SUMMATIVE ASSESSMENT 1

Summative Assessment

Sherry Gowan

Grand Canyon University: NUR 648E

August 26, 2020

SUMMATIVE ASSESSMENT 2

Summative Assessment

When selecting strategies to assess and evaluate learning, the facility’s philosophy must

be considered regarding the responsibility for learning and accountability. Active teaching

techniques are compatible with many strategies. Multiple choice testing is a different type of

interaction with the material than short essays and guided writing assignments. Challenges of

using strategies include the establishment of validity and reliability of data-gathering, and the

time involved, as well as the instruments and methods. To avoid some pitfalls associated with

these strategies, the following has been evaluated: What is the purpose of the evaluation and

assessment? What setting is best for the learning and assessment to take place? Which

assessment and evaluation strategy fits the purpose intended? Establish validity and reliability.

Assess the overall effectiveness. Determine the procedure of the strategy selected (Kirkpatrick &

Dewitt, 2017).

Matching the assessment strategy to the domain of learning involves the assessment of

cognitive learning with strategies requiring that the student either write, submit portfolios, or

complete a test. Assessments in the psychomotor domain involves simulations. Assessments in

the affective domain is very important to nursing. Bloom’s taxonomy is a form of affective

assessment and evaluation. The beginning student will be receiving and responding, but as the

student progresses, affective growth is demonstrated. Ultimately, the student will provide actions

and demonstrations of the knowledge embraced. This is the highest level of the affective-domain

(Kirkpatrick & Dewitt, 2017).   

Efforts have been made to align instructional objectives with formative and summative

assessments. These efforts provide instructors with numerous ways to measure learning. As the

responsibility of instructors, providing a test blueprint prior to creating the assessment

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the students are guided toward is incorporated. Test blueprints are a map of objectives assessed

on the test. Test blueprints also are maps that include different levels of learning within

different questions addressed (Research techniques and education, 2014).

This test blueprint is based on course and learning objectives of, caring for the pregnant

patient.  The domain of knowledge each question addresses as well as the rationale for the

strategies used are also included. An explanation for the test blueprint that best guides the

development of this particular summative assessment based on the learning objectives is

provided.

Basic test blueprints are made up of a table, which is called the matrix. It includes a two-

dimensional matrix chart, having an X and Y axis. Within it, describes item samples to be

selected in the test. A spreadsheet is the prefered format because it allows for easy calculations

and fine-tuning of the number of items in the exam (Siddiqui & Ware, 2013).

Table 1

Test Blueprint: Caring for the Pregnant Patient

Questi Student  StudentLearningOb  Bloom's Taxo  Type  Nu  Poi  %

ons: CourseObjec jectives: nomy Class of Test mber nt Wei
tives: The of Cognition:  Questio of Val ght
ability to n to Test ue: of
apply Measur Items Test:
knowledge e in
of caring for Objecti Each
the pregnant ves: : 
patient. 
 1.    Relates to the  Analyze Multipl 1  20  20
effects of opioid e choic %
meds during e
pregnancy. Toxicity
knowledge.  
 2.    Relates the effects  Analyze   Multip 1  20  20
of Magnesium le choic %
sulfate to e
anticonvulsant
SUMMATIVE ASSESSMENT 4

benefits and risks. 

 3.    Identifies with Knowledge  Multip 1  20  20
knowledge le choic %
of  Rho(D)immuneg e
lobulin.

 4.    Identifies with Knowledge  Multip 1  20  20

knowledge of le choic %
placenta abruptions. e
 5.    Relates to  Analyze  Multip 1  20  20
preeclampsia and le choic %
the benefits and e
risks of Magnesium
Sulfate
Totals:      Analyze3Kno Multipl 5 100 100
wledge 2 e choic %
e
               
               
Note: This testing blueprint is based on knowledge covered prior to this test. Every question
on this test is part of the objectives and has been discussed in class with multiple formative
assessments attempted to review questions prior to this particular summative assessment
(Research techniques and education, 2014).  

1: A pregnant woman comes to the labor and delivery unit having labor pains. She is

receiving opioid analgesics to relieve the pain. Analyze the following medications. Which

should be ready in the event of respiratory depression?

