Student Success Taking Notes &amp Studying

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Spring 2011; Spring 2012
Topic
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Note taking & studying self-evaluation.....3 Plan for Effective Listening and Note Taking......5 Cornell Note- Taking System.....6 Sample Nursing Cornell Notes...7 Streamline Your Notes...8 The Study Cycle.............10 PRR_Reading Your Text Efficiently....11 SQ3R_Survey, Question, Read, Recite, Review..14 Study or Buddy..............15 What did they say..16 What Level Was That: What is Blooms Taxonomy.....19 Sample Blooms Taxonomy Questions.........21 Test Taking Anxiety.....23 Test Taking Strategies.25 Test Taking Skills.....27 Taking Multiple Choice Test...29 Alternate Format Items.......31 Time Management Tips..34 Stress Management..37 Charts....38 Concepts Maps..41 Glossary.....49 Resources & References..53
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Directions: Check "yes" or "no" after reading each statement carefully. Remember it often
time takes time to change and develop new habits
I do not take lecture notes. I do not read my text book /ebook prior to class. I think it is sufficient to look at the power points (only) to understand info. My notebook papers are messy and in disorder. I do not know what information to write. I do not know how much information to write. I take notes slowly and do not have a chance to write everything down. I do not have a method for studying my notes. I study my notes but I am still unsuccessful on my test. I do not use text book resources like Evolve or The Point. I think it is sufficient to study for the test the night before only. I do not think you should study with other students. I dont seem to have time to study and enjoy social activities.
( ( ( ( ( ( ( ( ( ( ( ( (
) Yes ) Yes ) Yes ) Yes ) Yes ) Yes ) Yes ) Yes ) Yes ) Yes ) Yes ) Yes ) Yes
( ( ( ( ( ( ( ( ( ( ( ( (
) No ) No ) No ) No ) No ) No ) No ) No ) No ) No ) No ) No ) No
Self-Assessment Directions: If you answered "yes" to any of these questions you should:
1. 2. 3. 4. 5. 6.
Carefully review the rest of this information packet use what you can to ensure success Seek additional help from your Course Instructor & Review this Checklist with him/her Consider joining a study group if you are not already in one Contact STARS for a nursing tutor RTC Building 100 (757) 823 2891 Contact ACCESS for a nursing tutor Bowser Building 118 (757) 823-2196 If needed PDC- Prioritize what you want/Decide what you want /Choose what you want
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Did you know you can think about four times faster than a lecturer can speak? That means that in order to learn effectively from lectures, you have to listen and take notes effectively. This is an active process; it doesnt happen automatically. Try the strategies below and see how they work for you. BEFORE CLASS Develop a mind-set geared toward listening. Test yourself over the previous lecture while waiting for the next one to begin. Skim relevant reading assignments to acquaint yourself with main ideas, new technical terms, etc. Enhance your physical and mental alertness: eat a snack before class, sit in the front and/or center of the room, and focus your attention on the speaker.
DURING CLASS Listen for the structure and information in the lecture. Resist distractions, emotional reactions, or boredom. Pay attention to verbal, postural, and visual clues as to what's important. When possible, translate the lecture into your own words. Be consistent in your use of form, abbreviation, etc. Ask questions. Instead of closing your notebook early and getting ready to leave, listen carefully to information given toward the end of class; summary statements may be of particular value in highlight main points; there may be possible quiz questions, etc.
AFTER CLASS Clear up any questions raised by the lecture by asking either the teacher or classmates. Fill in missing points or misunderstood terms from text or other sources. Edit your notes, labeling main points, adding recall clues and questions to be answered. Key points in the notes can be highlighted with various colors.
PERIODICALLY Review your notes: glance at your recall clues and see how much you can remember before rereading Look for the emergence of themes, main concepts, methods of presentation over the course of several lectures Make up and answer possible test questions.
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Divide the page into 3 areas as shown: 1. Note-taking (during lecture) 2. Key Words and Questions for Self-Test (after lecture) 3. Summary (after lecture) 2 1/2 6
Key Words and Questions for Self-Test 2. After the lecture: As soon after class as possible, identify key words and formulate questions based on the information in the note-taking column. This will help to clarify meanings, reveal relationships, establish continuity, and strengthen memory. The key words and questions also serve as a basis for self-testing. IMPORTANT: Note any gaps in your notes, and fill them in on the facing page.
Note-taking Area
1. During the lecture: Use the note-taking column to record the lecture using brief and concise telegraphic sentences.
Summary Area 3. Summarize and Connect: Reflect on the information presented during lecture. Ask yourself questions such as: What information is most important? What is the significance of these facts? How are they connected to one another? How can I apply them? How do they fit in with what I already know? Then write a paragraph summarizing and connecting the information from the note-taking column and any information you filled in.
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(Not all inclusive of the Nursing Process) Key Words and Lecture Notes: The Nursing Process NUR___ Date:___________ Questions: The nursing process has five steps: assessment, nursing diagnosis, planning, implementation, and evaluation. Nursing Process Use of the nursing process is the foundation for clinical decision making. Data Analysis When you first meet a patient, you will conduct an initial assessment screening and Data Clustering then focus on cues and patterns of information to make a more comprehensive Diagnostic process assessment. NANDA Data analysis involves recognizing patterns or trends, comparing data with NOC standards, and then forming a reasoned conclusion about the datas meaning. NIC Data clustering organizes assessment data into meaningful clusters of defining Nursing Diagnosis characteristics or sets of signs and symptoms. Care Plan The diagnostic process includes analysis and interpretation of data, identification of Concept Map patient and family needs, and formulation of nursing diagnoses and collaborative problems. Nursing diagnoses provide the basis for selection of nursing interventions to achieve outcomes for which a nurse is accountable. NANDA International defines five types of nursing diagnoses: actual, health promotion, risk, syndrome, and wellness. During the planning component, you determine patient goals, establish priorities, What are the five steps develop expected outcomes of nursing care, and write a nursing care plan. to the nursing process? The Nursing Outcomes Classification (NOC) has labels for describing the focus of nursing care and then includes indicators for use in measuring success What are the types of The care plan or plan of care is a guideline for patient care so that all members of nursing diagnoses? the health care team can quickly understand the care given. A concept map organizes and links data about a patients multiple diagnoses in a What are the three types logical way. of nursing interventions? There are three types of nursing interventions: nurse-initiated, physician-initiated, and collaborative. The Nursing Interventions Classification (NIC) is a comprehensive standardized classification of the interventions that nurses use in the care of patients. Direct care interventions include activities of daily living, instrumental activities of daily living, physical care, counseling, teaching, controlling for adverse reactions, lifesaving measures, and preventive measures. When goals of care are not met, you identify factors that interfere with goal achievement, reassess the patients condition, revise existing or develop new nursing diagnoses, and select appropriate interventions. Summary Summarize the notes taken in your own words to ensure your understanding of the material. If you are having difficulty summarizing the material or understanding the material; refer to your study group and/ or your instructor.
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Note-Taking Concentrate on the lecture or on the reading material. Take notes consistently. Take notes selectively. Do NOT try to write down every word. Remember that the average lecturer speaks approximately 125-140 words per minute, and the average notetaker writes at a rate of about 25 words per minute. Translate ideas into your own words. Organize notes into some sort of logical form. Be brief. Write down only the major points and important information. Write legibly. Notes are useless if you cannot read them later! Don't be concerned with spelling and grammar. Streamlining Eliminate small connecting words such as: is, are, was, were, a, an Eliminate pronouns such as: they, these, his, that, them Do not eliminate: in, on. Drop the last several letters of a word (e.g.,substitute appropriate with approp Drop some internal vowels of a word (e.g., substitute large with lrg) Use Symbols to Abbreviate: WORD And/plus Equals Minus Number Times Greater than, more, larger Less than, less, smaller With Without Within Because Different Leads to, produces, results in Comes from Per Mutual interaction Increase Decrease SYMBOL &+ = # x > < w/ w/o w/in b/c d/f /
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Preview
Use syllabus to identify the course objectives and relevant text/chapters to review before class Take 15-20 minutes to look over chapter headings, keywords, diagrams, summary Formulate questions you want to answer
Prepare for Success
Think realistically and manage time with a study schedule Study when and where youre most alert Join a study group if possible Analyze and review test
Read / Take Notes

