12 Must Read Guidelines for Effective Nurse Test-Taking Skills

It is of a fact that reviews are just a way of enhancing your knowledge and confidence for the NLE. Remember that you are knowledgeable regarding the nursing concepts and you’ve spent 4 years learning about them. But these knowledge would be futile if you yourself cannot apply effective test taking skills.

Few researches have shown that examiners who fully understand test construction and who become familiar with appropriate test-taking strategies score higher than others with similar knowledge but with inadequate test-taking skills (TTS).

Remember that multiple choice tests are different from tests such as essays, identifications and true/false.

In multiple choice exams, the question is called the stem. The stem is followed by four alternative answers. One answer is correct, and the other three are called distractors because they distract your attention from identifying the correct answer.

It is important to note that these distractors are not necessarily incorrect answers but rather they may not be as correct as as the one you are required to choose.

The following are guidelines that will help you be better prepared during your examinations.

  1. Do not read extra meaning into the question
    • Tests questions are made to be direct and to the point. The question asks for one particular response and you should not read or add other information into the question.
      Often you will find questions that require “common sense” answers and that reading into these questions may give you an other interpretation. You should not search for subtle meaning about the questions or answers.
    • Ask yourself “What is the question asking?”. Look for keywords and phrases to help you understand. Interpret the question correctly first before reading into the choices.
  2. Understand exactly what the stem is asking before considering the distractors
    • Make sure you read the stem correctly. Notice particularly the way the question is phrase. Is it asking for the best response or the initial response? Understand what the question is asking.
  3. Rephrase the question in your own words
    • This technique requires you to interpret or translate the question into your own words so that it is very clear in your own mind. Rephrasing the stem of the question can assist your read the question correctly and in turn choose the appropriate response. Placing the question into your own words would help you in removing extraneous data and get into the core of the stem.
  4. When analyzing the distractors, isolate what is important in the answer alternatives from what is not important relative to the question.
    • In a good test construction, all of the distractors should be feasible and reasonable and should apply directly to the stem. There should be a commonality in all of the distractors.
    • Also, all of the distractors may be correct but not the right chose for the specific question that is being asked. The technique here is to ask yourself whether each possible alternative is true or false in relation to the stem.
  5. After choosing the correct answer alternative and separting it form the distractors, go back to the stem and make sure your choice does, in fact, answer the question.
    • Many test-takers fail to recheck the answer with the stem, and they answer the question incorrectly. An effective strategy is to judge all four alternative choices against the stem and not against one another. Read the stem, then check alternative 1 against the stem, then check alternative 2 against the stem and so on. This process will eliminate choosing an alternative that does not fit with the question.
  6. When a question contains multiple variables as alternative choices, use the “elimination of variable” technique.
    • Each question may pose different alternatives with several variables. Use the process of elimination. Study the question first and ask yourself what variable fits with this condition, or after examining the distractors underline the symptom that you know is correct. Now ask yourself what variable is not present with this condition. Again examine the distractors and cross out those variables that are incorrect. By this process your probably eliminated at least two distractors even without taking the time to consider the other two.
  7. When answering a difficult question, utilize your body of knowledge.
    • When you come across a difficult question and you cannot immediately identify the answer, go back to your body of knowledge and draw all the information that you do know about the condition. If you are unfamiliar with the disease or disorder and cannot choose the right nursing action, try to generalize to other situations. For example, if the question asks about dog bites, and you’ve never learned the course of the disorder, go back to an area of k nowledge that you do know, for example, circulation and body response to toxic substances. Even though you do not know exactly what to d, you might know what not to do. Eliminate distractors to increase your chances of arriving at the correct answer.
  8. The ability to guess correctly is both a skill and an art.
    • The board exams is not a “right minus wrong” type. It is important for you to answer every question even if you have to guess. Guessing gives you only a 25% chance of getting the correct answer.
      1. Try to eliminate at least one (or more) distractors as this will increase the percentage margin of chance for guessing correctly.
      2. Examine the distractors and if one is the exact opposite of another (e.g. complete bed rest is different from activity as tolerated; both cannot be correct since they are of opposites), choose the one that seems to be most logical.
      3. Try to identify the underlying principle that supports the question. If you can answer the question, you might then be able to guess the correct answer. This strategy is especially true with a psychosocial question.
      4. Look at the way the alternatives are presented. Are there two answers that are very close? often when this occurs, the ability to discriminate will show evidence of judgement. Check to see if one, more than the other, is the best choice for the question.
      5. Are there distractors that are presented not logical (which are correct in themselves but do not have anything to do with the question)? Eliminate these and focus on other alternatives.
      6. Use your intuition. If you cannot choose an alternative from a logical point, allow yourself to feel which one might be right. Often your subconscious mind will choose correctly (based on all the conscious knowledge you have of course) so simply let yourself feel which alternative might be right. Remember, its better to choose one answer than none at all.
  9. Choosing answer from a hunch
    • There comes a time when you are faced with a certain question and you have a hunch that this particular choice is correct. Do we depend on this “hunch?”. Current studies supports that hunches are often correct, for they are based on rapid subconscious connections in the brain. Your stored knowledge, recall, and experience can combine to assist you in arriving at the correct answer. So, if you have an initial hunch, go with it! Do not chance the answer if and only if, upon reflection, it just doesn’t seem right. On the other hand, if later in the test you find relevant information or make new connection of information and you feel that your answer was incorrect, do go back and change it.
  10. Choosing the best answer from a strategy point-of-view.
    • Frequently, the most comprehensive answer is the best choice (Longest the best!). For example, if two alternatives seems reasonable but one answer includes the other (i.e., it is more detailed, more comprehensive), then this answer would be the best choice. If an answer focuses on medical knowledge, be wary, for this laternative might be just a good distractor. Remember, this is a nursing test and questions are designed to thest your nursing compentency and safety. It is unlikely that a question would require a meidcal action for the correct answer; it may, however offer these actions as distractors. Beware of answers that contain specific qualifiers, such as “always’ and “never”. they rarely fit within a logical framework.
  11. Time Management is important
    • Time allotment for each question in the NLE is 2hours/100 questions is equal to 1.2 minutes. It is important to use your time wisely and program yourself not to spend too much time on one question. Since your are not penalized for incorrect answers, it is important to finish each portion of the test. Prepare yourself to practice time management by timing yourself for each question during your sample exams.
  12. Let the Divine Intervention Intervene 
    • If you cannot answer the question. Have faith in the Lord and thus you’ll be confident to answer each question. If you do not know, He knows. Ask for God’s help! Remember, you are doing this for His glory!


Smith S. (1989). Review questions for NCLEX-RN 5th Edition.