test taking[1] mw

Test Taking Skills

Positive Mental Attitude

• Helps control test anxiety• Challenge negative thoughts such as “This

is going to be a hard test. I’ll never pass.”• “Whether you think you can, or think you

can’t …. You’re right.” Henry Ford

Preparation

• Over-prepare– One of the best ways to ↓ test anxiety– Make a schedule e.g. one hour a day to review

notes

• Study habits– Avoid cramming– Don’t pull “all nighters”

Establish control

• Arrive early

• Bring supplies

• Manage personal comfort i.e. take care of basic physiologic needs before attempting to meet higher-level needs

Apply Critical Thinking to Multiple-Choice Questions• Examine, reframe, critique, and evaluate

the stem of each question

• Try to figure out the answer before looking at the choices.

Applying Critical Thinking to Multiple Choice

• Which is associated with a physiologic need of a pt with a colostomy?A. Disturbance in body image

B. Inadequate nutrition

C. Lack of knowledge

D. Skin breakdown

Applying Critical Thinking to Multiple Choice• Which is associated with a psychologic

need of a pt with a colostomy?A. Disturbance in body image

B. Inadequate nutrition

C. Lack of knowledge

D. Skin breakdown

“First” is asking you to set a priority

• A preoperative pt talks about being afraid of pain because of a previous experience with painful surgery. What should the nurse do first to help the pt deal with this fear?A. Encourage the patient not to be afraid

B. Teach the pt relaxation techniques.

C. Listen to the pt’s concerns about pain.

D. Inform the pt that medication is available.

What is the priority?

• A pt has just returned from the OR with a Foley catheter, an IV, & an oral airway, and is still unresponsive. Which assessment should be made first?A. Check the surgical dressing to ensure that it is

intact.B. Confirm the placement of the oral airway.C. Examine the IV site for infiltration.D. Observe the Foley for drainage.

Time ManagementSelf-Assessment of Barriers to

Productivity

1. I tend to procrastinate.

2. I lack organization

3. I flutter from one task to another.

4. I tend to socialize when I should be studying.

5. I attempt to do too much.

Procrastination

• Putting off or postponing something until a future time.

• It is a protective mechanism to delay having to deal with something that we would rather not deal with.

• In the short term it ↓ anxiety.

• In the long term it will waste time & ↑ anxiety.

When delaying a project, have you ever said to yourself:

• This is boring

• This is too hard

• I don’t know where to begin

• I’m not in the mood

• I’m too tired.

• I can do it tomorrow.

• I work better under pressure.

Balance Sacrifices & Rewards

• Commitment to become a nurse requires sacrifice.

• Time & energy diverted. • Rewards for studying usually not immediate but

in the extended future.• Graduating from nursing school, passing the

NCLEX, earning a paycheck, & enjoying the prestige of being a nurse are future-oriented rewards.

Learning

• The process by which you attain new information (cognitive domain), acquire new physical skills (psychomotor domain), or form new attitudes (affective domain).

Learning with Alphabet Cues

• The memorization of info can be facilitated if the info is associated with letters of the alphabet. Each letter serves as a cue that stimulates recall of information.– ABCs of cardiopulmonary resuscitation– The 3 P’s for the cardinal signs of diabetes are:

Polyuria, Polydipsia, & Polyphagia

Learning with Acronyms

• Word formed from the first letters of a series of statements or facts. It is useful to learning because each letter of the word jolts the memory to recall information.– On old olympic towering tops….– The Amer Cancer Society teaches the early warning

sings of cancer thru the acronym of CAUTION:• Change in bowel & bladder habits• A sore that does not heal• Unusual bleeding or discharge…

Knowledge Questions

• Require you to recall or remember information.

• You need to commit facts to memory to answer.

• Expect you to know terminology, specific facts, trends, sequences, classifications, categories generalizations, or theories.

Knowledge Questions

• When you are administering medications, qid means:A. Once a day

B. Twice a day

C. Three times a day

D. Four times a day

Knowledge Questions

• The 1st step of the procedure for making an unoccupied bed is:A. Pulling the curtain.