Use Cornell System during lecture or some other notetaking system if you need assistance with note taking Listen or read actively: find answers to your questions Synthesize lecture and reading material
Seek out nursing resources you need along the way
Test
Arrive early to reduce anxiety Do your job: think as clearly as possible, based on what you currently know For multiple choices, cover answers and generate your own response For multiple answer which statements are true and which are false
Review
Continue using Note-Taking format such as Cornell format 1) Identify Identify gaps or misunderstandings in the material 2) Clarify Fill-in gaps using resources such as text, Power points, instructor, fellow students, tutor, etc. 3) Summarize Identify main ideas and put them in your own words
Self-Test
(Keep levels of learning in mind: see Blooms Taxonomy ) 1) Rehearse Do practice problems Boost memory with repetition, mnemonic devices, etc. Test each other in your study group 2) Elaborate Explain ideas aloud (to self or group) Write and answer practice test questions 3) Apply Challenge yourself to apply the knowledge to critical thinking, problem-solving, or realworld situations
Organize
Create outlines, charts/tables, concept maps, flowcharts, diagrams to illustrate relationships (i.e., similarities, differences, thematic comparison, hierarchy, chronology, cause/effect, part/whole, etc.)
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PREVIEW - READ - RECALL at first glance seems to be an intricate and time consuming process. However, it gets easier and faster with practice, ensures thorough learning and facilitates later "relearning" when you review for exams. P-PREVIEW WHY? If you give your mind a general framework of main ideas and structure, you will be better able to comprehend and retain the details you will read later. HOW? Look quickly (10 minutes) over the following key parts of your textbook to see what it's all about and how it is organized: Title Front and back cover info. Author's biographical data Publication date Table of Contents Introduction or Preface Index Glossary Before you read each chapter, look over: o Title o Introduction o Subheadings o First sentences of each paragraph (should give main idea). o Any diagrams, charts, etc. o Conclusions or summaries Then answer the following questions: What is this mainly about? How is it organized? How difficult is it? About how long will it take to read? R-READ ACTIVELY WHY? Being an active reader will involve you in understanding the material, combat boredom, and will increase retention. HOW? Set realistic time goals and number of pages to be read. Divide your chapter into small (1/2 page? 1 column?) sections, rather than try to read the whole chapter nonstop. Ask yourself a question before each paragraph or section, then seek its answer. This will give you a definite purpose for your reading. Try inverting the subheading or first sentence into question form, using "who," "what," "when," or "how" if necessary.
o o o o o o o o
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Helpful Hint # 1
Do not pick a chair that is too comfortable.
Helpful Hint # 2
Instead, sit at a desk with a straight-back chair and plenty of light.
Helpful Hint # 3 Take breaks when you feel unable to stay with the material due to day- dreaming, drowsiness, boredom, hunger, etc. After a short break, you can return to your reading with more energy and alertness.
Helpful Hint # 4 If falling asleep while you read is the problem, try reading aloud while pacing.
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R-RECALL WHY? Research shows that 40 - 50% of the material we read is forgotten very shortly (about 15 minutes) after we read it. Immediate recall is an essential first step toward continued retention of the material. HOW? After reading each small section of material, choose one (or more) of the following methods: Recall mentally or recite orally the highlights of what you have read. Ask yourself questions (maybe the same ones you used before you read the section) and answer them in your own words. Underline and make marginal notes of the key words or phrases in the section. Underlining after you read is the best way to decide what's the most important information to remember. Make separate notes or outlines of what you have read. This technique often works for more technical material which you need to put into your own words. Recall with a friend. What you don't recall, he/she might. Review and edit your notes taken from the lecture. Begin thinking about what additional information you'll need to add from the text to fill in the gaps. Reread the related textbook material that you have previously skimmed. Re-preview and break the reading into logical subsections to be tackled one at a time. Plan far enough ahead of time that you'll be able to take a break and move away from the material at the end of each subsection if you feel overwhelmed. Read carefully and methodically, referring to figures, charts , tables and diagrams as appropriate. After reading a subsection, stop and recall what you've read: tell it to yourself in your own words; take relevant notes alongside the related lecture notes in your notebook , and/or make marginal notes in the textbook and highlight key details. (However, just highlighting in dense texts may not be the best form of recall since nearly all of many paragraphs may need to be highlighted and review would be difficult.) Draw your own diagrams or charts to summarize and translate information. Review your notes and the reading periodically. Information needs to be reviewed and used periodically for it to be stored in longterm memory. Reflect upon the information in various ways. How is this information or these functions related to each other? How do they affect each other? Apply ideas learned to other or new situations: What would happen to the body if one of these areas/functions/organs were damaged or destroyed?
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S=SURVEY Determine the structure or organization of the chapter.

