Write one stem nurse-patient scenario and then five multiple-choice test items, one for each phase of the nursing process, that relates to the scenario. Two test items need to be analysis multiple choice and three test items critical thinking multiple choice. For each test item written, identify the phase of the nursing process. Write clear, concise directions above the stem/scenario that applies to the set of five multiple choice test items. Place an asterisk (*) at the end of the one correct answer for each of the five multiple choice test items.
Write one true-false test item with clear, concise directions for the test-taker.
Write one matching test item exercise with at least six correct answer options. Write clear, concise directions for students above the matching exercise.
Review examples and follow best practices for writing each type of test item from the readings in McDonald.
Include an introduction (not an abstract), body of paper using APA (7th ed) Level 1 and Level 2 headings to separate different sections based on types of test items with examples, and a summary which highlights what you have learned from this exercise in item writing. Close with a conclusion based on the purpose of this paper.
Developing Multiple-Choice, Critical Thinking, True-False and Matching Test Items
Student’s Name
Institutional Affiliations
Developing Multiple-Choice, Critical Thinking, True-False and Matching Test Items
When evaluating the competency levels of their students, teachers must demonstrate fairness in the process by using valid and reliable tools. Instructors often use assessment questions to collect information regarding what students have mastered after the completion of a course (McDonald, 2017). Assessment questions are considered reliable when they are able to obtain similar scores with the same students irrespective of who or where an evaluation is conducted. Conversely, assessment questions are considered valid when they are designed in a manner that allows ranking of students based on their knowledge levels (Hinton et al., 2017). Some of the competencies that teachers usually assess in their learners are critical thinking and analysis skills. Multiple-choice tests, true-false tests, and matching test items are some of the assessment approaches used by educators to evaluate the critical thinking and analysis skills of learners in relation to the taught concepts (McDonald, 2017). Aligning these tests to specific stem nurse-patient scenarios promotes learning by enhancing the integration of the taught concepts to address a patient’s needs. The purpose of this assignment is to develop five multiple-choice test items, both analysis and critical thinking, that reflect the nursing process in relation to a stem nurse-patient scenario. The author will also develop one true-false test item and one matching test item exercise that relates to the stem nurse-patient scenario. The author will then highlight the lessons learned from the exercise.
Stem Nurse-Patient Scenario
A 68-year-old white male patient reports to the clinic with shortness of breath (SOB) or dyspnea. He also reports a cough. According to the patient, the current symptoms have lasted for 3 days and they have worsened progressively since day one. He denies noting any relieving or aggravating factors. The patient indicates that he has hypertension which he has been managing effectively using medication for the past two years. He reports past history of smoking and obesity. He also reports a history of chronic obstructive pulmonary disease (COPD) which required hospitalization a year ago. The patient is using 25 mg of Losartan orally daily to manage hypertension. To be able to effectively handle the patient described in this scenario, the nurse must apply critical thinking and cognitive analysis skills throughout the nursing process. The use of multiple-choice, true-false, and matching test items will enable the nurse educator to assess whether nursing students can successfully assess the patient’s needs, make an accurate diagnosis, develop a nursing care plan, implement the most appropriate interventions to treat the patient’s symptoms, and evaluate the effectiveness of the chosen interventions (McDonald, 2017).
Multiple-Choice Test Items
The following are the examples of five multiple-choice test items, one for each phase of the nursing process, that relates to the scenario above. Three test items are critical thinking multiple-choice questions while two test items are analysis multiple-choice questions.
Assessment Phase (Critical Thinking Multiple-Choice)
- The nurse assesses that a patient who has chronic obstructive pulmonary disease (COPD) exacerbation has shortness of breath (SOB) as one of the vital signs. Which one of the following choices give the most appropriate group of additional objective data that the nurse should collect to establish a nursing diagnosis in the given scenario? (Rawat & Sharma, 2021).
* a. Cardiovascular functioning, pulmonary functioning, musculoskeletal system functioning around the chest/thorax (Rawat & Sharma, 2021).
- Pulmonary functioning, musculoskeletal system functioning, abdominal functioning
- Pulmonary functioning, endocrine functioning, cardiovascular functioning
- Hematologic system functioning, cardiovascular functioning, and integumentary system functioning
Diagnosis/Analysis Phase (Analysis Multiple-Choice)
2.. Which of the following should be the initial diagnostic tests to perform to the patient described in the scenario based on the subjective data indicating that he has severe shortness of breath or dyspnea? Choose all that apply. (American Academy of Family Physicians, 2022).
