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

LeaRNursing Blog on Blogger

We've switched to blogger this month for our student blogs.

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)