Think about the title. Guess what will be included in the chapter. Read the introduction. The main ideas will help you understand or make sense of the details. Read the main-headings (boldface type). Here are the main ideas. Read the summary. Here is the relationship among the main ideas. Read the questions at the end of the chapter. These will help you to identify important parts of the chapter.
Q=QUESTION Turn each heading and subheading into a question. Especially while you are practicing this technique, write the questions down. This gives you a focal point for crystallizing a series of ideas (the answer). YOU ARE LOOKING FOR SOMETHING RATHER THAN SIMPLY LOOKING AT WORDS. Take one section at a time. Keep answers brief. Use your own words. R1=READ Read only that section, looking for the answers to your questions. Move quickly. Sort out ideas and evaluate them. If content does not relate to the question, give it only a glance. READ SELECTIVELY. R2=RECITE Answer the question in your own words, not the author's. Then write the answer using only key words, listings, etc. that are needed to recall the entire idea. Follow the above technique for each section of the chapter.
R3=REVIEW Increase retention and cut cramming time by 90% by means of immediate and delayed review. See review notes under the heading "Taking Lecture Notes." Try a variety of methods, such as: 3x5 cards, oral recitation, study groups.
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There is always going to be debate about studying alone or with a group. There is nothing wrong with studying either way if it works for you. The main objective and goal is to study. If you have been studying alone and it has not been working well you then you may need to form or join a study group. If you have been studying in a group and it has not been working well for you then you may need to join a new group or study alone. Please review the benefits of both and choose what will work for you. But choose wisely and if it isnt broke do not fix it! Studying Alone The advantage of studying on your own is that you can do it on your own time. You do not have to plan around the schedules of others. But you must still set guidelines and follow them when you are studying alone. Below are some tips for studying alone: Decide what to study: figure out what you'll study, for how long and how many chapters, pages, problems or case studies you want to complete. Once you've set your "schedule," stick to it. Complete difficult tasks first, but if you're a procrastinator, start with something simple and/or interesting to get you motivated and on task. Give yourself a break. Study for 50 minutes and then give yourself a 10 minute break. The break is a good time to stretch, relax or have a snack. Get out and study at a coffee shop, the library or the park. Stop studying when you're no longer being productive. Keep your schedule practical, flexible and realistic. Make time for socializing, studying and sleeping. If you're someone with lots of time, develop good organizational skills. For those with an already busy schedule, re-establish your priorities so that you aren't overdoing it. Repetition, repetition, repetition. It's true that practice makes perfect-read your notes several times over until you remember the important points. Get plenty of sleep. Pulling an all-nighter won't help you if you're mind turns to gelatin by the time you arrive for the exam. Instead, study until your usual bedtime, then plan to rise earlier than usual the next morning for last minute reviewing. Studying in Groups Don't forget, two heads are better than one. If you're not feeling too confident about a class or find it easier to learn by discussing study material, you may want to join a study group. It's a great way to share ideas and teach each other, just dont let the group lose focus. Below are some tips for getting the most out of your study group sessions: The ideal size of a study group is three. The smaller your study group, the more it will help you and members be more efficient, thorough and productive. Set goals. Each person should walk into a study session with a list of questions or goals to accomplish for that session. This will help keep the group on target and from wavering off. Group effort. Assign a portion of each chapter or assignment to a member of your group. From there, make up study questions for your portion and distribute copies to the others. And before you know you have all made a practice exam. No substitutions. Group study is not a substitute for individual learning and understanding. The key to learning is not the actual answer but the process of critical thinking. Each group member does not have to be a grade A student. Students from different perspectives can help each other learn. Each member should contribute ensuring that everyone is getting the most out of the group.
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GET THE MOST OUT OF CLASSES During even the most boring lecture, look interested. The secret of a good image is striving to be that which you wish to appear. Introduce yourself to your instructors. You don't want to just be a "face in the crowd. GET THE MOST FROM YOUR BOOKS Take your materials out of your house to study. Get away from distractions, undone dishes, radio and TV. The doughnut shop or all night cafe will offer quiet and ample amounts of coffee. Read nursing journals and magazines. Often current articles will compliment your text and make the information more easily understood. Use individual sheets of paper or large index cards to make a file of disease/conditions and their treatments. List etiology, signs and symptoms, diagnostic tests, interventions, etc. and keep them in a binder for future reference as well as present study. Take notes from your notes! After taking notes in class or from the book, put away the book and tape player and outline the notes. Turn course objectives (as found in the beginning of each chapter or from the course syllabus) into questions - instant study guide! THRIVE IN CLINICALS Whether you don't know how to make a bed or have been an EMT for years, remember everyone begins clinicals as different levels of experience. Focus on where you are going, what you will learn - not on how much (or little) you know now. If you have trouble remembering protocols, lab values or even your patient's name :) write them down on index cards and keep them in your pocket. The more you use them the more you study them. In Psych rotation, take a moment to center yourself before working with patients. Most respond best to a calm focused approach. Study your instructors. The more you know them the more likely you are to understand them and what they are expecting from you. If you don't know how to do a procedure, look it up, check the protocols, ask for help. Instructors would rather be "bothered" walking you through the procedure than fixing the mess or hearing the complaints if you do something wrong. Be helpful to the nurse you are assigned to for clinical. Take all the vitals, never contradict publicly, don't ask constant questions (that's what you have instructors for) The nurse will be glad of the help and be more likely to help you. ACE THE TEST Take your tests in comfort and style Wear comfortable loose fitting clothing on test day. Loose fitting does not mean sloppy. Do your confidence level a favor and dress for success. Cardigan sweaters, full skirts and stretch pants are comfortable without compromising your professional style and attitude. If you need to take issue with the instructor over a point on a test, do it privately. To dispute a mark in public will embarrass them and make them want to be proved right. And bring it up in the context that you need the correct information, not that youre going for that one little point. When the instructor and the text conflict, offer both answers on the test when possible. If not (as in multiple choice), most instructors will allow you to approach them quietly during the test. You can display your knowledge and ask which answer is being requested. Ask former students about an instructors testing style before taking that first exam.
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ADJUST YOUR ATTITUDE Buy a good personal planner and note all projects, deadlines and tests in it. Plan a realistic schedule and follow it. Just take one day at a time, confident that every day tasks bring you closer to your goal Being a nursing student is harder than being a nurse in many ways. Just relax, dont sweat the small stuff, and be receptive to patient and staff needs. Replace your fear, anxiety, and worry with joy. Have fun with what you know. Have fun learning neat new stuff. You cant stop bad things from happening but you can learn from it. You can enjoy your new role. Dont give up. Failure is not an option! Graduation is not a goal. It is simply the natural consequence of your actions! FORMING AND USING A STUDY GROUP FORM A STUDY GROUP! Especially one you can stick with through graduation. Develop an invested interest in each other and divide and conquer the huge amount of info Nursing students are expected to learn. Go through your notes together. Sometimes someone else puts information down in an especially memorable way. Sometimes someone else catches something you missed. Sit in the front row! Most study groups form from those you associate with during classes. So select your lab partner with care and sit in the front row with the students who are (or want to be) brilliant. Divide and conquer! Assign a portion of each chapter or assignment to each member of your group. Each person is to make up study questions for their portion and distribute copies to the others. Presto! Your own practice exam! Network with students ahead of you for information on courses and instructors. A little foreknowledge can go a long way. Make quizzes and ask each other questions about your subject. Reward yourself for the hard work and studying you have done along with a successful test - we all know they are not at all easy!!!!!!! USE TECH KNOWLEDGE Tape the lectures on audiocassette. Then listen to the lecture again while you rewrite your notes. You'd be surprised what you missed the first time. Search out and use web resources in your research papers. Also get the free learning software available from FTP sites on the net. Use your e-mail account to communicate with instructors. You are likely to get a well crafted, concise answer to your concerns if they must be put in writing. It also eliminates phone tag and restrictions to office hours. Some software and database programs allow you to create a template to your specifications. You can make forms for care plans, assessments, process recordings, any standard paperwork. Then all you need to do is fill in the blanks and print it up. WHEN YOU ALSO HAVE A FAMILY You may need to lower your standard of housekeeping. You want the place clean enough to stay healthy and organized enough to find your shoes in the morning. Care and upkeep of a significant other is important. Tell your SO how much you appreciate them and count on them. When they do something you find helpful - THANK THEM. Remember, youre in this together. If you have all day care (not hourly) use it! Drop the kids off when the doors open and STUDY. It helps the kids and you if you have a regular time you reliably pick them up though. Shop around for reliable daycare. Most facilities will send a child home "sick" with a touch of diarrhea or have an arbitrary degree temp as the "sick" point. Have a back up plan if your child is "under the weather" Look around your community for activities you kids can enjoy while you are in class or studying. Little league, after school programs and community events are all good possibilities. Set aside family time and protect it - even when you have a paper due the next day. Set aside study time and protect it - even if it means hiring a babysitter or trading babysitting duty with a friend. Enforce a "family homework time" let everyone study together at the table.
