How to Pick a Nursing School - The 10 Most Important Questions You Should Ask!

Question #2 -- What is the school's NCLEX® examination pass-rate?

The NCLEX exam is the standardized exam that all nursing school graduates must take and pass in order to receive their Registered Nursing license.

In order to sit for the NCLEX® exam:

• students must apply for the exam


• complete a background check


• documentation must be sent from the nursing school to the board of nursing in the state the student will be taking the exam to prove the student has successfully completed a nursing program
  

Security is very tight at the testing site. Fingerprints and photo IDs are required to sit for the computer adaptive test (CAT for short) at an approved testing center.

A school's NCLEX® exam pass rate is an important indicator of how well they will prepare you for the exam and for practice.

How can I find out what a school's NCLEX® exam pass rate is?

• You can ask the school for their pass rate and number of graduates for the last 5-10 years
• You can look the stats up yourself:

a. Each state has their own board of nursing.

b. Each board of nursing publishes NCLEX® exam pass rate statistics on all nursing schools in their state.

c. Just google the Board of Nursing in the state you are researching and there will be a listing that you can review.

What pass rate should I look for?

Here is an example of some of the statistics you can find on the national pass rates at http://www.ncbsn.org/ for 2008.

2008 Number of Candidates Taking NCLEX Examination and Percent Passing

Total Number of 1st Time Graduates

129,121

Overall Pass Rate

86.7%

A good rule of thumb for evaluating a school's pass rate would be to pick a school that at least meets the national pass rate (86.7% for 2008). If the schools you are evaluating are not accredited or they don't have a solid NCLEX pass rate - pass on to your next option. You deserve a school that will prepare you well for your career in nursing.

How to Pick a Nursing School - The 10 Most Important Questions You Should Ask!

Question #1 Accreditation -- Does is really matter?

Absolutely! As you are researching nursing schools this is one of the most important questions you can ask. NLNAC or the CCNE. (see below) are two national organizations that accredit nursing programs.

What is accreditation?
Accreditation means that the nursing school has met some rather rigorous standards and has been "audited" or reviewed by these organizations. Only schools that meet these standards earn the right to be called "accredited"

a. National League of Nursing Accrediting Commission (NLNAC)

• accredits master's, baccalaureate, and associate degree nursing programs
• go to this website to see if the schools you're interested in are accredited through NLNAC at this website http://www.nlnac.org/Forms/directory_search.htm

b. The Commission on Collegiate Nursing Education (CCNE)

• accredits master's and baccalaureate degree nursing programs
• go to this website to see if the schools you're interested in are accredited by CCNE at this website http://www.aacn.nche.edu/accreditation/

Why does it matter to me again?

Graduating from an accredited school is a requirement for most advanced degree programs. If you choose a program that is not accredited - you're taking a significant risk that you would not be accepted into another program.

Also, many employers will inquire if you have graduated from an accredited nursing program and usually prefer graduates from these nationally recognized programs.

So overall - with the amount of time and money you'll invest in nursing school - make sure you find a school that doesn't limit your opportunities - but one that opens the doors to you that you worked so hard to achieve! Make your choice an accredited one.

We wish you success in your career!

Analysis Level Questions

Analysis level questions require that you examine/analyze information, break information into parts, identify relationships in the data, and then make inferences or draw conclusions.

Try this analysis level question

Mr. Yen is in acute renal failure and has also been diagnosed with chronic CHF. His urine output has been 84 ml in 8 hours. Which of the following lab work would you expect to find on his admission lab work? Select all that apply:

a. K+ 2.8
b. pH of 7.38
c. HCO3 of 35
d. pH of 7.50
e. CO2 of 52
f. pH of 7.29

Still with us? Usually those 4 words bring fear into the hearts of all nursing students. "Select All That Apply". Keep in mind the best strategy is to make sure that you are very clear on what the question is asking - and take one answer at a time. The topic of the question is what what lab work would be expected for a patient in renal failure and chronic heart failure. So you ask yourself

a. Is a potassium of 2.8 what I would expect for a patient in renal failure and chronic renal failure? Answer - no, patients in renal failure have an elevated potassium 2.8 is hypokalemia
Eliminate this answer

b. Is a pH of 7.38 what I would expect for a patient in renal failure and chronic renal failure? Answer - no, normal pH is 7.35-7.45. Patients in renal failure are in metabolic acidosis, so the pH would be low or less than 7.35.
Eliminate this answer.

c. Is a HCO3 of 35 what I would expect for a patient in renal failure and chronic renal failure? Answer - no, normal HCO3 is 22-26. Patients in renal failure are in metabolic acidosis, and the failing kidneys can't keep the HCO3 (bicarb) levels normal - so they should be lower than normal.
Eliminate this answer.

