With thanks to Mrs. Sandra Brown, who reviewed the question bank against current practice guidelines and identified a set of questions whose answers had gone out of date as those guidelines changed.
This is unglamorous, genuinely difficult work. Spotting that a question is wrong means knowing not only the current standard but that the standard moved — that colorectal screening dropped from 50 to 45, that the AHA quietly removed clindamycin from dental prophylaxis, that metformin is no longer held before a contrast scan the way everyone was taught. A bank of 1,800 questions accumulates this kind of drift silently, and nobody notices until a student is taught the wrong thing.
Her review led directly to corrections in 17 questions, including three whose keyed answers were wrong:
and fourteen more where the rationale or NCLEX tip taught a superseded guideline as current — the metformin contrast-hold rule across nine questions, the AHA endocarditis prophylaxis regimens, the ACOG postpartum hemorrhage definition, and the ACS position on breast self-examination.
The full record is in CLINICAL_REVIEW.md.
Her review is also the reason this repository now has a written clinical accuracy
policy (CONTRIBUTING.md) requiring every guideline-dependent
question to name its source and year, so the next reviewer can tell at a glance
what needs rechecking. That is a lasting improvement to the project, and it came
from her work.
Thank you, Mrs. Brown. Students who will never know your name are getting better answers because of you.
If you spot a question that’s wrong — a changed guideline, a flawed distractor,
a rationale that no longer holds — please open an issue. See
CONTRIBUTING.md for what makes a report actionable.
Contributions that improve a question are credited here.