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Did your performance on a recent exam surprise you? Did you feel like you knew the material, but you werent able to answer the questions asked? Blooms Taxonomy is a hierarchy that describes levels of learning. Many students learn information at the knowledge level; however, most college courses test at the comprehension level or above. These higher levels focus on the ability to understand fundamental concepts, to apply ideas to solve problems, and to think in terms of the discipline. You may have done poorly on an exam because you didnt prepare at the level of the test. Even though you knew the information, or you grasped the concepts on a basic level, you werent able to use the intellectual skills the exam required. Use this guide to help you prepare for exams by anticipating test questions on a variety of levels. You may also use it to analyze returned tests determine the type of question, and figure out why you missed it.
LEVEL OF LEARNING Knowledge: rote memory; recall of specific information.
SAMPLE TEST QUESTION Define schizophrenia. List the steps of the Scientific Method. Explain the process of cross-breeding. Describe the low and high peaks of business cycles. Describe the contributions of computer technology to elementary education. Classify each of the following as a liability, asset, or owners equity. Interpret the following quote in Shirley Jacksons The Lottery: It isnt fair. It just isnt fair. How can there be inflation and unemployment at the same time? Summarize the key Supreme Court cases relevant to the integration of public schools. Justify the American troop withdrawal from Vietnam. Evaluate the contributions of Jackson Pollock to 20th century art.
Comprehension: basic understanding; putting an idea into your own words.
Application: applying knowledge and concepts to a new situation.
Analysis: breaking the information into parts so that the relationship between ideas is clear.
Synthesis: putting parts together into a whole to create new meaning or structure. Evaluation: making a judgment about the value of ideas/actions; taking a position and providing justification.
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Understanding Blooms taxonomy can help students understand why nursing tests really are harder than many other tests they have ever taken before! Student nursesespecially those just entering college from high school often complain that they have always done well on tests, that is, until now. Some report they are studying but not achieving the results they are used to. Rememberyou must practice your skills of blood pressure monitoring and IV starts. You must also practice your skill of test taking!
Evaluation
Make judgments about value of ideas
Synthesis
Put parts together to form new meaning or structure
Analysis
Identify component parts of concepts so organizational structure may be understood
Application
Use knowledge and understanding to solve problems; transfer abstract or theoretical ideas to practical situations
Comprehension
Understand concepts and be able to describe them in your own words
Knowledge
Memorize and recall information (but with no evidence of understanding)
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Level I involves: KNOWLEDGE This is the basic level of recalling certain knowledge. Note*KNOWLEDGE that must be committed into our memory banks includes: normal vital signs, normal assessment values, important lab values and basic medication facts. 1. Which of the following blood levels represents a therapeutic range for lithium? a. 0.1-0.5 mEq/L b. 0.4-0.8 mEq/L c. 0.5-1.5 mEq/L d. 1.0-2.5 mEq/L This question is asking for basic levelsimple recall. 0.5-1.5mEq/L is a therapeutic range for lithium Level 2 involves: COMPREHENSION This is a higher level of thinking because now we must understand the information and interpret data Note * question 1 above can be taken to this higher level. 2. Which sign or symptom is the nurse likely to assess if the clients lithium level is 0.2mEq/L? a. flight of ideas b. C/O severe constipation c. ataxia d. C/O extreme lethargy We know that 0.2 mEq/L is a sub-therapeutic level. Lithium is used to treat mania. Flight of ideas is a symptom of mania. If the blood level is not therapeutic, symptoms of mania have probably not yet abated. Level 3 involves: APPLICATION This is where we use or demonstrate the information. We have rationale for our actions. 3. The patient is ordered lithium carbonate 450mg b.i.d. PO. The nurse should hold the lithium carbonate if which of the following levels is present? a. lithium blood level 0.3 mEq/L b. sodium level 135 mEq/L c. lithium blood level 1.8 mEq/L d. sodium level 145 mEq/L Nurses should hold lithium when blood levels are too high or toxic. None of the sodium levels are abnormal. The 0.3 mEq/L lithium level is sub-therapeutic which would not require a nurse to hold the dose.
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Level 4 involves: ANALYSIS When nurses analyze, they break information down into parts and look for relationships. To analyze well one must compare and contrast. 4. You are providing discharge information to a client with Bipolar Disorder. The patients husband asks for more specific information regarding any dietary restrictions related to his wifes new medication. What information is important to include in the nutritional counseling of the patient in regards to the new medication Lithium? a. If sufficient roughage isnt eaten while taking lithium, bowel problems will occur. b. If the intake of carbohydrates increases, the lithium level increases. c. If the intake of calories is reduced, the lithium level will increase d. If the intake of sodium increases, the lithium level will decrease. The level of salt in your body affects the action of lithium. Once lithium reaches therapeutic range, it can be altered by small changes in daily salt intake. Any time the level of sodium increases, such as with a change in the dietary intake, the levels of lithium will decrease. Level 5 involves: SYNTHESIS To synthesize data means to put it together in a way that involves problem solving or predicting. 5. A 77-year-old, newly admitted inpatient is prescribed Lithium Carbonate 600 mg po daily in three divided doses. The nurse recognizes that this medication places the patient at risk for a. dehydration. b. impaired gas exchange. c. fluid volume excess. d. constipation. Lithium can cause you to urinate more frequently, which can lead to dehydration. Note*This can also increase your risk of toxicity. How?
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What is test Anxiety? Too much anxiety about a test is commonly referred to as test anxiety. It is perfectly natural to feel some anxiety when preparing for and taking a test. In fact, a little anxiety can jump start your studying and keep you motivated. However, too much anxiety can interfere with your studying. You may have difficulty learning and remembering what you need to know for the test. Further, too much anxiety may block your performance during the test. You may have difficulty demonstrating what you know during the test. Because test anxiety is a learned behavior, it can be unlearned. The first step is to determine where or why this behavior began and then begin the process of unlearning the response. The First Step: Identifying Sources of Test Anxiety Lack of Preparation: Knowing that you are not prepared can cause high levels of stress and anxiety. The solution is practice and apply proven study strategies as means of alleviating the stress you feel. This method allows you to face the next testing situation knowing that you have done your best to prepare. Fear of failure: You may be worried that you will not live up to the expectations of family and friends. You might be concerned that you will embarrass yourself by earning poor grades. You may have exaggerated the impact of an individual test, tying it directly to your career or life success. Feelings of helplessness: Instead of blaming your feelings on your lack of preparation, you blame it on the difficulty of the test, the inadequacy of the instructor, or other circumstances outside your control. This leaves you feeling victimized, helpless, out of control, and anxious. As a result, you waste valuable time contemplating your predicament and then don't study because you are convinced "it won't help anyway". "Negative self-talk" is when you unknowingly increase your test anxiety by reinforcing negative beliefs about yourself and your circumstances. Negative thoughts such as "I hate this class, I can't do this," "I'm going to fail this test," "I've never been good at taking tests," "This instructor writes terrible, unfair tests," and the like, set a tone that increases anxiety and sabotages success. How do I Know if I have Test Anxiety You probably have test anxiety if you answer YES to four or more of the following: 1. I have a hard time getting started studying for a test. 2. 3. 4. When studying for a test, I find many things that distract me. I expect to do poorly on a test no matter how much or how hard I study. When taking a test, I experience physical discomfort such as sweaty palms, an upset stomach, a headache, difficulty breathing, and tension in my muscles.
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5. 6. 7. 8. 9. 10.
When taking a test, I find it difficult to understand the directions and questions. When taking a test, I have difficulty organizing my thoughts. When taking a test, I often "draw a blank." When taking a test, I find my mind wandering to other things. I usually score lower on a test than I do on assignments and papers. After a test, I remember information I couldn't recall during the test.
WHAT CAN I DO ABOUT TEST ANXIETY? Many of the strategies available to combat test anxiety encourage you to focus your energies outward on exam preparation and performance. Here are some things you can do before, during, and after a test to reduce your test anxiety.
