Chapter I - Test Taking Strategies

Republic of the Philippines
SULTAN KUDARAT STATE UNIVERSITY

ACCESS Campus, EJC Montilla, Tacurong City
COLLEGE OF HEALTH SCIENCES
NURSING REVIEW 1
CHAPTER I ■ Students say, "I will worry about the

TEST TAKING STRATEGIES Nursing Licensure Exam when the
time comes." At this point, it is much
Preparing for Nursing Examinations too late. So think about this exam
early.
Purposes for Administering Exams ■ Research on the test plan as this
■ To test knowledge of the content provides a wealth of information
taught in a course. about the exam and lists the content
■ To test the ability to analyze and areas that will be tested on it.
apply concepts learned to care for ■ Use these lists as your study guides
clients in various situations. for preparing for exams for each
■ To ensure the development of a nursing course.
professional nurse who can safely ■ By doing this, consider that you are
and competently care for clients not only preparing for your nursing
served in the profession. exams but also preparing for the
■ To ensure the development of a Nursing Licensure Exam at the same
critical thinker who can make sound time.
clinical judgments and decisions ■ You will be ready when the Nursing
based on evidence-based practice Licensure Exam becomes a reality
■ To make certain that the student is a for you!
successful candidate who will pass
the NLE exam on his or her first take. Planning: Why Is It So Important?
■ Much of your success in nursing
The Nursing Licensure Exam: Why Do You school has to do with how you plan
Need to Think About It Now? and organize your time.
■ You may think that the Nursing ■ You will have a very busy schedule
Licensure Exam is far off, and it is; and will need to plan ahead to best
however, it is critical that you think prepare for your exams, clinical
about it the moment you enter your experiences, and other assignments.
first nursing class. You may ask, ■ Get an organizer with a calendar or
"Why is this important?" another type of calendar that you feel
■ To be successful on the Nursing will suit your needs, and use this as
Licensure Exam, you need to your planning guide for everything
become as familiar as you can with that you will need to do.
what this exam is all about as early ■ Oftentimes, the e-mail account linked
as possible in the nursing program. to your institution has an electronic
■ You need to know that taking the calendar that accompanies it. With
Nursing Licensure Exam will be a this calendar, important events can
reality once you graduate and that be marked for the entire group, and
this exam must be passed to become invitations can be sent using this
a licensed nurse. platform.
■ Often, students are concerned with ■ In addition to this, social media
the "here and now" of what they want accounts are commonly used as an
and need to accomplish and are not organizer for student and school
concerned about the future, the events.
Nursing Licensure Exam.
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■ Make notes about both your short- memorizing formulas for calculating a
term goals and your long-term goals. medication dosage or an intravenous
■ For your short-term goals, note your flow rate, is necessary in nursing.
classes and times, school meetings ■ However, the exam questions on a
and appointments, study session nursing exam are at a higher
times, assignment due dates, date cognitive level than memorization
and exam times, and any other and will require you to analyze or
obligations related to school. synthesize information and apply it to
■ For your long-term goals, note what a situation.
you plan to accomplish each year ■ You will not be able to rely only on
until your projected graduation date. recall skills to answer test questions
■ Look at your calendar daily to meet on a nursing exam. Instead, you will
any day-to-day obligations, and look need to understand pathophysiology
ahead at your long-term goals to be related to certain nursing content and
sure that you are ready for disease processes and use critical
graduation. thinking skills and clinical reasoning
to apply to clinical scenarios.
How Do Nursing Exams Differ From Other ■ Do not let that first nursing exam
Exams? “blow you away” or “throw you for a
■ When you enter your first nursing loop,” as some may say.
course, you need to remember that ■ Be ready for it, and you will do great
your exam experience in college up and pass!
to this point has related to testing in
support courses, such as anatomy What Types of Questions Can You Expect
and physiology, microbiology, on Nursing Exams?
chemistry, pathophysiology, nutrition, ■ Most questions you will encounter on
and genetics. nursing exams will be multiple
■ In these courses, test questions on choices, which consist of a question
exams have been primarily at the and four possible options.
cognitive level of knowledge or ■ You are probably very familiar with
understanding. these types of questions from your
■ These support courses have required support courses, but again, what you
not only a great deal of reading but need to remember is that nursing
also memorization in order to answer exam questions will require you to
the exam questions correctly. think critically and to use clinical
■ So basically, your test-taking skills to reasoning.
this point may be quite good but are ■ Other types of questions may be
based on knowledge, some utilized as well.
understanding, and memorization.
■ Nursing exams differ greatly from the Are Test-Taking Strategies Important?
exams that you have been used to ■ Test-taking strategies are important
taking. skills that will help you determine
■ Memorization alone will not get you what the question is asking, how to
through a nursing exam. Some select the correct answer, or how to
memorization, such as memorizing narrow your choices when you must
certain laboratory values or
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make an educated guess at an classes, simulation and skills lab, and

