Testing Success
Summer 2013
Most Common Testing
Mistakes

Prepare Superficially






Not preparing for class
Don’t do reading in text
Not part of study group
Cram night before exam
Depend on memorizing
Rely on what you think you know
Common Mistakes

Read questions on exam incorrectly







Don’t grasp what question is really asking
Misread due to hurrying
Miss key words in question
Don’t read all possible responses before
forming opinion
Select wrong answer by accident
Change answer
Don’t listen to inner voice / instinct
4 Levels of Thinking

Simple to Complex

Knowledge

Comprehension

Application

Analysis
Study Techniques to Increase
Knowledge







Repeatedly study content
Recite out loud
Flash cards
Write it down
Alphabet cues (3 P’s of diabetes = polyuria, polydipsia,
polyphagia)
Acronyms – word formed from first letters of facts
 (Caution – change in bowel/bladder habits, a sore that doesn’t
heal, unusual bleeding or discharge, thickening or lump,
indigestion or difficulty swallowing, obvious change in wart or
mole, nagging cough or hoarseness)
Acrostics - phrase, motto, or verse with first letters


Fat Soluable Vitamins = A, D, E, K (All Dieters Eat
Kilocalories)
Mnemonics – variation of acrostic, not every word related to
content
 There are 15 grains of sugar in 1 graham cracker (15 grains
= 1 gram)
Study Techniques to Increase
Comprehension

Explore “whys” and “hows”

Why or how is this information important?



Immobility causes pressure ulcers – why
Soap helps clean the skin – how
Study in small groups

Sharing promotes comprehension



Listen to impressions and opinions of others
Learn new information you may have missed
Reinforce your learning by teaching others
Study Techniques to Increase
Application

Apply concepts to what you already know


Gravity = force that draws all mass toward the
center of the earth
How does this apply to nursing




Hang urinary catheter bag below bladder
Hang IV bag above patient
Raise head of bed for patient with dyspnea
Elevate legs of patient with edema
Study Techniques to Increase
Analysis

Analysis requires you to critically think



Interpret a variety of data
Recognize commonalities, differences, and relationships
Identify differences

Causes of elevated blood pressure
 Many causes, each for different reason


Fluid retention, anxiety, infection
Practice test taking





Review rationales for right and wrong answers
Increase stamina
Control physical and emotional responses
Manage time
Practice test taking techniques
Test Taking Techniques





Most items have 4 options for responses
Chance of picking correct answer is 25%
Eliminate 1 distracter and choice of picking
correct answer is 33%
Eliminate 2 distracters and have 50/50
chance of picking correct answer
Lets look at increasing your odds
Step 1
Break question down into it’s components




Stem
 What is the question asking? READ SLOWLY AND
CAREFULLY
 Paraphrase into your own words before looking at options
 Try to answer in your own words before looking at options
Options
 Don’t pick one too quickly
 It may contain correct information but not answer the
question asked in stem
 Eliminate obviously incorrect options
Most students can reduce down to 2 possible answers
If you have not idea which one to pick……. THEN WHAT?
Step 2



Identify key words in stem that indicate
negative polarity
Not, except, never, contraindicated,
unacceptable, avoid, least, violate
This question is concerned with what is false
If all options appear correct re-read the stem
because you may have missed a key
negative word.
Step 2 question
A patient is receiving a low-sodium diet. What
food should the nurse teach the patient to
avoid because it is high in sodium?
1. stewed fruit
2. luncheon meats
3. whole grain cereal
4. green leafy vegetables
Step 3
Identify key words in stem that set a priority
 First, initially, best, priority, safest, most
 Requires you to rank all options in order of
importance
 If having trouble ranking


Eliminate option you think is most wrong then
next most wrong, etc.
See next slide for strategies for prioritizing
Strategies for Prioritizing


ABC’s (airway, breathing, circulation)
Maslow’s Hierarchy of Needs


Nursing Process (ADPIE)