Use good note-taking and study techniques to gain cognitive mastery of the material that will be covered on the test. This mastery will help you to approach the test with confidence rather than have excessive anxiety. Maintain a positive attitude as you study. Think about doing well, not failing. Think of the test as an opportunity to show how much you have learned. Go into the test well rested and well fed. Get enough sleep the night before the test. Eat a light and nutritious meal before the test. Stay away from junk foods. Stay relaxed during the test. Taking slow, deep breaths can help. Focus on positive self-statements such as "I can do this." Follow a plan for taking the test. Don't panic even if you find the test difficult. Stay with your plan! Don't worry about other students finishing the test before you do. Take the time that you need to do your best. Once you finish the test, forget about it temporarily. There is nothing more you can do until the graded test is returned to you. Turn your attention and effort to new assignments and tests. When the graded test is returned to you, analyze it to see how you could have done better. Learn from your mistakes and from what you did well. Apply this knowledge when you take the next test.
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Top Ten 1. Avoid reading into the question Do not ask what if assume it is the ideal hospital and focus on the specific patient in the question not all patients with that condition/diagnosis Focus on key words 2. Look for key words Common cue words: early/late, best, first, initial, immediate, most/least likely, most/least appropriate 3. Use guidelines for prioritizing Maslows hierarchy, ABCs, Nursing Process Common cue words: best, essential, first, highest priority, immediate, most important, next, primary 4. Identify the response format Ask yourself whether the question is looking for the option that is accurate (true) or the option that is inaccurate (false) 5. Answering communication questions Select the answer that focuses on the client/significant others feelings, concerns, anxiety, fears 6. Eliminate similar options Options that include the same idea are typically wrong the correct option is different 7. Eliminate options that contain absolute words Common cue words that are incorrect: all, always, every, must, none, never, only 8. Look for the umbrella option If there appear to be several correct options, look for the general statement that encompasses all other correct options 9. Use guidelines for delegating assignments Match the clients needs with the providers scope of practice Noninvasive interventions (skin, grooming, hygiene, bathing, dressing, ambulating, ROM) nursing assistant Invasive interventions (dressings, suction, urinary catheterization, non-IV medications) LPN Assessment, Planning, Teaching, Supervising, IV meds RN 25 | P a g e [email protected]: Spring 2011; Spring 2012
10. Guidelines for answering pharmacology questions Try to relate the patients diagnosis to the medication Identify medication classification to determine action and side effects dont memorize every side effect for every medication rather class similarities or unusual critical effects Antacids effect medication absorption Never open capsules Never crush enteric coated pills Never advise patient to take herbals or OTC meds without consulting MD Avoid alcohol & smoking w/meds Dont administer a med if order unclear or dosage higher than normal Client should not adjust or d/c med without first consulting MD Other general strategies Read the question carefully identify stem & key words Eliminate options you know are incorrect (usually 2 are obvious) Identify similarities in options Remember 5 rights in medication administration When asking for assistance, do all nursing management activities first Delegation delegate the most stable client, to the most qualified person, do not delegate something if it has specific guidelines Resource: Silvestri, L. (2005). Saunders strategies for success for the NCLEX-RN examination. Philadelphia: W.B. Saunders.
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1. Always read the entire question carefully before making a selection. Underline key elements in the questions before reading the answer choices. Try to figure out what the question is really asking. 2. Never leave a question unanswered. If you can eliminate two answers, you have a 50% chance of answering correctly. 3. Read all answers. If you are sure/positive that an answer is incorrect, draw a line through it or dont keep counting it. 4. Eliminate distracters in the stem of the question. Ask yourself, What is this question really asking? 5. After you answer the question, read the answer back in the question if it is a completion-type question to be sure that it completes the sentence. 6. If you cannot answer the question, skip it, and return to it. This is to prevent you from spending too much time attempting to answer one question. But flag it somehow so that you remember to come back to it. 7. Only change an answer if you are sure that you made an error. If you recall a specific piece of information that tells you that your answer choice is incorrect, then change the answer. Otherwise, stick with your first choice. If you think that maybe, perhaps, probably DONT CHANGE IT! 8. Look for questions that ask for negative responses. (What should the nurse avoid? Or the except choice Also, look for the response that states that the nurse knows that the client needs more teaching when he or she does) 9. If you dont know an answer or never heard of a disease or procedure, this does not mean that you cannot answer the question. There may be a clue in the stem of the question that helps you answer the question. Use your knowledge of anatomy & physiology, medical terminology, and general nursing knowledge such as the nursing process or perioperative care to help you answer the question. 10. If all answers seem similar, but there is one that stands out and is obviously different from the others, it could be the answer. 11. If more than one answer seems correct and there is a global response (meaning one that includes all of the others, it could be the answer. 12. With priority questions, think about what you would do FIRST. All of the options may be correct to do, but you must think of what you would do first. What is most important?
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13. Use the Nursing Process as a guide to help answer questions. Sometimes priority questions require that you use the nursing process. (i.e. You must always assess before you intervene. Think to yourself, Do I have enough information, or do I need to further assess the client to determine what my plan and interventions will be?) 14. Remember your ABCs: AIRWAY, BREATHING, & CIRCULATION In an emergent situation, the ABCs are always key. You must have a patent airway. Your knowledge of this concept is often tested as well. 15. Dont be quick to select none of the above or all of the above. At times they may apply, but not very often. 16. Remember that Maslow is KING. What he says goes. Physiological needs such as food, water, shelter, and air always take precedence over psychosocial needs (self-esteem, love, belonging, etc.) This concept is often tested as a prioritization question. 17. Remember that with Select All That Apply questions, you must select all, otherwise no credit will be given for that question (no partial credit available). 18. Hot Spot questions require that you click in a specific area to identify an anatomical landmark or identify a body structure.
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You should be familiar with the terminology and structure of the multiple-choice question. This type of question consists of two parts. The stem is the incomplete sentence or direct question that states or asks the critical element of the question. The stem is followed by distracters, which are the four choices that are provided. If it is your basic multiple choice questions only one choice will ever be the correct answer. It is either the only correct answer or the best answer. Some multiple-choice examinations have another component, the situation, which is set in a different type style from the rest of the test. The situation underlies and supplies pertinent information for a group of questions. You will want to be certain that you are aware of, and understand all of, the information given in each situation before proceeding to the questions. SITUATION Be sure to read the situation carefully. Although it may only provide background information (e.g., Paul Brooks, RN, is counseling several clients on the psychiatric unit), it may provide relevant and valuable information about the question that follow it (e.g., Paul Brooks is a discontented nurse, as evidenced by his attitude. He is counseling several depressed clients on the psychiatric unit). In the latter example, both the fact that nurse Brooks is discontented and the fact that he is counseling depressed clients may influence the correct answer to the question. STEM 1. 2. 1. 2. 3. Read it carefully. Do not jump to conclusions. Look for what is asked, not what you think should be asked. Try to identify the critical elements to be tested. Look for key words or terms. Example: A new mother on the maternity unit asks the nurse what she should do about the little white heads on her babys nose. How should the nurse respond? The key words have been underlined. The critical element being tested is the nurses knowledge that the tiny white spots on a newborns noose are milia (resulting from obstructed sebaceous glands), which will disappear spontaneously. DISTRACTORS 1. Try to think of the correct answer before reading the distracters. Incorrect distracters are written to sound plausible. Example The nurse should advise the mother to do nothing about the spots because they will disappear spontaneously.
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2.
Read the distracters to find the correct answer. Example A. I will show you how to squeeze them gently. B. It is best to ignore them because they will disappear in a few weeks. C. The doctor will probably prescribe an antibiotic ointment. D. Carefully rub them with a sterile cotton ball dipped in Phisoderm. If you know the critical element, B is obviously the best selection.
3.
If you do not know the correct answer, or are not sure, all of the distracter should be considered. The answer can be derived by using problem-solving techniques and the process of elimination. It is better to guess from two possible choices (a 50 percent probability of selecting the correct answer) than from four possible choices (a 25 percent probability of selecting the correct answer). Usually, you will have enough basic knowledge to make an educated guess. Example Distracter A, C, and D suggest that the little whiteheads are abnormal. With regard to selection A, the nurse should know that newborns have little resistance to infection and that squeezing their nose could result in an overwhelming staphylococcal infection. Thus, distracter A is eliminated. The nurse should also know that the newborns skin is thin and delicate. Therefore, rubbing it, however carefully, could cause an irritation or an abrasion. Thus, distracter D is eliminated. Distracter C implies a pathological process that requires medical, not nursing, care. Now you must make the final choice: whether or not the whiteheads are within the norm (and you now have a 50 percent probability of answering correctly).
4.
