Multiple response select N questions on the NextGen NCLEX . . . that is a whole month full of words! I can assure you that it sounds worse than it is.
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I am going to walk you through answering a multiple-response select N question and give you some insight into what these questions look like.
This might be new or unfamiliar to you, and you might have some nursing knowledge to gain in order to answer this particular question, but my goal is to give you some strategies for making the new and unfamiliar a lot less scary.
Let's get started.
You'll know that it's a multiple-response select N question by the following:
- More than 1 possible response a.k.a multiple possible responses
- The question specifies the NUMBER of responses to select
- Squares or boxes next to responses
Here is an example below:
So the question will say something like select four instead of select all that apply.
Doesn't this sound really familiar?
This is going to look a lot like a "select all that apply" question or a SATA question. In fact, you're going to see the same little boxes or squares that allow you to make multiple selections as we see on "select all that apply" questions.
Practice Multiple Response Select N Questions
Another thing that's going to help you with these next-generation item types is the utilization of the EHR or the electronic health record.
You can actually look through the following
- Patient description
- Nurses' notes
- History and physical
- Flow sheets
This information will help give you some indication about the correct item choices or the correct responses to the question. Pretty exciting, right?
Here are some examples:
Patient Description:
Nurses Notes:
Flow Sheet:
Alright, so here are some helpful tips for answering these types of questions.
One way is to cover up the answer choices that you're not considering. That way you can look at each of them one at a time. You can even treat each answer option as its own true or false statement.
Let’s do an example using the question below.
True or false is IV Labetalol a medication that the nurse might anticipate the client receiving to address the client's clinical condition and prevent complications in order to mitigate the effects of intracranial hemorrhage?
First, what is IV labetalol?
It's a beta-blocker. Did you notice on the Flow Sheets from the EHR, this patient's crazy hypertension and tachycardia? I bet you did! A beta-blocked will treat hypertension and tachycardia, so that's a good choice.
Practice NCLEX Prep Questions Here
Following the same process you'll go down to each of the medications and make a decision on whether or not this is a good option.
Another strategy that can help especially when we look at meds is to sort of group them together.
For example, we know that IV labetalol treats hypertension, and nicardipine does as well, since this patient is dealing with a major hypertensive crisis, that's also a good medication.
Now the other three medications also have something in common. They all treat clotting.
However, two of them treat clotting a little differently than the third.
Vitamin K and fresh frozen plasma aid in the clotting cascade. In this patient's case of intracranial hemorrhage, we do need to make sure that we're treating clotting.
HOWEVER, before we pick these medications, we should also go over the history and physical in the EHR and look at the client's home meds to see if there are any contraindications.
Now, something that I can tell right off, this patient is taking Coumadin and he has an intracranial hemorrhage.
Coumadin is an anticoagulant that is going to cause prolonged bleeding and this guy's already bleeding, so he needs everything he can get to help with clotting from medications like fresh frozen plasma and vitamin K.
Since he's taking Coumadin, we can tell that tissue plasminogen activator or TPA is actually contraindicated in this case.
Thanks to our nursing knowledge, and referring to the EHR, we know that the nurse can anticipate administering these four medications:
- IV labetalol
- Fresh Frozen Plasma
- Vitamin K
- Nicardipine
Remember the question asked, to select 4 medications the nurse might anticipate the client receiving to address the client's clinical condition and prevent potential complications.
Great work! Not so bad, right?
Before we close, Let’s talk about the linchpins:
- Item Type: Multiple Response Select N
- How to Answer: The question asks to select a specific number of responses
- What Helps: Pick out clues from the EHR based on what the question is asking - “address the client's clinical condition & prevent complications”
- Clinical Judgment: Knowing contraindications
Did you know that right now at NURSING.com, you can practice multiple response select N questions for free?
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Happy Nursing!
If you enjoyed this blog check out our other NextGen article:
Ultimate Guide in answering Matrix multiple Response on the NextGen NCLEX
