I find that many RN's stress about the possibility of being asked a clinical type question that they don't know how to answer.
They feel like they may be 'tested' on their nursing skills and knowledge and feel exposed and embarrassed if they don't know how to respond.
You know the type of question..."A patient presents with chest pain, what do you do?"
It is very difficult to prep for clinical scenarios. It's basically impossible! Because they could ask you literally anything. The options are endless.
So get your nose out of your med-surg textbook and stop stressing about it. Right now. Instead - you just need to focus on the big picture of how to answer a clinical question, should it even get asked. (and it's a slim chance it actually will!)
Here are 3 tips for answering clinical scenario questions in your RN interview:
1. Consider the nursing assessment process (ADPIE)
Assessment: You get more info
Diagnosis: You figure out what's happenin'
Planning: You make a plan with the patient/team
Implementation: Ya do it
Evaluation: You see how it went
Here is an example that ties this all together: A patient has chest pain, what do you do?
A:"I would start by further assessing the patient. I would ask them to describe their pain and get a set of vital signs.
D: I would call the physician to let them know and see what orders are needed for further investigation.
P/I: I would anticipate orders for an EKG, labs, pain meds, and oxygen. I would keep the patient and family informed of this plan.
E: I would continue to monitor the patient, assessing pain and any worsening symptoms until test results come back and additional plans are made.
If you truly don't know what types of interventions could be warranted - keep it vague! In this situation you could say 'tests and medications' instead of 'EKG, labs, oxygen'
#2 Think about prioritization and communication
You're never on an island when dealing with a patient. You're working with a team and you can ask for help and delegate! In fact - you should be doing that. So feel free to incorporate these into your response.
If you're asked about how you would prioritize which patient you'd see first out of x,y, or z - you can talk about your personal prioritization, and how you may also work within the greater team.
For example – “you have a patient with their call light on needing to use the bathroom, a patient with dementia who just set off their bed alarm, and a patient requesting nausea medication. Who do you see first?”
“First, I would respond to the bed alarm to make sure this patient is safe and isn’t going to fall. While assisting this patient back to bed, I would probably see if I have a nurse tech who can help get my patient to the bathroom in a timely manner. I would bring some nausea medication to my patient once I got my dementia patient settled. If it was taking a while, I could call the charge nurse or another coworker to help get my patient the nausea medication.”
#3 Don’t overthink it and just be honest
If you don’t know specific answers – don’t make it up or pretend you know what you’re talking about. You can speak in more generalization.
For example – let’s say the interview asks: “Your post-op cardiac patient was previously in normal sinus rhythm and now they are in atrial fibrillation. What diagnostic and treatment interventions do you expect?”
And you’re like…uhhh….
Don’t get too much in your head about needing the ‘right answer.’ Here is a more generalized response:
“First I would go see my patient and see how they are feeling. I would get a full set of vitals. I would let them know about the change in their heart rhythm and that I was going to contact the physician. Then I would notify the physician of the change in rhythm and provide them with any additional information they need. I would anticipate they may request some additional labs and tests, followed by some medications or increased monitoring. I would keep the patient informed along the way.”
So you can see I answered the question without giving specific information. If the interviewer would probe further “what medications do you think the physician may order?” Just be honest!
“I’m not sure. If I were to be in this situation and not clear on the plan of care – I would definitely look up some in the moment education, ask a coworker, and ask the physician”
The key here is not to just say “I’m not sure” or “sorry I don’t know” but to say that and then follow up with what you would do as a nurse if you don’t know something.
To wrap things up here – when it comes to getting ready for your RN interview – I would recommend spending most of your time prepping for behavioral-based questions. But hopefully this helped calm your nerves a little bit about the potential of a clinical interview question.
