1. BECOME TEST – WISE Mastering Computer-based Standardized Nursing Tests
Texas State University
St. David’s School of Nursing

2. Acknowledgements Liz Fuentes, MS, RN, FNP-C
Assistant Clinical Professor, Texas Women’s University
School of Nursing, Mott Community College, Flint, MI

3. Table of Contents Mastering Computer-based Standardized Nursing Tests
Slides
Solid Learning Strategies
General Test Taking Skills
How to Read and Interpret a Test Question 10
Parts of a Question
Practicing What We Just L earned
Mathematical Computations 21
Options
Types of Test Errors
Eliminating Incorrect Options
15 Test Taking Strategies
References

4. Learning Strategies: Your Guide to Classroom and Test-Taking Success
With the above workbook that you received at New Student Orientation
and
Learning Strategies Inventories worksheets posted on thewebsite
Complete Self-Assessment Inventories
One chapter at a time
You must have solid learning strategies to master standardized nursing tests

5. You are to fine tune and strengthen these learning strategies:
Getting the most from lectures
Preparing for class
Taking notes
Everyday learning
Studying
Reading strategies
Tips for remembering facts
Preparing for
Classroom assessments
Standardized nursing assessments

6. When studying – what works best for you?
Don’t change your mode of success
If study groups work for you – continue
If studying alone works – continue
If creating a quiet study space works – continue
If noise keeps you alert – go for it
If changing your study space every couple of hours works - continue
Assess your attitude toward test-taking
Be positive; it makes a difference
Be steadfast – determined
Checkout this New York Times ( ) article:
Forget What You Know About Good Study Habits

7. General Test-taking STRATEGIES
Avoid changing answers
Be systematic
Work at a steady pace
Stay focused
Breathe
Look for logic

8. THE TIME OF THE TEST ARRIVES….
Get sleep
Eat what is kind on your digestive system at a time that works well for you
Wear comfortable clothing and a watch
Or try wearing a “Sunday” outfit
Bring a pencil or pen
Goal: Be physically and mentally alert at an intensity that feels right to you

9. FORECAST POSITIVE RESULTS
“I am in control of my attitudes and my attitudes are positive. I can do well on this exam.”
and
I am steadfast – determined.

10. Standardized Nursing
Tests:
How to Read and
Interpret a Test Question

11. Parts of an Assessment Question
Situation/scenario: Statement giving information about a clinical problem
Stem: Specifically asks you something
Options: Choices to answer the stem

12. The Situation/Scenario
Sets the stage for the question
Usually describes a client, family member or significant other with a particular problem or set of problems
Contains some pertinent information

13. What is the Question Stem?
Central focus of the item
Presented as a question or incomplete item
Look for key words such as:
Most correct
Most likely
Do first
Initial
Highest priority
May require information from the situation in order to answer

14. Stem Types
True response stem – asks for a true statement (commonly used)
False response stem – asks for the incorrect answer (not commonly used)

15. Options: Choices to answer the stem
One option is the most correct answer
The other options are called distracters
May be four options of similar length
May be two short and two long answers
May be similar in length and designed as the correct answer
Must be plausible, but not correct
If an option contains both correct and incorrect information – it is a distracter
Negative Options – not common but you need to be familiar with them
Changes direction of the question
Looks for the WRONG answer
The correct option answers what the stem of the question is asking you, so make sure to re-read the stem (central focus of a question) after you’ve chosen your answer

16. Options: Choices to answer the stem
Tips
Separate what the question is telling from what it is asking
Scenario vs. stem (usually asks for true statement)
Always identify the client, issue, key words
Eliminate options offering new information
Given: The nurse is always therapeutic and time is available

17. Let’s practice what we just learned plus learn a few strategies

18. Sample Nursing Test Question
The nurse is preparing a medication for a client and observes the date of expiration occurred two months ago. Which action should the nurse perform?

19. Sample Nursing Test Question
Situation/Scenario
Question Stem
The nurse is preparing a medication for a client and observes the date of expiration occurred two months ago. Which action should the nurse perform?

20. Options to the Nursing Test Question
A. Give the medication
Discard the medication
Omit the medication
Return the medication to the pharmacy
Rationale: Laws require all medication to have an expiration date. Outdated medication should be returned to pharmacy for proper disposal.

21. Mathematical Computations
Be mindful of mathematical questions which will be included in an exam:
The nurse is to administer an antibiotic to a child who weighs 22 lbs. The dosing is mg/kg/day.
First you would need to convert lbs to kgs: 2.2lb=1kg so this child weighs 10 kgs.
Then multiply 10 kg by 40 mg (right in the middle of the recommended dose) = 400mg/day.
Amoxicillin comes in 125 and 250mg/5cc (1 teaspoon).
Antibiotic dosing should be divided throughout the day. Divide the total dose per day (400mg) by 3 doses throughout the day = 133mg.
The child can receive 125mg or 5cc three times daily.