B. Washing your hands

C. Collecting the clean linen.

D. Placing the bottom sheet.

Knowledge Questions

• What is the normal range of a radial pulse in an adult?A. 50 – 65

B. 70 – 85

C. 60 – 100

D. 110 – 125

Memorization

• Knowledge questions require you to remember info that forms the foundation of nursing practice.

• Commit information to the brain through repetition for recall at a later time– Repeatedly studying by reciting it out loud– Reviewing it in your mind– Writing it down– Preparing flash cards

Comprehension Questions

• Require you to understand the information.

• Must commit facts to memory as well as translate, interpret, & determine the implications of that information.

• Demonstrate understanding when you paraphrase info, interpret or summarize info, or determine the implications, consequences or effects of information.


• To evaluate the therapeutic effect of a cathartic, the nurse should assess the pt for:A. increased urinary output

B. A decrease in anxiety

C. A bowel movement

D. Pain relief


• When clarifying is used as a therapeutic communication tool, the nurse is:A. Summarizing the patient’s communication

B. Verifying what is implied by the patient

C. Restating what the pt has said.

D. Paraphrasing the patient’s message.

Application Questions

• Application of info demonstrates a higher level of understanding.

• Requires the learner to show, solve, modify, change, use, or manipulate information in a real situation or presented scenario.

• You must apply concepts you learned previously to concrete situations.

• Test your ability to use info in a new situation.• This involves the critical-thinking process.

Application Questions

• When lifting a heavy patient higher in bed, the nurse can prevent self-injury by:A. Keeping the knees & ankles straight

B. Straightening the knees & bending at thewaist

C. Placing the feet together & keeping the kneesbent

D. Positioning the feet apart with one foot placedforward

Analysis Questions

• Require you to interpret a variety of data & recognize the commonalities, differences, & interrelationships among presented ideas.

• Analysis questions make the assumption that you know, understand, and can apply information

• Then requires an ability to examine information, which is a higher thought process than knowing, understanding, or applying information.

Analysis Questions

• Studying blood pressure:– Memorize the parameters of a normal BP

(knowledge)– Develop an understanding of what factors

influence & produce a normal BP (comprehension)

– Identify a particular pt situation that would necessitate obtaining a BP (application)

– Differentiate among a variety of situations & determine which has the highest priority for assessing the BP (analysis)

Analysis Questions

• A pt who is undergoing cancer chemotherapy says to the nurse, “this is no way to live.” Which response uses reflective technique?A. “Tell me more about what you are thinking.”

B. “You sound discouraged today.”

C. “Life is not worth living?”

D. “What are you saying?”

Analysis Questions

• The physician orders 500 mg of an antibiotic to be administered via an IM injection. A 1-gram vial of the medication, which needs to be reconstituted, carries the statement: Add 2.7 mL of solution to yield 3 mL. How much solution should the nurse administer?A. 0.5 mLB. 1 mLC. 1.5 mLD. 2 mL

Multiple Choice Questions

• The entire question is called an item.• Each item consists of 2 parts

– Stem: statement that asks the question– Options: contain the possible responses

offered

• One of the options answers the question & is the correct answer.

• The remaining options are incorrect & are called distractors (they are designed to distract you from the correct answer).

Example

• What should the nurse do immediately before performing any procedure?A. Shut the door

B. Wash the hands

C. Close the curtain

D. Drape the patient

The stem that is a complete sentence:• What is the most common reason why

older adults become incontinent of urine?A. The muscles that control urination become

weak.B. Their increase in weight places pressure on

the bladder.C. They use incontinence to manipulate &

control others.D. Older adults tend to drink less fluid than

younger patients.

The stem that is an incomplete sentence• To best understand what a patient is

saying, the nurse should:A. Demonstrate interest

B. Listen carefully

C. Remain silent

D. Employ touch

The stem with a positive polarity• An older adult who is dying starts to cry &

says, “I was always concerned about myself first & I hurt many people during my life.” What is the underlying feeling being expressed by the patient?

