Basic Information on
Test taking for Nursing
Exams
First year
Do not approach exams believing the
questions are “tricky.”
If you know the answer do not use test
taking strategies.
The perfect world according to the
textbook, not what you see
everyday.
Look for the answer that will let
the exam writers know the client
is in safe hands.
Basic, common, and general
knowledge, not critical care
concepts.
There is one, and only one, correct answer.
If you find it, keep it, don’t convince yourself
to choose another! Remember your first
instinct is often the best.
Test Taking Strategies
Odd-Man out
 Two opposites
 Partially incorrect
 Nursing process
 ABC’s
 Maslow’s Hierarchy of Needs
 Global options
 Similar distractions

Any time they give the AGE it
is usually significant
Any time they give you
TIME,
it is usually significant.

A Director of a
nursing program
returns to her office
and has four phone
calls. In which order
should the Director
prioritize return of
phone calls?
a.
b.
c.
d.
A student who “thinks
she is failing and
doesn’t know what to
do”.
The bookstore
manager wants the
book order for next
semester ASAP.
School administrator
with “impending crisis”.
Daughter could “use
some cash”.
Your friend has just
completed a 2-hour
exam in anatomy and
is very cranky. She
tells you that she
woke up 30 minutes
before the exam, got
dressed in 10
minutes, and made it
to the exam despite a
20-mile drive. Your
first action should be:
a.
b.
c.
d.
Take her to Pizza
Hut for pizza.
Tell her she
probably flunked the
exam.
Recommend that
she fast to cleanse
her system of toxins.
Suggest psychiatric
help.
During the immediate
postoperative period
after a transurethral
resection of the
prostate (TURP),
what common
physical problem
should the nurse
observe for?
a.
b.
c.
d.
Sexual impotence.
Thrombophlebitis
Venous bleeding
Atelectasis
The client is responsible for
making decisions about
their healthcare.
The nurse is responsible for
providing the client with
information on which to
base these decisions.
A client says to the nurse,
“My doctor ordered
Adefovir (Hesera) for me,
so I guess I’ll be cured.”
Which nursing response
would be most
therapeutic?
a.
b.
c.
d.
“Yes. Although it’s
relatively new and its
results remain tentative,
it does seem so.”
“Yes, it will cure the
disease but you will
want to monitor for side
effects and stop the
medication immediately
if any occur.”
“Although this
medication cannot cure
your disease, it will
control it.”
“Yes, but just be certain
to divide the dosage as
the doctor has indicated
in his instructions.”
A client with type I diabetes
asks the nurse if it will be
possible for her to breastfeed
after the birth of the baby. The
nurse’s best response would
be:
a.
b.
c.
d.
“It is possible but it can be
difficult because
breastfeeding mothers have
increased insulin
requirements.”
“Certainly, we encourage you
to breastfeed because it can
be beneficial both physically
and psychologically.”
“Yes, you may, and it is
encouraged, but keep in
mind that hyperglycemia can
cause a decrease in milk
production.”
“Generally, breastfeeding is
contraindicated in women
with diabetes because it
places a greater physical
strain on them.”
Answers should be
supportive of culture
All correct answers, reread the stem, what
exactly is the question
asking?
When asked “What will
the nurse do first” think
nursing assessment or
“What will keep the client
safe?”
A confused elderly client
has wet herself and is
standing in the hospital
corridor in a puddle of
urine. She has trouble
getting to the bathroom in
time. She looks
ashamed. She says to
the nurse, “I want to go
outside for a walk now.”
Which of the following
statements would be the
most therapeutic
response by the nurse?
a.
b.
c.
d.
“Before we go for a
walk, perhaps we can
make a list that will help
you make your
bathroom trips easier.”
“Right now, let me wipe
up the urine on the floor,
and let’s get a change
of clothing for you. I am
sure that this problem is
upsetting for you.”’
“This has been a
problem for you. Let’s
see if we can find a
solution together.”
“Wetting yourself is very
upsetting. Yes, let’s
take a walk.”
The nurse enters the
room of a diabetic
client, and finds the
client difficult to
arouse, with warm,
flushed skin. The
pulse and respiratory
rate are elevated from
the client’s baseline.
Which of the following
should the nurse plan
to do first?
a.
b.
c.
d.
Prepare an insulin
drip.
Give the client a
glass of orange
juice.
Administer a bolus
of 50% dextrose.
Check the client’s
capillary blood
glucose.
The physician has
prescribed Shersye
1.5 Gm daily for a
post-op client. The
client complains of
nausea and vomiting
after taking the drug.
The nurse should
recommend that he
take the medication:
a.
b.
c.
d.
On an empty
stomach.
With food or milk
At night before
retiring.
In four divided
doses.
80% of drugs cause
nausea and vomiting!
General tips about medications
Learn generic and trade names, they will
usually be a part of any questions.
 Don’t choose drug therapy as the first
response unless there is not another
choice that will solve the problem.
 Avoid medicating clients as the first
response.

