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CRITICAL THINKING & TEST TAKING STRATEGIES CRITICAL THINKING & TEST TAKING STRATEGIES

PRELUDE PRELUDE
+ Is it possible to correctly answer a question even without knowing a thing
about the question?
+ Is it possible to narrow the choices into 2 options even without reading the
question?
+ Is it possible to correctly identify the correct answer by studying only the
configuration of the options?
+ Is it possible to know the side effect of a drug without knowing the drug?
+ Is it possible to answer a question confidently even without a question?
CRITICAL THINKING CRITICAL THINKING
a way of deciding whether a claim is true, partly true, or false.
TEST TAKING STRATEGIES TEST TAKING STRATEGIES
I. PRINCIPLE OF INITIATIVE CRITICAL THINKING INITIATIVE CRITICAL THINKING
STEPS :
1. Cover the options.
2. Read the question carefully.
3. Try answering the question first without looking at the options.
4. Select the option that most closely matches
your answer.
When an adult client loses consciousness, the nurse should check for what pulse?
A. Carotid.
B. Apical.
C. Brachial.
D. Radial.
A dying patient is giving cash to the nurse amounting of Php 500,000.00 which he refers to
as a gift for the nurses kind gesture to him while he is being hospitalized. What should the
nurse do with the gift?
A. Tell the patient to state it in her last will and testament to make it legal.
B. Accept the money and make no fuss about it. It is not a big deal.
C. Report to the BIR for proper tax computation to avoid any lawsuit.
D. Refuse to accept the gift.
The universal sign for choking / airway obstruction (distress signal) is:
A. Clutching of neck.
B. Tongue out, neck limp on the side.
C. Shouting for help.
D. Coughing forcefully.
Which of the following is used to estimate the TBSA (Total Body Surface Area) of a burn
patient?
A. Rule of Nine.
B. Guthrie Test.
C. Parkland Formula.
D. Chubby Checker.
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II. PRINCIPLE OF PRIORITIZATION PRIORITIZATION
When the question is asking for a priority, most important, primary, first, or
initial, use prioritization.
ABCs of Life Nursing Process RACE (in case of fire) Maslows
Hierarchy
Airway#1 Assessment #1 Rescue #1 Self-
actualization
Breathing Diagnosis Alarm Self-esteem
Circulation Planning Confine Love and
Belongingness
Implementation Extinguish Safety and
Security
Evaluation Physiologic Needs
#1
The nurse just came after a meal from the canteen and saw a burning sofa spreading to the
curtains in the hospital lobby. She is holding a glass of mineral water. Which of the following
should the nurse do first?
A. Pour the water in the burning sofa and curtain.
B. Activate the alarm system.
C. Call the attention of the nurse supervisor and the security guard.
D. Confine the area by closing the entrance and exit doors.
In case a victim with burning clothes on is running and approaching towards a nurse, it is
best for the nurse to immediately:
A. Log roll on the ground.
B. Assess the victims ABC.
C. Embrace the victim and share the
agony.
D. Tell the patient to drop & roll on the
ground.
What if the burn source is electrical, which of the following is best to do?
A. Hold and pull the victims hair
forcefully.
B. Disconnect the electrical source.
C. Splash with a bucket of water.
D. Administer the antidote.
A burn client is receiving narcotic for pain relief. He has an ongoing IVF and an indwelling
catheter. Which of the following is the priority action of the nurse?
A. Check the respiratory status.
B. Monitor the urine output.
C. Strict dietary compliance.
D. Regulate the IVF as ordered.
A trauma client, alone in his room, is seen by the nurse tilting his head and whispering
words, as if he is talking to someone. What should the nurse do initially?
A. Initiate suicidal precaution.
B. Ask the client if he is hearing voices.
C. Formulate a nursing diagnosis of risk for injury directed to self.
D. Evaluate the effects of the antipsychotic medication.
III. PRINCIPLE OF CONTRADICTION CONTRADICTION
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When two options contradict each other, there is a higher chance that one of
them is the correct answer.