Use common sense: Do not read into questions or answers. Be wary of words such as always, never, all, and none. Remember: the correct answer may be partially right, but never partially wrong.
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An alternate item format (previously known as an innovative item format) is an examination item, or question, that uses a format other than standard, four-option, multiple-choice items to assess the learners ability. NCLEX-RN standards have been raised slightly to reflect the increased acuity of patients that entry-level nurses care for in the current practice environment Alternate item formats may include: Multiple-response items that require a the student to select one or more than one response; More than one response can be correct: Select all that apply. If the answer choice is false throw it out as a possible answer Tests ability to differentiate, consider/judge clusters of data Example: A teen arrives on the pediatric unit for surgical correction of slipped capital femoral epiphysis. In assisting the adolescent with mobility preoperatively, which action(s) would be appropriate? Select all that apply. 1. Obtain the correct size crutches. 2. Tell the teen to bear only as much weight as is comfortable. 3. Assist the adolescent into bed and position comfortably. 4. Administer pain medications as needed. 5. Encourage active range-of-motion exercises in bed. You would select options 1, 3, and 4.
Fill-in-the-blank items that require a student to type in number(s) in a calculation item; One correct numerical answer Dosage calculation, I.V. drip rates, intake and output Calculation items should be rounded at the end of the calculation. (Per NCSBN) Example: The physician has ordered cefotetan disodium (Cefotan) 2 grams IV over 30 minutes to be infused one hour before surgery. The pharmacy sends a solution that has 2 grams Cefotan in 100 ml NS. What would the flow rate be in ml/hour to infuse this order? Answer: type your answer here ml/hour. You would type 200 in this box. Hot spot items that ask a student to identify one or more area (s) on a picture or graphic; Requires student to identify answer on an illustration Tests ability to locate anatomical structures (physical assessment, placement of tubes, injection sites) Tests ability to interpret waveforms (ECG, fetal monitoring) Tests positioning of equipment (seat belts, crutches)
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Example: In the image of the ECG complex below click on the area that would indicate the patient has had a myocardial infarction
Chart/Exhibit/Image Format where students will be presented with a problem and will need to read the information in the chart/exhibit to answer the problem; Example: A patient is admitted to the Emergency Department for treatment after stepping on a rusty nail at a job site. The physician orders Tetanus Immune Globulin 250 units IM stat. Which illustration indicates the angle at which this injection should be administered by the nurse? 1. A 2. B 3. C 4. D
Your answer should be 1. A Drag/Drop Ordered Response items that require a student to rank order or move options to provide the correct answer; Example: At the beginning of a 7 AM to 7 PM shift a nurse receives a report, which is completed by 7:20 AM. Place in order of priority the tasks that should be performed by the nurse. 1. Give a prn pain medication to a patient in pain 2. Change a patients dressing that must be done 2 times a day 3. Administer the ordered 8:00 AM medications to the patients on the unit 4. Obtain the vital signs of a patient who is complaining of shortness of breath Answer: _______________ You should have answered 4, 1, 3, 2
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Nursing students provide patient care, as well as complete a variety of assignments. As a nursing student, time management skills are extremely important. Learning time management for nurses as a student will help you later on in your nursing career. These same time management skills are important for your study habits. Time management skills can play a significant part in students completing assignments on time, grades, getting enough sleep, and having free time which we all need. Find a happy balance now and help avoid nurse burnout. General time management skills are important for everyone. Whether you work fulltime or part time, in your home or outside the home, are a student, or a stay at home parent, you will need to know how to manage your time. Not everyone situations is the same in nursing school. You may be a full time or part time worker, you may be a mother, father, sister, brother and the list goes online. Having a schedule (even if you have to change it up a bit now and then) can help keep you on track. You may find it helpful to plan meals in advance if you are a single parent with not a lot of family support. Typical person has many activities to do everyday. These things should be done to facilitate living. People however need to work to survive life. Earning for living is one among the major task of every individual. It is never easy to gain money; everyone should work hard for it. It is not only the working people who experience busy lives, but almost all people including the ones that lives at home, they are the ones who do all the house hold shores. Students as well, they also live busy lives. You, as a student, know how busy a student life is. Schools have so many activities and task to be done. Sometimes these activities are even brought home. Students are pre-occupied with these activities almost everyday of their lives. If they will not manage it well, they may neglect some of their activities that also need attention. These activities are also worthy to our life, like bonding with family members, spending time with friends and mingling with other people. A student may need to know how to handle all their tasks well to be able to manage it properly. Being a nursing student is a hard task. Nursing students deals with study of care to the people who need it. Nursing is the care for the sick and healthy people as well. It deals with activities such as feeding and caring for infants, promoting growth and development, promoting prevention to all the diseases, to preserve injuries and promote health faster wound healing and promoting good health to the entire citizen.
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A student nurse should learn these tasks. These students are learning how to deal with diseases that are not easy to learn. As you know, science is never an easy subject but most of the subjects in nursing course are under the curriculum. In nursing course, students need to learn many skills that are important for practicing the nurse profession. With all these activities, student nurses are not able to do some of their tasks other than learning nursing alone. Student nurses may need to prioritize all their activities to provide more room for other activities that are important as well. Time management maybe the best tool for student nurses. Time managements are one of the most important techniques that everyone needs to learn. This is a technique used by many people to facilitate better management of time. Activities are done in an organized manner. With the use of time management, these nursing students will be given the chance to perform other useful activities other than the nursing course itself. These following are suggestions that can be followed by the student nurses to manage time in a systematize manner. First thing to do is to organize all the activities to do. Make a checklist of the tasks with proper prioritization. After the end of the day, check off the completed or accomplished tasks. This is a great help in the identification of the tasks not yet done over a day. Begin to focus on the activities giving less priority to the things you do not need to do. Before venturing in to the activities that are not included in the list, your priority tasks must be done first. Avoid interruptions such as chatting with classmates and doing unnecessary activities. You can entertain these activities after your tasks are done. Avoid the activities that will suck all of your time. There are many activities that need much attention but with less productive outcome. Things like watching televisions, sending emails, chat on internet and telephone conversations are just some of the less important things you need to do for a day. Never give all or too much time on these activities. With proper time management, student nurses will be able to do other activities that also enhance their personality. Things like dealing with other people and establishing rapport during meeting other people. It is also healthy that people like student nurses give themselves a break from all of their activities for the day. This will be a great help to manage the precious time.
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Nurture Your Spirit Exercise as Part of Your Daily Routine Eat Whole Natural Foods Eat Consciously Drink Plenty of Water Use Visualization to Calm Your Mind Affirmations Heart-Centered Awareness Advanced Stop Technique Here are the instructions for practicing the Advanced Stop Technique. When you feel stress building from highly emotional communication, overwhelming situations, negative self-talk, etc, silently say stop to yourself. Visualize a stop sign in your mind Take a deep breath and focus your attention in and around the area of your heart, also known as your heart-space. Imagine that you are breathing into your heart-space and then bring to mind a loving moment, thought, or feeling. For instance you could imagine holding an infant; cuddling or petting a favorite pet; being in love, etc. From your heart-space, do one of the following: Ask yourself, What would be a useful or wise response to this situation? OR Repeat an affirmation that is meaningful to you in this situation such as: I feel calm and peaceful inside, I listen and respond with kindness & compassion. I am quiet & centered inside and choose what is best right now.
Diaphragmatic Breathing Progressive Muscle Relaxation Shortened Progressive Muscle Relaxation Deep Muscle Relaxation Autogenic Training Guided Imagery Mindfulness Meditation Affirmations
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Concept Mapping is a power learning and studying tool. Concept maps can be used for Diagnoses and Medications. Instructors and students reported satisfaction from use of concept maps in the educational process. Teaching with the aid of concept maps has been incorporated as an innovative and viable teaching method in nursing educatio. (2004) Concept maps are considered a powerful metacognitive tool that can facilitate the acquisition of knowledge through meaningful learning. (2006) WHY USE THE CONCEPT MAPS? Concept maps assess how well students see the "big picture". They have been used for over 25 years to provide a useful and visually appealing way of illustrating students' conceptual knowledge.
WHAT IS THE CONCEPT MAPS? A concept map is a diagram of nodes, each containing concept labels, which are linked together with directional lines, also labeled. The concept nodes are arranged in hierarchical levels that move from general to specific concepts.
