Test Taking Tips for Nurses

If you have taken nursing exams, you understand that they are different than exams you may have taken previously. With nursing exams, it is not enough to just memorize information. You need to learn as much as you can to apply the information you are learning. The human body is complex, and your patients will have complex needs. The nursing exams are designed to test your comprehension to help you think like a nurse. The more exams you take, the more you will be able to understand the nursing exam style.

APPLICATION QUESTIONS

Application questions require you to utilize the knowledge that you have learned. To answer an application question, you must take the remembered and comprehended information and apply it to client situations. Application questions test your ability to use information in a client scenario:

An elderly client’s skin looks dry. When providing back care, the nurse should:

A. Apply a moisturizing body lotion

B. Wash the back with strong soap and water

C. Massage using short kneading strokes

D. Leave excess lubricant on the client’s skin

To answer this question, you must know that dry skin is common in the elderly, and that moisturizing lotion helps the skin to retain water and become more supple. When presented with this scenario, you have to apply your knowledge concerning developmental changes in the elderly and the consequences of using moisturizing lotion.

Higher level questions require you to analyze a variety of data and recognize the commonalities, differences, and relationships among the presented ideas. Higher level questions make the assumptions that you know, understand, and can apply the information. Now you must identify, examine, dissect, evaluate or investigate the information presented in the scenario. This type of question tests your analytical ability.

A client has dependent edema of the ankles and feet and is obese. The nurse should expect the health care provider to order which of the following diets? A. Low in potassium and high in fat

B. Low in salt and low in calories

C. High in calcium and low in vitamin C

D. High in magnesium and high in carbohydrates

To answer this question, you have to understand the inherent relationship between salt in the diet, fluid retention, obesity, and caloric intake. You also must understand the impact of vitamins and minerals, carbohydrates, proteins, and fats in a diet for a client with edema and obesity. When you answer this question, you must understand and examine the information presented, identify the interrelationships among the elements, and arrive at a conclusion.

PARTS OF THE QUESTION

The stem is the initial part of a multiple choice item. The purpose of the stem is to present a problem in a clear and concise manner. The stem should contain all the details necessary to answer the question.

The types of stems are:

A. Complete sentence example: What should the nurse do first when the client asks to get out of bed?

B. Incomplete sentence example: To best meet the client’s needs, the nurse should:

C. Positive example: The nurse understands that the underlying issue with the client is:

D. Negative example: The nurse should avoid which of the following situations?

TIPS FOR ANSWERING QUESTIONS

Determine what the question is asking. Determine most important facts. Read the question again. Sometimes rephrasing the question in your mind can help. Choose the BEST option (more than one answer may be correct. Choose the Best.) Always assess before intervening unless you were given assessment data.

SPECIFIC STUDY TECHNIQUES FOR NURSING EXAMS

If the question asks you what to do in a situation, use the nursing process to determine which step is next. If the question asks what the client needs, use Maslow’s Hierarchy to determine what to do first. If the question indicated that the client doesn’t have an urgent physiological need, always focus on safety. Remember to choose A, B, C, and then safety. Always choose the physical answer before the psychological answer if there are any urgent physiological data in the question. If the question involves communicating with a patient, use the principles of therapeutic communication.

PRIORITY QUESTIONS

Read the stem carefully while looking for key words such as “first,” “initially,” “best,” and “most.” These words modify what is being asked. This type of question requires you to put a value on each option and then place them in rank order. All of the answers may be correct to some degree; however, there is one answer that you would do FIRST.

Which of the following would be a priority for a nursing student the night before an exam?

A. Working all night and getting no sleep

B. Attending a party with free alcoholic beverages

C. Studying with another student and testing each other

D. Planning a vacation and making the reservations.

The state licensing exam (NCLEX-RN) tests almost exclusively from the higher order, priority question standpoint. Therefore, as you progress through the nursing program, you will be tested progressively toward this goal.