-
Website
http://thehappyhospitalist.blogspot.com/ -
Original page
http://thehappyhospitalist.blogspot.com/2008/05/pop-quiz-dr-nurse.html -
Subscribe
All Comments -
Community
-
-
Top Commenters
-
Popular Threads
All Comments
The pharmacology and histo-based ones killed me.
Technically on 7, the stratum lucidum is right underneath the stratum corneum; the next best answer is granulosum ("Californians Love Girls in String Bikinis").
Anyone know the reasoning on 20?
Note to self: don't use TestPrepReview.com
Its an old fashioned way of looking at antiarrhythimics!
Quinidine & Procainamide are "traditionally" known as Class IA, Mexilitine is Class IB & Amiodarone is Class III.
Class I is subdivided based on the time to recovery & altho amiodarone "fits" with both quinidine & procainamide based on this one factor, it does it entirely differently (mostly due to blocking the K channels).
Quinidine & Procainamide are conisdered open state blockers & Amiodarone is considered an inactivated state blocker.
Bad Question = throw it out!
Love your blog though. I see your point. Here is my point. I don't want to be a doctor I want to be a nurse and part of being a nurse is having sufficient medical knowledge to care for the patient, to communicate to aberrant pt responses to treatment, to recognize and intervene with appropriate treatment when a pt responds to treatment adversely, to communicate to the pt about their disease processes should they have any more questions after you have left---again all of which is predicated upon a decent amount of medical knowledge.
We covered all of that stuff in the pre-required courses to get -in- to nursing school.
Maybe I just went to a particularly thorough community college, but all of the questions you asked were right out of 100's level bio, A and P and psych.
Bullshit. You learned about SIADH in a prereq bio class in a community college?
Bullshit. You learned about SIADH in a prereq bio class in a community college?<<
Yes indeedy, in anatomy and physiology, 200's level biology courses (I went to a two-year school). Our school is relatively well-known for the quality of it's nursing program, so the microbiology, bio and A and P teachers specifically go out of their way to include content that will help prepare us for nursing school.
You know what else? We get WAY more hours at the bedside than our local state and private four-year universities as well.
Honestly, I don't know what's so suprising about people learning about elementary disorders of the endocrine system. Using basic pathophysiology to help students understand things like the renal regulation of osmolarity, the intravascular fluid space and neuroendocrine processes just makes sense.
While I'm on the subject, If you actually look at nursing curriculum (and NCLEX-RN prep for that matter), you'll find questions that are much more difficult than what's in this post.
For example, we're responsible for knowing the actual numbers for arterial blood gasses, not just "low" "high" and "normal", and our questions tend to ask us to differentiate between partially compensated values in addition to too much of one thing or not enough of another.
It's constantly suprising to me how little doctors know about what Nurses do and how we're prepared. None of the medical students I've talked to received any formal training on the subject.
We receive a great deal of formal training on how to deal with doctors, however. We are the last line of defence against lazy, tired, impaired or incompitant doctors. We receive a lot of training on how to guide doctors to write the orders we already know the patients need. The scope of competant nursing practice includes knowledge of the above, since if we carry out an incorrect order, we are the ones to blame because we are trained to know better.
There's a lot of grumbling in the AMA about stripping NPs of the ability to diagnose and treat diseases, and this is unfortunate, since it represents a perversion of the same "free market" that MD's seem to cherish in the health care delivery system. It smacks more of protecting their six-figure educational investment rather than improving patient outcomes and delivering quality care to the most people possible.
That's a very different story than a prereq bio course taken BEFORE nursing school. If you get an ASN, A&P is taken in nursing school.
"While I'm on the subject, If you actually look at nursing curriculum (and NCLEX-RN prep for that matter), you'll find questions that are much more difficult than what's in this post."
None of the questions posted are representative of the difficulty of questions actually on the USMLE, like Megan said. Most of them are 2-3 steps - such as "The patient has these symptoms - what are the side effects of the first-line treatment?"
If you're assuming I don't know much about nurses, you're completely wrong. My wife is a nurse, and she already looked over my USMLE-World questions and gave up after just several. She didn't even know where to begin.