A. AmbivalenceB. Sadness

C. Anger

D. Guilt

The stem with a positive polarity• Which intervention most accurately

supports the concept of informed consent?A. Obtaining the patient’s signature

B. Explaining what is being done & why

C. Involving the family in the teaching plan

D. Teaching preoperative deep breathing &coughing.

The stem with a negative polarity

• On what part of the body should the nurse avoid using soap when bathing a pt?A. Eyes

B. Back

C. Under the breasts

D. Glans of the penis

The stem with a negative polarity• Which suggestion would be the least

therapeutic when teaching the pt about promoting personal energy?A. Eat breakfast every day

B. Exercise three times a week

C. Get adequate sleep each night

D. Drink a cup of coffee each morning

What we do first? Assess the patient• While making rounds, the nurse finds a pt

on the floor in the hall. What should be the nurse’s initial response?A. Inspect the pt for injury

B. Transfer the pt back to bed

C. Move the pt to the closest chair

D. Report the incident to the nursing supervisor

Which choice is different?

• What should the nurse do to avoid patient accidents?A. Keep an overbed table in front of a sitting

patient

B. Determine the strength of a pt before walking

C. Provide a cane for ambulation if the pt is weak

D. Apply a vest restraint when a pt uses awheelchair

Identify Key Words

• First, initially, best, priority, safest, most:these words modify what is being asked

• They require you to put value on each option The nurse is assigned to care for a pt who is

incontinent of urine & stool. What should the nurse apply to best protect this pt’s skin?A. A petroleum-type jellyB. An incontinence padC. Talcum powderD. Cornstarch

Identify Key Words

• When key words such as “most important” are used, frequently all the options may be appropriate nursing care for the situation however only one is most important.

Identify Key Words

A pt has significant short-term memory loss & does not remember the primary nurse from day to day. When the pt asks, “Who are you?” what would be the most appropriate response?A. “You know me. I take care of you every day.”

B. “Don’t worry. I’m the same nurse you had yesterday.”

C. “My name is Sue Clark. I am the nurse caring for you.”

D. Say nothing, because it would probably upset thepatient.

Identify Clues in the Stem

• A clue is the intention or unintentional use of a word or phrase that leads you to the correct answer. May have relationship to another word or phrase in the stem.

To meet a pt’s basic physiologic needs according to Maslow’s Hierarchy of Needs, what should the nurse do?A. Pull the curtain when the pt is on a bedpan.B. Maintain the pt in functional alignment.C. Respond to the call light immediately.D. Raise both side rails on the bed.


• A word or phrase in the stem is significant because it is similar to or a paraphrase of a word or phrase in the correct answer.

What should the nurse do to help meet a patient’s self-esteem needs?A. Encourage the pt to perform self-care when

able.B. Suggest that the family visit the pt more often.C. Anticipate needs before the pt requests help.D. Assist the patient with bathing & grooming.


• Word or phrase in the stem is identical to word or phrase in the correct answer

What should the nurse do to meet a patient’s basic physical needs?A. Pull the curtain when providing care

B. Answer the call bell immediately

C. Administer physical hygiene

D. Obtain vital signs

Identify the Central Person in the Question• A pt who has experienced the surgical removal of

a breast (mastectomy) says to the nurse, “My husband can’t look at my incision & hasn’t suggested having sex since my surgery.” What should be the initial action of the nurse?A. Arrange to speak with the husband about his concernsB. Plan to teach the husband that the wife needs his

supportC. Explore the patient’s feelings about her husband’s

behaviorD. Make an appointment with Reach for Recovery for the

patient.

Identify the Central Person in the Question• A pt is friendly, has many visitors, and

appears happy. However, when the pt’s daughter visits, the pt cries & complains of pain. When the daughter becomes upset, the nurse should:A. Explore the situation with the daughterB. Encourage the pt to be more positiveC. Continue to observe this situation from a

distance.D. Tell the daughter that the pt usually does not

cry.

Patient centered options

• Questions may test ability to be pt centered & tend to explore pt feelings, identify pt preferences, empower the pt, afford the pt choices, or in some other way put emphasis on the pt.


• When assisting a pt who recently had an above-the-knee amputation to transfer into a chair, the pt starts to cry & says, “I am useless with only 1 leg.” What would be the nurse’s best response?A. “You still have one good leg.”B. “Losing a leg must be very difficult.”C.”A prosthesis would make a big difference.”D. “You’ll feel better when you can use crutche

s.”


