Wednesday, December 10, 2014

Cramming for exams: Prioritizing at its finest

Quick.  You have, for whatever reason, not kept up with the reading for a class.  Tomorrow is the final, and you don't know what you're doing.

(Bear with me.  I pulled an involuntary all-nighter--my brain just would not stop racing.  Granted, that's not all that uncommon while in school, still, I am not sure I'll write what I mean to write, so, if something sounds nonsensical, it probably is.  Hopefully that'll add to the post since I'm assuming you're reading this post because you're cramming, probably with an all-nighter.)

I've been reading my Asinine Testing Insanity book for this OB test tomorrow, trying to cram the whole thing into one night of reading, which, I'll admit, isn't the best plan I've had this year, but, we do what we gotta do.  (I mean, they did say it doesn't count, right?)  By now, you've taken at minimum, one test, usually more like 4, and you know where your weak spots are.   For example, I know that the question about normal neonate head circumference always gets me (it is, by the way, 32-36.8 cm or 12.6-14.5 in, which sound like numbers people made up just to make me mad, but they aren't), and I always forget what "telangiectatic nevi" is (stork bites, or flat red marks that blanch, found around the infant's face, that are benign and fade by second year).

Lab values are maddening, but one of the best things to capitalize on.  They change from source to source.  My tip?  Memorize the ATI values (vs the professor's values) because these questions will only pop up once or twice on a 50 question exam from your professor, and you can afford to miss 2 points on a unit exam, but you don't want to mess up on the ATI and have to repeat the course--and standardized tests love to screw you on lab values.

Data you just need to know cold.  There's no way around it.  Some data you're just going to have to route memorize.  For me it was just repeating it, writing it, posting it next to light switches and on bathroom mirrors over and over and over, one fact per day, like memorizing a series of phone numbers (remember back in the day when people actually had to remember phone numbers?  I can still recite my childhood home number from over 20 years ago: 312-985-4715).  And sure, I forget it, but if I glance at them before an exam I can still recall them.

And that's not to say I've got everything memorized.  Like today, I've only got 20% of neonatal data memorized.  But you know what?  Honestly, there are general things you should know, like VS, and the rest will come on a printout when you're at work, so don't sweat it.

Speaking to my classmates, I don't have these memorized, and I'm betting not many of you have these memorized either, so here's the ATI version:

For term babies
Expected VS:
BP: 60-80/40-50mmHg** NOTE: this is different than our professor's ranges of 60-80/45-55mmHg
HR: 100-160/min ** NOTE: this is different than our professor's range of 110-160bpm
Resp: 30-60 c up to 15 seconds of apnea
Temp: 36.5-37.2C or 97.7-98.9F axillary

Expected reference ranges of physical measurements:
Weight: 2,500-4,000 g
Length: 45-55cm
Head circumference: 32-36.8cm (or about 2-3 cm larger than chest circumference due to cephalocaudal development)
Chest circumference: 30-33cm

Expected lab values: 
Hgb: 14-24 g/dL
Hct: 44-64%
RBC: 4,800-7,100,000/mm3
Leukocyte: 9,000-30,000mm3
Platelets: 150,000-300,000/mm3
Glucose: 40-60
Bilirubin: 0-6 mg/dL on day 1; 8mg/dL or less on day 2; 12 mg/dL or less on day 3

Good luck today!



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