Strategies in taking the NLE

Strategies for Taking Tests

‘Twas the Night Before Testing

• Go to bed on time.

•Put a few number 2 pencils with erasers in your bag.

•Solve family/friend problems before the testing date.

The Morning of Testing

• Start your day as you always do.

• Eat a good breakfast.

• Think of what you will do to relax after your test.

• Think Positive!Think Positive! And don’t And don’t

forget to PRAY.forget to PRAY.

Multiple Choice Questions

• If you do not understand the directions, ask for help.

• Read the question and allall answer choices before marking anything.

Pace Yourself

• Don’t spend too much time on any one question. Do your best and then move on.

• Answers the easiest questions first, but be sure to go back to those questions you skipped.

Multiple Choice Questions

• Do not change your answers unless you are very uncertain about your first answer choice.

• Try to answer every question. Make the most intelligent guess you can.

The Process of Elimination

• After you have been through all of the questions once, go back and find questions you have some knowledge about and eliminate choices that you know are incorrect.

I know C isn’t the answer!

The Process of Elimination

• If you can eliminate two wrong answers, your chance of choosing the right answer is greater.

Answering Questions

• Don't guess blindly, but if you have time to think about the best answer choice, make it!

Skip, Return, Check

• If you finish early, check to make sure you have answered all questions.

Key Words

• Find key wordskey words or phrasesphrases in the question that will help you choose the correct answer.

Are we communicating?

• Make sure you understand what the question is asking.

• Be sure you are responding to the question that is being asked.

• A patient is receiving Dilantin to stabilize his seizure condition. One morning, when he is taking a walk in the corridor, you, his nurse, notice his gait is extremely ataxic and that he complains of dizziness.

How to avoid “reading into” the question

• Identify the “INTRODUCTORY STATEMENT” and the “STEM”

• Separate what the question TELLS you from what it is ASKING.

Each test question consists of 3 parts:

1. Introductory statement

2. Stem, which asks you to select an answer

3. Four options, from which you must select the answer.

Introductory Statement

• May – give you information about a clinical

problem– Present data– State a nursing topic such as a nursing

intervention or a disease

• Always includes a SPECIFIC QUESTION that must be answered using nursing knowledge.

Stem

• The specific question in the introductory statement

• Asks you to solve a specific problem and select one of the four options as the answer.

Example

• A client is receiving care at the clinic. Her doctor has prescribed an iron supplement and an increased intake of Vit. C in her diet. The nurse understands that the best rationale for increasing Vit. C in the client’s diet is to:

Introductory Statement vs. Stem

• Introductory Statement : TELLS you about the client’s health problem and GIVES you the clinical information that you should consider in answering the questions.

• Stem: ASKS the nurse to solve the specific problem and select 1 of the 4 options.

Basic Rules for Test-Taking Success

• Rule 1: Know the parts of a test question and how to read them

Stem Forms of a Question

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 form in incomplete sentence

Basic Rules for Test-Taking Success

• Rule 1: Know the parts of a test question and how to read them

Stem Forms of a Question

A 41-year-old, at term and a diabetic, arrived at the labor and delivery room in early labor.

Which of the following assessment data should the nurse obtain upon admission?

The assessment data that the nurse should gather include

?

?

?

• Rule 2: Read the question carefully before looking at the options; identify key words in the stem

Note: THE STEM IS THE HEART OF THE ITEM!!!

• All of the following behaviors are typical of a 3-year-old except

A. Putting on make-up and playing grown up

B. Reciting address and telephone numbers

C. Throwing a ball about 5 feet

D. Identifying animals from a picture book

Watch out for these words

• First• Primary• Initial• Early• Best

• Most/ least

• Most important

• Priority

• Except

• An early sign of respiratory distress you might observe is

A. Increased pulse rate

B. Cyanosis

C. Decreased pulse rate

D. Clammy skin

• Rule 3: Identify the theme of the item, and base it on information provided in the stem. Don’t assume information that is not given.

• A husband was admitted to the ER in delirium tremens (DTs). This admission is his 3rd 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 his drinking problem?”