• What should the nurse do first when combing a female pt’s hair?A. Moisten the hair with tap water

B. Apply a hair conditioner to the hair

C. Ask the pt how she prefers to wear her hair

D. Begin at the roots & comb with long, evenstrokes

Avoid words with no exception

• Just• Always• Never• All• Every• None• Only • Some absolutes, such as “all pts should be

treated with respect,” are correct

Avoiding absolute terms

• How can the nurse best improve circulation when giving a pt a bath?A. apply soap to the washcloth

B. Keep the pt covered

C. Use only hot water

D. Use firm strokes

Avoiding absolute terms

• When providing perineal care for pts, by what action can nurses most appropriately protect themselves from microorganisms?A. Washing their hands before giving care

B. Wearing clean gloves during perineal care.

C. Discarding the contaminated water in thetoilet

D. Encouraging pts to provide all of their owncare

Identify opposites and those answers that are the same• The physician orders anti-embolism

stockings for a pt. When should the anti-embolism stockings be put on?– A. While the pt is still in bed– B. When the pt complains of leg pain– C. When the pt’s feet become edematous– D. After the pt gets out of bed in the morning

Identify opposites and those answers that are the same• When a pt is in bed, a wrist restraint should

be tied to the:A. Side rails

B. Foot board

C. Bed frame

D. Headboard

Identify duplicate facts among the options• A pt has a vest restraint. While making this

pt’s occupied bed, what must the nurse do to promote pt safety?A. Keep the vest restraint tied & lower both side

rails

B. Keep the vest restraint tied & lower one siderail

C. Untie the vest restraint & lower both side rails

D. Untie the vest restraint & lower one side rail

Which one is different?

• The patient you’re taking care of has scurvy. Which food should you include in his diet?A. Hamburgers

B. Steak

C. Fish

D. Oranges

Other considerations

• Answer difficult questions by eliminating the obviously incorrect responses first then select the best of the remaining options


• If a choice says “Everything will be alright” it’s the wrong answer

• If a choice says “Don’t feel (fill in the blank ie bad, guilty, sad, angry, etc)” it’s the wrong answer

• Offering advice or telling them what to do is often the wrong answer (don’t confuse with teaching)

• If a choice says “stay with the patient w/o speaking” it may be the right answer

Other considerations• Select responses that are therapeutic, show

respect, & communicate acceptance

• Eliminate responses that are bizarre, inappropriate & punitive


• Which of the following responses by the nurse is most appropriate when the pt complains “I’m tired of waiting, I want my bath now. You’re never here when I need you.”A. “What do you mean, I’m never here? I spent 3 hours

with you yesterday.”B. “I’m sorry you’ve been waiting. Let’s get you

comfortable now & I’ll be back in 20 minutes to give you a bath.”

C. “I’m doing my best. You know I have 3 other pts to take care of today besides you.”

D. “I must see another pt right now. She’s really sick today. I’ll be back as soon as I can.”

Other rules when taking a test

• Manage time effectively – allow approx one minute per item

• Try to block sound & motion interference during test-taking

• You shouldn’t care what others are doing, how soon they finish, how far they are, or whether you’re the last one done. You’re not competing with them


• Do not change answers without good reason or sound rationale

• When you decide to change an answer, your behavior is often driven by anxiety & nervousness rather than sound, rational thought.


• When to change an answer: – Your original answer was a guess– You suddenly remember the answer because

of a question you answered later

Which test taker are you?

• The Rusher – individual who hurries thru the entire process in a desperate rush to complete the test before essential facts that have been studied are forgotten.

• The Turtle – does nothing fast when it comes to testing. Often fearful of missing important points, reads & rereads, underlines important points, scratches out unwanted responses & then rereads everything again.


• The Squisher – individual who views exam as hurdle to jump, barrier to cross, very preoccupied with grades, fears personal failure. Faces upcoming test with an attitude of “I’ll worry about it tomorrow” in order to avoid the anxiety of a test.


• Thought process of squisher:– The test in in 2 weeks. I’ll do the required

readings this weekend.– I’m sure I won’t need to do the readings if I

review my class notes very thoroughly.– I’ll probably remember the material better if I

study the night before the test.– Holy crap. The test is in 2 hours. I’ll flip through

my notebook & hope for the best.

test taking[1] mw

Education