Surgical count is done at least three times in the OR. When is the first count done?
A. Before the surgery.
B. Before closing the peritoneum.
C. After the surgery.
D. Whenever convenient to the nurse.
When a client is prone to keloid formation, which of the following type of surgical needle is
used for suturing?
A. Eyed. B. Eyeless. C. Threadless. D. Cotton.
Dirty cases such as incision and drainage (I&D) are scheduled:
A. First.
B. Last.
C. Depending on the availability of
instruments.
D. According to the preference of the OR
team.
Total colectomy is a surgical approach in the treatment of colon cancer. After the procedure,
which of the following is expected to be created?
A. Tracheostomy.
B. Temporary ileostomy.
C. Permanent ileostomy.
D. Colostomy.
Which of the following is not a factor for HIV transmission?
A. Multiple sexual partner.
B. Polygamy.
C. IV drug addiction.
D. Monogamy.
Brachytherapy also refers to:
A. Internal radiation.
B. 50 consecutive stem cell therapy
sessions.
C. 100 sessions of radiation exposure.
D. External radiation.
IV. PRINCIPLE OF COMMONALITY & DIFFERENCE COMMONALITY & DIFFERENCE
Two or more options having the same essential configuration and thought are
UNLIKELY the correct answers.
Diuretics are best taken:
A. In the morning.
B. After dinner.
C. Before sleep.
D. At bedtime.
DNR (Do Not Resuscitate) is an advanced directive that follows the principle of:
A. Justice.
B. Equality.
C. Fairness.
D. Autonomy.
Which of the following should be initiated in a client with bleeding gastric ulcer?
A. Diet as tolerated.
B. Regular diet.
C. Anything the client wants.
D. NPO.
V. PRINCIPLE OF UMBRELLA EFFECT UMBRELLA EFFECT
An option that is more inclusive is usually the correct answer.
Which of the following is contraindicated in a client with active gastro-intestinal bleeding?
A. Ibuprofen.
B. NSAID.
C. Aspirin.
D. Naproxen.
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Which of the following should be limited in the diet of a client with peptic ulcer?
A. Wine and beer.
B. Lechon and sisig.
C. Coffee and tea.
D. Fat, alcohol and caffein.
Which of the following indicates an increased ICP?
A. Elevated BP.
B. Slow heart rate.
C. Irregular respiration.
D. Cushings Triad.
VI. PRINCIPLE OF POSITIVE-NEGATIVE HARMONY POSITIVE-NEGATIVE HARMONY
A positive question will always ask for a positive answer and so is a negative
question.
All of the following is not an incorrect manifestation of hyperthyroidism, except all but one:
A. Weight gain.
B. Cold intolerance.
C. Diaphoresis.
D. Lethargy.
All but one food item is not inappropriate to be added in the dietary plan for a client with
hyperthyroidism except all but one:
A. Cigarette. B. Iced coffee. C. Milk. D. Meat.
VII. PRINCIPLE OF GRAMMATICAL HARMONY GRAMMATICAL HARMONY
An option that coincide with the grammatical configuration of the question is
most likely the correct answer.
The nurse enters the room of a young male client with a diagnosis of anxiety disorder and
sees him masturbating. The nurse should:
A. Say, Excuse me. and then leave the room.
B. Tell me whats bothering you. Im your nurse and Im ready to help.
C. Masturbation is normal with his age. It is part of growing up. However, it is inappropriate
to do it in a hospital.