The best initial response for the nurse is

A. Don’t feel guilty, I know this must be difficult for you.

B. Let’s go into the lounge, so we can talk more about your concern.

C. You need to convince him to seek professional help.

D. How long has your husband been drinking?

• Rule 4: Answer difficult questions by eliminating the obviously incorrect responses first, then select the best of the remaining options.

• Quickly reduce your options to only 2!

• Rule 5: Select responses that are therapeutic, show respect, and communicate acceptance. Eliminate responses that are bizarre, inappropriate or punitive.

• 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, “I’m tired of waiting, I want my bath now. You’re never here when I need you.”

A. “What do you mean, I’m never here? I spent 3 hours with you yesterday.”

B. “I’m sorry you’ve been waiting. Let’s get you comfortable now, and I’ll be back in 20 minutes to give you a bath.”

C. “I’m doing my best. You know I have 3 other patients to take care of today, besides you.”

D. “I must see another patient right now. She’s really sick today. I’ll be back as soon as I can.”

• Rule 6: Know the basic principles that guide the practice of nursing.

• A 48-year-old woman was brought to the Hospital in a debilitating state with Helsink’s disease. Her husband states 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 to

A. Give them a few hours of privacy so they can gather their composure

B. Introduce them to other clients in the day room so they won’t feel isolated

C. Get her settled in her room; give them a basic orientation to their immediate surroundings

D. Assist her to ambulate in the corridor to regain her strength

• Activities that would be appropriate for her are those that would allow her to

A. Compete with others

B. Succeed at a task

C. Engage in social interaction

D. Tax her thinking skills

• Rule 7: Look for patterns in your performance and flaws in your thinking. Analyze your test-taking behaviors, then establish strategies to correct these problems

Common Test-Taking Errors• Not recognizing or remembering subject matter• Not understanding subject matter• Not recognizing item idea• Not recognizing principle or rationale for correct answer• Missed key word• Not reading all distractors carefully• Not understanding question• Reading into the question• Using incorrect rationale for choosing response• Changing the answer• Other

• Rule 8: Manage your time effectively during test-taking

• Rule 9: Do not change answers without good reasons.

• Rule 10: Choose options that are within the realm of nursing. Be able to differentiate the need for nursing judgment from the need for physician judgment

• A 58-year-old is recovering from a suprapublic prostatectomy. His urinary output for 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

A. Irrigate the foley catheter

B. Notify the physician

C. Take vital signs

D. Empty the drainage bag

• A patient is receiving Dilantin to stabilize his seizure condition. One morning, when he is taking a walk in the corridor, 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 is being taken?

A. Very unsteady gait, probably owing to Dilantin toxicity. Notify physician.

B. Complaining of dizziness while walking. Gait unsteady, returned to bed, BP 110/70, pulse 112, RR 32. Physician notified.

C. Gait very unsteady. Returned to bed. Physician notified.

D. Gait unsteady. AM dose Dilantin withheld. BP 110/70, pulse 112, RR 32.

Computation• When using scratch paper on a

question requiring computation, double check to make sure that you have copied the problem correctly from the test booklet!

Math Computation• Line up place value correctly on your

scratch paper (thousands, hundreds, tens, ones) or the answer will be incorrect.

Math Computation• If your answer does not match one

of the choices, reread the problem, recopy the numbers, and try solving it again.

A Matter of Time

• If any time remains, spend it on those questions about which you know nothing or almost nothing.

• As you go back through, do not change all answers.

• Remember: Your first guess is usually right.

It’s About Time

• Don’t spend too much time rewriting or obsessing about neatness.

• Don’t worry if you run out of time.

Final Tips

• Fill in bubbles fully, write neatly, and erase stray marks.

• Double-check the test number in your test booklet against the answer sheet every few questions to be sure you haven’t gotten on the wrong number.

The Death Grip

• If your arm tires during testing it is probably due to the grip that you have on your pencil.

• Relax the grip and give those muscles a break.

• Do not do arm exercises during testing as this disturbs others.