answer. clinical experiences.
■ Use of test-taking strategies is critical ■ You will need to complete a great
when taking a nursing exam because deal of reading and assignments and
in many of the exam questions, all take and pass exams. There are only
options may be correct, but 24 hours in a day, and you will have
depending on the way the question is a limited number of hours in each day
worded, you may need to prioritize to to spend on studying, so you need to
select the correct answer. use this time as effectively and as
■ In addition, many times you may be efficiently as possible.
able to narrow your choices down to
two options and then you may How Do You Identify and Plan Your Study
struggle with making a selection. Times?
■ In these situations, the use of test- ■ An important part of identifying time
taking strategies is essential. for study is using a calendar.
■ Therefore, it is important to become  Electronic calendar
skillful in the use of test-taking  Traditional paper type of
strategies. calendar
■ Choose the type that best fits your
needs, and let it be your academic
Developing Study Skills life-guide.
■ At the beginning of each semester,
What Are Good Study Skills? enter your class schedule into your
■ Having good study skills means: calendar.
 Developed conscious and ■ Pay close attention to due dates for
skillful study habits assignments and exam dates. Enter
 Devised a consistent study these dates in the calendar.
schedule that incorporates ■ In addition, enter into your calendar
methods for learning and any other important dates, such as
understanding nursing content extracurricular activities or other
 Established a routine that personal activities you have
promotes use of clinical scheduled.
judgment and synthesis of ■ Carry your calendar with you when
client information. you go to class. The instructor may
■ Good study habits develop through change an assignment due date or
time management and discipline. It is an exam date, so you want to be sure
important to remember that success that you can make that change in
comes from working hard, so you your calendar.
should think beyond the task of ■ Once all this information has been
studying; instead, incorporate study added to your calendar, you can plan
into your daily routine. your study times.
■ Time management is an important ■ Your calendar or academic life-guide
factor in developing good study is critical to your success in
habits and skills. In the nursing effectively managing your time and
program, you will be very busy with developing a study plan for the
semester.
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■ Be sure to look at your calendar ■ Set regular study time sessions for
every day to plan for the following each day because this will help
day. Look ahead to the next week, establish a routine that becomes part
and note what is scheduled (e.g., an of your school life, and remember
exam) or due (e.g., an assignment). that it is acceptable to revise your
■ If you are diligent about entering your study time sessions if necessary.
semester schedule and course ■ In other words, if you find a particular
requirements into your calendar and study time is not working, select
reviewing your calendar daily, you another time to take its place. During
can easily manage your time in a your study time be sure your time is
busy semester. spent on something related to your
nursing course work.
What Study Habits Do You Need to
Develop? Study Habit 2: Try Not to Do Too Much
■ Habits can be good or bad, and you Studying at One Time
need to focus on developing good ■ It is better to plan more than one
habits for studying. study time per day rather than to plan
■ If you develop good habits and stick a lengthy block of study time.
to them, you will be successful in the ■ In other words, plan more than one
nursing program. You can develop study session daily.
many study habits for yourself, and ■ If you try to do too much studying at
you may already have some study one time, you will easily tire and will
habits in place you developed. not be able to concentrate and retain
■ If you do, and if these worked, the information.
integrate these study habits into your ■ Your study time will be more effective
Nursing course study plan. if you space it over shorter periods of
time.
■ Always maintain a positive attitude
Top-10 Pyramid Points and Study Habits that you will be successful; you are
studying and adequately preparing.
Study Habit 1: Plan Daily Specific Times for
Studying Study Habit 3: Set Goals for Your Study
■ Look at your calendar to identify daily Time
times that are free of any other ■ Think about what you want to
commitments, such as class or accomplish during each study time.
clinical obligations, and make these Set your goal in writing.
your study times. Block these times ■ This will help you keep focused and
off in your calendar as your study concentrate on your task at hand.
times. Then work at meeting your goal.
■ If you have breaks between classes, ■ If for whatever reason you are unable
use them for study. For example, if to meet your set study time goal, do
you have a class from 8:00AM to not become discouraged. Just look at
10:00AM and do not have another where you left off, revise your goals
class until 1:00PM, block out the time for your next study session, and keep
between these classes as study time. moving forward on your plan!
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Study Habit 4: Avoid Procrastination lounge, cafeteria, or cafe. Find your

■ Stick to your study schedule, and special area of tranquility, and post a
start studying as you planned to do. “do not disturb” sign.
■ It is very easy to get off track and ■ Be sure that your cell phone is off
procrastinate because “I just do not and that any other phone or the
feel like studying” or “the content or television is off or far enough away
assignment is difficult” or “I would from you so that you will not be
rather be doing something else.” distracted.
■ If you procrastinate, you will not meet ■ Your study area should be adequate
your goals and will need to rush at a and roomy enough to support your
later time to complete your work. necessary books, notes, and other
■ This places unnecessary stress on essentials required to make the study
you and then you will end up having session a success.
to cram, so start studying when you ■ The lighting in your special study
planned to. area should be soft and provide the
■ You will feel great after your study right amount of light to allow easy
session knowing you accomplished a reading.
goal. ■ Remember that temperature control
is also critical to your comfort. If it is
Study Habit 5: Study the Most too hot, you may become sleepy. If it
Difficult Material When You Are Most Alert is too cold, you may begin to shiver
■ Some students do best with studying and have difficulty concentrating.
in the early-morning hours, some do ■ So find a room temperature that is
better during the daytime hours, and comfortable for you.
some do best during the evening ■ Remember that your special study
hours. area should be quiet and
■ You need to determine which time is comfortable.
best for you and when you are most
rested, are alert, and have the most Study Habit 7: Seek Help When You Do Not
mental energy. Understand the Material
■ Once you have determined this, use ■ If you are having difficulty
this time to work on your most difficult understanding the material, seek
material. If you have the mental help.
energy and stamina, this difficult ■ Remember that in many cases “two
material will be easier to grasp. heads are better than one.” You can
ask another student to help explain a
Study Habit 6: Find a Special Study Place difficult content area that you do not
That Is Free of External Distractions understand, but do not ever hesitate
■ Your special study area should be to ask your instructor to explain the
quiet and comfortable. It can be your information to you.
dormitory room, a study lounge, the ■ During your study session, if you are
library, a special room at home, or “stuck” and are not able to
any other quiet area that works for understand the information using the
you. resources that are immediately
■ Do not plan to study in a crowded or available to you, move on to the next
noisy room, such as a student social
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topic. Do not waste your valuable is important for the functioning of

