Exam Administration and Analysis

1. You will work with your preceptor to develop 5 MCIs on the content related to
your lecture content. Test Questions. Submit the test questions you developed
here. For each question, designate the correct answer(s) by asterisk (*). Indicate
Blooms cognitive level (use application or analysis levels only. Note: depending
on the situation, your questions may or may not be used in the exam.
Test Questions for Immunity-Tuberculosis
1. A nurse is conducting an educational session with community members
regarding tuberculosis (TB). The nurse tells the group that the first symptoms
associated with TB is:
A. Bloody, productive cough
B. A morning cough with the expectoration of mucoid sputum***
C. Chest pain
D. Dyspnea
Answer: B
Rationale: The first pulmonary symptom includes a slight morning cough with
expectoration of mucoid sputum. Options A, C, and D are late symptoms and
indicate extensive lung involvement.
Content Area: Adult health/ Respiratory
Patient/Client Need: Health promotion and maintenance
Cognitive Level: Application
Integrated Process: Teaching/Learning
2. A nurse performs an admission assessment on a client with a diagnosis of
Tuberculosis (TB). The nurse reviews the results of which diagnostic test that
will confirm this diagnosis?
A. Bronchoscopy
B. Chest x-ray
C. Sputum culture***
D. Tuberculin skin test
Answer: Sputum culture
Rationale: Definitive diagnosis of TB is confirmed through culture and
isolation of Mycobacterium Tuberculosis. A presumption diagnosis is made on
the basis of a tuberculin skin test, a sputum smear that is positive for acidfast bacteria, a chest x-ray, and biopsy.
Content Area: Adult health/ Respiratory
Patient/Client Need: Physiological Integrity
Cognitive Level: Analysis
Integrated Process: Nursing Process/Assessment

3. A nursing instructor asks a nursing student to describe the route of

transmission of tuberculosis. The nursing instructor concludes that the
student understands this route of transmission if the student states that TB is
transmitted by:
A. The airborne route***
B. Blood and body fluids
C. The fecal-oral route
D. Hand to mouth
Answer: The airborne route
Rationale: Tuberculosis is an infectious disease caused by the bacillus
Mycobacterium Tuberculosis and is spread primarily the airborne route.
Options B, C, and D are not correct.
Content Area: Adult health/ Respiratory
Patient/Client Need: Safe, Effective Care Environment
Cognitive Level: Analysis
Integrated Process: Teaching/Learning
4. A client with tuberculosis is being treated with isoniazid and rifampin. A nurse
is preparing instructions for a client regarding these medications. Which of
the following statements would be included in the plan of care?
A. You must discontinue the medication if gastrointestinal irritation occurs.
B. You must take the medication with meals.
C. The entire course of medication needs to be completed.***
D. Fluids must be increased while taking this medication
Answer: The entire course of medication needs to be completed.
Rationale: The client needs to be instructed that the entire course of
medication needs to be completed. It is preferable to take the medication one
hour prior or 2 hours after a meal. If GI upset occur, the medication should
not be discontinued, and in this situation a small amount of food may be
taken to reduce the irritation. It is not necessary to increase fluids while
taking this medication.
Content Area: Pharmacology
Patient/Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Integrated Process: Teaching/Learning
5. A nurse is reading a Mantoux skin test for a client with no documented health
problems. The site has no induration and a 1mm area of ecchymosis. The
nurse interprets that the result is:
A. Positive
B. Negative***
C. Uncertain
D. Borderline

Answer: Negative
Rationale: A positive reading has an induration reading 10m or more. A small
area of ecchymosis is considered normal and probably related to the injection
technique.
Content Area: Adult health/ Respiratory
Patient/Client Need: Physiological Integrity
Cognitive Level: Analysis
Integrated Process: Nursing process and Analysis

