Test Taking Techniques

1. Test Taking Techniques Joy Borrero, RN, MSN 9/08

2. How to pass your nursing exams: • Get NCLEX review book • Log on to Evolve website: Potter and Perry Tex, review rationales • Practice ATI questions • CAI • Remember “Maslow” when answering priority questions: Keep them breathing Keep them safe

3. 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

4. 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.

5. 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.

6. Multiple Choice Questions • Try to answer the question yourself before looking at the answers given • 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.

7. 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.

8. Use ABCS • Airway • Breathing • Circulation • Safety If ABC is taken care of, go for the option that is the least dangerous to the patient

10. When reading the question ask yourself: • Who is the client? • What is the problem? • What specifically is asked about the problem? • What time frame is being addressed? • Identify which nursing process step is being tested

11. Use the following rules together with your knowledge: • Initial=Assessment • Essential=Safety • Law of opposites • Odd man wins • Repeated words • Absolutely not

12. What action would violate medical asepsis when making an occupied bed? • Wearing gloves when changing the linen • Returning unused linen to the linen closet • Using the old top sheet for the new bottom sheet • Tucking clean linen against the springs of the bed

13. A patient is on a low sodium diet. Before discharge, the pt should be taught to avoid: • Stewed fruit • Luncheon meats • Whole grain cereal • Green leafy vegetables

14. When rubbing a pt’s back, the nurse should never: • Knead the skin • Wipe off excess lotion • Use continuous, firm strokes • Apply pressure over the vertebrae

15. 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? • Petroleum type jelly • An incontinent pad • Talcum powder • Cornstarch

16. What should be the nurse’s first action before administering an enema? • Verify the physician’s order • Collect the appropriate equipment • Arrange for a bathroom to be empty • Inform the patient about the procedure.

17. To meet a pt’s basic physiologic needs according to Maslow, what should the nurse do? • Pull the curtain when the pt is on a bedpan • Maintain the pt in proper alignment • Respond to the call light immediately • Raise both side rails on the bed

18. What should the nurse do to meet a pt’s self-esteem needs? • Encourage the pt to perform self-care when able • Suggest that the family visit the pt more often • Anticipate needs before the pt requests help • Assist the pt with bathing and groomimg

19. Type 1 Question Format These are questions that ask for: • Initial or first action • Priority factors • Identification of initial or beginning symptoms or signs • Anticipated findings.

20. CUES • 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-Ross?

21. Keep vigilant! Never chose an option without reading all of the options or all of the parts of one option!

22. 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?

23. Rewording the Question Which color is not a primary color? • Red • Yellow • Brown • Blue

24. Try This A child has swallowed an alkaline solution. The goal for the nurse is to: • Neutralize the substance • Identify the specific solution • Prevent scarring/ obstruction • Provide emotional support

25. 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

26. Make a note of time parameters: Day one vs day three Preop vs Postop During After Before Predisposing vs. complication

27. 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.

28. During the assessment of a client with early LVHF, the nurse might expect the client to report which of these findings? Key words

29. In clients with sickle cell anemia which terminal complication does the nurse anticipate if the sickling process occurs? Key Words Reword

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

31. What body system is unaffected by the enzymes given to children with CF? Key words Reword

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

33. 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

34. 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

35. 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: • Constipation • Severe abdominal cramping • Infection following the procedure • Perforation of the bowel

36. Cluster Approach:Shave or shorten sentences 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? • Offer the client a magazine to read • Guide the client in slow rhythmic breathing • Turn the light s low, give a PRN calming agent and close the door • Call the MD and ask for an increase in the dosage of the PRN pain med

37. Read vertically with series What observations are anticipated in a client who is hemorrhaging? • Rising temp, HA, weak pulse • SOB, generalized discomfort, thready pulse • HTN, mottled skin, irregular pulse • Sighing respirations, decreased urine output, faster pulse

38. The immobilized client is prone to the development of PN. To prevent this, the nurse would: • Encourage hyperventilation • Order prophylactic antibiotics • Assist the client to C&DB • Teach the client about the dangers of overexertion and encourage rest.

39. Which of the following contains all the elements necessary for informed consent? • The nurse explains the procedure and obtains the written consent. • Any hospital employee may obtain the client’s signature on the consent form • The physician explains the operative procedure and obtains the consent on a form that IDs the procedure • The client signs the consent for the specific procedure after the MD explains the procedure and associated risks.

40. DM is the most common disorder of glucose regulation owing to decreased amount/absence of insulin that results in abnormal metabolism of: • Carbohydrates • Protein • Fat • CHO, protein, and fat

41. Guessing • Don’t panic. Pause and use your critical thinking skills • Do not read into the question. JUST THE FACTS! • Be cautious in choosing an option that has absolute words in it: all,none,always, forever, never • Content cannot be in the option if it is not in the question

42. A 145lb, active, 91 yo male falls while painting his garage. He is admitted to your unit with a fxhip. He does not like hospital food and refuses to eat. His basic caloric need during hospitalization is expected to : • Decrease because of his inactivity • Decrease because of his advanced age • Increase because of his high activity level • Increase because of his fracture

43. 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 provided. • 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.

44. 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

45. References 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