Physiological always a priority
Assessment must be completed before other
steps
Safety of patient is going to be a priority
Rarely is “call the physician” a priority
Step 3 question
The nurse is assigned to care for a patient who
is incontinent of urine and feces. What
should the nurse use to best protect this
patients skin?
1. incontinence pad
2. talcum powder
3. petroleum jelly
4. lamb skin
Step 4

Identify key words/clues in stem that direct
attention to content
Takes a broad concept and focuses to a more
specific aspect of the concept
To meet patients basic physiological needs
according to Maslow, what should the nurse do?




1.
2.
3.
4.
Assist patient with meals / fluid intake
Pull curtain when patient is on bedpan
Respond to call light immediately
Raise both side rails on the bed
Step 4
Word / phrase in stem significant
because similar to or a paraphrase of
a word or phrase in correct answer
What should the nurse do to help meet the patient’s
self-esteem needs?
1.
Encourage patient to perform self care
2.
Ask family to visit more often
3.
Anticipate patient needs
4.
Help patient with bathing
Step 4
Clang Association

Word / phrase in stem is identical to word / phrase
in correct answer
What should the nurse do to meet patients basic
physical needs.
1.
Pull curtain when providing care
2.
Answer call bell immediately
3.
Administer physical hygiene
4.
Obtain vital signs
Step 5

Identify patient centered options
Explore patient feelings, preferences, afford
patient choices, and empower the patient

Use therapeutic communication skills to
validate the patient’s feelings, fears, and
concerns

The patient is the priority
Step 5 question





When assisting a patient who recently had an above
the knee amputation to transfer into a chair, the
patient starts crying and says, “I am useless with
only one leg.” What is the nurses best response?
1. “Losing a leg can be very difficult”
2. “You still have use of one good leg”
3. “A prosthesis will make a big difference”
4. “You’ll feel better when you can use crutches”
Step 5 question
An oriented patient states, “I always forget the
questions I want to ask when my heath-care
provider visits me.” What is the nurses best
response?
1. Offer to stay when health care provider visits
2. Remind patient of health care providers next visit
3. Give patient pen and paper to write questions
4. Suggest family member be present to ask
questions

Step 6

Identify specific determiners in options
A word/statement that conveys a thought or
concept that has no exceptions



Always, never, all, every, none, and only are absolutes
These statements with these words are
generally false
There are few absolutes in nursing so
examine carefully as there are some

All patients should be treated with respect
Step 6 question
The nurse is giving a bed bath. How can the
nurse best improve the patient’s circulation
during the bath?
1.
2.
3.
4.
use firm strokes
use only hot water
keep patient covered
apply soap to washcloth
Step 6 question
A patient states the elastic straps of the oxygen
mask feel too tight. How should the nurse
respond?
1. explain the mask must always stay firmly in
place
2. replace face mask with nasal cannula
3. pad straps with gauze
4. adjust the straps to loosen
Step 7
Identify opposites in options

When options are opposites, more often than
not, one is the correct answer.
Step 7 question
A nurse understands that the progress of
growth and development in all older adults
1. Slips backwards
2. Moves forward
3. Becomes slower
4. Remains stagnant
Step 7 question
A health care provider orders anti-embolism
stockings for a patient. When should the nurse
apply these stockings?
1. While patient is still in bed
2. When patient reports leg pain
3. When patients feet become edematous
4. When patient gets out of bed in the morning
Step 8
Identify equally plausible or unique options
 2 or more options are similar/comparable,
one is no better than the other
 So… use “If” “Then” technique




If I perform this intervention in the option then
what will be the outcome?
Usually equally plausible options are
distracters and can be eliminated
If you find 3 equally plausible options then the
4th option will probably appear unique
Ask yourself “Which of these is different?”
Step 8 question
What is the main reason passive range of
motion exercises are performed?
1. Increase endurance
2. Prevent loss of mobility
3. Strengthen muscle tone
4. Maximize muscle atrophy
Step 8 question
What should the nurse do immediately before
performing any patient procedure?
1. Shut the door
2. Wash hands
3. Close curtain
4. Drape patient
Step 9