6. A nurse is preparing to give a bed bath to an immobilized client with

tuberculosis. The nurse should plan to wear which of the following items
when performing this care?
A. Particulate respirator, gown, and gloves.***
B. Particulate respirator and protective eyewear
C. Surgical masks and gloves
D. Surgical masks, gown, and protective eyewear
Answer: Particulate respirator, gown, and gloves.
Rationale: The nurse that is in contact with the client with TB should wear an
individually fitted particulate respirator. The nurse would also wear gloves per
universal precautions, and wear a gown when clothing could become
contaminated, such as when giving a bath.
Content Area: Adult health/ Respiratory
Patient/Client Need: Safe, Effective Care Environment
Cognitive Level: Application
Integrated Process: Nursing Process/Implementation
2. Include the Test blueprint that was developed for the exam. If there was
no test blueprint, develop one from the exam as it was administered.
Exam 3 Grid
o Cellular Regulation24 questions
o Sexuality12 questions
o Immunity18 questions
o Interpersonal4 questions
o Dosage calculation--2
3. Overall Test Analysis and Individual Question Analysis
a. See McDonald (2014) chapters 11 and 12 and provide an analysis of the
exam as a whole including
i. Number of items
---60
ii. Number of examinees--48
iii. Mean76.58
iv. Median76.82
v. Low Score63.46
vi. High Score85.17

vii.
KR 20 or reliability coefficient: recommended rangethe test
analysis did not give the KR20. According to McDonald, the estimates
provided by these formulas are indications of the degree to which the
individual item responses correlate with the total test score or how well a test
correlates with itself.
viii. One to two sentences describing your overall evaluation of the
exam.
1. This was a hard test based on the mean score of 76.58.
The students did not do well on this test.

4.
Question analysis: See McDonald p. 284 and Evaluate 3 individual items
(does not have to be the one you wrote)
1. P value or item difficulty
a. DiscriminationGood-10questions, Fair- 20
questions, Poor-26 questions, Not calculated -4
questions
2. Point biserial for each question option (A-D)1.67

A client with tuberculosis is being treated with isoniazid and rifampin. A

nurse is preparing instructions for a client regarding these medications.
Which of the following statements would be included in the plan of
care? Pvalue= 0.97, 97% students answered correctly 47/48
a. You must discontinue the medication if gastrointestinal irritation
occurs.
b. You must take the medication with meals.
c. The entire course of medication needs to be completed.***
d. Fluids must be increased while taking this medication
A nurse is preparing to give a bed bath to an immobilized client with
tuberculosis. The nurse should plan to wear which of the following
items when performing this care? Pvalue=0.875, 87.5% students
answered correctly 42/48
a. Particulate respirator, gown, and gloves.***
b. Particulate respirator and protective eyewear
c. Surgical masks and gloves
d. Surgical masks, gown, and protective eyewear
A patient who is newly diagnosed with stage 4 colon cancer asks the
nurse, What does it mean that I have stage 4 colon cancer?
pvalue= 0.979, 97% of students answered correctly, 47/48

5. Coaching: using Exam Diagnostics Tool (EDT) or other tool

discussed/recommended by preceptor.
Refer to the folder on Blackboard with EDT resources including video
examples.

a. Discuss the testing coaching process using the EDT. Place the
experience in context by providing a sentence or two about the
student you coached. Provide one completed testing coaching
forms you used with the student. Write a narrative reflection about
this experience, including student response.
b. The student that I coached is generally a good student. She does
well on her grades including previous 2 tests. She made a 74 on
this test.
c. EDT Coaching Tool.doc
d. I had a pleasant experience visiting with this student. She felt her
main problem was that she changed several answers. The test is
conducted on the computer, the program used does not allow for
students to go back. Once the student accepts the answer, the
program moves on to the next question. I learned that the testing
process offered by MCC is much like the NCLEX. The students will
not be able to go back to the previous question when they take
state boards, and this testing process allows for the students to get
used to testing. The student was very open. The concepts that were
tested over were very broad, the student did not know exactly what
to concentrate on.
Grading Criteria Exam Activities and Analysis
Category

Points earned

Test Blueprint
5 submitted questions
Test analysis
Question analysis
Coaching documentation
Total

20
20
20
20
20
100