22. Option Position Myths Example:
No one position is favored; A vs. B vs. C vs. D
When in doubt – select C is a myth that item
writers know about…
Don’t look for shapes, letters, sequences, or patterns in answers
Example:
“I have too many C answers”
There is no pattern to answers

23. One Last Option Myth
The longest answer contains the most information but don’t assume the information in the longest answer is correct

24. Umbrella Option Contains other options within it
Present when there is more than one right answer found

25. Priority Option ABC’s Airway Breathing Circulation Safety Maslow
Patient first
Safe Care

26. Don’t “Read Into” Options
Take question at face value
If it walks like a duck….

27. Types of Testing Errors

28. First Error Type Misperceiving Information Words are read incorrectly
Information is overlooked
See next slide for an example

29. Read These Options ONCE IN A A LIFETIME BIRD IN THE THE HAND PARIS
THE SPRING
ONCE
IN A
A LIFETIME
BIRD
IN THE
THE HAND

30. What did you see?
Did you see “Paris in the Spring”, “Once in a Lifetime” and “Bird in the Hand?”
Look again at the next slide

31. Each option has repeated words
PARIS
IN THE
THE SPRING
ONCE
IN A
A LIFETIME
BIRD
IN THE
THE HAND

32. Second Error Type Misprocessing information Not recognizing a key word
Example
Dysphagia may be misread as dysplasia
Focusing on the wrong key word in a distracter

33. Third Error Type Misapplying the response
Results when knowledge cannot be applied to the question
Graduates have a great deal of knowledge, but may have difficulty narrowing it to a particular answer

34. Eliminating Incorrect Options

35. Absolutes 101 Anti-hypertensives always make you dizzy
Patients should never self-medicate
Doubtless the nurse is correct
The patient was completely satisfied with treatment

36. Qualifiers The medication is probably the cause of the problem
Patients usually walk after surgery
Aspirin is the best medication
No one ever documents that way

37. There is no penalty for guessing but you don’t want to “have to” guess too frequently

38. Test-taking Strategies
The following are 15 strategies for mastering computer-based standardized nursing tests
We have included so many because different types test questions require different strategies to answer the question stem correctly
Your assignment is to practice these strategies to determine which ones work best for you

39. Strategy 1 Read the client description and question carefully
Take time to read each word in the situation
Read the question stem – be sure you understand what it is asking
Form an answer in your mind, then select the option closest to your answer
The correct answer answers what the stem of the question is asking you, so make sure to re-read the stem (central focus of a question) after you’ve chosen your answer
Once a question is answered, it’s done…. Go to the next question

40. Strategy 2 The information provided is the only information to use
Avoid adding information to the situation
Don’t assume information that is not there
Don’t refer to personal experience

41. Strategy 3 Go with your gut Go with your intuition
It may be a trigger to your memory if it sounds familiar
Or perhaps your subconscious is at work

42. Strategy 4 Identify the step of the nursing process being tested
If an assessment question is asked, answers should involve collection more data
You need to become sensitive to words that indicate the phase of the nursing process being tested

43. Strategy 4: Example continued
For example:
The nurse completes a client’s vitals and notes the following:
RR: 28 per minute
Temperature: 98.6°F
HR: 90
BP: 100/70
Which of these results would be concerning to the nurse?

44. Strategy 4: Options with rationales
Temperature: No, it is in normal range
Respiratory rate: Yes, the client is tachypneic
BP: No, 100/70 could be a normal range for this client
HR: No, 90 is within normal range

45. Strategy 5 Concentrate on the question at hand
Each question demands your undivided attention
Once a question is answered, it’s done…. Forget it!

46. Strategy 6 Every question has the same point value
No question carries more weight on the test than another
If you don’t know an answer, make an educated guess and move forward

47. Strategy 7 Don’t test angry  Avoid personalizing a question
Some topics, such as abortion, abuse or rape trigger personal emotions
Answer according to what you have learned, not according to what you believe

48. Strategy 8 Generally, avoid answers containing qualifying words Always
Never
All
None
Nothing is always, never, or none

49. Strategy 9 Look for answers that are somehow different
If three options give a specific age, but the fourth option generalizes (i.e. adult), the general option is usually the correct one

50. Strategy 10 Look for answers that facilitate something such as:
Client teaching
Assisting the client toward independence
Look for facilitative words:
* Assist * Help
* Aid * Reinforce
* Support * Foster
* Encourage * Nurture
* Facilitate * Endorse

51. Strategy 11 Look for relationships between answers:
Item writers usually write the question first, the right answer next, then the distracters
Usually the correct answer has a connection with the other options
Incorrect answers don’t have a relationship with each of the other answers

52. Strategy 12 Select the answer that is most inclusive
If more than one answer looks to be correct, see if one of the answers contains the other
The more comprehensive an answer is, the more likely it is the correct one

53. Strategy 13
When given the option to medicate or use a non-pharmacologic treatment, select the non-pharmacologic treatment
Alternative methods of treating a problem should be attempted before administering medications

54. Strategy 14
For each option note (quickly - in your head) if it’s a true statement (+), a false statement (-) or a not sure (?)
If there are 2 matching options left, select the more familiar
If there is 1 matching and 1 not sure, pick the matching one
GO WITH YOUR GUT

55. Strategy 15: Practice Practice Practice
Take practice tests – timed at 2 minutes for each question
Goal: 9 of 10 answers correct
Take practice tests – timed at 1.5 minutes for each question
Take practice tests – timed at 1 minute 15 seconds
Take practice tests – timed at 1 minute for each question
Good resource:
for online
Practice Nursing Assessments

56. Practice Practice Practice
Using practice tests in a timed environment helps reduce anxiety when it’s time for the real thing
Practice Practice Practice
We are serious about practicing…

57. References Mott Community College Nursing Department
Mott Community College
Nursing Department
Flint, Michigan
FUENTES, ELIZABETH E., MS, RN, FNP-C, Assistant Clinical Professor Texas Woman's University PowerPoint presentation: Test Taking Strategies
Zerwekh, J. & Claborn, J.C. (2003). Family Nurse Practitioner Certification Review. St. Louis: Saunders.