larger, I will seek immediate
medical help.”
B. “I will eat green leafy vegetables in
moderation, as they are healthy, but can increase the thickness of my blood,
potentially causing a clot.”
C. “I will keep all scheduled appointments for
blood work because it is important to monitor my PT/ INR levels to ensure that
my Coumadin dose is therapeutic.”
D.
“If I get a severe headache,
worse than any other headache I have ever had in my life, I will take two
aspirin, and take a nap, as that should help.”
Number 6 addresses the basic principles of nursing and
medication administration, and is based on the five rights of medication
administration. I do not think that just because two people answered this
question incorrectly that it should be removed or changed, it is clearly asking
which of the orders that is listed is complete.
Question number 7 is an application question that asks the
student to identify a critical potassium level. Three of the options given are
within normal limits. This question should not be changed either, because it addresses
laboratory blood values, which are important for the nurse to be able to
identify.
The following questions were included in the initial quiz,
and the percentage answered correctly for each.
You are the RN charge nurse on the medical surgical unit,
and you are in charge of delegating assignments for the shift. Which of the
following would be the most appropriate to delegate to the LPN/LVN? 100% of quiz takers answered this question correctly
A.
A 25 year old patient who requires IV antibiotic
therapy, and needs a PICC line dressing change before administering the
antibiotic.
B.
A 72 year old patient who requires Lasix 20mg IV
push
C. A 50 year old patient who is 3
days post op and requires a simple dressing change
D.
A 45 year old patient who is a newly diagnosed
diabetic and requires discharge teaching
You are caring for a patient who is newly diagnosed with
Congestive Heart Failure CHF. Which statement by the patient would indicate
that your patient teaching has been a success? 100%
of quiz takers answered this question correctly
A.
I will watch my salt intake and ensure that I do
not exceed 4g or 4000mg per day in my diet
B. I will conduct a daily weight,
keep a log of my daily weight, and report to my doctor immediately any weight
gain of 3 or more pounds in one day
C.
If I feel that I am urinating too frequently, I
will not take my diuretic for a few days to help with the frequency of
urination, after all, I don’t want to fall getting out of bed so much at night
D.
I will just smoke one half pack of cigarettes
per day, as this is healthier than one pack.
Which statement by the client receiving anticoagulation
therapy with Coumadin would indicate a need for further teaching? 88% of quiz takers answered this question correctly
E.
If I notice that I have a bruise that is three
inches or bigger and continually gets larger, I will seek immediate medical
help.
F.
I will eat green leafy vegetables in moderation,
as they are healthy, but can increase the thickness of my blood, potentially
causing a clot.
G.
I will keep all scheduled appointments for blood
work because it is important to monitor my PT/ INR levels to ensure that my
Coumadin dose is therapeutic
H. If I get a severe headache,
worse than any other headache I have ever had in my life, I will take two
aspirin, and take a nap, as that should help
Which of the following foods should a patient receiving
Coumadin therapy be instructed to eat in moderation? 100%
of quiz takers answered this question correctly
A. Spinach and other green leafy
vegetables
B.
Corn
C.
Brown Rice
D.
Lean Chicken Breast
A client receiving Lopressor 50mg IV should most importantly
have which vital signs checked prior to administration? 100% of quiz takers answered this question correctly
A.
Temperature
B.
Respirations
C. Blood pressure and heart rate
D.
Pain
Which of the following orders is complete, not requiring
nurse clarification? 75% of quiz takers answered
this question correctly
A. Tylenol 650mg PO q4hours PRN for
mild pain
B.
Ativan 1mg PO PRN
C.
Ibuprofen 400mg q6hours PRN for moderate pain
D.
Haldol 2mg IM q6hours PRN
Which of the following laboratory values is considered
critical? 88% of quiz takers answered this question
correctly
A.
Potassium 4.2 mEq/L
B. Potassium 2.8 mEq/L
C.
Potassium 3.7 mEq/L
D.
Potassium
4.9 mEq/L
References
Herrman, J., & Johnson, A. (2009). From beta-blockers to
boot camp: preparing students for the NCLEX-RN. Nursing Education Perspectives, 30(6), 384-388.