A. Oxycodone (Oxycontin).

B. Morphine Sulfate.

C. Meperidine hydrochloride (Demerol).

D. Naloxone (Narcan).
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Rationale: Pregnant women may be prescribed opioid analgesics when requested and

experiencing moderate to severe labor pain. Since respiratory depression may occur with opioid

toxicity, Naloxone (Narcan) works as an opioid antagonist. The other options are opioid

analgesics also. Analyzing is part of the upper pyramid of Bloom’s taxonomy. The student

should have a memory of medications. Analyzing and arranging the order and reasoning, the

student may question if the same applies to a pregnant patient (Vera, 2019).

2: A pregnant client is ordered magnesium sulfate therapy in efforts of controlling

preeclampsia. The client is experiencing toxicity from the medication. Analyze the

following factors in order to report evidence noted during recent hourly assessment?

A. Deep tendon reflexes are present.

B. Serum magnesium levels of 7 mEq/L

C. Urine output = 25ml/hr.

D. Respirations of 10 breaths per minute.

Rationale: This is an analytical question. The student must have basic knowledge of the

medication. The student must analyze what to assess for each hour while the pregnant patient is

on magnesium sulfate and that it is a central nervous depressant to prevent seizure activity by

relaxing the body. Student must relate signs of toxicity including decreased urine output,

maintained at least 25-30ml/hr, decreased maternal and fetal heart rate, hypotension, loss of deep

tendon reflexes, and respiratory depression. The student may be sidetracked on the urine output,

but analyzing the question and knowing the priorities of the selection given, D is the correct

answer (Vera, 2019).

 
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3: A student nurse is asked by the nurse instructor to explain Rho(D) immune globulin,

also known as (RHoGAM). Analyze why RHoGAM is needed to be given to a pregnant

woman at 28 weeks and again after the delivery of her baby? The instructor determines

that the student nurse understands the medication’s purpose when the student says that it

will protect the patient and her baby from:

A. German Measles.

B. Rh incompatibility.

C. Pernicious anemia.

D. Rh+ blood.

Rationale: The answer is B. Rh incompatibility. When mom is Rh negative, mom

becomes sensitized to the Rh antigen. If fetus is Rh positive, blood cells from the baby may cross

the bloodstream during pregnancy, during an accident causing a blow to the abdomen, and

during labor and delivery. This causes mom to form antibodies against the Rh-positive blood.

This could cause death to the fetus and to mom. Administration of RhoGAM prevents the

development of antibodies against Rh-antigens.  The student again must have the knowledge,

which is at the base of Bloom’s taxonomy pyramid, but must also analyze the previous

information with analytical reasoning in order to answer this question correctly (Vera, 2019).

4: When applying knowledge of the pregnant woman, which of the following is most likely

to be assessed if the pregnant woman has a placenta abruption?

A. Titanic uterine contractions.

B. Board like, rigid abdomen.

C. Excessive vaginal bleeding.

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D. Premature rupture of membranes.

Rationale: B is the correct answer. A rigid or board-like abdomen is the most common

sign noted during the assessment. The patient may also report sharp stabbing pain at the upper

abdomen, high in the uterine area because of the separation. This question is knowledge based,

but also may have some analytical properties to it when stumped with the answer of vaginal

bleeding. Bleeding is occurring, but it is behind the uterus and is usually not seen until the

surgical intervention of the cesarean section is performed (Vera, 2019).

5: Caring for a pregnant patient with severe preeclampsia receiving IV magnesium sulfate,

analyze and select all nursing interventions that apply while caring for the patient.