Remember ABC’s
Airway
Breathing
Circulation
If you have an opportunity to
suction,
Suction!
Never heard of it,
It’s not the answer.
If it is in your pool of
answers, you have
access to it.
Remember Maslow:

The nurse is caring
for a client admitted
yesterday for an
acute cerebral
vascular accident.
Which nursing
diagnosis has the
highest priority?




a. Anxiety
b. Knowledge deficit
c. Impaired
swallowing.
d. Altered family
processes
Reflection

Is frequently used with therapeutic
communication and assessment of
teaching needs.
A client says to the
nurse, “Ever since my
wife passed on, my
life is empty and has
no meaning.” Which
of the following is the
most appropriate
nursing response?
a.
b.
c.
d.
“What would your
children think if they
knew how you felt?”
“Most people who
lose a loved one feel
empty.”
“Your life has no
meaning?”
“Let’s talk about the
positive things that
you have in your
life.”
A client with heart
disease says to the
nurse, “I guess I’ll
never be able to eat
ice cream again.”
The nurse most
appropriately
responds with which
of the following
statements?
a.
b.
c.
d.
“There are lots of
other foods you can
eat.”
“Ice cream has too
much fat content, so
why would you even
want to eat it.”
“You don’t think you
will be able to eat ice
cream at all?”
“Why do you say
that?”
When you don’t know the answer, look
again at what question is asking.
 Underline it.
 Look for patterns in the answers. Does
three of the four answers address the
questions in a similar fashion?

The physician has
ordered digoxin
(Lanoxin) 0.25 mg
PO daily. Currently
the client has a pulse
rate of 96. In
preparing the care
plan, the nurse
knows that Lanoxin
will:
a.
b.
c.
d.
Not affect cardiac
conduction.
Slow the cardiac
rate.
Maintain a constant
cardiac rate.
Increase the cardiac
rate.
The nurse in the emergency
room receives a telephone
call from emergency medical
services and is told that
several victims who survived a
plane crash will be
transported to the hospital.
Several victims are suffering
from cold exposure because
the plane plummeted and
submerged into the local river.
The initial nursing action of
the emergency room nurse is
which of the following?
a.
b.
c.
d.
Supply the triage rooms with
bottles of sterile water and
normal saline.
Call the laundry department
and ask the department to
send as many warm
blankets as possible to the
emergency room.
Call the nursing supervisor
to activate the agency
disaster plan.
Call the intensive care unit
to request that nurses be
sent to the emergency room.
All answers
correct…Chose the
answer with the “most
stuff”, that is the most
inclusive answer.

When two opposites are present, usually
one is the answer.
A nurse develops a
plan of care for a
client newly diagnosed
with Graves’ disease.
The nurse includes
which of the following
in the plan?
a.
b.
c.
d.
Provide a diet low in
calories and protein.
Keep the room
temperature cool.
Encourage frequent
ambulation and other
physical activities.
Place extra blankets
on the client’s bed.
Many times the answer to the question is
in the stem.
 Make sure you look to see if stem is
negative or positive.

