Sometimes pure hard work and mental preparedness is not enough. The ability to answers exams or any test faster is a must specially if it is bounded by time. Usually the pressure sets in if the time is working against you and even if you’ve prepared 100%, it can ruin entirely what you have poured in.
The Parts of a Question
The question contains several parts:
- the case (sometimes called scenario) – the description of the client and what is happening to him/her
- the stem – the part of the question that asks the question
- the correct response
- distracters – incorrect but feasible choices
The most important skill for the test taker is the ability to read the question carefully and determine the key elements in each question. Each question has key words. Key words relate to the client; to the problem; and to specific aspects of the problem.
Factors such as age, sex, and marital status may be relevant. When a child’s age is given it often is very relevant to the answer. Vital signs vary with age. Preoperative teaching methods vary with age. Appropriate toys and diversional activities vary with age. Always pay special attention to the age of a client when it is given. Also consider who is the client for this question. That is, who is the focus of the question. The client may be the identified sick person, or it might be a relative of the identified sick person, or even a staff member.
The problem may be a disease, a symptom or a behavior.
Details of the Problem
- Is the question asking for nursing actions or client symptoms or family responses?
- Does the question ask about a specific aspect of nursing care assessment, planning, implementation, evaluation?
- Does the question ask details relevant to a specific symptom or behavior the client exhibits?
- Is there additional information about the client or the problem that is important?
- “What action takes priority?”
- “What should the nurse do first?”
- “What should the nurse do initially?”
- “What is essential for the nurse to do?”
Physiologic needs are first, followed by safety needs, then love and belonging, self-esteem and self-actualization.
The first step of the nursing process is assessment! When the stem of a question asks for the initial nursing action always look to see if there is a relevant assessment answer. The nurse will take an action only when there is enough data to act. Call the physician only when there is not a nursing action that should be taken first. The stem of the question may ask for a nursing action and the correct answer may be to assess.
When the stem of the question asks what is essential for the nurse to do, think safety. Remember many of the test questions are safety questions.
What is the Time Frame?
Whenever a specific time frame is indicated in a question it is very important. Pay attention to it. Time related words may be like early or late in relation in symptoms, pre operative or post operative, care on the day of surgery or later postoperative care.
Words from the question are repeated in the answer. Frequently the same word or a synonym will be in both the question and the answer.
When two answers are opposite such as high blood pressure and low blood pressure or increase the drip rate and stop the IV, or turn on the right side and turn on the left side, the answer is usually one of the two.
If two or three answers say the same thing in different words none can be correct. If the answers are too alike, then neither one is correct.
Odd Answer Wins
The answer that is different from the others is apt to be the correct answer. It may be the longest or the shortest or simply very different in content or style.
One answer includes the others. There may be more than one correct answer. One answer is better than all the others because it includes them.
Test Item Check List
Use this handy list to check yourself every time you answer a test question.
Say to yourself, DID I CAREFULLY…
- Read the stem?
- Read all of the options?
- Read the stem again?
- Look for key words?
- Eliminate obviously incorrect options?
Answers containing universal or absolute words are very apt to be incorrect. Very little in life or nursing is always correct or incorrect. Answers stated in absolute terms should be looked at with great caution.
Choosing between the two best options
After eliminating the incorrect options and you are having difficulty choosing between two seemingly correct responses, use the following strategies:
- Eliminate Similar Distracters – If two options are essentially saying the same thing or include the same idea, then neither of them can be the answer. The answer has to be the option that is different.
- Reread two seemingly correct options – If two options seem equally correct, reread them carefully; there must be some difference between them. Reread the stem; you may notice something you missed before.
- Look for a global response – A more general statement may also include correct ideas from other options.
Guidelines to follow during the exam:
- Budget your time – Although you may not know exactly how many questions you’ll be asked to answer, you can estimate a little over 1 minute per question. Keep moving at a steady pace.
- Read each question thoroughly but quickly – In general, your first reaction to a question is the correct one. Remember that the examination is designed to determine if you’re minimally competent and safe.
- Concentrate on one item at a time. Don’t worry about how many questions you’ll have to answer.
- Answer questions as if the situation were ideal. Assume the nurse had all the time and resources needed. You’re only concerned about one patient, the one in the question.
- Focus on the key words in the stem.
- Identify whether the stem is seeking a true response or a false response. Those stems asking for false responses are easily misread.
- Reword a difficult stem.
- Try answering the question before you’ve read the options provided.
- Always read all options before selecting the best one.
- Relate each option to the stem.
- Use logic and common sense to figure out the correct response.
- Remember that the correct option will tend to have greater applicability and flexibility.
- Clueless? Look for clues in answer choices instead of in the stem of the question.
10 Things to Remember on the day of the examination:
- Get up early.
- Wear comfortable clothes.
- Check your things. (pencils, pens, etc.)
- Eat breakfast.
- Leave early so you will arrive early.
- Do NOT study while you wait for your examination.
- Read, listen to music, relax.
- Leave notes and books at home.
- Listen carefully to the instructions given by the test administrators.
- Say a little Prayer before you begin.
The best of luck to all Nursing Examinees!
Lippincott Review Series