Write a research paper titled “Analyse test items and congruence using blue prints.”

Write a research paper titled “Analyse test items and congruence using blue prints.”Do faculty have questions for you? What was the best thing about the test? What aspect(s) of the test needs clarification? For example, was the purpose of the test clearly defined? Was the desired difficulty and discrimination levels of the test items and rationale clearly explained? Were you able to determine the scoring procedure(s) that will be used? Was the arrangement of items on the test organized with write specific directions for each item format? Were the general directions for the test clear? Was there a scoring key? Was the explanation to students regarding how students were to prepare for taking the test clear and concise? Were there any grammatical or spelling errors? What suggestions might you offer to your colleagues.

3. A minimum of two (2) questions and constructive criticism or feedback ** answer questions and make sure ask minimum of 2 questions to each and constructive criticism

Test Blue Print: Physical Examination: General Survey, Vital Signs, and Pain

The purpose of this test is to prepare pre-licensure BSN students to meet competency standards related to physical examination. It includes assessing the patient’s vital signs, pain level, and general survey. A basic understanding of normal and abnormal vital signs, pain levels, and normal and abnormal physical assessments will be assessed. The test consists of fifteen questions and will test the student’s knowledge, comprehension, and application to basic patient assessment.

The test questions will vary in difficulty based on the type of questions, and material. Since NCLEX utilizes multiple-choice, list-in-order, and case study questions, this test will aim to provide varying types of question formats as well (Oermann & Gaberson, 2021). All questions will be objective without utilizing an essay question format (Oermann & Gaberson, 2021). The difficulty level for this test will be based on the type of question but should be between .30 and .70. The discrimination index should be above .20.

Learning Objectives

Upon completion of this test students will:

1, Identify normal and abnormal vital sign readings. (Remembering)

Differentiate between inspection, auscultation, percussion, and palpitation evaluation methods and utilize them in the correct order. (Understanding)
Apply pain scales to patient assessments as the fifth vital sign. (Applying)
Compare and Contrast general survey assessments as normal or abnormal. (Analyzing).
Learning objectives will span the cognitive domain from lower levels of basic knowledge to the application of that knowledge in analyzing case studies (Oermann & Gaberson, 2021).

Content
R
U
Ap
An
Total #b
I. General Survey
1

1
2
4
II. Methods of Assessment
3
1
1

5
III. Vital signs
2
1

1
4
IV. Pain

1
1

2
Total #b
2
1
4
8
15
1. Remembering
Multiple choice (3), True/ False (3)

Assesses: identifying, recalling, naming
2. Understanding
List in Order (1) Multiple choice (2)

Assesses: differentiating, interpreting, drawing conclusions
3. Applying
Case study (3)

Assesses: predicting, modifying, demonstrating
4. Analyzing
Multiple choice (3) Assesses: comparing, contrasting, and identifying nursing interventions.
The following levels of learning as evidenced by Bloom’s taxonomy include:

R Remembering
C Understanding
Ap Applying
An Analyzing
bTotal Number of points (Oermann & Gaberson, 2021, p. 55).

Reference

Oermann, M. H, & Gaberson, K.B. (2021). Evaluation and testing in nursing education.

(6th ed). Springer Publishing Company.

Purpose and Preparation

The purpose of this exam is to prepare pre-licensure BSN students to meet competency standards related to physical examination. It includes assessing the patient’s vital signs, pain level, and general survey. A basic understanding of normal and abnormal vital signs, pain levels, and normal and abnormal physical assessments will be assessed. Students will participate in simulation labs where they will practice general patient assessments. Students will also prepare for this exam by attending lectures, reading assigned chapters in their textbook, and reviewing a test blue print study guide.

Difficulty and Discrimination Levels

Each question on this exam will be worth four points for a total score of fifty possible points. Partial credit will be given for test questions that may require more than one answer. The difficulty level for this test will be based on the type of question but should be between .30 and .70. The discrimination index should be above .20 which is desirable for most exams like this (Oermann& Gaberson, 2021).