study time. every cell in your body. A nurse is
■ Make note of the information that you also a teacher, and you will be
do not understand, and seek teaching your clients about the
clarification later. importance of eating healthy. So
■ Start the next topic to make the most practice what you will be
of the study time you have planned. preaching!
Make your own “flash cards” to help ■ Breakfast is an extremely important
you remember that difficult-to-learn meal because it starts your day with
information. the fuel that you need to think and
perform all the activities ahead of
Study Habit 8: Plan Study Breaks you; however, be sure to eat a
■ Study breaks are important to keep healthy breakfast.
your mind fresh and alert. ■ Stay away from bacon, sausage, and
■ All people differ in terms of the length high-sugar syrups. Instead, for
of time that they can sit and study example, eat a bagel or toast with
and maintain focus to concentrate, so some peanut butter, cereal, or fruit,
don’t compare your study needs to and drink some juice.
those of other students. ■ Eat lighter meals and eat more
■ How will you know when you need a frequently to keep your body fueled
study break? If you are having and energized.
difficulty focusing and are moving ■ Include complex carbohydrates and
through content but are not grasping protein in your diet for energy.
the material, then you need a study ■ Carry snacks in your backpack for
break. between meals or for your study
■ If you read a page of content but at breaks, but again, be sure that these
the end of the page you do not snacks are healthy ones.
remember what you read, then you ■ Also, be careful not to include too
need a study break. much caffeine in your daily diet as it
■ If you are experiencing “mind chatter” will make you jittery and nervous and
or are thinking about things other cause you to have difficulty focusing
than the task you are supposed to be and concentrating.
focusing on, then you need a study ■ Exercising regularly is another
break. extremely important habit to develop.
■ If you are feeling sleepy or hungry,  Exercise will:
you need a study break.  Enhance or maintain your
physical fitness and strength and
Study Habit 9: Eat a Healthy Diet, and your overall health.
Exercise Regularly  Boost the immune system
■ Eating a healthy diet will build and  Help prevent disease
maintain your energy level and your  Improve your mental health.
stamina to meet your set goals. ■ Exercise is also a great outlet when
■ Did you know that eating fatty foods you take a study break; take a walk
will slow you down? Yes they will; so during your break.
you need to avoid fatty foods. As you ■ This will get your circulation flowing,
will learn in nursing school, nutrition and you will find that your mind will
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clear and you will be able to focus ■ Whatever it may be that is keeping
and concentrate. you awake needs to be eliminated
from your mind.
Study Habit 10: Get an Adequate Amount of ■ How do you do this? This may be a
Sleep Every Night trial-and-error sort of task that will
■ Sleep is like food, air, or water. You require implementing various
need it to think and function measures or strategies to help you
adequately, and you need it to fall asleep until you find the one that
survive. will work for you.
■ Lack of an adequate amount of sleep ■ Remember that a measure that
will cause mental, emotional, and works for someone else may not
physical fatigue and irritability. work for you; however, if you
■ Think about it—do you want to go determine what will work for you and
into a classroom to take an exam get into the habit of implementing this
feeling irritable or mentally, measure repetitively, you will find that
emotionally, or physically fatigued? you will easily be able to fall asleep at
Of course not, because then you are night.
placing yourself at risk for failure. ■ Measures to Promote Sleep
■ If you develop a schedule for  Develop a time schedule for when
studying and stick to it, then you will you will go to bed at night.
not have to worry about being up all  Avoid taking naps during the day.
night preparing for an exam the next Avoid consuming caffeine-
day. containing drinks and foods.
■ One of the worst things that you can  Eat healthy and exercise regularly
do is to cram the night before an (avoid exercise within 3 or 4 hours
exam and stay up all night studying. of bedtime because activity
If you do this, it will be very difficult to increases metabolism and
focus and concentrate while taking alertness for a few hours).
the exam.  Avoid eating heavily close to
■ If you have developed a structured bedtime.
study plan and stuck to it, the night  Adjust the room temperature to
before the exam will require simply a meet your physical needs; a cool
review of the content. environment is best.
■ So get into the habit of going to bed  Keep the lights off in the room at
at night at a specific time that will bedtime.
provide you with an adequate amount  Ensure a quiet environment; place
(6 to 8 hours) of quality sleep. a “sleeping” sign on your door,
■ Do you have difficulty falling asleep? and use comfortable earplugs if
If you do, this is probably because necessary.
you are lying in bed thinking about all  Turn your clock around or place it
sorts of things, such as everything in a drawer so that you cannot
that you need to get done over the see it.
next day, the next week, and the  Perform a relaxation technique,
remainder of the semester; or you such as reading; slow, deep
may have other sorts of things on breathing; or meditating.
your mind.
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 Use a natural sleep remedy, such stomachache, nausea, vomiting, or

