Test Taking Strategies for NLE board Exam

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. We have outlined test taking tips and strategies applicable not only in the June 2009 Nursing Board Exam but also in any type of multiple choice exams including NCLEX. 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

Key Words 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. Client 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. Problem/Behavior 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?

Priority Setting    

“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. Repeated Words 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. Opposites 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. Same Answer 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. Umbrella Answer 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?

Absolutes 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.

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Deadly all every total nothing always each only any nobody

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Dangerous main chief avoid primarily major shall inevitable eliminate rarely

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Safe usually almost frequently probably potentially may sometimes partial some

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never none

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impossible too

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might should few essentially generally occasionally nearly maybe could commonly average seldom often normally

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.  Multiple Choice Test Taking Tips Tips on answering multiple choice questions Read the question before you look at the answer. Come up with the answer in your head before looking at the possible answers, this way the choices given on the test won't throw you off or trick you. Eliminate answers you know aren't right. Read all the choices before choosing your answer. If there is no guessing penalty, always take an educated guess and select an answer. Don't keep on changing your answer, usually your first choice is the right one, unless you misread the question. In "All of the above" and "None of the above" choices, if you are certain one of the statements is true don't choose "None of the above" or one of the statements are false don't choose "All of the above". In a question with an "All of the above" choice, if you see that at least two correct statements, then "All of the above" is probably the answer. A positive choice is more likely to be true than a negative one. Usually the correct answer is the choice with the most information.

Multiple choice Tests Multiple choice questions usually include a phrase or stem followed by three to five options: Test strategies: 

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Read the directions carefully Know if each question has one or more correct option Know if you are penalized for guessing Know how much time is allowed (this governs your strategy) Preview the test Read through the test quickly and answer the easiest questions first Mark those you think you know in some way that is appropriate Read through the test a second time and answer more difficult questions You may pick up cues for answers from the first reading, or become more comfortable in the testing situation If time allows, review both questions and answers It is possible you mis-read questions the first time

Answering options Improve your odds, think critically: Cover the options, read the stem, and try to answer Select the option that most closely matches your answer Read the stem with each option Treat each option as a true-false question, and choose the "most true" Strategies to answer difficult questions:           

Eliminate options you know to be incorrect If allowed, mark words or alternatives in questions that eliminate the option Give each option of a question the "true-false test:" This may reduce your selection to the best answer Question options that grammatically don't fit with the stem Question options that are totally unfamiliar to you Question options that contain negative or absolute words. Try substituting a qualified term for the absolute one, like frequently for always; or typical for every to see if you can eliminate it "All of the above:" If you know two of three options seem correct, "all of the above" is a strong possibility Number answers: toss out the high and low and consider the middle range numbers "Look alike options" probably one is correct; choose the best but eliminate choices that mean basically the same thing, and thus cancel each other out Double negatives: Create the equivalent positive statement and consider Echo options: If two options are opposite each other, chances are one of them is correct Favor options that contain qualifiers The result is longer, more inclusive items that better fill the role of the answer

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If two alternatives seem correct, compare them for differences, then refer to the stem to find your best answer

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Always guess when there is no penalty for guessing or you can eliminate options Don't guess if you are penalized for guessing and if you have no basis for your choice Use hints from questions you know to answer questions you do not. Change your first answers when you are sure of the correction, or other cues in the test cue you to change.

Guessing:

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Remember that you are looking for the best answer, not only a correct one, and not one which must be true all of the time, in all cases, and without exception