Test Taking

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					Test Taking Techniques
      Joy Borrero, RN, MSN

    How to pass your nursing exams:

• Get NCLEX review book
• Log on to Evolve website: Potter and Perry Tex, review
• Practice ATI questions
• Remember “Maslow” when answering priority questions:
     Keep them breathing
     Keep them safe
                  Top 10 Tips
• Be consistent with time and place
• Limit the study time to 45-60 minutes, then take a 10
  minute break
• During break- do somehing mindless
• Prioritize as you study or review-what you need to know
  versus what you want to know
• Alternate subjects every hour
• Use a highlighter to ID essential facts or concepts
                  Top 10 Tips

• Use yellow paper or notecards for note-taking

• On low energy day-study content you consider easy and fun

• On high energy days-study content you consider difficult
  and boring

• Keep a portable study reference or some review cards in the
  car, purse or pocket.
                      Test taking tips
•   Read the test instructions carefully and if you don’t understand something
    ask your proctor

•   Synchronize your watch with the proctor’s

•   Cross out any answers that make no sense.

•   Look for answers that contradict basic nursing knowledge

•   Watch for answers that contain absolutes such as “never” because these
    answers are seldom correct

•   Pick the best answer based on which answer is true.

•   If you are still stumped always think Maslow and the hierarchy of needs

•   Briefly review the exam before handing it in to make sure you didn’t
    misread an always, never or except question.

•   Don’t obsess over every question-trust your gut instincts.
     Multiple Choice Questions
• Try to answer the question yourself before looking at the answers

• Answer the questions you know first. Mark the ones you are not
  sure of and go back to them

• Your first instinct is usually correct, don’t change an answer unless
  you are sure you made a mistake

• Take questions at face value- don’t get caught up looking for tricks.
  There probably aren’t any. Stick to the facts, don’t read to much into
  the question.

• Watch meanings of sentences containing double negatives. Cross
  out both negatives and then answer the question.
 If you are still having trouble:

• Rephrase the question in your own words

• Underline, circle or highlight key words. This can
  help untangle complicated questions.

• Look for answers in other test questions

• Cross out the answers you know are incorrect, and
  select your answer from the remaining options

• Never leave a question unanswered.
                 Use ABCS

• Airway

• Breathing

• Circulation

• Safety

If ABC is taken care of, go for the option that is the
   least dangerous to the patient
      When reading the question ask

1.   Who is the client?

2.   What is the problem?

3.   What specifically is asked about the problem?

4.   What time frame is being addressed?

5.   Identify which nursing process step is being tested
 Use the following rules together with
           your knowledge:

• Initial=Assessment

• Essential=Safety

• Law of opposites

• Odd man wins

• Repeated words

• Absolutely not
  What action would violate medical
asepsis when making an occupied bed?

A. Wearing gloves when changing the linen

B. Returning unused linen to the linen closet

C. Using the old top sheet for the new bottom sheet

D. Tucking clean linen against the springs of the bed
 A patient is on a low sodium diet. Before
discharge, the pt should be taught to avoid:

  A. Stewed fruit

  B. Luncheon meats

  C. Whole grain cereal

  D. Green leafy vegetables
  When rubbing a pt’s back, the nurse
           should never:

A. Knead the skin

B. Wipe off excess lotion

C. Use continuous, firm strokes

D. Apply pressure over the vertebrae
•   The nurse is assigned to care for a pt who is
    incontinent of urine and stool. What should the
    nurse apply to best protect this patient’s skin?

A. Petroleum type jelly

B. An incontinent pad

C. Talcum powder

D. Cornstarch
•   What should be the nurse’s first action before
    administering an enema?

A. Verify the physician’s order

B. Collect the appropriate equipment

C. Arrange for a bathroom to be empty

D. Inform the patient about the procedure.
To meet a pt’s basic physiologic needs according to
    Maslow, what should the nurse do?

A. Pull the curtain when the pt is on a bedpan

B. Maintain the pt in proper alignment

C. Respond to the call light immediately

D. Raise both side rails on the bed
What should the nurse do to meet a pt’s self-esteem
A. Encourage the pt to perform self-care when
B. Suggest that the family visit the pt more often
C. Anticipate needs before the pt requests help
D. Assist the pt with bathing and groomimg
   Type 1 Question Format

These are questions that ask for:

• Initial or first action

• Priority factors

• Identification of initial or beginning symptoms or

• Anticipated findings.

• Consider all of the options are correct
• Do not look for the incorrect option
• Can easily narrow the options to 2
• Then consider these priorities:
 Is there a time element?
 What is the length of the disease process (acute/chronic)?
 Associated essential concepts: Maslow, ABC, Kubler-
             Keep vigilant!