D. Assessment of the clients behavior should be done initially.
Witch Hazel being part of hemorrhoid management serves as an:
A. Astringent that promotes clumping of protein.
B. Hot sitz bath has fewer side effects than Witch Hazel.
C. Witch Hazel is a high fiber food needed to prevent constipation.
D. Eating spicy food should be avoided because it can aggravate hemorrhoids.
On physical examination of a client with appendicitis, the nurse should be looking for
tenderness on palpation at McBurneys point, which is located in the:
A. Rebound tenderness in the RLQ indicates appendicitis.
B. The appendix may rupture which can cause peritonitis.
C. Right lower quadrant of the abdomen.
D. Analgesic should not be given because it can mask the rupture of appendix.
VIII. PRINCIPLE OF RE-APPEARING VISAGE RE-APPEARING VISAGE
A word or phrase that appears in the question and then re-appears in one of the
choices makes that choice most likely the answer.
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The nurse has a thorough knowledge of the anatomy of the hepato-biliary tract when she
says that bile enters the duodenum through the:
A. Foramen of Luschka and Magendie.
B. Pancreatic duct.
C. Common bile duct.
D. Jugular vein.
Which of the following is responsible in the epiphyseal growth of the bones?
A. Gonadotropin.
B. Melanin.
C. Growth hormone.
D. Corticosteroids.
A survivor of an accident repeatedly blames himself and tells the nurse he should have died
instead of his girlfriend. This is an example of:
A. Denial.
B. Survivors guilt.
C. Remuneration.
D. Grief.
Which of the following is an example of a sling lift used to carry/transfer a patient?
A. Hoyer lift.
B. Neck leash.
C. Fork truck.
D. Gurney.
IX. PRINCIPLE OF IMPROBABLE EXTREMES IMPROBABLE EXTREMES
Extreme modifier (always, all, never, only, everyone) makes an option most
likely an INCORRECT or a FALSE statement.
Which of the following is true about cryptorchidism?
A. It is always unilateral.
B. It can only be diagnosed after 1 year
old.
C. It will never lead to cancer.
D. It refers to undescended testis.
Which of the following is not true about vaginismus?
A. It may result from sexual trauma.
B. Penile entrapment is a potential result.
C. Muscle relaxant is part of pharmacological therapy.
D. It is always a voluntary attempt of the vagina to prevent the entry of the penis.
UTI is the most common nosocomial infection. Which of the following is true about UTI?
A. It affects female only.
B. Wear cotton always to reduce recurrence of UTI.
C. All cases are due to unsterile urinary catheterization.
D. Drinking cranberry juice reduces the chance of having UTI.
X. PRINCIPLE OF CENTRAL TENDENCY CENTRAL TENDENCY
In an all-numeric options, the correct answer is most likely located in between
the extremes.
The atmosphere is composed of atmospheric gases. How many percent does oxygen
comprise?
A. 78 %.
B. 57 %.
C. 21 %.
D. 1 %.
Discharge plan of diabetic clients include injection-site-rotation to prevent lipodystrophy.
You should emphasize that the space between sites should be:
A. 6.5 cm.
B. 5.5 cm.
C. 2.5 cm.
D. 1.5 cm.
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Different parts of the body heal at different speed. Common time to remove stitches also
varies. When is the ideal timing to remove suture on the face?
A. After suturing.
B. After 1 day.
C. After 3-5 days.
D. After 7-10 days.
XI. PRINCIPLE OF DRUG TECHNIQUE DRUG TECHNIQUE
Most drugs, especially psychotropic medications, act as either CNS stimulants
or CNS depressants. When 3 of the options are up, choose the only down, vice
versa.
A client is receiving Morphine SO4 to relieve the pain associated with MI. Which of the
following is an adverse effect of the drug?
A. Nervousness.
B. Bradypnea.
C. Tremors.
D. Rapid heart rate.
The nurse is assessing a client who has been admitted to the emergency department. Which
signs would suggest an overdose of an anti-anxiety agent?
A. Combativeness and excessive sweating.
B. Agitation and hyperactivity.
C. Suspiciousness and increased blood
pressure.
D. Lethargy and impaired memory.
The nurse is monitoring a client receiving tranylcypromine sulfate. Which serious adverse
reaction can occur with high dosages of this drug?