* a. Electrocardiogram
* b. Chest radiograph
- Thyroid stimulating hormone test
* d. Pulmonary function test
Planning (Critical Thinking Multiple-Choice)
- When developing a nursing care plan for the patient described in the scenario, which client need or problem should the nurse give priority? (Rawat & Sharma, 2021).
- A history of COPD
- The fact that the patient has hypertension
* c. Dyspnea/shortness of breath
- A cough
Implementation (Analysis Multiple-Choice)
- The nurse has confirmed through diagnostic tests that the patient has COPD exacerbation and recommends starting him on salbutamol, a short-acting bronchodilator inhaler. To ensure patient safety during drug use, the nurse should teach the patient to observe the following except? (Peche et al., 2021).
- Use the medication as prescribed by adhering to the recommended dose and time of use
- Report to the clinic or make a call when strange symptoms occur
* c. Double the dosage when dyspnea worsens
- Visit the clinic for evaluation and guidance when the drugs are depleted
Evaluation (Critical Thinking Multiple-Choice)
- To evaluate the effects of salbutamol on the patient’s symptoms, which clinical data should the nurse collect to monitor the drug’s effectiveness? (Peche et al., 2021).
- An improvement in dyspnea
- Improvement in coughing
- Absence of wheezing
* d. All of the above
True-False Test Items
The following is an example of a true-false test item directing the test-taker to state whether the given statement is true or false in relation to the stem nurse-patient scenario;
Direction: In patients presenting with SOB such as the one described in the scenario, an electrocardiogram is usually performed to detect skeletal abnormalities in the chest (American Academy of Family Physicians, 2022).
- True
* b. False
Matching Test Item Exercise
The nurse educator can use the following example of a matching test item exercise to evaluate students’ understanding of the rationale for conducting various diagnostic tests in a patient with COPD exacerbation;
Direction: In the space to the left of each diagnostic test in column I, fill in the specific clinical data from column II (using numbers) that each test is meant to measure in a patient with COPD exacerbation. Use each clinical data only once. (Mayo Clinic, 2022).
| Column I (Diagnostic tests) | Column II (Clinical data) |
| a. 6 Lung/pulmonary function test or spirometry | 1. Oxygen saturation of the blood |
| b. 4 Chest X-ray or radiograph | 2. Emphysema |
| c. 2 Computed tomography/CT scan of the lungs | 3. Gaseous exchange between the lungs and the blood |
| d. 5 Electrocardiogram | 4. Skeletal abnormalities in the chest |
| e. 3 Arterial blood gas analysis | 5. Abnormalities of the heart rate or rhythm |
| f. 1 Pulse oximetry | 6.The ability of the lungs to supply enough oxygen to the blood |
Summary of Lessons Learned and Conclusion
One major lesson has been learned from this item writing exercise. The specific lesson learned is that even multiple-choice, true-false, and matching test items are good ways of assessing learning outcomes. Therefore, it is appropriate to conclude that when developed appropriately, multiple-choice, true-false, and matching test items can serve as reliable and valid ways of evaluating nursing student’s understanding of how to effectively approach a stem nurse-patient scenario.
References
American Academy of Family Physicians. (2022). Diagnostic evaluation of dyspnea. https://www.aafp.org/afp/1998/0215/p711.html#:~:text=The%20most%20useful%20methods%20of,or%20exclude%20many%20common%20diagnoses.
Hinton, J. E., Mays, M. Z., Hagler, D., Randolph, P., Brooks, R., DeFalco, N., Kastenbaum, B., & Miller, K. (2017). Testing nursing competence: validity and reliability of the nursing performance profile. Journal of Nursing Measurement, 25(3), 431-458. doi: 10.1891/1061-3749.25.3.431. PMID: 29268828.
Mayo Clinic. (2022). COPD: Diagnosis. https://www.mayoclinic.org/diseases-conditions/copd/diagnosis-treatment/drc-20353685#:~:text=During%20the%20most%20common%20test,walk%20test%2C%20and%20pulse%20oximetry.
McDonald, M. E. (2017). The nurse educator’s guide to assessing learning outcomes. 4rth ed. Jones & Bartlett Learning
Peché, R., Attar-Zadeh, D., Scullion, J., & Kocks, J. (2021). Matching the inhaler to the patient in COPD. Journal of Clinical Medicine, 10(23), 5683. https://doi.org/10.3390/jcm10235683