A. Notify physician immediately if respirations are less than 17 per minute.

B. Monitor vital signs every 2 hours.

C. Notify physician if urinary output is less than 25 ml per hour.

D. Monitor deep tendon reflexes hourly.

E. Monitor intake and output hourly.

F. Monitor renal function and cardiac function closely.

G. Keep calcium glauconite on hand in case of magnesium sulfate overdose.

Rationale: This question is a strong analytical question. Gravitating up the Bloom’s

taxonomy pyramid, knowledge base must be strong. The question and the answers must be

analyzed closely to uncover, all that apply. Caring for a pregnant patient with severe

preeclampsia requires close monitoring every 30-60 minutes, respirations are not less than 12,

calcium glauconite is at the bedside as the antidote for magnesium sulfate toxicity, urine output

doesn’t drop below 25 ml per hour because medication is excreted by the kidneys, that the
SUMMATIVE ASSESSMENT 8

patient does have reflexes and assessed hourly, and renal and cardiac function is monitored

closely (Vera, 2019).

This particular test blueprint guides the development of multiple choice questions

providing a clear domain of knowledge and the rationale for the strategy (Assessment Blueprint,

2013). The questions are guided by the learning objectives, clearly addressed. Learning

objectives identify what the student must do to learn Summative assessments test cognitive

ability of the objectives given. Questions were derived from facts, known as the stem. Multiple

choice questions includes the keyed response, or the answer with at least three distracters (Sulla,

2012). Included within this multiple choice test, there are two knowledge-domain questions,

aimed at recall of specific methods and processes. The goal of three analytical questions are

aimed at achieving the upper pyramid of Bloom's taxonomy framework of the student's cognitive

abilities. Analysis is the relationship between ideas (Research techniques and education, 2014).  

Summative assessments shifts the focus in assessments during the learning process, as in

formative assessments, to the mastery of the course objectives. This type of assessment has been

followed by numerous opportunities of practice assignments during class. Now, students should

be ready to provide the evidence of learning the assigned course goals. Exams, such as this one,

are constructed with multiple choice questions. Writing multiple choice questions can be difficult

to write in order to measure the upper levels of cognition, according to Bloom’s Taxonomy.

Sophisticated knowledge acquisition and critical thinking skills are ideal (Baudier,

2014). Offering students, a range of summative assessments provides different ways to test

students’ cognitive domains. Demonstrating the mastery of course objectives will allow students

the benefit from the variety and motivate the personal evidence of learning above and beyond the

traditional final exam format(Baudier, 2014).

SUMMATIVE ASSESSMENT 9

 
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References

Assessment Blueprint [PDF]. (2013).

https://www2.ed.gov/teachers/assess/resources/toolkit/docs/assessment-blueprint.pdf

Baudier, J. (2014). Summative assessments. Kennesaw State University.

https://cetl.kennesaw.edu/summative-assessments

Darling-Hammond, L., Flook, L., Cook-Harvey, C., Barron, B., & Osher, D. (2020).

Implications for educational practice of the science of learning and development. Applied

Developmental Science, 24(2), 97–140. https://doi.org/10.1080/10888691.2018.1537791

Kirkpatrick, J., & Dewitt, D. A. (2017). Strategies for assessing and evaluating learning

outcomes. Nursekey. https://doi.org/https://nursekey.com/strategies-for-assessing-and-

evaluating-learning-outcomes/

Kurt, S. (2019). Using Bloom’s Taxonomy to Write Effective Learning Objectives: The ABCD

Approach. https://educationaltechnology.net/using-blooms-taxonomy-to-write-effective-

learning-objectives-the-abcd-approach/

Research techniques and education. (2014, September 14). Test blueprints. Educational Research

Techniques. https://educationalresearchtechniques.com/2014/09/30/test-

blueprint/#comments

Siddiqui, I., & Ware, J. (2013). Test blueprint for multiple choice questions exams. Journal of

Health Specialties, 2(3), 123–125. https://doi.org/DOI: 10.4103/1658-600X.137888

Sulla, N. (2012). Writing multiple choice test questions. YouTube.

https://www.youtube.com/watch?v=irqXYvVnzbk
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Vera, M. (2019). Maternal and child nursing practice quiz # 1 (30 questions).. Nurselabs.

https://doi.org/https://nurseslabs.com/nclex-exam-maternal-child-health-nursing-1-30-

items/

Vera, M. (2019). Obstetrical nursing: Antepartum nclex-rn practice quiz (50 questions)..

Nurselabs. https://doi.org/https://nurseslabs.com/nclex-exam-obstetrical-nursing-

antepartum-50-items/