Never chose an option without reading all of the
  options or all of the parts of one option!
Awkwardly Worded Questions

• Need to clarify what is being asked.
• Don’t get upset over them
• Reword the question
What does the nurse include about what to avoid?
What should the patient avoid?
The nurse would assess for all but which of the following?
What would the nurse not look for?
     Rewording the Question

Which color is not a primary color?

a)   Red

b)   Yellow

c)   Brown

d)   Blue
                    Try This

A child has swallowed an alkaline solution. The goal
    for the nurse is to:

a.   Neutralize the substance

b.   Identify the specific solution

c.   Prevent scarring/ obstruction

d.   Provide emotional support
       With every question:

Be alert to key words such as: most, least
 first, initially, immediately
 best, main
 short, long
 toxic vs therapeutic levels
 side effects vs. expected effects
 most likely, commonly, frequently
         Make a note of time

Day one vs day three

Preop vs Postop




Predisposing vs. complication
Note unfamiliar words, reword the question without
  these words

Note the age of clients

Identify words of essence such as “acute” vs. “chronic”

Pinpoint locations such as hospital, home, PACU, etc.
During the assessment of a client with early LVHF, the
  nurse might expect the client to report which of
  these findings?

Key words
• In clients with sickle cell anemia which terminal
  complication does the nurse anticipate if the sickling
  process occurs?

Key Words

• For the client with…. is the nurse most likely not to
  avoid instruction that includes the use of aspirin?

Key words

• What body system is unaffected by the enzymes
  given to children with CF?

Key words

In performing the assessment of the client, what should
   the nurse not omit?

You used your 50-50, but you can’t call
     a friend or poll the audience

Read the question and note key words or clues

Read one option and note key words or clues

Read the question again

Read the second option and note key words or clues

This gives you 2 separate thoughts
A young pregnant client has a hx of heroin addiction.
  For which problem should this client also be
  screened for a potential dx at this time?

 a. Anemia

 b. Syphilis

 c. TB

 d. Symptomatic bacteremia
          Focus Techniques

Underline: key individual words
Who is being asked about?
A client is being scheduled for a colonoscopy. The most
     serious complication associated with this procedure is:
a.   Constipation
b.   Severe abdominal cramping
c.   Infection following the procedure
d.   Perforation of the bowel
     Cluster Approach:Shave or shorten

An hour after receiving pain meds, a new postop pt was
    still complaining of severe (9/10) leg pain. Pain
    med cannot be given for another 2 hours. How can
    the nurse best assist the client with dealing with the
    pain now?
a.   Offer the client a magazine to read
b.   Guide the client in slow rhythmic breathing
c.   Turn the light s low, give a PRN calming agent and
     close the door
d.   Call the MD and ask for an increase in the dosage
     of the PRN pain med
  Read vertically with series

What observations are anticipated in a client who is

a.   Rising temp, HA, weak pulse

b.   SOB, generalized discomfort, thready pulse

c.   HTN, mottled skin, irregular pulse

d.   Sighing respirations, decreased urine output, faster
The immobilized client is prone to the development of
    PN. To prevent this, the nurse would:

a.   Encourage hyperventilation

b.   Order prophylactic antibiotics

c.   Assist the client to C&DB

d.   Teach the client about the dangers of overexertion
     and encourage rest.
Which of the following contains all the elements necessary for
    informed consent?
a.   The nurse explains the procedure and obtains the written
b.   Any hospital employee may obtain the client’s signature
     on the consent form
c.   The physician explains the operative procedure and
     obtains the consent on a form that IDs the procedure
d.   The client signs the consent for the specific procedure
     after the MD explains the procedure and associated risks.
DM is the most common disorder of glucose
   regulation owing to decreased amount/absence of
   insulin that results in abnormal metabolism of:

a.   Carbohydrates

b.   Protein

c.   Fat

d.   CHO, protein, and fat

• Don’t panic. Pause and use your critical thinking
• Do not read into the question. JUST THE
• Be cautious in choosing an option that has
  absolute words in it: all,none,always, forever,
• Content cannot be in the option if it is not in the
A 145lb, active, 91 yo male falls while painting his
    garage. He is admitted to your unit with a fx hip.
    He does not like hospital food and refuses to eat.
    His basic caloric need during hospitalization is
    expected to :
a.   Decrease because of his inactivity
b.   Decrease because of his advanced age
c.   Increase because of his high activity level
d.   Increase because of his fracture
                  Extra Hints:
• Use common sense and logic
• Do not read into a question, assume something, make
  the client sicker than he is, speculate on the situation
  or mentally add anything more than the information
• Remember each question contains all the info
  necessary to answer the question correctly
• Be cautious with answers that involve “notifying the
  physician” without checking for an appropriate
  nursing intervention first.
             After the test

• Review the questions that you have missed.
• Place the incorrect answer in a category of C
  (lack content knowledge) or M (misread)
• Review C and see if you could have made an
  association between the info and the option
• Review M and see how you could have avoided
  reading into the question or ID key words

Rollant, Paulette D. (1999). Soar to Success: Do Your
  Best on Nursing Tests.

Nugent, Patricia M. & Vitale, Barbara A. (2008). Test
  Success. Test-taking Techniques for Beginning
  Nursing Students. 5th Edition. Philadelphia: F.A.
  Davis Company

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