Cover Page with General Directions

Name___________________________ Exam #_______ (this will be numbered by proctor)

Basics of Assessment: General Survey, Vitals, Pain Exam

Directions:

This exam will cover the unit on basic assessment including general survey, vitals, and pain examinations.
This test will be fifteen questions in length.
Please do not write anything other than your name on this cover sheet.
You can write your answers with a pen or pencil in the space provided for each question.
Each question will be worth four points each, with options for partial credit on questions that require multiple answers.
The questions are in various formats including multiple-choice, true-false, and others so please pay careful attention to them.
There is a time limit of thirty minutes, and you will be notified when five minutes are remaining.
If you have a question, please raise your hand and the proctor will come to you.
When you have finished your exam, please leave it with the proctor at the back of the room and you may exit.
Regular class instruction time will resume after testing approximately at 12:30.

1. You are assessing your patient on morning rounds, what skin assessment findings would be considered abnormal? Select all that apply.
a. Cyanosis
b. Diaphoretic
c. Pallor
d. Pitting edema
e. Warm and Dry

2. Which of the following general survey assessment findings refers to the abnormal accumulation of fluid leading to swelling in the body?
a. Cyanosis
b. Diaphoresis
c. Edema
d. Pallor

3. Which of the following pain assessment scales is most commonly used to evaluate pain intensity in pediatric patients?
a. McGill Pain Questionnaire
b. Numeric Rating Scale
c. Visual Analog Scale
d. Wong-Baker FACES Scale

4. Fill in the Blank: The numerical rating scale is a commonly used pain assessment tool where patients are asked to rate their pain on a scale from 0 to 10 with 0 being no pain and 10 being__________________________________________________________.

5. Which of the following symptoms is most associated with hypertension?
a. Confusion, weakness, and slurred speech
b. Dizziness and lightheadedness upon standing.
c. Nausea, vomiting, and abdominal pain
d. Severe headache and visual disturbances

6. True or False (circle one): Tachycardia refers to a heart rate that is slower than normal.

7. At what point does the systolic blood pressure cross the threshold into hypertensive crisis?
a. 90 mmHg
b. 120 mm Hg
c. 180 mmHg
d. 200mmHg

8. Which of the following is most associated with hypotension?
a. Chest pain and shortness of breath
b. Severe headache and ringing in the ears.
c. Stomach pain and diarrhea.
d. Dizziness and lightheadedness

9. Directions: for each assessment finding in Column A, select the proper term in
Column B.
Column A (Assessment) Column B (Term)
_____1. Unusual Yellowing of skin
——-2. Bluish skin and mucosa
——-3. Reddened skin
——-4. Pale skin a. Cyanosis
b. Pallor
c. Flushed Skin
d. Jaundice

10. Examine the picture below. Select the area of the chest by marking an X where you would auscultate the heart. (picture of a male patient in a hospital bed)

11. You begin your morning assessment of Mrs. Jones. She is a 77-year-old female admitted with syncope. She has a history of Diabetes Mellitus, hypertension, and anemia. Her vital signs are 80/50, heart rate 95, respirations 18, temperature 98.8, and oxygen saturation 98%. She states she feels lightheaded especially when she stands up.
1. Which vital sign do you think is causing her symptoms?
2. What would you need to communicate with her doctor about?

12. You are caring for a 50-year-old woman who had a right mastectomy with lymph nodes removed for breast cancer a year ago.
1. What are some special concerns for obtaining her vital signs?
2. How would you communicate this with other staff members?