A 22-year old sustained
fracture of the tibia and
fibula while playing
football. A long leg cast
was applied, and the
client was admitted to
the orthopedic unit.
Following four weeks of
bed rest, the nurse notes
decreased breath
sounds in the lower
lobes of both lungs.
What is the best
explanation for this
change in breath
sounds?
a.
b.
c.
d.
The client did not take
deep breaths while the
nurse examined his
lower lobes.
Because of improper
positioning, the client
has developed
pulmonary edema.
Atelectasis, caused by
immobility, has resulted
in the decreased breath
sounds.
The client's resistance
is down, and he has
caught a cold from
someone else.

The most common test taking strategy is
probably ODD MAN OUT, that is one
answer is very different from the other
three.
A 56-year old male is
admitted through the
Emergency Department
with crushing substernal
chest pain. The admitting
diagnosis is acute
myocardial infarction.
Immediate admission
orders include oxygen by
nasal cannula at
4L/minute, blood work, a
chest radiograph, a 12lead ECG and 2 mg of
morphine sulfate given
intravenously. The nurse
should first:
a.
b.
c.
d.
Administer the
morphine.
Obtain a 12-lead ECG
Obtain the blood work.
Order the chest
radiograph.
Practice

Let’s Identify what test taking strategy we
are using…
A patient is on a lowsodium diet. Before
discharge the patient
should be taught to
avoid:
a.
b.
c.
d.
Stewed fruit.
Luncheon meats.
Whole grain cereal.
Green leafy
vegetables.
A client is anxious about
impending emergency
abdominal surgery. The
nurse’s statement that best
addresses the client’s
complaints of thirst and pain is:
a.
b.
c.
d.
“Seven-up would be better
for your nausea, and I’ll give
you a pain medication to
reduce your anxiety.”
“Do these deep breathing
and leg moving techniques to
reduce your pain, and I’ll
bring you some hot tea.”
“I can let you have an
occasional ice chip to suck
on, and I’ll see about
applying a heating pad for
the pain.”
“This IV that I’m starting will
help decrease your thirst,
and you’ll receive medication
for pain just before surgery.”
A client has rib fractures
and a resulting
pneumothorax. The
physician orders
Morphine sulfate 1-2
mg/hour IV as needed
for pain. The primary
objective of this order is
to obtain adequate pain
control so the patient can
breathe effectively.
Which of the following
outcomes would indicate
successful achievement
of this objective?
a.
b.
c.
d.
Pain rating of “no pain”
by the client.
Decreased client
anxiety.
Respirations 26/min.
PaO2 of greater than
70 mm Hg.
A nurse is caring for a
client with chronic back
pain who is taking high
doses of opioids narcotics
for pain. The nurse will
teach the client or family
about what common side
effect of these
medications?
a.
b.
c.
d.
Inability to change
position.
Problems with
communication.
Constipation.
Diarrhea.
A nursing assistant
reports to the nurse
that his client is
having difficulty
breathing. When the
nurse enters the
client’s room, the
nurse’s first priority
would be to:
a.
b.
c.
d.
Elevate the head of
the bed .
Elevate the foot of
the bed.
Assess the radial
pulse.
Assess the blood
pressure.
The nurse assesses
the laboratory results
of a client with
pheochromocytomia.
The magnesium level
is 7 mEq/L. On the
basis of this
laboratory result, the
nurse would monitor
for:
a.
b.
c.
d.
Drowsiness.
Hypertension.
Hyperpnea.
Hyperactive
reflexes.
The nurse is caring
for a client who is
scheduled for
radiation therapy.
The nurse prepares a
nursing care plan for
the client, and in the
planning, the nurse
expects that the most
common response by
the client would be:
a.
b.
c.
d.
“I’m certain that this
will do the trick.”
“Will I be radioactive
afterwards?”
“This is just one of
several treatment
options I have for
treatment.”
“This treatment is
great because it is
invisible and very
effective.”
A client tells the nurse “I
increased my fiber, but I
am very constipated.”
What further information
does the nurse need to
tell the client?:
a.
b.
c.
d.
“Just give it a few more
days and you should be
fine.”
“Well that shouldn’t
happen. Let me
recommend a good
laxative for you.”
“When you increase the
fiber in your diet, you
also need to increase
liquids.”
“I will tell the doctor you
are having problems,
maybe he can help.”
A client is to have a
nasogastric tube inserted
because of an obstruction
in his bowel. The nurse
explains the procedure to
him and is about to begin
the insertion, when the
client says, “No way! You
are not putting that hose
down my throat. Get
away from me.” Which of
the following statements
is the best nursing
response?
a.
b.
c.
d.
“You have the right to
refuse treatment. Why
don’t you talk to your
doctor about it?”
“Something is upsetting
you. Can you tell me
what it is?”
“What do you feel about
this hose?”
“I would just get it over
with, because you won’t
get better without this
tube.”
New Format Questions

