Test Taking Skills

 Apply Critical Thinking to Multiple-choice

Questions.
– Although we want you to know as much as
possible, there is no way you can know or
experience everything.
– You can learn how to critically approach exam
questions to maximize your test-taking success.
– Knowledge+Understanding+Ability to
Approach Questions
Strategy #1 Examine, reframe, critique
and evaluate the stem of each question.

 Question:
– Leg exercises after surgery are encouraged primarily to:
 First, examine, critique, evaluate the stem:
– What are the key words in the question?
– What do you need to know to answer this question?
 Second, construct the correct answer before
looking at the options.
– What are the possibilities for correct answer?
 Leg exercises after surgery are
encouraged primarily to:
 1. Promote venous return
 2. Limit joint contractures

 3. Prevent muscle atrophy

 4. Increase muscle strength

The correct answer is: 1.
promote venous return
Strategy #2: Pay careful attention to the
context or focus of the question.
 Question 1: Which is  Question #2: Which is
associated with a associated with a
physiological need of psychological need of
a patient with a a patient with a
colostomy? colostomy?
– 1. Disturbance in body – 1. Disturbance in body
image image
– 2. Inadequate nutrition – 2. Inadequate nutrition
– 3. Lack of knowledge – 3. Lack of knowledge
– 4. Skin breakdown – 4. Skin breakdown
Answer to Question #1 is: 2. Skin
breakdown.

Answer to Question #2 is: 1.

Disturbance in body image.
Strategy #3: Avoid reading into the question.
(This is also known as: “Don’t make the
patient any sicker!)
 You can avoid reading  Read all the options
into the question by: before choosing the
– Underline or note the correct answer.
important words in the – Do not add information
question. to an option.
– Do not focus only on
– Do not add information
your experiences (they
from your mind. my be too narrow for a
– Do not read between point of reference.
the lines about the – Pretend you are are in
information presented. the perfect, NCLEX
hospital
Strategy #3 question: A bronchoscopy was performed on a
client at 7 AM. He returns to his room and the nurse plans to
assist the client with his AM care. What is the best nursing
action?
 1. Encourage the client to take a shower
 2. Perform all his AM care

 3. Postpone the AM care until the client is

more comfortable and can participate

 4. Cancel all of the AM care since it is not

necessary to perform after a bronchoscopy

 The correct answer is: 3.
Postpone the AM care until the
client is more comfortable and
can participate.
Strategy #4: Identify key words in
the question that set a priority.
 “most important”  This type of question is
asking you to put a value
 “first” on each option and then
 “best” place them in rank order.
 “safest”  Rank the options in your
mind from 1-most
 “most’ desirable option to 4-least
 “priority” desirable option. The
correct answer will be the
option you ranked as 1.
Strategy #4 Question: A patient adaptation that may
first indicate internal abdominal bleeding
postoperatively would be:
 1. Pain in the area of bleeding and a
decreased heart rate.
 2. Cool, clammy skin and a decreased heart

rate.
 3. Restlessness and an increased heart rate.

 4. Apathy and a decreased heart rate.

The correct answer is: #3
Restlessness and an increased
heart rate.
 Strategy #4 continued:
 If you are having trouble doing this,
eliminate the option you believe to be most
wrong.
 Reread the question to identify a key

word(s).
 Strategy #4 Question:
 A patient has significant short-term memory loss and does
not remember the primary nurse from day to day. When
the patient asks, “Who are you?” what would be the most
appropriate response?
– 1. “You know me, I take care of you every day.”
– 2. “Don’t worry. I’m the same nurse you had
yesterday.”
– 3. “My name is Sue Clark. I am the nurse caring for
you. “
– 4. Say nothing, because it would probably upset the
patient.
 The correct answer is: 3. “My
name is Sue Clark. I am the nurse
caring for you.”
Strategy #4…a second question.
 A patient has just returned from surgery with an
IV and does not have a gag reflex. Which planned
intervention takes priority?
– 1. Ensure adequacy of air exchange
– 2. Observe the dressing for drainage
– 3. Check for IV infiltration
– 4. Monitor vital signs
The correct answer is; 1. Ensure
adequacy of air exchange.
 Strategy #4 continued:
 Other tips for prioritization
questions:
– Think ABC’s: airway comes
before breathing which
comes before circulation.
– Think of Maslow’s hierarchy
of needs: physiologic comes
before psychological.
– Think of the nursing process:
assessment comes before
diagnosis, planning,
intervention and evaluation.
Look before you touch.
– Think of safety issues:
a first issue often is
meeting basic needs of
survival—oxygen,
nutrition, elimination,
environmental hazards.
– Hand washing is nearly
always the correct
option.
 Strategy #5: Select the most
comprehensive answer.
 All options may be correct but one option includes
the other three or needs to be considered first.
– The nurse is planning to teach a diabetic client about
his condition. Prior to the teaching, what is important
for the nurse to evaluate?
• 1. Required dietary modifications
• 2. Understanding of the exchange list
• 3. Ability to administer insulin
• 4. Present understanding of diabetes
The correct answer is: 4. Present
understanding of diabetes.
Strategy #6: Read the stem slowly and carefully to identify
words that indicate negative polarity. The question being
asked is probably concerned with what is false.

 Except  Which intervention is

unrelated to the prevention
 Never of postoperative
thrombophlebitis?
 Not
– 1. Massaging the legs
 Further teaching is – 2. Ambulating regularly
needed when – 3. Increasing fluid
 Violate intake
– 4. Applying
 Avoid antiembolism stockings
 Contraindicated
The correct answer is #1
Massaging the legs.