Transcript TestTakingSkills

Test Taking Skills
Rita Carey-Nita
Avoid asking What If?
Focus on the information in the question
 Do not add information or read into the
question
 Rule out definite incorrect options first
 Then re-read the question and make
choice based on remaining options
 Trust yourself

Example of What If ?
A nurse is changing the tapes on a
tracheostomy tube. The client cough, and the
tube is dislodge. The initial nursing action is
to:
1. Call the physician to reinsert the tube.
2. Ventilate the client using a manual
resuscitation bag and face mask.
3. Cover the tracheostomy site with a sterile
dressing to prevent infection
4. Call the respiratory therapy department to
reinsert the tracheostomy tube.
What If
A nurse is changing the tapes on a
tracheostomy tube. The client cough, and the
tube is dislodge. The initial nursing action is
to:
1. Call the physician to reinsert the tube.
2. Ventilate the client using a manual
resuscitation bag and face mask.
3. Cover the tracheostomy site with a sterile
dressing to prevent infection
4. Call the respiratory therapy department to
reinsert the tracheostomy tube.
Strategic Words
Makes difference with regard to what
question is asking
 Helps to focus your attention on a critical
point to consider when answering the
question
 All options may be correct but one is
priority or most essential

Strategic Words
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
Best
First
Immediately
Initial
Most likely
Least likely
Most appropriate
Least appropriate
Early
Late
Example of Strategic Word ?

A client with a diagnosis of heart failure
reports the occurrence of sudden
shortness of breath and dyspnea. The
nurse takes which immediate action:
1.
2.
3.
4.
Calls the physician
Administers oxygen
Elevates the head of the bed
Prepares to administer furosemide
(Lasix)
Answer for Strategic Word ?

A client with a diagnosis of heart failure
reports the occurrence of sudden
shortness of breath and dyspnea. The
nurse takes which immediate action:
1.
2.
3.
4.
Calls the physician
Administers oxygen
Elevates the head of the bed
Prepares to administer furosemide
(Lasix)
Prioritizing Questions

What is the first priority in regards to
scenario?
◦ Think about the question
◦ Apply nursing knowledge
◦ Apply clinical experience

For listing answers according to priority
you must list what is first then next & so
on…
Prioritizing Strategic Words










Best
Essential
First
Highest priority
Immediate
Initial
Most important
Primary
Vital
Next
Prioritization Question

The nurse is assigned to care for four
clients. When planning client rounds,
which client should the nurse check first ?
1. A client on a ventilator
2. A client in skeletal traction
3. A postoperative client preparing for
discharge
4. A client admitted on the previous shift
who has a diagnosis of gastroenteritis
Prioritization Question

The nurse is assigned to care for four
clients. When planning client rounds,
which client should the nurse check first ?
1. A client on a ventilator
2. A client in skeletal traction
3. A postoperative client preparing for
discharge
4. A client admitted on the previous shift
who has a diagnosis of gastroenteritis
Ingredients of Question

See Box 5.3
Subject of Question
What is the subject or focus of the
question?
 Focus on the subject to help eliminate
incorrect options
 If the option does not fit the subject, you
know to rule it out.

Example of Subject of the Question
The nurse is planning to teach a client in
skeletal leg traction about measures to
increase bed mobility. Which item would
be most helpful for this client?
1. Television
2. Fracture bedpan
3. Overhead trapeze
4. Prepares to administer furosemide
(Lasix)
Subject of Question
The nurse is planning to teach a client in
skeletal leg traction about measures to
increase bed mobility. Which item would
be most helpful for this client?
1. Television
2. Fracture bedpan
3. Overhead trapeze
4. Prepares to administer furosemide
(Lasix)
Positive Versus Negative Query
Pay attention….Is the question asking you
for a positive or a negative answer
 Example of Positive Query

◦ The patient shows an understanding of the
goal of treatment when…..
 Looking for a positive response by patient

