# Nursing Entrance Test - for mathematicians or nurses?

By Murray Bourne, 01 Feb 2009

Some years ago I taught math to a group of trainee nurses. The aim of the course was to prepare these students for drug calculations, drip rates, temperature taking and so on.

I have to say I got quite concerned as the course proceeded. Many of the students had great difficulty with fractions, percentages, decimals and rates — all the things that a nurse should be competent in before doing any calculations that could end up being life-threatening.

I vowed that if I was ever hospitalized, I would require the nurse to let me check the drug calculation before I let them come near me with the syringe.

Anyway, recently I was looking over some preparation material for a nursing entrance test. The Nursing Pre-Entrance Exam Online Course has some practice tests available. The one on fractions and square roots made me wonder whether these students were going to undertake a math major, or whether it really was for nurses.

None of the questions even vaguely mentions nursing. I know it is a Pre-Entrance Exam, and they haven't even studied any nursing yet, but if they are going to prepare for this sort of test, why not do it in the context of nursing? By making it look like math (and not like something that will be useful), it is more likely to increase math anxiety and be counter-productive.

For example, the following question would leave many people wondering how it would help them to be a better nurse.

Which of these numbers is a factor of 21

A. 2

B. 5

C. 7

D. 42

E. 44

I suspect students would find this next question hard because of the language used. It would seem like a trick question:

If the value of x and y in the following fraction are both tripled, how does the value of the fraction change?

XZ / Y

The Advanced Algebra test also seems a lot more mathematical than nursing-specific. For example, here's a question with poor grammar that I imagine many students will not be able to do, and I'm not sure they really need the skill for nursing:

If the average of three numbers is V. If one of the numbers is Z and another is Y, what is the remaining number?

A. ZY - V

B. Z/V – 3 - Y

C. Z/3 – V - Y

D. 3V- Z - Y

E. V- Z – Y

Then there's this one:

6. Which of the following is not a rational number?

A. -4

B. 1/5

C. 0.8333333……

D. 0.45

E. √2

Don't get me wrong. I think the math behind most of the questions is just fine and I can see how much of it can be related to nursing. But the questions were clearly written by math people, not nursing people. I would prefer my nurse could calculate the correct drip rate, rather than solve something like the algebra or rational number questions above.

Any nurses like to comment?

See the 5 Comments below.

1 Feb 2009 at 6:49 pm [Comment permalink]

Actually in my school,

artsstudents can study Biology. If they would like to be nurses in the future, a grade in Biology in the HKCEE would suffice. However although I, a science student good at Math, also studies Biology, I must say that there are only a few mathematical calculations in the syllabus, like subtraction and reading/drawing graphs.Just for your interest.

9 Feb 2009 at 1:16 am [Comment permalink]

Interesting you'd write that. Check out nurse studies by Hoyles, Noss and Pozzi - one of my all-time favorite pieces of mathematics education research. The differences between zero mistakes on the ward, where proportional reasoning is situated in practice, and some forty percents on the standardized, context-free tests OF THE SAME MATH CONTENT... It blew my mind when I read the study, but it makes perfect sense.

[This paper is no longer available.]

22 Feb 2009 at 4:15 pm [Comment permalink]

Lisa:Thanks for the input. Sadly, a lot of science courses reduce the math content as much as possible so as not to scare off students...Maria:Thanks - it's a great paper.There are still lots of math educators who stick stubbornly to a "keep it pure and un-applied - it's good for 'em" policy. But this research points to the conclusion that quite a different approach is needed.

"In situ" is the key term used - students should be placed in as many 'real' situations as possible and required to figure out problems that require mathematical thinking. The 'correct' way to do it may not bare any resemblance to the way their text book says it should be done.

23 Feb 2009 at 2:00 am [Comment permalink]

We just had a funky conversation at the Living Math mailing list about kids being fluent in tenths and hundredths, but not general decimals - because their "in situ" decimal knowledge is limited to money. The knowledge is robust, but not transferable.

The discussion of whether we should keep math general and abstract ("pure"), or situated and applied, is like asking if you'd rather walk on just your left leg, or just your right leg.

I think you need to work with many situations, AND abstract and formalize generalities arising from all the situations. One without the other is lame ^_^

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I have an OT question: do you know of any forum where people interested in multiplicative reasoning research hold discussions of their work?

23 Feb 2009 at 1:31 pm [Comment permalink]

Hi Maria

Another Maria has a post on the issue (kind of) here: Multiplication as many groups of the same size.

As for the applied thing, I did say "as many ‘real’ situations as possible" - not 100% applied (which of course, is not possible or practical).