Approach “select all that apply” questions
like you would true/false questions.
Which of the following
interventions would
be helpful for the
student who is in a
nursing program.
Select all that apply.





Low-calorie diet with
high fiber.
Add alcohol to daily
routine.
Include daily exercise in
routine.
Join a study group.
Obtain psychiatric help .
Which of the following
assessment data for a
hospitalized senior adult
should alert the nurse to
an increased risk for
falls? Select all that
apply.






Obesity
Visual impairment
Bright lighting in room
History of falls
Use of walker when
ambulating
Lack of restraint use
Many times the “ideal” answer is not there.
Re-read the stem.
Focus on the adjectives.
Don’t jump at expected words!
Look at answers for clues.
If two options say the
same thing or include the
same idea, then neither
of these options can be
correct.
A client arrives at the
health care clinic after
sustaining an eye
injury in which paint
thinner splashed into
the eye. The nurse
would initially ask the
client which of the
following questions?
a.
b.
c.
d.
“Did you bring the
container of paint
thinner with you?”
“What time did the
injury occur?”
“Did you flush the
eye after the injury?”
“What brand of paint
thinner caused the
injury?”
The wife of a victim who
sustained an eye injury
calls the emergency
department and speaks to
a nurse. The wife reports
that her husband has hit
in the eye area by a piece
of board while building a
shed in the backyard.
The nurse advises the
wife to immediately?
a.
b.
c.
d.
Apply ice to the affected
eye.
Call an ambulance.
Irrigate the eye with cool
water.
Bring the husband to the
emergency department.

A client with an upper
respiratory infection
(common cold) tells
the nurse, “I am so
angry with the nurse
practitioner because
he would not give me
any antibiotics.” What
would be the most
accurate response by
the nurse?




a. “Antibiotics have no
effect on viruses.”
b. “Why do you think
you need an
antibiotic?”
c. “Let me talk to him
and see what we can
do.”
“I agree with you. You
do need an antibiotic.”

Which of the following
routes of drug
administration would
be the most rapidly
absorbed?




a. Oral tablet
b. Oral syrup solution
c. Sublingual tablet
d. Oral sustainedreleased capsule
Strategies That DON’T Work on
most exams
When in doubt, choose C.
 Selecting the answer that you don’t know.
 Selecting the response that is a different
length compared to other choices (the
longest answer).

Testing Hints
Look for the correct answer, not the best
answer.
 If all of the answers are true, re-read the
question. What is it asking?
 If all the answers are correct, choose the
most inclusive answer.

Studying skills
Don’t use only practice questions to study.
 Write your own questions.
 Re-write your notes if the concept isn’t
clear.
 Study with someone who is smarter than
you!
