Cherry and Jacob Contemporary Nursing Case Study

Cherry & Jacob: Contemporary Nursing Student Case Studies Case Study 1 During clinical, Heather overheard a new nurse graduate talk about registering to take the NCLEX-RN® examination. The nurse graduate said that this state’s examination was more difficult than a neighboring state, so she was going to take it there because the two states belonged to the state licensure compact. Heather also heard the graduate describe how the NCSBN in their state decided to increase the minimum level of competency for new nurses to test their ability to apply the nursing process and determine appropriate responses and interventions for patient care. She also described how the phases of assessment and intervention were weighted more heavily than planning, diagnosing, and evaluating. 1. Which statement by the graduate nurse is incorrect concerning the role of the National Council of State Boards of Nursing? The current state examination is more difficult than the other states. 2. Can one state’s examination be more difficult than another state’s examination? Defend your response. No, because all states use the same concepts for the examination. According to our book it states, “graduates from all programs take the same NCLEX-RN examination.” 3. Would the graduate nurse be able to transfer her license? Why? Yes, she can after she passes the examination. She will have to pay that specific states transfer fee. Case Study 2 Congratulations! You are now ready to take the NCLEX-RN examination and become a real nurse. Your instructor brought in graduates from last semester who related their experiences taking the NCLEX® examination. As you listen to their stories, you realize that every one of them thought they failed after leaving the testing site. You feel your anxiety level rise as they smile and tell the class that they answered anywhere from 75 to 265 questions. Some stated they took a review course, whereas others just reread their course notes and used NCLEX® review books or websites. The graduates also related stories about the topics they encountered; some thought they had a large number of nursing priority questions, and others spoke about specific areas of nursing. After the class, you feel more confused about the examination than before. 1. Why did some students have to answer only 75 questions, whereas others had 265? They have to reach a certain mastery level per content area. Those who get to 75 and have mastered all the areas and those who don’t hit the mastery levels will get more questions. 2. Why did the nurses identify different areas of focus for their tests? Those are areas that weigh heavier on certain concepts than others. 3. How would you evaluate a NCLEX® review course? Review possible courses that appeal to you and apply the evaluation process. I would choose a program that will help me identify my weak and strong areas. I like courses that provide physical learning materials such as books and written materials. 4. How would you evaluate NCLEX® review books? Review available books that appeal to you and apply the evaluation process. Reviewing the contents page, test questions, and any digital resources that come with the book. From there I would determine the purpose, relevance of information, and decide if the review book appealed to me. For instance, our NCLEX book we had gotten in the beginning of our first time has served the purpose of each class. The information, questions, and informative boxes all have helped me apply the accurate answers to my tests. 5. Having worked as a nursing assistant for 2 years, you have watched nurses perform in the clinical setting. Why might you not use this experience to answer test questions? Working as a nursing assistant is a different role than a nurse. The nurse has more responsibility and experience level. Questions that you may think is the answer because you have done it at your job would be wrong because this question pertains to a registered nurse scenario. Also, real world experiences do not always match with what the book says. That can make you choose a different answer based off your experiences. 6. You know that your test anxiety is based on past testing experiences. With this in mind, develop a plan to decrease your pretest anxiety. Creating a pretest and using good study habits. Any topics that still seem unfamiliar I would focus a bit more. Exercising the brain with 40 to 50 questions a day to help with understanding and memorization of the material. Relaxation techniques and hydration. Case Study 3 Carol just finished taking the NCLEX-RN examination. One of the questions involved evaluating the outcomes from a nursing intervention. She recalled a similar experience from her position as a nursing assistant and how the nurse, who had six clients that day, performed the procedure in a way different from what Carol learned in school but with the same outcome. Carol answered the question based on this experience. The next question concerned delegating to a nursing assistant. Carol felt confident, knowing that she was an excellent nursing assistant and that her nurse delegated many tasks to her, especially complicated dressing changes and treatments. The subsequent question asked about the nursing care priority for a client complaining of a new headache. Carol selected the response that involved completing a nursing intervention because she thought that turning off the lights would be more important than performing a nursing assessment. 1. Explain why Carol’s dependence on her experiences from working as a nursing assistant might hinder her from responding appropriately to the first NCLEX® question. She is using real world experiences that are not always correct. You can have a nurse you have been watching do patient care for many years but, then you realize this nurse is not textbook and is rushing through patient care to get more time to eat in the break room. 2. What error in judgment did Carol make in responding to the question concerning delegation? She again used real life experiences since she was a nursing assistant and had been involved of changing dressings. Which is not the responsibility of a nursing assistant. Nursing assistants should only be doing basic wound care not complicated. 2. How should Carol have responded to the question concerning the nursing priority for a client with new onset of a headache? Carol should have done an assessment. Any new onset of symptoms should alert the nurse. Turning off the lights and ignoring the patient is not effective to understanding why the patient has a headache.