as drinking a cup of warm diarrhea.
caffeine-free tea. ■ Test anxiety also can cause
headaches, excessive sweating, a
rapid heart rate (feeling like the heart
Test Anxiety is pounding), and rapid breathing.
■ Some students may describe their
What are your concerns? physical feelings related to test
■ Test anxiety anxiety as “I feel like throwing up” or
■ Failure “I feel like I might pass out.”
■ Drawing a blank ■ Test anxiety can also cause
■ Attitude overwhelming feelings of
helplessness and a sense of feeling
What Is Test Anxiety? out of control of the situation.
■ Test anxiety is a psychological
condition that can cause a significant What Will Help Prevent Test Anxiety?
amount of stress related to preparing ■ One important way to prevent test
for and taking an examination. anxiety is to be as prepared as
■ Test anxiety is a type of performance possible for the exam.
anxiety because the individual is ■ Time management and a structured
under pressure to do well in order to study plan also prevent test anxiety
pass. because you are planning ahead and
■ A person with test anxiety working on preparing for a test and
experiences tension and stress other assignments well in advance of
before, during, and possibly after the scheduled date.
finishing an exam. ■ You cannot procrastinate.
■ Test anxiety can block the thinking Procrastinating places unnecessary
processes and cause poor pressure on you, creating test anxiety
performance with testing, regardless or making test anxiety worse.
of the amount of preparation for the ■ If you study daily rather than
exam. cramming at the last minute, you will
know the content well enough so that
How Can You Know If You Have Test you can recall it even if you are
Anxiety? stressed.
■ Preparation also builds your
■ If the anxiety is overwhelming and
confidence because you will feel
you cannot control it, your thinking
more comfortable about knowing the
processes will be blocked, you will
material.
have difficulty focusing and
concentrating, and you will forget the
material that you learned. What Can You Do When You Are
■ Anxiety related to taking an Experiencing Test Anxiety?
examination can cause various ■ Relaxation techniques can help when
symptoms. you experience test anxiety because
■ Test anxiety can bring on a feeling of they relax you and help you gain
“butterflies in the stomach,” a control.
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■ Several types of relaxation How Can You Control Your Test Anxiety
techniques that you can use include Before the Exam?
resting your eyes, muscle ■ Before the examination you may
relaxation/tightening exercises, become anxious and think, “I am not
meditation, or breathing exercises. ready!” As a nursing student, it is
Use whatever technique works for important to remember that it is very
you. difficult to feel 100% prepared for an
■ Breathing exercises are a commonly exam.
used technique that can be done at ■ This feeling is not necessarily caused
any time, including during your by inadequate preparation and is
testing. usually caused by test anxiety.
■ These exercises will not only help ■ First, stay away from peers who are
relax you but also oxygenate your experiencing anxiety before the
brain and body. exam. These peers may be
discussing content and what might be
What Should You Do the Night Before the asked on the test, and this is going to
Exam? cause confusion and fear about
■ Remember to avoid cramming the preparing well enough, contributing to
night before the exam because this anxiety.
will increase your test anxiety. ■ Next, stop whatever you are doing
■ Prepare ahead, and rest your body and reflect on all that you have
and your mind. accomplished in your preparation
■ Remember that the mind is like a plan.
muscle, and if it is overworked, it has ■ Sit quietly somewhere where you can
no strength or stamina. concentrate on relaxing and tell
■ On the night before the exam, as yourself that you indeed prepared
long as you have prepared well and adequately for the test and are ready.
followed your study plan all along, put ■ Smile, brush those negative feelings
your textbook and notes away and away, do your breathing exercises,
get to bed early. and keep repeating to yourself, “I am
■ At bedtime perform deep-breathing going to do well. I am prepared.”
exercises and listen to soothing Repeating this statement will build
music to help you relax and fall the extra confidence that you need by
asleep. helping you maintain a positive
■ Set your alarm clock and plan to get attitude, relax, and focus before the
up 15 to 30 minutes earlier than exam.
usual to have some time to wake up
and eat a healthy breakfast. How Can You Control Your Test Anxiety
■ If possible, walk to class on the day During the Exam?
of the exam to get the circulation and ■ During the exam if you begin to
oxygen moving throughout your experience any anxious feelings, sit
body. back in your chair, close your eyes,
■ Remember that you have prepared and perform a relaxation technique,
yourself well for the challenge of the such as breathing exercises.
day ■ The breathing exercises are also
helpful if you begin to feel your mind
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wandering, if you feel distracted, or if ■ If you are allowed to write on the test,
you are unable to concentrate on the jot down data that you needed to
test question. memorize and may need as a
reference, such as a laboratory
Before and During the Test value. Remember though that you
■ Manage your daily routine before the will not be able to do this when you
test take the NLE. Jotting down data is
■ Manage your study habits before the known as brain dumping and is not
test allowed when you take the NLE.
■ Manage your travel on the day of the ■ Read each question and all options
test slowly and carefully.
■ Manage the supplies you will need ■ Take your time when answering a
for the test question.
■ Manage your own personal comfort ■ Use nursing knowledge and test-
■ Manage the test environment taking strategies to help you answer
■ Maintain a positive mental attitude the question.
■ Skip any questions that are difficult.
The Reality ■ Answer all the questions that you
know and that are easy for you to
■ You were selected to participate in
answer.
this program because of your ability
■ Once you have answered all the easy
to achieve excellence.
questions, go back to the questions
■ Nursing tests will be unlike any tests
that were difficult.
you have ever taken.
■ Nursing tests require more than just Note: These tips relate specifically to
“recall” of knowledge. They require pencil-and-paper tests.
critical thinking.  On a pencil-and-paper nursing
exam taken in nursing school, one
Empowerment strategy is to skip questions that
■ Challenge negative thoughts are difficult and go back to them
■ Used controlled breathing once you have answered as many
■ Desensitize yourself to the fear as you can. On other type of
response exam (online exams), you need to
■ Perform muscle relaxation
remember that you will not be
■ Over prepare for each test
■ Exercise regularly able to skip a question and then
go back to it. You must answer
Structured Sequence for Taking an Exam the question on the computer
■ Place your name on the test and on screen in front of you or the test
any other required testing will not advance. So be prepared
documents. for this type of testing when you
■ Read the directions. take online exam.
■ Skim through the pages in the test so
that you have an idea of how to pace
yourself.
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Left-Hemisphere versus Right-Hemisphere ❑ Patient-centered realistic measurable

