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 youve 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 childs 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 What What What action takes priority? should the nurse do first? should the nurse do initially? is essential for the nurse to do?

Physiologic needs are first, followed by safety needs, then love and belonging, self-esteem and selfactualization. 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. Deadly all every total nothing always each only any nobody never none Dangerous main chief avoid primarily major shall inevitable eliminate rarely impossible too Safe usually almost frequently probably potentially may sometimes partial some might should few essentially generally occasionally

 Choosing between the two best options

nearly maybe could commonly average seldom often normally

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.

Guidelines to follow during the exam: Budget your time Although you may not know exactly how many questions youll be asked to answer, you can estimate a little over 1 minute per question. Keep moving at a steady pace. Read each question thoroughly but quickly In general, your first reaction to a question is the correct one. Remember that the examination is designed to determine if youre minimally competent and safe. Concentrate on one item at a time. Dont worry about how many questions youll have to answer. Answer questions as if the situation were ideal. Assume the nurse had all the time and resources needed. Youre only concerned about one patient, the one in the question. Focus on the key words in the stem. Identify whether the stem is seeking a true response or a false response. Those stems asking for false responses are easily misread. Reword a difficult stem. Try answering the question before youve read the options provided. Always read all options before selecting the best one. Relate each option to the stem. Use logic and common sense to figure out the correct response. Remember that the correct option will tend to have greater applicability and flexibility. Clueless? Look for clues in answer choices instead of in the stem of the question.

10 Things to Remember on the day of the examination: 1. 2. 3. 4. 5. 6. 7. 8. 9. Get up early. Wear comfortable clothes. Check your things. (pencils, pens, etc.) Eat breakfast. Leave early so you will arrive early. Do NOT study while you wait for your examination. Read, listen to music, relax. Leave notes and books at home. Listen carefully to the instructions given by the test administrators. 10. Say a little Prayer before you begin.

Test Taking Strategies By: J.L. Jalandoni R.N. Introduction: The board exam is a test for entry-level nurses. This means that it does NOT expect you to know everything. So, dont panic when you encounter questions and you do not have any idea what is being asked. Use test taking strategies in answering it. After doing an extensive review and you still feel like you dont know enough, dont feel bad. Its natural to be anxious. A little anxiety will actually help you during the board exam as it will keep you alert and focused. Test Taking Strategies: Take time in reading the question, read the question carefully and find out what the question is asking. Keywords are very important. Keywords in the question are usually associated with the option containing the right answer. Be aware of the time, if you dont know the answer take a deep breath and proceed to the next question. You need to answer each question for around 1 minute. The remaining time will be spent on taking a break once in a while when you feel tired and shading your correct answers to your answer sheet. I personally recommend a 3 minutes break every 20 minutes of answering questions. Never, change your answer unless you are absolutely sure with your new answer. (Erasures in answer sheets are not recommended) When answering questions which you have no idea, choose the longest option. It takes more words to make the statement correct and also remember that more words may also make the statement wrong so read them carefully. Always focus on the Patients Ability rather than the Patients Disability. Interventions must be client/patient centered. In choosing answers, always begin with INDEPENDENT NURSING ACTIONS. Nursing interventions: Independent are nursing actions that the nurse may perform for the patient without the need of a doctors order. Interdependent are nursing actions that collaborates with other members of the health team (Patient, Dietitian, Med-techs, Pharmacist etc.). Dependent are nursing actions that requires a doctors order. Example: The nurse is caring for a patient with a fever. During the morning rounds, the patient complains of headache. The nurse proceeds to check the temperature and finds it to be elevated at 37.9 C, the nurse should: a. Administer paracetamol to relieve headache and fever as ordered b. Perform a tepid sponge bath c. Document the temperature and call the Physician d. Check CBC for signs of infection In the example above, the independent nursing action is option B. Therefore option B is the correct answer. Choose the option that is totally different from the other choices and stick with it. Example: The nurse is caring for a patient on heparin infusion. During the morning care, the patient complains of sore gums after brushing teeth. The nurse should: a. Stop the infusion

b. Notify the doctor c. Assess for bleeding d. Administer protamine sulfate In the example above, options A, B, and D are all nursing interventions. Only option C involves nursing assessment. Therefore option C is the correct answer. If you dont know the right answer, look for the wrong answer and try to eliminate it first. This will narrow down your options. Another Test Taking Strategy is that if the question is asking for a positive answer, choose the answer with positive result and vice versa. Absolute words are usually negative. Choices with always all never only are considered negative. Nursing science in not absolute. If you encounter options that are all correct, look for the umbrella type of option that fits all the other option. Remember that no two option can be correct at the same time. One of my favorites among the Test Taking Strategy is that if you have no clue for any of the option, choose option C. Option C is usually the best or the worst answer that you could come up with. If you are the examiner, you always put more thinking of the option C making it a tricky option. All of the Above option, and you are positively sure that two answers are correct, and one option is doubtful, choose the All of the Above option. Remember that no two option can be correct at the same time. The Coma, Coma and Rule in Test Taking Strategy To use this, first categorize the options with the same answers, then look for the answer that is incorrect. All other option with the incorrect answer are wrong. If the question asks about What Nursing Action Always think about the NURSING PROCESS A.D.O.P.I.E. If the question asks about Patient needs Always think about the MASLOWS HIERARCHY OF NEEDS and remember that PHYSIOLOGIC NEEDS is priority. If the question asks you about Prioritization Always think about the (ABC) Airway, Breathing, and Circulation. If you cannot find these, choose the option which prioritize SAFETY. In eliminating options, the similar options are automatically wrong options. For example bradycardia and slow pulse. Since both have the same meaning, automatically eliminate both of these option. No two option can be correct at the same time. Look for opposite options. Example: High Blood Pressure and Low Blood Pressure. These options are the exact opposite. One cannot exhibit both symptom at the same time making one of the option correct. In Psychiatric Nursing, verbalization of patients feelings is very important. Remember not to reinforce hallucinations and delusions. Acknowledge feelings and present reality. Nursing diagnosis is usually focused on Altered thought process/content. Goals set for patient/client is to have an optimal level of functioning. In a community setting, the Vision Statement have words like disease free and progressive health for Filipinos. The Mission Statement have words like availability, accessibility, and affordability. The Goals Statement have words like promote, reduce, quality and equality of health for men and women. Do practice in answering Nursing Board Exam Questions everyday as this will help you to develop test taking strategies. You need to answer at least 2000 Nursing board exam questions for you to pass the local board exam.

Test Taking Strategies by: JL. Jalandoni R.N. Check these things several Days Before: 1. Ensure that all PRC documents, prescribed calculator, pencil, sharpeners, and pens are in order. 2. Visit the site of the exam and the exact room assignment a day before the exam. Also, try locate where the nearest comfort room is located. 3. Get adequate rest and sleep 4. Avoid dairy products and fatty foods at least 2 days before the exam 5. Check nursing uniform and shoes to ensure that everything still fits 6. Plan meals ahead (consider availability of food in exam site) Check these things on the Day of the Exam: 1. Bring water (remove labels), candies, and light snack 2. Place all belongings in a clear plastic envelope 3. Bring medications such as anti-diarrheals, no-drowse cough and cold remedies, Broncho dilators if asthmatic, Paracetamol for headache, toothache, etc. 4. Be at the exam site early 5. Always listen to the instructions given by the proctor. Ask questions when in doubt. 6. Take toilet breaks before the start of every exam. 7. Avoid discussing answers with others in the lobby as this will tend to increase anxiety. Use the time instead to relax in preparation for the next set of exams.