d. Is a pH of 7.50 what I would expect for a patient in renal failure and chronic renal failure? Answer - no, normal pH is 7.35-7.45. Patients in renal failure are in metabolic acidosis, so the pH would be low or less than 7.35.
Eliminate this answer.

e. Is a CO2 of what I would expect for a patient in renal failure and chronic heart failure? Answer - no, normal CO2 levels are 35-45. Patients in renal failure are in metabolic acidosis, so the body will try to compensate by "blowing off" CO2 (remember Kussmaul's respirations?) and you should see a lower CO2 level.
Eliminate this answer.

f. Is a pH of 7.29 what I would expect for a patient in renal failure and chronic heart failure? Answer - yes FINALLY ;0), normal pH is 7.35-7.45. Patients in renal failure are in metabolic acidosis, so the pH would be low or less than 7.35.
Select this answer.

WHEW! All that work for just one answer?

That can really happen - but just to be sure - do one final check by making sure that the one you selected is an appropriate answer to what the question was asking and you're on your way to mastering select all that apply and analysis level questions.

Why are Nursing School Tests / Exams SO Hard?

Welcome back. In yesterday's post we looked at knowledge and comprehension level questions.

Knowledge level questions just require you to have basic knowledge in order to answer a question. Comprehension level questions require you to understand basic knowledge.

Today let's look at application level questions.


Application Level Questions
Require you to know several pieces of information in order to answer the question.

Mr. Stevenson has CHF and will be going home on Digoxin and Lasix. Which of the following assessments would require immediate follow-up by the nurse.

a. rhonchi bilaterally
b. Na of 138 milliEquivalents/liter
c. K of 3.0 milliEquivalents/liter
d. Digoxin 1.5 nanograms per milliliter

In order to answer this question - you need to know the following pieces of information: normal blood levels of sodium, potassium, and Digoxin and if bilateral rhonchi are normal.

• Normal Na is 135-145
• Normal K is 3.5-4.5
• Digoxin is 0.8-2.0
• Rhonchi bilateraly is not normal

You would want to follow up on the assessment that indicates the patient is in the most danger or risk of harm. Normal lab values do not indicate risk - so eliminate b. and d.

Now you are left with the two abnormal assessments a low potassium and rhonchi. Neither are what you'd want for a patient - however the question is about Digoxin, Lasix, and CHF. The low potassium is the correct answer because low potassium puts the patient at increased risk for Digoxin toxicity.

In an application level question - it is not enough to have basic knowledge or to understand that knowledge. You must be able to apply your understanding of knowledge in the context of the question in order to pick the correct answer.

Our next blog will explain the differences in analysis level questions.

Why Are Nursing School Tests/Exams So Hard?

Blame a man named Benjamin Bloom. He was an educational theorist who came up with names for categories of types of questions an exams. Your faculty know who he was - and they use these categories to develop test questions for your nursing school exams.

Let's start at the bottom with the simplest types of questions (everyone wishes exams were that easy!) Knowledge is the "simplest" or most straight forward of the categories of different types of questions.

Knowledge -- is basic "regurgitation" of facts. i.e. If you can memorize - you can answer these types of questions. You won't (or shouldn't) find many of these types of questions in nursing school

How many chambers does the heart have?

a. 1

b. 2

c. 3

d. 4

Comprehension is a little trickier - but still these questions can be answered with a little late night cramming the night before the exam. A comprehension level question would be more along the lines of the following:

Put the following chambers in the correct order that a RBC would travel back to the heart to exchange CO2 for O2

a. Left Atrium, Right Atrium, Right Ventricle, Right Atrium

b. Right Atrium, Right Ventricle, Left Atrium, Left Ventricle

c. Right Ventricle, Right Atrium, Left Ventricle, Left Atrium

d. Left Atrium, Left Ventricle, Right Atrium, Right Ventricle

Best Way to Fail a Nursing School Exam

It's one of the biggest and most frustrating mistakes that nursing students make -- if you are studying for nursing school exams and only study at the level that answers knowledge and comprehension level questions -- you're not seeing the scores on the exams that you would like - or that are passing.

Nursing School exams are written at the level above comprehension - or the application and analysis levels.

Tomorrow we'll give you strategies on how to prepare to answer application and analysis level questions on your nursing school exams. Some simple changes to your study habits can reward you with much more satisfying nursing school exam scores.

LeaRNursing Nurse Consultant Team

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Check us out for the kind of advice we, as expert nurses, wish we would have had when we were students! We blog, because we want to mentor and support the next generation of nurses. Please feel free to post questions and comments here and our team of experts will respond to you here.

The LeaRNursing Nursing Consultant Team
(big title for nurses who care about students ;0)