Brain Processing goals with time frame.
Left-Hemisphere Right-Hemisphere ❑ Identify appropriate nursing actions.
Rational problem Main ideas to establish ❑ Evaluate outcomes.
solving strategies and relationships that can
logical sequencing. be abstracted as the
foundation for intuitive Maslow’s Hierarchy of Needs
problem solving.
Rational learners break First learns from content
down situations into and experience then
components and look for applies and analyzes
universal rules and principle.
approaches that can be
applied in all situations.
Examinations
1. Must be approached as learning
opportunities.
2. Review before turning in.
3. Identify key concepts:
❑ -”What is happening?” Applying Critical Thinking
❑ -”What should I do?” ■ Think of it this way:
Remember: If all your energy is spent on “We cannot stand in the same river twice,
defending your response, then your mind is because water rushes away as new water
not open to different perspectives, which takes its place and the rushing water
ultimately limits your learning. changes the river bed. The decisions we
make today may not fit circumstances that
Critical Thinking Requirements change tomorrow.”
❑ Identify assumptions. ■ IN OTHER WORDS; NO CLINICAL
❑ Use a method to collect and organize AND PATIENT SITUATION WILL BE
information. EXACTLY LIKE A PREVIOUS
❑ Validate the accuracy and reliability EXPERIENCE.
of collected information. ■ One different factor in a situation can
❑ Determine the significance of change the entire landscape of the
collected information. situation.
❑ Determine the inconsistencies in
collected information. The Multiple Choice Questions
❑ Identify patterns of patient responses.
Components of a MCQ
❑ Identify stressors and common
responses to stressors. ■ It is objective
❑ Identify gaps in information. ■ It has more than one answer
■ In nursing, a MCQ can have a good
❑ Determine relationships in given
answer, a better answer, an even
information.
better answer, but you need to pick
❑ Identify actual problems and patients
the BEST answer.
who may be at risk.
■ Only one item is correct.
❑ Establish priorities. (Maslow’s)
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Components ■ Key words: FIRST, INITIALLY,

■ The entire question is called an “item” BEST, PRIORITY, SAFEST AND
■ Each item is made up of a “stem” that MOST
asks the question ■ These words occasionally are
■ Under each stem you will find your emphasized by an underline, italics,
“options.” Boldfaced, or CAPITALS
■ Among the option there is only one ■ You must also consider stem polarity
best answer referred to as “correct when selecting the correct option.
answer”
■ Since only one option is correct, the Stem Polarity
other options are referred to as ■ Can be positive or negative
“distractors.” ■ A stem with a positive polarity will ask
you to pick out the option that is true.
The “Item” ■ A stem with a negative polarity will
■ The entire MCQ ask you to pick out the option that is
■ Objective not true.
■ By understanding the polarity of the
Sample question, you can eliminate wrong
■ What should the nurse do answers.
STEM
immediately before performing any ■ Positive polarity words: Understand,
I apply or differentiate correct
procedure? T information
a) Shut the door E
CORRECT ■ Negative polarity: Contraindicated,
b) Wash the hands ANSWER M
OPTIONS further, unacceptable, least, NOT,
c) Close the curtain
never, least, avoid. These identify
d) Drape the patient
interventions that are unacceptable.
Sample 2 - You try!
Positive Polarity
■ When providing care to a patient with
■ This question is concerned with the
a nasogastric tube, the nurse
truth, a fact, a principle.
recognizes that the tube goes into
■ This question attempts to determine if
the:
you are able to understand, apply or
a) Stomach differentiate correct information.
b) Bronchi
c) Trachea
Positive Polarity Stem
d) Duodenum
■ Which intervention most accurately
supports the concept of informed
The “Stem”
consent?
■ This is first part of the item that asks
a) Obtaining the patient’s
the question.
signature
■ Should present a problem in a clear
b) Explaining what is being done
and concise manner.
and why
■ It should have all of the details you
c) Involving the family in the
need to answer the question.
teaching plan
■ It can be a complete or an incomplete
sentence.
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d) Teaching preoperative deep concerned about myself first and I

breathing and coughing hurt so many people during my life.”
What is the underlying feeling being
Negative Polarity expressed by the patient?
■ Concerned with what is false. a) Ambivalence
■ Asks a question with a negative b) Sadness
statement. c) Anger
■ Typically uses words like “except,” d) Guilt
“not,” or “never.”
■ May use other words like The “Options”
“contraindicated,” “unacceptable,” ■ The second part of the item
“least,” or “avoid.” ■ Possible responses
■ Requires that you recognize ■ Options can be a sentence (Before
exceptions to the rule. performing a procedure, what should
nurse do first? Collect the equipment
Negative Polarity Stem for procedure, position pt. for
■ On what part of the body should the procedure, explain procedure to pt.,
nurse avoid using soap when raise the bed to highest position)
providing bed bath to a patient? ■ Completes the sentence begun in the
a) Eyes stem (The RN understands that the
b) Back primary etiology of obesity is? Lack of
c) Under the breasts variety nutrients, glandular disorder
d) Glans of the penis prevents weight loss, caloric intake
that exceeds metabolic needs,
You pick - Is this positive or negative? psychological problem that causes
overeating)
■ Range of motion (ROM) exercises
■ Can be an incomplete sentence
should NOT be done:
(which nursing intervention is
a) For comatose patients common when caring for all pts. with
b) On limbs that are paralyzed infections? Donning a mask, wearing
c) Beyond the point of resistance a gown, washing hands,
d) For patients with chronic joint discouraging visitors)
diseases ■ Just a single word (What is the nurse
doing when formulating a nurse dx?
Positive or Negative? Planning, assessing, analyzing,
■ What position would be implementing)
contraindicated for the patient who
has dyspnea: A, B, C, D and sometimes E
a) Supine ■ Only one option in a MCQ is correct
b) Contour ■ The typical number is 4-5 which
c) Fowler’s reduces the likelihood of guessing.
d) Orthopneic ■ An option can be a sentence, it can
complete the sentence started with
One More the stem, it can be an incomplete
■ An older adult who is dying starts to sentence or it can be a single word.
cry and says, “I was always
13 | P a g e
NURSING REVIEW 1
The Sentence Option The “Correct Answer”