Example of Negative Query
◦ The patient requires further patient teaching
when stating….
 Looking for an incorrect response by the patient
Positive Query
The nurse has provided discharge instructions regarding
nitroglycerin therapy to the client with angina. Which
statement by the client indicates an understanding of the
home use of the nitroglycerin?
1.
“If I use the nitroglycerin and the pain does not subside in
15 minutes, I should go to the hospital.”
2.
“When I have pain, I should lie down and place a tablet
under my tongue. If unrelieved in 5 minutes, I should take
another tablet.”
3.
“When I have pain, I should put a tablet under my tongue.
If I have a burning sensation, I should call the doctor
immediately.”
4.
When I experience chest pain, I can continue what I’m
doing. If it doesn’t go away in 10 minutes, I should use a
nitroglycerin tablet.”
Positive Query
The nurse has provided discharge instructions regarding
nitroglycerin therapy to the client with angina. Which
statement by the client indicates an understanding of the
home use of the nitroglycerin?
1.
“If I use the nitroglycerin and the pain does not subside in
15 minutes, I should go to the hospital.”
2.
“When I have pain, I should lie down and place a tablet
under my tongue. If unrelieved in 5 minutes, I should take
another tablet.”
3.
“When I have pain, I should put a tablet under my tongue.
If I have a burning sensation, I should call the doctor
immediately.”
4.
When I experience chest pain, I can continue what I’m
doing. If it doesn’t go away in 10 minutes, I should use a
nitroglycerin tablet.”
Negative Query
A nurse has provided medication instructions
to a client who will be taking warfarin
sodium (Coumadin) indefinitely. Which
statement by the client indicates a need for
further teaching?
1. “I need to use a soft toothbrush.”
2. “I need to use a straight razor for shaving.”
3. “I need to avoid drinking alcohol while
taking this medication.”
4. “I need to carry identification about the
medication being taken.”
Negative Query
A nurse has provided medication instructions
to a client who will be taking warfarin
sodium (Coumadin) indefinitely. Which
statement by the client indicates a need for
further teaching?
1. “I need to use a soft toothbrush.”
2. “I need to use a straight razor for shaving.”
3. “I need to avoid drinking alcohol while
taking this medication.”
4. “I need to carry identification about the
medication being taken.”
Focus on ABC’s

Think ABC’s
1. Airway
2. Breathing
3. Circulation
If you don’t have an airway…you have
nothing
 With physiological questions focus on
first airway, then breathing & move on to
circulation

ABC Question
A client with a compound (open) fracture of the
radius has a cast applied in the emergency
department. The nurse provides home-care
instructions and tells the client to seek medical
attention if which of the following occurs?
1. Numbness and tingling are felt in the fingers
2. The cast feels heavy and damp 24 hours after
application
3. The entire cast feels warm during the first 24
hours after application
4. Bloody drainage is noted is noted on the cast
during the first 6 hours after application.
ABC Question
A client with a compound (open) fracture of the
radius has a cast applied in the emergency
department. The nurse provides home-care
instructions and tells the client to seek medical
attention if which of the following occurs?
1. Numbness and tingling are felt in the fingers
2. The cast feels heavy and damp 24 hours after
application
3. The entire cast feels warm during the first 24
hours after application
4. Bloody drainage is noted is noted on the cast
during the first 6 hours after application.
Maslow’s Hierarchy

Physiological are first priority
1. Airway~Respirations~Heart
Rate~Nutrition~Elimination

Safety & Security
2. Protection from injury~sense of security

Love & Belonging
3. Having support system~not isolated

Self-Esteem
4. control~competence~positive
regard~acceptance~worthiness

Self-Actualization
5. hope~spiritual well-being~enhanced growth
Maslow Hierarchy
A nurse is assigned to care for a client
experiencing difficult labor. When assisting
with planning care, the nurse would consider
the highest priority to be frequent:
1. Position changes and providing comfort
measures
2. Explanations to family members about
what is happening to the client
3. Monitoring for changes in the physical
condition of the mother and fetus
4. Reinforcement of breathing techniques
learned in childbirth preparatory classes
Maslow’s Hierarchy
A nurse is assigned to care for a client
experiencing difficult labor. When assisting
with planning care, the nurse would consider
the highest priority to be frequent:
1. Position changes and providing comfort
measures
2. Explanations to family members about
what is happening to the client
3. Monitoring for changes in the physical
condition of the mother and fetus
4. Reinforcement of breathing techniques
learned in childbirth preparatory classes
Question focusing on the Nursing
Process

Think about the steps of the nursing process
◦
◦
◦
◦
◦
Data Collection (Assess)
Diagnose
Plan
Implement
Evaluate
If it is a question involving the nursing
process determine which step the question
is focused on
 Then choose the option that addresses that
step

Nursing Process

If it is a data collection (AKA: Assessment) step
look for options that have terms such as:
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
Check
Collect
Determine
Find out
Gather
Identify
Monitor
Observe
Obtain information
Recognize
Nursing Process

Planning phase:
◦ The planning of care
◦ Focuses on setting goals
◦ Organizing or managing care

Implementation phase:
◦
◦
◦
◦
◦
The action of providing care
Managing care
Providing care
Communicating
Documenting
Nursing Process

Evaluation phase
◦ Evaluates the success or failure of the plan of
care
◦ Focus on comparing the actual outcome with
the planned or expected outcome
◦ Focus on possible factors the cause
interference of accomplishment of goals
◦ May use a negative query for this type of
question
Nursing Process Question

