Friday, September 18, 2009

CRNE Exam Questions..Isn't there more than 1 right answer?

One of the most common concerns we have from students is that the CRNE exam often appears to have more than 1 right answer in the list of choices.
Lets work through an example:

Question:

1.  Jonathan is a 4 year old boy who was recently diagnosed with diabetes.  His family appears to be coping well, but they tell you they feel as though they are alone, and can't speak to their friends about their experiences.  Which of the follow responses would be most appropriate?

a. "I can see you are upset, would you like to talk about it?"
b. "You seem to be coping very well, I know things are difficult now, but most families say things improve with time"
c.  "It is important to remember that although diabetes is difficult, it is not as terrible as some of the other diseases that can effect children"
d.  "Many families find it helpful to speak with other people who have experienced similar feelings or circumstances, would you like me to arrange for you to speak with one of these families?"

First, lets look at option a.


"I can see you are upset, would you like to talk about it?"


Good Points:  This is often answer students choose.  It is the first answer, and it appears to be supportive, open ended and appears that the nurse is approaching the family in a caring way.
Bad Points:  Although this answer invites more questions, it doesn't address the families concerns.  Remember, the family has stated that they feel alone, and that they can't speak to their friends about their experiences.


Ok, let's deconstruct option b.

"You seem to be coping very well, I know things are difficult now, but most families say things improve with time"


Good Points:  Good points are hard to find with this response.  You are acknowledging what you are seeing in the family, but you are not addressing the families concerns.
Bad Points:  Again, you are not addressing the families concerns.  Think about how the family would feel, they would most likely feel as though the nurse gave them the "brush off".  The CRNE exam is designed to ensure that you are responding to the patient.  So, Eliminate b as an option!


Now, lets look at option c.

"It is important to remember that although diabetes is difficult, it is not as terrible as some of the other diseases that can effect children"


Good points: I can't think of any!  This is a complete brush off, and does not address the concerns of the family at all.
Bad Points:  Option C is designed to be a dead give away.  Remember, on a multiple choice exam there is often 1 answer that you can eliminate right at the beginning.  


Finally, lets look at option d.

"Many families find it helpful to speak with other people who have experienced similar feelings or circumstances, would you like me to arrange for you to speak with one of these families?"

Good points:  This question is both supportive, as well as responsive to the families concerns.  Return to the original question...what is the family telling you?  They are telling you they feel alone.  Offering to connect them to other families is the right answer.

Connecting the dots.....
-Hopefully you would have been struggling to choose between a. and d.
If you read the question carefully, you realize that d is the response that best answers the families concerns.

This is just one example of a question that can confuse you on the CRNE Exam.
Make sure you read the question carefully and choose the response that best addresses the concerns of the patient, family, or situation.

If you would like to work through more of these types of questions, join us for our course, January 9th and 10th, 2010!