■ Before performing a procedure, what ■ There is one BEST answer among
should the nurse do first: the option given referred to as the
a) Raise the patient’s bed to its correct answer.
highest position
b) Collect the equipment for the The “Distractors”
procedure ■ Remaining answers which house
c) Position the client for the incorrect answers
procedure ■ Designed to make you doubt and
d) Explain the procedure to the distract you away from the correct
client answer.
The “complete the sentence option.” STEP 1: Identify the KEY CONCEPT being
■ The primary etiology of obesity is a: tested
a) Lack of balance in the variety ■ What is happening?
of nutrients ■ What should I do?
b) Glandular disorder that ■ Need to: RERAME, CRITIQUE AND
prevents weight loss EVALUTATE STEM
c) Caloric intake that exceeds ■ ANSWER BEFORE LOOKING AT
metabolic needs CHOICES
d) Psychologic problem that
causes overeating ■ A patient has just returned from the
operating room with a Foley catheter,
The incomplete sentence option (missing IV line, and oral airway & is still
parts of speech subject and verb) unresponsive. Which nursing
■ Which intervention is common when assessment should be made first?
caring for all patients with infections? A. Check the surgical dressing to
a) Donning a mask ensure that it is intact.
b) Wearing a gown B. Confirm the placement of the
c) Washing the hands oral airway.
d) Keeping visitors out C. Observe the Foley catheter for
drainage.
The one word wonder D. Examine the IV site for
■ Which word best describes feelings infiltration.
associated with a child in Erickson’s
stage of autonomy versus shame and KEY CONCEPT: Priority of care for the
doubt? unresponsive patient
a) Hers ■ Key words that answer what is
b) Mine happening?
c) Theirs ❖ Postoperative patient
d) Nobody’s ❖ Oral airway
❖ Unresponsive
■ Key words that answer what should I
do?
❖ Assessment
14 | P a g e
NURSING REVIEW 1
❖ Should be made first ■ Which is associated with a

■ Question being asked: What physiological need of a patient with a
assessment takes priority when colostomy?
caring for an unresponsive A. Disturbance in body image
postoperative patient with an oral B. Inadequate nutrition
airway? C. Lack of knowledge
D. Skin breakdown
Explore the Consequences of Each Nursing
Action in Each Alternative ■ “Physiological” modifies the word
■ ASK MANY DIFFERENT “need” and is the CLUE in the STEM
QUESTIONS: ❖ Therefore the correct answer
❖ Is the action safe? is D.
❖ Is the action unsafe? • SKIN BREAKDOWN
❖ Is the statement true?
❖ Is the statement false? Change physiological to psychological
❖ Is this a fact? within the stem
❖ Is this an inference? ■ Which is associated with a
psychological need of a patient with a
STEP 2: Avoid reading into the question; do colostomy?
not rewrite the question A. Disturbance in body image
■ Ask yourself: B. Inadequate nutrition
■ Did I read additional information into C. Lack of knowledge
the stem of question? D. Skin breakdown
■ Did I have difficulty deciding among
the options because I would have Now the ENTIRE focus has changed
done something completely different? ■ Correct answer is now A.
■ Did I delete an option because my ❖ Disturbance of body image
experience was different from the
■ CLUE in the STEM is NOW:
patient situation presented?
■ Did I view the question in light of a ❖ PSYCHOLOGICAL
more sophisticated level of curricular
content than that being tested? Cognitive Levels of Nursing Questions
■ Did I view the patient scenario in 1. Knowledge
more depth than necessary? 2. Comprehension
3. Application
STEP 3: Change the focus of the question 4. Analysis (synthesis and evaluation)
■ To explore additional situations using Knowledge Questions

MCQ is to change one of the key ❑ Require you to recall or remember
facts in the stem of the question in information.
order to alter the focus of the ❑ Commit facts to memory
question. ❑ Expect you to know: terminology,
■ Identify the next best option that facts, classifications, principles
answers the question.
15 | P a g e
NURSING REVIEW 1
What is the expected range of a radial pulse ❖ T: Temperature ↑

in an adult?
A. 50-65 BPM Acrostics: phrase or motto where first word
B. 70-85 BPM prompts memory for rest
C. 90-105 BPM ❑ Studying fat soluble vitamins
D. 110-125 BPM remember motto:
❖ “ALL DIETERS EAT
❑ To answer correctly you have to KILOCALORIES”
know the range of an adult radial ❖ A, D, E, AND K ARE FAT-
pulse. SOLUBLE VITAMINS
❖ 70-85 BPM is within the
expected range of 60-100 in Mnemonics: similar to acrostic except not q
an adult. word is r/t piece of content
❑ “There are 15 grains of sugar in 1
To increase your knowledge graham cracker” therefore
❑ Memorize ❖ 15 grains = 1 gram
❑ Use Alphabet cues ❑ HDL and LDL
❑ Use Acronyms ❖ Happy cholesterol and lousy
❑ Acrostics cholesterol
❑ Mnemonics
Comprehension Questions
Memorize
❑ Must understand the information
❑ Use of repetition ❑ Commit facts to memory - as well as -
❑ Facilitate by using lists, flash cards or translate, interpret, determine
learning wheels implications of the information,
consequences and effects.
Alphabet Cues
❑ CAB’s ❑ A nurse uses the interviewing
❑ 3 P’s of diabetes: technique of clarification when
❖ Polyuria (U) interviewing a patient. What is the
❖ Polydipsia (T) nurse doing when this
❖ Polyphagia (H) communication technique is used?
A. Paraphrasing the patient’s
Acronyms; word formed from letters of a message.
series of statements B. Restating what the patient has
❑ Infection remember the word said.
INFECT: C. Reviewing the patient’s
communication.
❖ I: Increased P/R/WBC
D. Verifying what is implied by
❖ N: node enlarge
the patient.
❖ F: function impaired
❖ E: erythema, edema and
You have to know:
exudate
❖ C: C/o pain ❑ Clarifying is a therapeutic tool that
promotes communication between
16 | P a g e
NURSING REVIEW 1
the patient and the nurse bending at the knees, which