A. Loss of muscle tone.
B. Bradycardia.
C. Hypertensive crisis.
D. Depression.
XII. PRINCIPLE OF TELL ME MORE TELL ME MORE
In therapeutic communication, remember to focus on the clients feelings,
concerns, anxieties and fears. This is best summarized by a response that
encourages VERBALIZATION.
A client says to the nurse, I am a worthless person. I should be dead. The nurses best
reply is:
A. What makes you feel that youre worthless?
B. What you say is not true so stop worrying about being worthless.
C. You are not worthless. It is what you say that makes you worthless.
D. Dont say you are worthless because you are not a worthless person. Nobody in this
world is worthless.
During a conversation with a depressed client on an inpatient unit, the client says to the
nurse, My family would be better off without me. The nurses best response is:
A. Everyone feels like this when depressed.
B. Why dont you talk to your family about this?
C. Life is like a rosary that is full of mysteries.
D. You sound upset. Are you thinking of hurting yourself?
Maria Salvacion says that she is the incarnation of the holy Virgin Mary. She said that she is
the child of the covenant that would save this world from the evil forces of Satan. One
morning, while caring for her, she stood in front of you and said Bow down before me! I am
the holy mother of Christ! I am the Blessed Virgin Mary! The best response by the nurse is:
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A. Tell me more about being the Virgin Mary before I bow down.
B. Being the Virgin Mary is not easy. You must think about it well.
C. Excuse me but you are no longer a virgin so you cannot be the Blessed Virgin Mary.
D. You are Maria Salvacion.
XIII. PRINCIPLE OF MAGIC WORDS MAGIC WORDS
Word(s) in the NCLEX and local board exam which when appearing in an option
will make that option most likely the correct answer.
The most important quality that a nurse should demonstrate before establishing a
therapeutic relationship with the client is:
A. Self-
awareness.
B. Integrity.
C. Knowledge.
D. Skills.
The most basic and an important infection control measure is:
A. Envl
sanitation
B.Wearing of
gloves.
C. Handwashing.
D. Sterilization.
The best management for constipation is:
A. High fiber diet.
B. Increased OFI.
C. Bowel
retraining.
D. Laxative.
CONCLUSION CONCLUSION
+ Is it possible to correctly answer a question even without knowing a thing
about the question?
Rquiem trnam dona ei Dmine; et lux perptua lceat e). Requiscat in pace. Amen.
A. Lethargy. B. Hypoactivity. C. Bradycardia. D. Restlessness.
+ Is it possible to narrow the choices into 2 options even without reading the
question?
h t . i ; ; t ; 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 11 1 1 1 1 1 11 1 1 1 11
A. Pharmacologic. B.
Desensitization.
C.Non-
pharmacologic.
D.
Complimentary.
+ Is it possible to correctly identify the correct answer by studying only the
configuration of the options?
3 .
. ?
A. Wait for a while, everyone says patience is a virtue.
B. This is not normal. All depressed clients react the same way with anti-depressants.
C. This is normal. Antidepressants usually take 2 to 4 weeks to take effect.
D. Your depression is getting worst! I am going to place you in seclusion. Guards!
+ Is it possible to know the side effect of a drug without knowing the drug?
A client has been receiving a dose of sodiumchloride metadiamino paradioxy arsenobenzo
methylenesulphoxylate. Which of the following should you tell the client regarding the
potential side effect of the drug?
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A. Avoid driving or operating heavy machineries. The drug causes drowsiness.
B. Avoid exercising. The drug causes palpitation and tachycardia.
C. Do not go to high places. The drug causes tachypnea.
D. Your BP should be monitored. The drug causes hypertension.
+ Is it possible to answer a question confidently even without a question?
No Question
A. CNS
depression.
B. Low BP.
C. Bradycardia.
D. Rapid
breathing.
No Question
A. Cerebral
edema.
B. Increased ICP.
C. Head injury.
D. Cardiac arrest.
No Question
A. Irreversible. B. Permanent. C. Temporary. D. Lifetime.
Ad Majorem Dei Gloriam
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