Selected Reference

Nugent, P.M. and Vitale, B.A. (2004). Test Success, 4th Edition. FA Davis Company: Philadelphia

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Phases of Test-Taking

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Preparation

• Learning should take place before you sit down to study for the test.

• Studying for a test should be reviewing the material and formulating applications of the material to the clinical setting.

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Types of Questions

• Knowledge– What is the normal range of a radial pulse in

an adult?

• Comprehension– When clarifying is used as a therapeutic

communication tool, then nurse is:• Verifying what is implied by the patient

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Types of Questions

• Application– When lifting a heavy patient higher in bed,

the nurse can prevent self-injury by:• Positioning the feet apart with one foot placed

forward

• Analysis– A patient has dependent edema of the ankles

and feet and is obese. Which diet should the nurse expect the physician to order?

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Anatomy of a Multiple Choice Question

The issueThe stemThe options

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Key Words

• These are words that influence the issue, the stem or the options.– Priority = first, initially, best, most, safest– Negative = not, except, never,

contraindicated, unacceptable, avoid, unrelated, violate, least

– Specific determiners (no exceptions) = just, always, never, all, every, none, only

– General = early, late, immediately, most likely, least likely, initial

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The Issue

• What is the specific subject or problem of the question?

• May relate to a procedure, a disorder, a problem, a behavior, a medication, a toxic effect of a medication, etc.

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The Stem

• The stem is the question.– Compete sentence– Incomplete sentence– Positive polarity (what is true)– Negative polarity (what is false)

• It may be preceded by a brief case scenario.

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• Complete sentence, positive polarity

What should be the first action of the nurse when a fire alarm rings in a health-care facility?Key words – first actionIssue – ringing fire alarm

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• Complete sentence, negative polarity

On what part of the body should the nurse avoid using soap when bathing a patient?Key words – avoid using soapIssue – part of body being bathed

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• Complete sentence, positive polarity, and case scenario.

The nurse is assigned to care for a patient who is incontinent of urine and stool. Which should the nurse apply to best protect this patient’s skin?Key words – best protectIssue – patient’s skinCase scenario – incontinence

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• Incomplete sentence, positive polarity

To best understand what a patient is saying, the nurse should:Key words – best understandIssue – what patient is saying

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• Incomplete sentence, negative polarity

Range-of-motion (ROM) exercises should not be done:Key words – not be doneIssue – range of motion exercises

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• Incomplete sentence, negative polarity, and case scenario.

A patient is on a low sodium diet. Before discharge, the patient should be taught to avoid:Key words – avoid Issue – patient teachingCase scenario – low sodium diet

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The Options

• Multiple choice options consist of one best response answer and two-three distractors– Option is a sentence– Option completes the sentence begun in the

stem– Option is an incomplete sentence– Option is a single word

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Option is a Sentence

• Grammatically correct• Has a subject and verb

….Before performing a procedure, what should the nurse do first?

1. Raise the patient’s bed to its highest position2. Collect the equipment for the procedure3. Position the patient for the procedure4. Explain the procedure to the patient

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Option Completes Stem

• The stem and the option together form a sentence

…The primary etiology of obesity is a:1. Lack of balance in the variety of nutrients2. Glandular disorder that prevents weight loss3. Caloric intake that exceeds metabolic needs4. Psychologic problem that causes overeating

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Incomplete Sentence Option

• A phrase or group of words that conveys a unit of thought, an idea, or a concept

.When should mouth care be administered to an unconscious patient?

1. Whenever necessary2. Every 4 hours3. Once a shift4. Twice a day

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Single Word Option

• Can be any part of speech that conveys information

…What is the nurse doing when formulating a nursing diagnosis?

1.Planning2.Assessing3.Analyzing4.Implementing

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IDENTIFY!• key words in the stem that set a priority• clues in the stem• central person in the question• patient-centered option• opposites in options• equally plausible or unique options, usually

eliminate• global (umbrella) option• duplicate facts among the options• options that deny patient feelings, concerns

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Test Taking Tips

• Concentrate on one question at a time• Read every question carefully• Read every line and do not scan the

question• Ask yourself “What is the question

asking?”• Try to answer the question without

looking at the options, then match your answer with one of the options.

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Test Taking Tips

• Don’t waste too much time on any one question – this is a time to wear your watch

• Eliminate wrong options and do not go back to them

• Pick the most complete option• Be sure the entire answer is option

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Test Taking Tips

• Do NOT change answers, your first instincts are usually correct

• The answer should grammatically match the question

• Select the options that are within the realm of nursing practice

• Identify the client, the answer must relate to the client

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Making Educated Guesses

• Select the most general answer when other choices are specific

• Choose the longest answer when others are much shorter

• Choose the answer with the middle value when others are high or low

• Choose neither of two similar answers• Choose one of two opposite answers

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Making Educated Guesses

• Choose among familiar answers• Choose logical answers• Avoid answers with absolutes (always,

never, none, all) in them• Use ABC’s or Maslow’s to select answers

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