Concept Map Resources http://www.stanford.edu/dept/SUSE/SEAL/Reports_ Papers/Vanides_CM.pdf http://www.flaguide.org/cat/conmap/conmap1.php http://www.ehow.com/how_5526833_makenursing-concept-map.html http://www.snjourney.com/ClinicalInfo/CarePlans/c onceptmapguide.pdf http://www.northshorecollege.edu/assets/docs/sea rchable/fpc-pn-ms2-MS2-MS3-ConceptMap.pdf
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CONCEPT MAPPING CONTENTS (suggestion) 1. CENTRAL FOCUS: The central focus is a picture that shows the idea or concept being depicted. This picture should be drawnnot cut out, and should give the viewer an immediate idea of what you are trying to show. 2. DIAGRAM LINES: Your map has primary lines coming out from your central focus and these contain your primary information (NANDAS). It also has secondary lines extending down from the primary line which contains the modifying information (interventions). ALL WORDS ON THE CONCEPT MAP ARE CAPITALIZED. There should be a minimum of 5-6 words per line. 3. COLOR AND PICTURES: You should use color and pictures throughout the map for emphasis of key information. Use of too many colors or pictures can be confusion. Use enough to draw the viewers interest. You are not graded on artistic ability, keep it simple. 4. RATIONALE CLOUDS: Rationales should consist of only 2-3 words which summarize why you have these interventions. What do you want to accomplish with these interventions. The rationales are placed in clouds and are connected to the group of interventions with a line of (ooooooo)s, 5. CORRELATION LINES: These lines are used to show the relationship between the primary information and the secondary information. A dotted line () shows the direct relationship between the primary information. How the NANDAS relate to each other. A dashed line (-----------) denotes indirect relationships between the secondary information or interventions. Do the interventions from one NANDA relate to the interventions of another NANDA? MAKING A CONCEPT MAP 1. Choose your central focus, for case study this will be your patient. 2. Create a picture to represent your central focus and place it in the center of your poster board/paper 3. Decide on your key information (NANDAS) by analysis your assessment information. Your NANDAS will also be used in your patient care plan. 4. Draw primary lines on poster from central focus. Place your primary information (NANDAS) on these line. Be sure that ALL LETTERS ARE CAPITALIZED. Place information in priority. 5. Organize all the secondary information (interventions, implementation, and patient teaching) 6. Draw secondary lines extending from the primary lines. Place measurable interventions on the secondary lines. Be sure that ALL LETTERS ARE CAPITALIZED 7. Add pictures and colors for emphasis on the things you think are important. 8. Analyze the correlation of primary information and secondary information and put in the appropriate lines (.) lines for primary information that relates and (----------) for secondary information that relates.
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Medical Diagnosis Inflammation of the lung parenchyma (respiratory bronchioles and alveoli.) Infectious caused by bacteria, viruses, fungi, protozoa and other microbes. Noninfectious caused by aspiration of gastric contents and inhalation of toxic or irritating gases. Classified as: community acquired, hospital acquired or opportunistic. Nursing Care Focuses on supporting optimal respiratory function & promoting rest to reduce metabolic & oxygen needs. Health Promotion: immunization against influenza & pneumococcal pneumonia.
Subjective Assessment productive cough of rust-colored or purulent sputum or nonproductive cough Chest aching/pain related to breathing Shaking chills Difficulty breathing or shortness of breath
Nursing Diagnosis- Ineffective breathing pattern related to pain
Outcome: maintain normal pulmonary function Intervention Provide for rest periods Assess for pleuritic discomfort. Provide analgesics as ordered Provide reassurance during periods of respiratory distress. Administer oxygen as ordered Teach slow abdominal breathing. Teach use of relaxation techniques, such as meditation, quiet music
Objective Assessment Fever Limited breath sounds and fine crackles or rales over affected lung Cough Respiratory excursion, use of accessory muscles of respiration Skin color may have cyanosis Dyspnea Diagnostic test WBC with differential Sputum specimen for C &S Chest x-ray or CT scan
Nursing Diagnosis- Activity intolerance
Problem Pneumonia
Outcome Intervention Assess activity tolerance, noting any increase in pulse, respirations, dyspnea, diaphoresis, or cyanosis. Assess with self-care activities, such as bathing. Schedule activities, planning for rest periods. Provide assistive devices, such as overhead trapeze. Enlist the familys help to minimize stress and anxiety levels Perform active or passive ROM exercise. Provide emotional support and reassurance that strength and will return to normal when the infectious process has resolved.
Nursing Diagnosis Ineffective airway clearance related to excessive sputum
Outcome- expectorate secretions effectively Intervention Assess respiratory status, including vital signs, breath sounds and skin color q 4 hours. Assess cough and sputum (amount, color, consistency, and possible odor) Monitor ABG results: report hypoxemia and other abnormal results to physician. Place in Fowlers or high-Fowlers position. Encourage frequent position changes and ambulation as allowed Increase fluid intake to 2500-3000cc per day Incentive spirometry q4h during waking hours
Erikson Development Stage
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Medical Diagnosis
Subjective Data
Nursing Diagnosis
Outcome STG: Intervention
Evaluation:
Objective Data Nursing Diagnosis
Chief Complaint
Outcome Intervention Nursing Diagnosis
Erickson Stages Outcome- STG Intervention Evaluation:
Rationale
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Disorder
Cause Risk Factors
Diagnostic Test
Signs & Symptoms
Nursing Interventions
Medications
Medical Treatments
Potential Complications
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Drug Category
Used for Indications
Adverse Reactions
Contraindications & Precautions
Drug Drug Interactions
Nursing Interventions
Client Education
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Abnormality defect, irregularity, anomaly, oddity Absence nonappearance, lack, nonattendance Abundant plentiful, rich, profuse Accelerate go faster, speed up, increase, hasten Accumulate build up, collect, gather Accurate precise, correct, exact Achievement accomplishment, success, reaching, attainment Acknowledge admit, recognize, accept, reply Activate start, turn on, stimulate Adequate sufficient, ample, plenty, enough Angle slant, approach, direction, point of view Application use, treatment, request, claim Approximately about, around, in the region of, more or less, roughly speaking Arrange position, place, organize, display Associated linked, related Attention notice, concentration, awareness, thought Authority power, right, influence, clout, expert Avoid keep away from, evade, let alone Balanced stable, neutral, steady, fair, impartial Barrier barricade, blockage, obstruction, obstacle Best most excellent, most important, greatest Capable able, competent, accomplished Capacity ability, capability, aptitude, role, power, size Central middle, mid, innermost, vital Challenge confront, dare, dispute, test, defy, face up to Characteristic trait, feature, attribute, quality, typical Circular round, spherical, globular Collect gather, assemble, amass, accumulate, bring together Commitment promise, vow, dedication, obligation, pledge, assurance Commonly usually, normally, frequently, generally, universally Compare contrast, evaluate, match up to, weigh or judge against Compartment section, part, cubicle, booth, stall Complex difficult, multifaceted, compound, multipart, intricate Complexity difficulty, intricacy, complication Component part, element, factor, section, constituent Comprehensive complete, inclusive, broad, thorough
Conceal hide, cover up, obscure, mask, suppress, secrete Conceptualize to form an idea Concern worry, anxiety, fear, alarm, distress, unease, trepidation Concisely briefly, in a few words, succinctly Conclude make a judgment based on reason, finish Confidence self-assurance, certainty, poise, selfreliance Congruent matching, fitting, going together well Consequence result, effect, outcome, end result Constituents elements, component, parts that make up a whole Contain hold, enclose, surround, include, control, limit Continual repeated, constant, persistent, recurrent, frequent Continuous constant, incessant, nonstop, unremitting, permanent Contribute be a factor, add, give Convene assemble, call together, summon, organize, arrange Convenience expediency, handiness, ease Coordinate organize, direct, manage, bring together Create make, invent, establish, generate, produce, fashion, build, construct Creative imaginative, original, inspired, inventive, resourceful, productive, innovative Critical serious, grave, significant, dangerous, life threatening Cue signal, reminder, prompt, sign, indication Curiosity inquisitiveness, interest, nosiness, snooping Damage injure, harm, hurt, break, wound Deduct subtract, take away, remove, withhold Deficient lacking, wanting, underprovided, scarce, faulty Defining important, crucial, major, essential, significant, central Defuse resolve, calm, soothe, neutralize, rescue, mollify Delay hold up, wait, hinder, postpone, slow down, hesitate, linger Demand insist, claim, require, command, stipulate, ask Describe explain, tell, express, illustrate, depict, portray
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Design plan, invent, intend, aim, propose, devise Desirable wanted, pleasing, enviable, popular, sought after, attractive, advantageous Detail feature, aspect, element, factor, facet Deteriorate worsen, decline, weaken Determine decide, conclude, resolve, agree on Dexterity skillfulness, handiness, agility, deftness Dignity self-respect, self-esteem, decorum, formality, poise Dimension aspect, measurement Diminish reduce, lessen, weaken, detract, moderate Discharge release, dismiss, set free Discontinue stop, cease, halt, suspend, terminate, withdraw Disorder complaint, problem, confusion, chaos Display show, exhibit, demonstrate, present, put on view Dispose to get rid of, arrange, order, set out Dissatisfaction displeasure, discontent, unhappiness, disappointment Distinguish to separate and classify, recognize Distract divert, sidetrack, entertain Distress suffering, trouble, anguish, misery, agony, concern, sorrow Distribute deliver, spread out, hand out, issue, dispense Disturbed troubled, unstable, concerned, worried, distressed, anxious, uneasy Diversional serving to distract Don put on, dress ones-self in Dramatic spectacular Drape cover, wrap, dress, swathe Dysfunction abnormal, impaired Edge perimeter, boundary, periphery, brink, border, rim Effective successful, useful, helpful, valuable Efficient not wasteful, effective, competent, resourceful, capable Elasticity stretch, spring, suppleness, flexibility Eliminate get rid of, eradicate, abolish, remove, purge Embarrass make uncomfortable, make selfconscious, humiliate, mortify Emerge appear, come, materialize, become known Emphasize call attention to, accentuate, stress, highlight Ensure make certain, guarantee Environment setting, surroundings, location, atmosphere, milieu, situation Episode event, incident, occurrence, experience