13. When assessing the abdomen what assessment methods would you utilize? Select all that apply.
a. Palpation
b. Percussion
c. Auscultation
d. Inspection

14. You are caring for a white male who is a post-op patient who had abdominal surgery two days ago. As you begin your assessment you notice that his skin is pale, and he seems to be very tired. You look back at the following nurses’ notes:
Date Time Skin Assessment
1/15 2130 Pink, warm, dry
1/15 0800 Pink, warm, dry
1/14 2200 Pink, warm, dry

What would be concerning regarding your assessment?
What other assessments would you do?
Would there be any labs you would anticipate obtaining?

15. You check your patient’s vital signs and notice that their blood pressure is 70/50, and their heart rate is 122. What would be your first intervention?
a. Ask them to tell you what day it is.
b. Get them to drink some water.
c. Help them stand up to assess for any dizziness.
d. Place the head of the bed in Trendelenburg.

Answer Key
1. A, B, C, D
2. C
3. D
4. The Worst Pain ever
5. D
6. False
7. C
8. D
9. 1: D, 2: A, 3:C, 4:A
10. On the patient’s left chest.
11. Her blood pressure is low, or hypotensive. Communicate blood pressure and her symptoms of feeling lightheaded.
12. Blood pressure should not be taken in the right arm, to prevent lymphedema. Communication should be provided to all staff members with possible signage to alert other staff members not to take blood pressure readings in the right arm.
13. A, B, C, D
14. His skin has been warm, pink, and dry. Now his skin color is pale. Check his vital signs including blood pressure and heart rate. Blood work such as a CBC.
15. D

PLEASE SEPEARTE BOTH INTO DIFF PARAGRAPHS THANKS

Next one is **

In the healthcare setting, a nurse routinely auscultates a client’s lung sounds to determine the patient’s ventilation status and if any complications are present.
True
False
Conducting airways are a conduit of airflow that “conditions” inspired air we breathe. And lung airway structures are where gas-exchange happens within the lungs. Both are important parts of our respiratory system and are compiled of many different underlying structures.
Directions: For each group you must match the underlying structure for that category (Conducting or Lung). Drag each underlying structure into its respective category as it pertains to the respiratory system.
Items:

