TEST TAKING

STRATEGIES
Lesson 1
 EXAMPLE
• A 61 yr old man, Mr. Regalado, is admitted
to the private ward for observation after
complaints of severe chest pain. You are
assigned to take care of the client. When
doing an initial assessment, the best way for
you to identify the client’s priority problem is
to:
1. Interview the client for chief complaints and
other symptoms
2. Talk to the relatives to gather data about history
of illness
3. Do auscultation to check for chest congestion
4. Do a physical examination while asking the client
relevant questions
 Test taking strategies
• Consider the nursing process
– Remember that assessment comes
before analysis, which comes before
planning, which comes before
implementation, which comes before
evaluation
– If the question asks you to assess, you
can immediately eliminate options that
aren’t assessment options.
 EXAMPLE
• Josie brought her 3 month old child to
your clinic because of cough and colds.
Which of the following is your primary
action?
1. Give cotrimoxazole tablet or syrup
2. Assess the patient using the chart on
management of children with cough
3. Refer to the doctor
4. Teach the mother how to count her
child’s breathing
Lesson 2
 EXAMPLE
• Wendy is admitted to the hospital with signs
and symptoms of stroke. Her Glasgow Coma
Scale is 6 on admission. A Central venous
catheter was inserted and an IV infusion was
started. As a nurse assigned to Wendy, what
will be your priority goal?

1. Prevent skin breakdown

2. Preserve muscle function
3. Promote urinary elimination
4. Maintain a patent airway
 Test taking strategies
• Apply Maslow’s hierarchy of needs
– Physiologic needs are the most basic
and the first need to be met
– Second needs to be met are safety
and security
– Always satisfy the lowest-level need
first

• Apply the ABCs

 EXAMPLE
• When caring for Larry after an
exploratory chest surgery and
pneumonectomy, priority would be
to maintain:

1. Supplemental oxygen
2. Ventilation exchange
3. Chest tube drainage
4. Blood replacement
 EXAMPLE
• Carlo, 16 yrs old comes to the ER with
acute asthmatic attack and in acute
respiratory distress. Which of the ff
nursing actions should be initiated
first?

1. Provide emotional support

2. Administer oxygen at 8lpm
3. Suction the client every 30 min
4. Administer bronchodilator by
nebulizer
Lesson 3
 EXAMPLE
• You are caring for Conrad who has a
brain tumor and increased ICP. Which
intervention should you include in your
plan to reduce ICP?

1. Administer bowel softener

2. Position Conrad with his head turned
toward the side of the tumor
3. Provide sensory stimulation
4. Encourage coughing and deep
breathing
 Test taking strategies

• Consider patient
safety
 Test taking strategies
Rudy was diagnosed to have chronic renal failure.
Hemodialysis is ordered that an A-V shunt was
surgically created. Which of the following
actions would be of highest priority with
regards to the external shunt?

1. Avoid taking BP or blood sample from the arm

with the shunt.
2. Instruct the client not to exercise the arm
with the shunt
3. Heparinize the shunt daily
4. Change the dressing of the shunt daily
 EXAMPLE
• You identified a potential risk of a pre
and postoperative clients. To reduce
the risk of patient’s harm from fall,
you will implement the ff, except

1. Assess potential risk of fall

2. Take action to address any identified
risk
3. Allow client to walk with relative to OR
4. Assess and periodically reassess
individual client’s risk for falling
Lesson 4
 EXAMPLE
• During the morning endorsement, the outgoing nurse
informed the nursing staff that Regina, 35 yrs old
was given Flurazepam (Dalmane) 15 mg at 10 pm
because she had trouble sleeping. Before
approaching Regina, the nurse read the observation
of the night nurse. Which of the following
approaches of the nurse validates the data
gathered?
1. I learned that you were up till ten last night. Tell me what
happened before you were finally able to sleep and how was
your sleep?
2. Hmm.. You look like you had a very sound sleep. That pill you
were given last night is effective isn’t it?
3. Regina, did you sleep well?
4. Regina, how are you?
 Test taking strategies
• Consider verbal and nonverbal
therapeutic communication
– Listen to the client
– Try to understand the client’s needs
– Promote clarification and insight about
the client’s condition
 EXAMPLE
• The client says, “I want to tell you something
but promise me that you will keep this a
secret.” A therapeutic response of the nurse
is:

1. Yes, our interaction is confidential provided

that information you tell me is not
detrimental to your safety
2. Of course yes. This is between you and me.
3. Yes, it is my principle to uphold my client’s
rights
4. Yes, you have the right to invoke
confidentiality of our interaction.
Lesson 5
 Test taking strategies
• Avoid reading into the question
– This means that you are considering
issues beyond the information
presented in the question
– Strategies to prevent this from
happening include:
» Identify parts of a question
» Read carefully
» Look for keywords or key phrases
» Identify the issue
» Use the process of elimination
» Avoid asking yourself “What if”
 Test taking strategies
Parts of a question:
• Case situation
• Question stem
• Options

