Strategies for Effective TestTaking

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Strategies for Effective Test-Taking

• Adelita G. Cantu, PhD, RN

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Know the parts of a test question and how to read
them

• Three main parts
• Background statement (brief scenario that will
  provide useful info to answer question)
• Stem (this contains specific problem or intent of
  the item, presented as question or incomplete
  statement formed by subject and verb)
• List of options (list of possible answers)

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Examples

• Stem forms
• A young woman arrived at the hospital in early
  labor
• Which of the following signs is the best
  indicator that labor is progressing?
• The best indicator that labor is progressing is

• Background statement
• Stem in question form
• Stem in incomplete statement

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Examples

• A 41-year old, at term and a diabetic, arrived at
  the LD suite in early labor.
• Which of the following assessment data should the
  nurse obtain upon admission?
• The assessment data that the nurse should gather
  include

• Background statement
• Stem in question form
• Stem in incomplete form

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Read the question carefully before looking at the
options, identify key words in the stem

• Stem is heart of the item
• Provides the focus, directs your thinking
• Key words found in the stem
• first, primary, initial, early, most important,
  except

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Example

• A 3-year-old child was admitted to the ER after
  being rescued from a fire in his home. He is
  having difficulty breathing.
• An early sign of respiratory distress that you
  might observe is
• increased pulse rate
• cyanosis
• decreased pulse rate
• clammy skin

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Identify the theme of the item, base it on info
found in the stem, dont assume

• A husband was admitted to the ER in delirium
  tremens. This admission is his third visit in 2
  weeks. While waiting to see her husband, the wife
  said to the nurse, What in the world can I do to
  help my husband get over this drinking problem?
• The best initial response for the nurse is
• Dont feel guilty I know this must be difficult
  for you.
• Lets go into the lounge, so we can talk more
  about your concern.
• You need to convince him to seek professional
  help.
• How long has your husband been drinking?

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Answer difficult questions by eliminating the
obviously wrong first

• Eliminate
• The reread stem
• Identify rationales
• Select strongest option
• If cannot eliminate, take a wild guess and select
  any answer. Not penalized for guessing, 25 of
  getting it right

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Select responses that are therapeutic, show
respect and communicate acceptance

• A patient is recovering from a colon resection
  for removal of a malignant mass in the large
  bowel. Following breakfast one morning she tells
  the nurse, Im tired of waiting, I want my bath
  now. Youre never here when I need you.
• Which of the following responses by the nurse is
  the most appropriate?
• What do you mean, I m never here? I spent 3
  hours with you yesterday.
• Im sorry youve been waiting. Lets get you
  comfortable now, and Ill be back in 20 minutes
  to give you a bath.
• Im doing my best. You know I have three other
  patients to take care of today, besides you.
• I must see another patient right now. Shes
  really sick today. Ill be back as soon as I can.

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Know the basic principles that guide the practice
of nursing

• Know nursing and the nursing process
• Focus on learning principles
• Broad concepts
• Recognize and learn common needs and aspects of
  care of high-volume patient populations

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• A 48-year-old woman was brought to a nursing home
  in a debilitating state with Helsinks disease.
  Her husband says that she has become very
  unstable on her feet her motor skills have
  become very spastic. She is becoming increasingly
  irritable and is having difficulty eating by
  herself. The couple appears very depressed.
• Following the initial assessment, the best action
  for the nurse is
• Give them a few hours of privacy so they can
  gather their composure
• Introduce them to other clients in the day room
  so they wont feel so isolated
• Get her settled in her room give them a basic
  orientation to their immediate surroundings
• Assist her to ambulate in the corridor to regain
  her strength

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• Activities that would be appropriate for her are
  those that would allow her to
• Compete with others
• Succeed at a task
• Engage in social interaction
• Tax her thinking skills
• When you confront strange or unfamiliar
  background statements or vignettes, dont panic.
  Proceed with the question. Look for behavior
  patterns or clinical portraits that will provide
  clues for nursing action.

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• Look for patterns in your performance and flaws
  in your thinking. Analyze your test-taking
  behaviors, then establish strategies to correct
  these problems.
• Did not recognize or remember subject matter
• Did not understand subject matter
• Did not recognize item idea
• Did not recognize principle or rationale for
  correct answer
• Missed key words
• Did not read all distracters carefully
• Did not understand question
• Read into question
• Used incorrect rationale for selecting response
• Changed the answer

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Choose options that are within the realm of
nursing

• Test questions that are action-oriented are based
  on clinical judgment.
• A 58-year-old is recovering from a suprapubic
  prostatectomy. His urinary output in the past 2
  days has been satisfactory however the nurse now
  notices that it is becoming increasingly bloody.
• The initial action of the nurse should be to
• Irrigate the Foley catheter
• Notify the physician
• Take vital signs
• Empty the drainage bag

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• A patient is receiving Dilantin to stabilize his
  seizure condition. One morning when he is taking
  a walk in the hall, you, his nurse, notice his
  gait is extremely ataxic and that he complains of
  dizziness.
• Which of the following nurses notes indicates
  that appropriate nursing action was taken?
• Very unsteady gait, probably owing to Dilantin
  toxicity. Notify MD.
• Complaining of dizziness while walking. Gait
  unsteady, returned to bed, BP 110/70, pulse 112,
  respiration 32. MD called.
• Gait very unsteady. Returned to bed. MD notified.
• Gait unsteady. AM dose of Dilantin withheld. BP
  110/70, pulse 112, respiration 32.