(knowledge) & you must explain why permits the muscles of the
or how this facilitates communication legs, rather than back, to bear
(comprehension). the patient’s weight.
ANWER IS D Analysis Information/ Question

❑ D. Verifying what is implied by the ❑ Interpret a variety of data; recognize
patient. commonalities, differences and
❑ Clarification is a method used to interrelationships among presented
verify that the patient’s message is ideas.
understood as it is intended ❑ Learn to discriminate
❑ Can be used to gain more ❑ Differentiate the significance of
information without interpreting the information
original statement.
Blood Pressure
Application Question ❑ First you will memorize the normal
❑ Requires you to show, solve, modify, range (knowledge)
change, use or manipulate ❑ Then you develop an understanding
information. of what factors influence and
❑ May be theories, technical principles, produce a normal blood pressure
and rules of procedures. (comprehension)
❑ Test ability to use information that ❑ Then you identify a particular patient
has been taught. situation that necessitates obtaining
a BP (application)
❑ A nurse is going to assist a heavy ❑ Now differentiate among a variety of
patient higher in bed. What should situations to determine which has
the nurse do to prevent self-injury? the highest priority for assessing the
A. Keep the knees and ankles BP (analysis)
straight.
B. Straighten the knees while Analysis promotes higher acuity thinking
bending at the waist. ❑ Identify those differences:
C. Place the feet together and ❑ Causes of hypertension each ↑ for
keep knees bent. different reason
D. Position the feet apart with ❖ Infection (↑ in metabolic rate)
one foot placed forward. ❖ Fluid retention (causes
hypovolemia)
Answer: Must know & understand principles ❖ Anxiety (constricts the blood
of good body mechanics vessels)
❑ D. Position the feet apart with one
foot placed forward. Practice Test Taking
❖ Both actions provide a wide ❑ Reinforces learning
base of support that promotes ❑ Identifies learning
stability; placing one foot in ❑ Understand and grasp concepts
front of the other facilitates ❑ Identifies nursing interventions
17 | P a g e
NURSING REVIEW 1
❑ Applies principles ■ Interpret data

❑ Analyzes information ■ Identify the need for additional data
❑ Applies critical thinking skills ■ Identify nursing diagnoses
■ Communicate the diagnoses to
The Nursing Process others
■ Maslow’s hierarchy and Gordon’s
❑ Your blueprint for success
Functional Health Patters—useful
■ Five steps:
here.
1. Assessment
2. Diagnosis
Sample-Diagnosis
3. Planning
4. Implementation ■ A patient had a stroke that resulted in
5. Evaluation paralysis of the right side. When
clustering data the nurse grouped the
following data together: drooling of
Test Questions
saliva and slurred speech. Which
■ Are written to test your knowledge of information would be the most
a specific concept, skill or theory from significant to include with this
the perspective of the nursing clustered data?
process.
a) Excessive aphasia
■ The nursing process is your blueprint
b) Difficulty swallowing
for critical thinking!
c) Inability to perform
ADLs
Assessment d) Incontinence of urine
■ First Step and stool
■ Collecting data ■ Remember your ABCs
■ Physical examination, interviewing,
reviewing Sample-Diagnosis
Interpret Data
Sample - Assessment ■ A patient has a loss of appetite, has
■ While making rounds, the nurse finds difficulty falling asleep, and has lost
a patient on the floor in the hall. What interest in activities of daily living.
should be the nurse’s initial Which feeling reflects these
response? adaptations?
a) Inspect the patient for injury a) Anger
b) Transfer the patient back to b) Denial
bed c) Depression
c) Move the patient to the closest d) Acceptance
chair
d) Report the incident to the Planning
nursing supervisor
■ Third Step
■ Involve the patient
Diagnosis ■ Set goals
■ Second Step ■ Establish outcomes
■ Analysis ■ Establish priorities
■ Validate how your data are related ■ Plan appropriate interventions
■ Cluster data
18 | P a g e
NURSING REVIEW 1
■ Anticipate patient needs Sample-Planning Question

■ Recognize the need to collaborate Set Priorities
■ Coordinate care with other disciplines ■ A Patient Has Just Returned From
Surgery With An IV And Does Not
Critical words to look for: Have A Gag Reflex. Which Planned
■ “Achieve,” “desired,” “plan,” Intervention Takes Priority:
“effective,” “goal,” “priority,” a) Ensure Adequacy Of Air
“develop,” “formulate,” “establish,” Exchange
“collaborate,” “determine.” b) Observe The Dressing For
■ All of these indicate that your Drainage
question is a planning question. c) Check For Infiltration
■ You mess up on a planning question d) Monitor Vital Signs
when you select options that: ■ Remember Your ABCs.
Don’tmess up the plan! Implementation

■ Don’t Include The Patient ■ Fourth Step
■ Contain Inappropriate Goals ■ Recognize steps in the process
■ Misidentify Priorities ■ Implement a procedure or treatment
■ Reflect Goals That Are Unrealistic Or ■ Identify or respond to life-threatening
Immeasurable or adverse effects
■ Fail To Include Family Members Or ■ Prepare a patient for procedure,
Significant Others treatment, surgery
■ Fail To Coordinate And Collaborate ■ Identify or use concepts associated
With Other Health Team Members with teaching, motivation, and
communication.
Sample-Planning Question ■ Recognize the relationship between a
ID Goals procedure and an expected outcome.
■ The Nurse Is Caring For A Patient ■ Recognize when to document or
With A New Temporary Colostomy. report patient care and responses
Which Would Be A Realistic Short-
Term Goal For This Patient? Critical words to look for:
a) The Patient’s Bowel Will ■ “dependent,” “independent,”
Function Within 2 Days “interdependent,” “change,” “assist,”
b) The Patient Will Have Regular “counsel,” “teach,” “give,” “supervise,”
Bowel Elimination “procedure,” “treatment,” “reassess,”
c) The Patient Will Be At Risk “facilitate,” “delegate,” “implement.”
For Impaired Skin Integrity ■ All indicate an implementation
d) The Patient’s Skin Will Remain question
Intact Around The Stoma ■ You mess up when you select an
option that…..
Patient Centered, Specific (Measurable),
Realistic and Achievable Within the Time Don’t mess up!
Frame. ■ Implements actions outside of your
scope of practice
19 | P a g e
NURSING REVIEW 1
■ Fails to identify or respond to life- ■ Implementing safe effective care

