Let me clarify...in my facility and where I work within my facility, I will never see a Careplan again.
When I was on clinicals, the floor nurses just ticked off they reviewed them. (This was a different facility). They themselves stated repeatedly they never use them and never do anything with them aside from ticking the box in the system.
Anywho...in my bubble, they are long gone. As for the style of questions, it is supposed to help you critically think or develop those skills. That is a challenge when you come with experience and have already found "your flow" in patient care and already have a working base knowledge of the real world healthcare.
For example...I have three questions which pop out as I argued them passionately and I only "won" a reversal on one of them.
1. You have a patient returning from PACU, what is the FIRST thing you do?
Two of the choices I threw out immediately, then I had to choose between assessing LOC and applying pulse ox.
Well, I chose assess LOC because in my mind I would be doing this "Hey Mr. Smith, how are you? John, can you open your eyes, I am applying this to your finger, John?"
So that is assessing LOC FIRST...but the correct answer was apply pulse ox. (Always, always use ABCs no matter what you think, you do ABCs first!)
2. The question clearly described a person hyperventialting by action and blood gas.
Easy to throw out two choices as always. I then had either have the patient breathe in a paper bag, or calmly talk the patient down and slow their breathing.
Of course I chose calm them/coach their breathing because that is what I have done for the better part of my career as that is most effective and most recommended. Even every Evidence Based Medicine article I pulled up supported my position. The paper bag is NOT recommended. Sure it works but it is NOT best practice.
But....they want you to breathe in a paper bag.
3. This is the one I WON!!!
You are called into a room where a patient is complaining of shortness of breath. What is the first thing you do?
Again, threw out two, left with sit them up or apply nasal cannula.
The answer was apply nasal cannula. I argued this question till I was blue in the face. I said you would never not sit a patient first, as that may be all they needed without further intervention. They stuck to their ABC response and I could not find any source aside from common sense and experience that you sit them up first as it is least invasive. Heck, you take any non-medical trained person from the streets and put them in a room with grandma who says they cant breath, our first natural human reaction is to sit them up!!
Anyways, I argued and argued. Then one day on clinical, this same instructor was in a room where a patient complained of SOB. I was SO SO SO happy...when the first thing he did was sit the patient up to further eval. He did this reflexively.
Finally, out of two years of nursing school and a bazillion challenges...this was the one and only question reversal I won.
Long story short...."they" say they want you to critically think and use best practice. However, when you come with those skills and use them, "they" really do not want that. I wish I had more progressive school/instructors, however their methods are dated and they are stuck in an old school way of teaching nursing.
Jump through the hoops, then "you do you".