"It smacks more of protecting their six-figure educational investment rather than improving patient outcomes and delivering quality care to the most people possible."
No one else is going to look out for a physician's best interests.
2) The idea of nurses being able to even come remotely close to passing step 1 is just laughable.
That's a very different story than a prereq bio course taken BEFORE nursing school. If you get an ASN, A&P is taken in nursing school.<<
Where I went to school, it was a are much more difficult than what's in this post."
None of the questions posted are representative of the difficulty of questions actually on the USMLE, like Megan said. Most of them are 2-3 steps - such as "The patient has these symptoms - what are the side effects of the first-line treatment?"<<
Well, those are the questions you presented, so those were the ones I had to work with. If you were actually talking about different questions, maybe you should have posted those?
>>If you're assuming I don't know much about nurses, you're completely wrong. My wife is a nurse, and she already looked over my USMLE-World questions and gave up after just several. She didn't even know where to begin.<<
The difference isn't so much in the education, I think, after all, we're studying the same organism. All I had to go on was the questions you posted, and anyone who thinks you can get through nursing school without learning about the elementary things you posted doesn't have a clear understanding of how nurses are prepared. Apparently you were talking about a completely different set of questions that weren't posted ::shrug::
>>"It smacks more of protecting their six-figure educational investment rather than improving patient outcomes and delivering quality care to the most people possible."
No one else is going to look out for a physician's best interests.<<
Reducing the role of nurse practitioners serve physicians interests how?
>>1) These questions are nowhere near the difficulty of actual step 1 questions. I'm studying for step 1 now and honestly, these questions seem like they were taken from a bogus website. Virtually every S1 question is a clinical situation with "double pump" q/a choices....not simple one liners like this.<<
It doesn't seem like that large a jump, really, I think the big difference is how the theory is put into practice, not so much the academic preparation.
>>2) The idea of nurses being able to even come remotely close to passing step 1 is just laughable.<<
You are, like most people without a clear understanding of the nursing profession, painting nurses as a whole with a broad brush. There's lots of levels, lots of specialties, and lots of focuses of preparation.
Sure, maybe the majority of nurses (60% of us only have associates degrees) don't have that detailed of a level of understanding, but many do. It all depends on what the job requires. If your job only requires that you know the ins and outs of say 20 medications, 50 procedures and 10 diagnoses or so, then some people are naturally going to just focus in on that grind and forget about the bigger picture because it's not important to their work.
I think you'll find that the people who excel, however, continue learning and broadening their understanding, and you might be surprised by what they know.
I was just remarking to a fellow student how the boards must have been so much easier 20 years back...PCR was just born, nobody even dreamt of sequencing the genome, and cancer was a big nebulous question mark (still is actually, I feel bad for med-students in 2030).
I guess on the upside the exam is computerized now.
__________________
An 82-year-old man has multiple chronic lesions on his face and back. The lesions are 0.5-1.5cm, well-circumscribed, light brown, and slightly raised with a rough surface. The clinician examining the patient is able to "peel away" parts of the lesion with the dull side of a scalpel. The lesions seen here would be most likely to have which of the following histologic features:
A) Koilocytic features
B) Melanocytes in the upper levels of the epidermis
C) Nuclear atypia of basal cells
D) Pseudo-horn cysts
E) Tripolar mitoses
_________________________
28 year old patient diagnosed with multiple sclerosis. Treated with an initial therapy X, but found side effects intolerable. Now is given a drug that is administered by SubQ injection. The new drug mimics Myelin Basic Protein. Which drug is it?
A) Baclofen
B) Glatiramer acetate
C) Levamisole
D) Mitoxantrone
E) Natalizumab
______________________
Last one: Woman brings her child to a public health clinic for the first time. The physician notices small pigmented macules over the child, including the buccal mucosa, lips, palms, and skin not exposed to sun. The child is at increased risk for which of the following?
A) Angiomyolipoma
B) Cystic Kidney Disease
C) Glioblastoma
D) Pancreatic Cancer
E) Renal Cell Carcinoma