threatening situations
■ Fails to reassess the patient Last But Not the Least
■ Fails to modify interventions based Evaluation
on changing patient needs ■ Fifth Step
■ Fails to identify that you need ■ Identify steps in the evaluation
additional assistance to provide safe process
care ■ Identify actual outcomes as desired
■ Reflects a lack of knowledge to safely or undesired
implement interventions ■ Identify whether an outcome has
■ Fails to document accurately the been met or not
patient’s response ■ Identify progress or lack of progress
■ Delegate inappropriately towards an outcome or a goal
■ Recognize that the process of
Sample-Implementation evaluation is continuous
■ The primary nurse assigns a staff ■ Recognize that the nursing process is
nurse to insert an indwelling urinary dynamic and cyclical.
(Foley) catheter. What is the first
thing that the staff nurse should do? Critical Words
a) Explain the procedure to the ■ “expected,” “met,” “desired,”
patient “compared,” “succeeded,” “failed,”
b) Gather all equipment at the “achieved,” “modified,” “reassess,”
bedside “ineffective,” “effective,” “compliance,”
c) Check the physician’s order “noncompliance.”
d) Wash hands thoroughly ■ All indicate an evaluation question
■ You mess up when options are
Sample-Implementation selected that:
■ A patient has an order for a 2-gram
sodium diet. What should the nurse Don’t mess up!
teach this patient to avoid? ■ Do not thoroughly and accurately
a) Salt reassess the patient after care is
b) Sugar given.
c) Liquids ■ Fail to appropriately cluster new data
d) Margarine (what step is this from?)
■ Teaching = implementation ■ Fail to determine the significance of
new data
Sample-Intervention ■ Come to inappropriate or inaccurate
■ What is the underlying rationale for conclusions
turning a patient every 2 hours? ■ Fail to modify the plan of care based
on changing patient needs or
a) To relieve pressure
circumstances.
b) To assess skin condition
c) To ensure the skin is clean
and dry Sample-Evaluation
d) To provide massage to bony ■ A patient on a bland diet complains
prominences about a poor appetite. What would be
20 | P a g e
NURSING REVIEW 1
the MOST effective way to determine ■ *Avoid reading into the question
whether the patient’s nutritional ■ Make educated guesses
needs have been met? ■ Maintain a positive mental attitude
a) Institute a 3-day food intake ■ Check your answers and answer
study sheet
b) Weigh the patient at the end of
the week
c) Request an order for a dietary
assessment Knowledge is a treasure, but
d) Compare a current weight with
practice is the key to it.
the weight history
“Both minds and fountain pens
A Few Hints will work when filled, but
Before you answer minds, like fountain pens, must
■ Break it down be filled.”
■ Rephrase in your own words -Arthur Guiterman-
■ Read each option carefully (it may
contain some correct information but
not all.
■ Identify polarity
■ Identify key words in the stem that
set a priority (rank) References:
■ Identify clues in the stem
1. Nugent, B.M., & Vitale, B.A. (2004).
More Test success: Test-taking techniques
■ Identify patient-centered options for beginning nursing students
■ Identify determiners (always, never,) (4th ed.). Philadelphia, PA: F.A.
they limit your options Davis.
■ Identify opposites in options—one will 2. NurseReview.Org - Study Skills and
be the correct answer or you can Test Strategies for the New Nursing
eliminate both Student
■ Look for equally plausible or unique 3. Bamar, P. Tanner, CA, & Chesa, CA.
options (1998). Expertise in nursing practice
■ Identify the global option caring. Clinical judgment and ethics.
■ Identify duplicate facts among the New York Springer. Nd
options 4. Dowell, B. M. (2008). KATTS: A
■ Identify options that deny patient framework for memorizing NCLEX-
feelings, concerns or needs (these RN performance. Journal of Nursing
are wrong). Education 47. 183-188.
5. O'Neill, T. R., Markes, C. M. &
Reynolds, M. R. (2005). Reevaluating
A few final thoughts
the NCLEX-RN pausing standard.
■ Arrive on time for your tests Journal of Nursing Measurement
■ Bring the right tools 13/4), 147-165
■ Understand all of the directions
before you begin
■ Manage your time wisely
21 | P a g e

Chapter I - Test Taking Strategies

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Republic of the Philippines

SULTAN KUDARAT STATE UNIVERSITY

CHAPTER I ■ Students say, "I will worry about the

make an educated guess at an classes, simulation and skills lab, and

Study Habit 4: Avoid Procrastination lounge, cafeteria, or cafe. Find your

topic. Do not waste your valuable is important for the functioning of

 Use a natural sleep remedy, such stomachache, nausea, vomiting, or

Left-Hemisphere versus Right-Hemisphere ❑ Patient-centered realistic measurable

Components ■ Key words: FIRST, INITIALLY,

d) Teaching preoperative deep concerned about myself first and I

The Sentence Option The “Correct Answer”

❖ Should be made first ■ Which is associated with a

■ To explore additional situations using Knowledge Questions

What is the expected range of a radial pulse ❖ T: Temperature ↑

the patient and the nurse bending at the knees, which

ANWER IS D Analysis Information/ Question

❑ Applies principles ■ Interpret data

■ Anticipate patient needs Sample-Planning Question

Don’tmess up the plan! Implementation

■ Fails to identify or respond to life- ■ Implementing safe effective care

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