Alveoli

Bronchi

Bronchioles

Larynx

Lobules

Mouth

Nasal Passages

Pharynx

Trachea

During the respiratory assessment the nurse notices the client is having some shortness-of-breath. After auscultating the lung sounds, the nurse notices some high-pitched, musical sounds coming from the left lower lobe. This sound is primarily heard during expiration. Based on these findings, which abnormal breath sound is being described?
Wheeze
Crackles-coarse
Pleural Friction Rub
Crackles-fine
Select All that Apply:
From the list below choose which items are considered Objective Health Data.
Wheezing in the lower lobes
History of COPD
Cyanosis of the lips
Oxygen saturation of 90%
Complains of SOB
Family History of lung cancer
You are taking care of a client who was recently diagnosed with COPD (Chronic Obstructive Pulmonary Disorder). This client is getting ready to discharge, as the nurse what is the MOST important education you should make sure this patient receives?
Smoking cessation will slow the progression of this disease.
Immunizations against respiratory infections will decrease your likelihood of contracting life-threatening infections.
You should not include breathing exercises into your daily regimen.
Oxygen therapy may be prescribed if your condition worsens.
You are a new graduate nurse in the Critical Care Unit. You have a client with End-Stage COPD who has been admitted with dyspnea, increased respirations, wheezing, and pleuritic chest pain. During your morning assessment you notice that the patient’s oxygen saturations are at 88%, and he is on 6L via nasal cannula. You also notice that the patient’s work of breathing has increased, and his respirations are now 24 bpm. After reviewing the subjective and objective data, what would be your next nursing intervention?
Increase the patient’s oxygen.
Call the doctor for further instructions.
Come back in 30minutes to reassess.
Instruct the patient to turn, cough, and deep breathe.
During your respiratory assessment it is important to include all aspects of the assessment. This includes auscultation, percussion, palpation, and inspection. While palpating your patient’s posterior thorax, you must test the patient’s chest expansion. At what level on the back does the nurse need to place their hands to examine chest expansion?
You have a client on your floor that has become increasingly short-of-breath, they have a Temperature of 101.3, and they have a productive cough. You were able to obtain a sputum culture for this patient. During auscultation you notice some coarse crackles in the lower lobes. Upon further investigation you remember this patient has a history of COPD. Based on these new symptoms, what could be this patient’s diagnoses?
Asthma
Tuberculosis
Pneumonia
Cancer
Select All that Apply:
You just admitted a client to your unit with active Tuberculosis. What are some clinical manifestations that you would expect this patient to have?
Fever
Weight gain
Night sweats
Blood-tinged sputum
Dyspnea
Pain
A client is admitted to your floor for difficulty breathing. When the client arrives, he seems to be uncomfortable, and you notice he is wearing oxygen. After further review, you ask the patient “Do you wear oxygen at home?”
This question is an example of obtaining what kind of health data?
Subjective Health Data
Objective Health Data
A 20-year-old male has been admitted to the trauma unit related to a car accident. During the accident the client obtained a concussion, left tibia fracture, broken nose, broken ribs, and a punctured right lung. During your shift assessment at 0800 you find the client’s oxygen saturation at 98% on 2L via nasal cannula, his respiratory rate at 20, his heart rate at 80bpm, his Temp is 98.1, and his BP is 130/86. He does complain of a pain scale of 5/10 related to his chest tube in the right lung. You make sure to assess the tube site and it is free of drainage, the tube is secured, the dressing is occlusive, and the tubing is free from kinks. During auscultation you notice both lungs are clear. You give the patient some Dilaudid 1mg for the pain and come back to re-assess in 30 minutes.
0830 You go back to your client’s room to find him in extreme distress. His respirations are 30bpm, HR is 120, oxygen saturation is now at 85%, and his BP is 100/65. Upon further assessment you notice he has a tracheal deviation, and on auscultation his right lung sounds are absent.

What is your next nursing intervention based on the information above?
Obtain a chest x-ray.
Assess the chest tube for kinks.
Prepare for a thoracentesis.
Call the Doctor
In what order does the nurse perform the respiratory assessment:
Percuss, Palpate, Inspect, and Auscultate
Auscultate, Inspect, Palpate, and Percuss
Inspect, Palpate, Percuss, and Auscultate
Inspect, Auscultate, Palpate, and Percuss
You just received a shift report from the night shift nurse in the Critical Care Unit. You have received a 65-year-old, male with a diagnosis of Sepsis due to Urinary Tract Infection. During your shift assessment you notice the client cannot complete sentences without gasping for air in between words. On inspection you notice his lips are blue, his work of breathing has increased, and he is sitting in the tripod position. He is currently on 2L via nasal cannula, and he has no prior history of any respiratory or cardiac diseases. While assessing your client his bed side monitor beeps. Based on the vital signs below, and the information listed above, what would you expect to do next?
Time
HR
RR
O2
Temp.
BP
0400
80
18
92% 2L
98.1
135/78
0800
115
24
83% 2L
100.1
95/45

Call the Doctor
Assess the patient’s lung sounds.
Administer Antibiotic therapy.
Call the Rapid Response Team
During auscultation of the lungs the nurse notices a low-pitched, grating sound. It occurs during inspiration and expiration. What would the nurse chart this finding as?
Crackles (Fine)
Sonorous Wheeze
Pleural Friction Rub
Sibilant Wheeze
Fill in the Blank: You are assessing your client’s respiratory system. Part of your assessment includes percussion. During percussion you would expect to hear ­­­­­­­­_________________sounds over healthy lung tissue.

Answer Key:

True
Lung
Larynx Alveoli
Mouth Lobules
Nasal Passages
Pharynx
Trachea
Bronchi
Bronchioles
Wheeze
A, C, D,
A
D
T9-T10 Spaces
C
A,C, D, E
A
B
D
C
Hyperresonance

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