Essential necessary, fundamental, vital, important, crucial, critical, indispensable Etiology assigned cause, origin Exaggerate overstate, inflate Excel to stand out, shine, surpass, outclass Excessive extreme, too much, unwarranted Exhibit show signs of, reveal, display Expand get bigger, enlarge, spread out, increase, swell, inflate Expect wait for, anticipate, imagine Expectation hope, anticipation, belief, prospect, probability Experience knowledge, skill, occurrence, knowhow Expose lay open, leave unprotected, allow to be seen, reveal, disclose, exhibit External outside, exterior, outer Facilitate make easy, make possible, help, assist Factor part, feature, reason, cause, think, issue Focus center, focal point, hub Fragment piece, portion, section, part, splinter, chip Function purpose, role, job, task Furnish supply, provide, give, deliver, equip Further additional, more, extra, added, supplementary Generalize to take a broad view, simplify, to make inferences from particulars Generate make, produce, create Gentle mild, calm, tender Girth circumference, bulk, weight Highest uppermost, maximum, peak, main Hinder hold back, delay, hamper, obstruct, impede Humane caring, kind, gentle, compassionate, benevolent, civilized Ignore pay no attention to, disregard, overlook, discount Imbalance unevenness, inequality, disparity Immediate insistent, urgent, direct Impair damage, harm, weaken Implantation to put in Impotent powerless, weak, incapable, ineffective, unable Inadvertent unintentional, chance, unplanned, accidental Include comprise, take in, contain Indicate point out, sign of, designate, specify, show Ineffective unproductive, unsuccessful, useless, vain, futile Inevitable predictable, to be expected, unavoidable, foreseeable
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Influence power, pressure, sway, manipulate, affect, effect Initiate start, begin, open, commence, instigate Insert put in, add, supplement, introduce Inspect look over, check, examine Inspire motivate, energize, encourage, enthuse Institutionalize to place in a facility for treatment Integrate put together, mix, add, combine, assimilate Integrity honesty Interfere get in the way, hinder, obstruct, impede, hamper Interpret explain the meaning of, to make understandable Intervention action, activity Intolerance bigotry, prejudice, narrow mindedness Involuntary instinctive, reflex, unintentional, automatic, uncontrolled Irreversible permanent, irrevocable, irreparable, unalterable Irritability sensitivity to stimuli, fretful, quick excitability Justify explain in accordance with reason Likely probably, possible, expected Logical using reason Longevity long life Lowest inferior in rank Maintain continue, uphold, preserve, sustain, retain Majority the greater part of Mention talk about, refer to, state, cite, declare, point out Minimal least, smallest, nominal, negligible, token Minimize reduce, diminish, lessen, curtail, decrease to smallest possible Mobilize activate, organize, assemble, gather together, rally Modify change, adapt, adjust, revise, alter Moist slightly wet, damp Multiple many, numerous, several, various Natural normal, ordinary, unaffected Negative no, harmful, downbeat, pessimistic Negotiate bargain, talk, discuss, consult, cooperate, settle Notice become aware of, see, observe, discern, detect Notify inform, tell, alert, advise, warn, report Nurture care for, raise, rear, foster Obsess preoccupy, consume Occupy live in, inhabit, reside in, engage in Occurrence event, incident, happening Odorous scented, stinking, aromatic
Offensive unpleasant, distasteful, nasty, disgusting Opportunity chance, prospect, break Organize put in order, arrange, sort out, categorize, classify Origin source, starting point, cause, beginning, derivation Pace speed Parameter limit, factor, limitation, issue Participant member, contributor, partaker, applicant Perspective viewpoint, view, perception Position place, location, point, spot, situation Practice do, carry out, perform, apply, follow Precipitate to cause to happen, to bring on, hasten, abrupt, sudden Predetermine fi x or set beforehand Predictable expected, knowable Preference favorite, liking, first choice Prepare get ready, plan, make, train, arrange, organize Prescribe set down, stipulate, order, recommend, impose Previous earlier, prior, before, preceding Primarily first, above all, mainly, mostly, largely, principally, predominantly Primary first, main, basic, chief, most important, key, prime, major, crucial Priority main concern, giving fi rst attention to, order of importance Production making, creation, construction, assembly Profuse a lot of, plentiful, copious, abundant, generous, prolifi c, bountiful Prolong extend, delay, put off, lengthen, draw out Promote encourage, support, endorse, sponsor Proportion ratio, amount, quantity, part of, percentage, section of Provide give, offer, supply, make available Rationalize explain, reason Realistic practical, sensible, reasonable Receive get, accept, take delivery of, obtain Recognize acknowledge, appreciate, identify, aware of Recovery healing, mending, improvement, recuperation, renewal Reduce decrease, lessen, ease, moderate, diminish Reestablish reinstate, restore, return, bring back Regard consider, look upon, relate to, respect Regular usual, normal, ordinary, standard, expected, conventional Relative comparative, family member
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Relevance importance of Reluctant unwilling, hesitant, disinclined, indisposed, adverse Remove take away, get rid of, eliminate, eradicate Reposition move, relocate, change position Require need, want, necessitate Resist oppose, defend against, keep from, refuse to go along with, defy Resolution decree, solution, decision, ruling, promise Resolve make up your mind, solve, determine, decide Response reply, answer, reaction, retort Restore reinstate, reestablish, bring back, return to, refurbish Restrict limit, confine, curb, control, contain, hold back, hamper Retract take back, draw in, withdraw, apologize Reveal make known, disclose, divulge, expose, tell, make public Review appraisal, reconsider, evaluation, assessment, examination, analysis Ritual custom, ceremony, formal procedure Rotate turn, go around, spin, swivel Routine usual, habit, custom, practice Satisfaction approval, fulfillment, pleasure, happiness Satisfy please, convince, fulfill, make happy, gratify Secure safe, protected, fixed firmly, sheltered, confident, obtain Sequential chronological, in order of occurrence Significant important, major, considerable, noteworthy, momentous
Slight small, slim, minor, unimportant, insignificant, insult, snub Source basis, foundation, starting place, cause Specific exact, particular, detail, explicit, definite Stable steady, even, constant Statistics figures, data, information Subtract take away, deduct Success achievement, victory, accomplishment Surround enclose, encircle, contain Suspect think, believe, suppose, guess, deduce, infer, distrust, doubtful Sustain maintain, carry on, prolong, continue, nourish, suffer Synonymous same as, identical, equal, tantamount Thorough careful, detailed, methodical, systematic, meticulous, comprehensive, exhaustive Tilt tip, slant, slope, lean, angle, incline Translucent see-through, transparent, clear Unique one and only, sole, exclusive, distinctive Universal general, widespread, common, worldwide Unoccupied vacant, not busy, empty Unrelated unconnected, unlinked, distinct, dissimilar, irrelevant Unresolved unsettled, uncertain, unsolved, unclear, in doubt Utilize make use of, employ Various numerous, variety, range of, mixture of, assortment of Verbalize express, voice, speak, articulate Verify confirm, make sure, prove, attest to, validate, substantiate, corroborate, authenticate Vigorous forceful, strong, brisk, energetic Volume quantity, amount, size Withdraw remove, pull out, take out, extract
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Academic Skills Center http://www.dartmouth.edu/~acskills/success/notes.html Blooms Taxonomy http://www.utexas.edu/academic/ctl/assessment/iar/students/plan/objectives/bloom.php Bon Secours Memorial College of Nursing Academic Success Resources http://bsmcon.edu/current-students-academic-success-resources.html Center for Academic Success UMDNJ School of Nursing http://sn.umdnj.edu/studentsonly/cas/Managing%20Your%20Time.pdf Cornell Note-Taking System http://academic.cuesta.edu/acasupp/AS/619.htm National Council State Board of Nursing https://www.ncsbn.org/index.htm RN NCLEX TEST PLAN 2013 https://www.ncsbn.org/1287.htm Sanger Learning System University of Texas http://www.utexas.edu/ugs/slc/study & http://www.utexas.edu/student/utlc Stress Management Exercises for Nursing Students http://www.ahna.org/Resources/StressManagement/ForNursingStudents/ExercisesforStudents/tabid/1816/De fault.aspx Study Guide and Strategies http://www.studygs.net/texred2.htm Time Management for Nursing and Nursing Students http://www.nurses-neighborhood.com/time-management-for-nurses.html Wisc-Online is a digital library of Web-based learning resources called "learning objects." http://www.wisc-online.com/ Colgrove, K., Hargrove-Huttel, R. 2 Edition. Med-Surg Success : A Course Review Applying Critical Thinking to Test Taking ISBN-13: 978-0-8036-2504-4 Boman, J., Gul R (2006) Nurse Education in Practice Concept mapping: A strategy for teaching and evaluation in nursing education Volume 6, Issue 4 , Pages 199-206 Nugent, P., Vitale, B. 2 Edition. Fundamentals Success: A Q&A Review Applying Critical Thinking to Test Taking ISBN-13: 978-0-8036-2779-6
nd nd
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Student Success Taking Notes &amp Studying

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Spring 2011; Spring 2012

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Prepare for Success

Read / Take Notes

Seek out nursing resources you need along the way

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Do not pick a chair that is too comfortable.

Instead, sit at a desk with a straight-back chair and plenty of light.

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S=SURVEY Determine the structure or organization of the chapter.

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LEVEL OF LEARNING Knowledge: rote memory; recall of specific information.

Comprehension: basic understanding; putting an idea into your own words.

Application: applying knowledge and concepts to a new situation.

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Nursing Diagnosis- Ineffective breathing pattern related to pain

Nursing Diagnosis- Activity intolerance

Nursing Diagnosis Ineffective airway clearance related to excessive sputum

Erikson Development Stage

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Outcome STG: Intervention

Objective Data Nursing Diagnosis