The nurse develops a plan of care for an older client
with diabetes mellitus. The nurse plans to first:
1. Structure menus for the diet
2. Teach about insulin administration
using videotapes
3. Encourage dependence on others to
prepare the client for this chronic
disease
4. Determine the clients ability to read
label markings on syringes and blood glucose
monitoring equipment
Nursing Process Question:
Assessment

The nurse develops a plan of care for an older
client with diabetes mellitus. The nurse first must:
1. Structure menus for the diet (plan)
2. Teach about insulin administration
using videotapes (implementation)
3. Encourage dependence on others to
prepare the client for this chronic
disease (implementation)
4. Determine the clients ability to read
label markings on syringes and blood
glucose monitoring equipment(assessment)
Client Needs

Remember the importance of safety
measures
◦ Call bell~side rails~bed in low
position~handwashing

Psychosocial Integrity
◦ Questions regarding emotional, mental & social
well-being
◦ Use of therapeutic communication as correct
option
◦ Select options that focus on the feeling of patient,
caregiver, significant others.
Client Needs

Health Promotion
◦ Questions focus on promotion of patient
health or maintenance of health
◦ May focus on normal growth and
development
◦ Early detection or screening for illness
◦ May focus on patients willingness & readiness
to change health habits
◦ These questions are often set up as negative
query
Certain options to watch for

Eliminate comparable or alike options
◦ If only one answer is correct, you know these can
be eliminated narrowing your choices

Eliminate options with close-ended words
◦ Options with the following words are usually
wrong; too extreme
 All~Always~Every~Must~None~Never~Only

Look for umbrella options
◦ This option contains the concepts of the other
options as well
◦ This is usual a correct option
Comparable or Alike Question
A nurse instructs an adolescent with irondeficiency anemia about the
administration of oral iron preparations.
The nurse tell the adolescent that it is
best to take iron with:
1. Cola
2. Soda
3. Ginger ale
4. Tomato juice

Comparable or Alike Question
A nurse instructs an adolescent with irondeficiency anemia about the
administration of oral iron preparations.
The nurse tell the adolescent that it is
best to take iron with:
1. Cola
2. Soda
3. Ginger ale
4. Tomato juice

Delegating


There may be question regarding delegation
Key Principles:
◦ Know your scope of practice as well as the CNA
& RN
◦ Which tasks can be delegated to the CNA?
◦ What are the skill and duties you can perform?
◦ What is strictly the role of the RN?

Keep in mind..Depending on the
setting…you may be the one
delegating or in charge.
Delegating Question
A nurse is planning the client assignment
for the day and most appropriately assigns
which client to the nursing assistant?
1. A client on strict bedrest
2. A client with dyspnea who is receiving
oxygen therapy
3. A client scheduled for transfer to the
hospital for surgery
4. A client with a gastrostomy tube who
requires feedings every 4 hours
Delegation Question
A nurse is planning the client assignment
for the day and most appropriately assigns
which client to the nursing assistant?
1. A client on strict bedrest
2. A client with dyspnea who is receiving
oxygen therapy
3. A client scheduled for transfer to the
hospital for surgery
4. A client with a gastrostomy tube who
requires feedings every 4 hours
Pharmacology Questions



If familiar with medication, use your nursing
knowledge
Will include generic and trade name
Break down the medication
◦
◦
◦
◦
What class is it?
Is there a specific disease process it is used for?
What are some common side-effects?
Think about the common endings to medications
 olol-beta-blocker
Pyramid Points






No antacid with meds
Don’t not crush enteric coated & sustained
release tablets or open capsules
Patients should never adjust doses or
abruptly stop medications
Use caution with over the counter and
herbal supplements
Use caution with alcohol and smoking
Never administer a medication that is
questionable or illegible
Calculations
Calculations
 If there is a question requiring calculations
always recheck your math
 Review and understand your formulas for
dosage calculations or for IV therapy
 Unfortunately this is a point of
memorizing the formula
 Need to know it to apply it
Some key study skills
Be sure not to cram
Find a study method that works best for you
Determine best time for you to study
Know what type of learner you are and utilize
methods that work best for you
 Sometimes study groups are good and sometimes
bad




◦ You need to know material before you can work in
group setting
◦ Choose study partner carefully
◦ Don’t take someone’s word for it
◦ Be sure they know what they are talking about
Wrap Up

Some general principles for test day:
◦
◦
◦
◦
◦
BREATHE
RELAX
Dress comfortable
Give yourself enough time to arrive for test
On the day of a test just have confidence that
you know the material
◦ Trust yourself