Example:
(Case situation) Fe is experiencing left sharp pain
and occasional hematuria. She was advised to
undergo IVP by her physician. The IVP
reveals that Fe has small renal calculus that
can be passed out spontaneously. (Question
stem) To increase the chance of passing the
stones, you instructed her to force fluids and
do which of the following?
A. Balanced diet C. Strain all urine
B. Ambulate more D. Bed rest
Lesson 6
 Test taking strategies
Key words or key phrases:
• Focus your attention on the critical
and specific points
• May indicate there is only one
option
• May indicate that you need to
prioritize
• May indicate a true response or a
false response question
Common keywords or key phrases that
indicate there is only one correct
option:

• Early sign • Avoid

• Late sign • Ineffective
• Understands • Inadequate
• Goal has • Unable to
been tolerate
achieved
 EXAMPLE
• After cleaning the abrasions and applying
antiseptic, the nurse applies cold compress to
the swollen ankle as ordered by the
physician. This statement shows that the
nurse has correct understanding of the use of
cold compress:

1. Cold compress reduces blood viscosity in the

affected area.
2. It is safer to apply than hot compress.
3. Cold compress prevents edema and reduces
pain.
4. It eliminates toxic waste products due to
vasodilation
Lesson 7
Common keywords or key phrases
that indicate the need to
prioritize
• Best • Highest or lowest
• First priority
• Initial • Most effective or
• Immediately least effective
• Most likely or least • Order of priority
likely • At highest risk
• Most appropriate or • At lowest risk
least appropriate • Best understanding
 EXAMPLE
• Which of the following should be given
highest priority when receiving patient
in the OR?

1. Assess level of consciousness

2. Verify patient identification and
informed consent
3. Assess vital signs
4. Check for jewelry, gown, manicure and
dentures
 EXAMPLE
• Irma is terminally ill, she speaks to you in
confidence. You now feel that Irma’s family
could be helpful if they knew what Irma has
told you. What should you do first?

A. Tell the physician who in turn could tell the

family
B. Obtain Irma’s permission to share the
information with the family
C. Tell Irma that she has to tell her family what
she told you
D. Make an appointment to discuss the situation
with the family
Lesson 8
 Test taking strategies
Identify issues of the question:
• The specific subject content that the
question is asking about
• Will assist in eliminating the incorrect
and direct you to selecting the correct
option
Issues can include:
• Physiologic integrity
• Safe, effective care environment
• Health promotion and maintenance
• Psychosocial integrity
 Test taking strategies
• Eliminate options that contain absolute
words such as all, always, never.
Example:
A nurse is providing dietary instructions to a
client about low-fat diet. The nurse tells
the client to:
a. Never use butter for cooking
b. Read the labels on food items to
determine fat content
c. Eat only foods that have less than 1% fat
content
d. Drink fluids only if they are fat free
Lesson 9
 EXAMPLE
• Post IVP, the patient should
excrete the contrast medium. You
instructed the family to include
more vegetables in the diet and
a. Increase fluid intake
b. Barium enema
c. Cleansing enema
d. Gastric lavage
 Test taking strategies
• Eliminate options that contain medical
rather than nursing interventions
Example:
A nurse is caring for a client with CHF who
suddenly experiences dyspnea. Nurse
suspects pulmonary edema and would
immediately:
a. Obtain Furosemide and a syringe
b. Places the client in high-Fowler’s position
c. Obtains a dose of morphine sulfate
d. Inserts a foley catheter
Lesson 10
 Test taking strategies
Which of the following statements about
immunization is NOT true
a. A child with diarrhea due for OPV should
receive the OPV and make extra dose on the
next visit
b. There is no contraindication to immunization
if the child is well enough to go home.
c. There is no contraindication to immunization
if the child is well enough to go home and
should be immunized in the health center
before referral are both correct.
d. A child should be immunized in the health
center before referral.
 Test taking strategies

• Ensuring that all

parts of an option
are correct
Lesson 11
 Test taking strategies

A client is admitted to the hospital with a

diagnosis of pericarditis. Which
manifestation differentiates pericarditis
from other cardiopulmonary problems?
a. Chest pain that worsens on inspiration
b. Pericardial friction rub
c. Anterior chest pain
d. Weakness and irritability
 Test taking strategies

• Look for similar

concepts in the
question and in one
of the options
 EXAMPLE
• A child with ear problem should
be assessed for the following,
except:
a. Is there any fever?
b. Ear discharge
c. How long ear discharge is
present?
d. Ear pain