Identify Global Options
Which option is more comprehensive than
the others

Usually a broad, general statement whereas
the distracters are more specific

Pick out the option that is different
Step 9 question
The most effective way for the nurse to prevent
the spread of infection in the hospital is by:
1. Administering antibiotics to sick patients
2. Limiting the spread of microorganisms
3. Isolating patients who are sick
4. Keeping all unit doors closed
Step 9 question
When the nurse is repositioning a patient what
is the most important principle of body
mechanics?
1. Elevating the arms on pillows
2. Maintaining functional alignment
3. Preventing external rotation of hips
4. Placing a small pillow under the lumbar
curvature
Step 10
Identify duplicate facts among the options

When each option contains 2 or more facts

Identify 1 fact as incorrect and can eliminate
whole option

Increases your chances of selecting correct
answers
Step 10 question
A health care provider orders a 2-gram sodium
diet. Which group of nutrients are most
appropriate for this diet?
1. Fruit, vegetables, bread
2. Hot dogs, mustard, pickles
3. Hamburger, onions, ketchup
4. Luncheon meats, rolls, vegetables
Step 11
Identify options that deny patient feelings,
concerns, and needs
 Avoid Pollyanna syndrome – not everything is
ok (nor does it have to be)
 Don’t diminish patient concerns, provide false
reassurances, or cut off patient
communication
 Options that imply everything will be alright
deny the patients feelings, change the
subject, encourage the patient to be cheerful,
or transfer nursing responsibility to others are
usually distracters and can be eliminated
Step 11 question
The day before surgery for a hysterectomy a
patient says to the nurse, “I am worried that
I might die tomorrow.” What is the nurses
best response?
1. “It is really routine surgery”
2. “The thought of dying can be frightening”
3. “You need to tell your surgeon about this”
4. ”Most people who have this surgery survive”
Summary











Break down into components
Negative polarity
Priority key words
Key words/clues directing to content
Patient centered options
Specific determiners for no exceptions
Opposite options
Equally plausible or unique options
Global options
Duplicate facts in options
Deny feelings, concerns, or needs
Best Nursing Practices Keep Patients Safe
Optimizing Every Great Decision Delivered
General Test Taking Strategies
Follow your regular routine night before test
 Go to bed usual time

Sleep deprivation decreases reactions time and
cognitive skills

Eat normally
Relax

………

General Test Taking Strategies






Arrive Early for exam
Use the rest room
Relax
Meditate
Collect thoughts
Avoid comparing notes with other students
Anxiety is contagious – avoid anxious
classmates
General Test Taking Strategies





Mange your time during the exam
Know how much time you have for each
question
Stay on target
Use all the time allotted
Read each item slowly
If bogged down move on and come back to
that question
General Test Taking Strategies
Avoid reading into question





Answer question based on information given / stated
in stem
When reading stem underline important words
Don’t add information from your own mind
Don’t make assumptions about information given
Read all options before selecting one



Refer back only to words underline as important in stem
Don’t add information to an option
Option may contain correct information but have nothing to
do with what the question is asking
General Test Taking Strategies



Make educated guesses
Reduce the number of options and guess
Trust your instincts
Do not change your answer
General Test Taking Strategies





Maintain a positive mental attitude
Too much anxiety interferes with your
attention, concentration, and problem solving
ability
Feel in control by skipping difficult questions
Enhance relaxation by practicing deep
breathing
Tell self “I am prepared to do well” “I studied
hard” “I will be successful”
Go to your special place of relaxation
General Test Taking Strategies


Check your answers and answer sheet
Make sure you clearly marked the answers
you meant to select
Did you fill in all questions?