Download - Test Taking Skills 2008
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Test Taking StrategiesDena Evans, MPH, BSN, RN
Assistant Professor
Department of Nursing
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Reference
Nugent, B.M., & Vitale, B.A. (2004).Test success: Test-taking
techniques for beginning nursingstudents (4thed.). Philadelphia,PA: F.A. Davis.
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What are your concerns?
Test anxiety
Failure
Drawing a blankAttitude
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The Reality
You were selected to participate inthis program because of your ability
to achieve excellence.
Nursing tests will be unlike any testsyou have ever taken.
Nursing tests require more than justrecall of knowledge. They requirecritical thinking.
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EMPOWERMENT
First step
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Empowerment
Challenge negative thoughts
Used controlled breathing
Desensitize yourself to the fearresponse
Perform muscle relaxation
Over prepare for each test Exercise regularly
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Before and During the Test
Manage your daily routine before the test
Manage your study habits before the test
Manage your travel on the day of the test
Manage the supplies you will need for thetest
Manage your own personal comfort
Manage the test environment Maintain a positive mental attitude
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Components of a MCQ
It is objective
Ithas more than one answer
In nursing, a MCQ can have a goodanswer, a better answer, an evenbetter answer, but you need to pickthe BEST answer.
Only one item is correct.
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Components
The entire question is called anitem
Each item is made up of a stemthat asks the question
Under each stem you will find youroptions.
Since only one option is correct, theother options are referred to as
distractors.
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Sample
What should the nurse doimmediately before performing anyprocedure?
a) Shut the door
b) Wash the hands
c) Close the curtain
d) Drape the patient
OptionsCorrect Item
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Sample 2You try
When providing care to a patient witha nasogastric tube, the nurserecognizes that the tube goes intothe:
a) Stomach
b) Bronchi
c) Trachea
d) Duodenum
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Stem Polarity
Can be positive or negative
A stem with a positive polarity will ask
you to pick out the option that is true.A stem with a negative polarity will
ask you to pick out the option that isnot true.
By understanding the polarity of thequestion, you can eliminate wronganswers.
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Positive Polarity
This question is concerned with thetruth, a fact, a principle.
This question attempts to determineif you are able to understand, apply
or differentiate correct information.
Example
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Positive Polarity Stem
Which intervention most accuratelysupports the concept of informedconsent?
a) Obtaining the patients signature
b) Explaining what is being done and why
c) Involving the family in the teaching
pland) Teaching preoperative deep breathing
and coughing
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Negative Polarity
Concerned with what is false.
Asks a question with a negative statement.
Typically uses words like except, not,or never.
May use other words like contraindicated,unacceptable, least, or avoid.
Requires that you recognize exceptions tothe rule.
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Negative Polarity Stem
On what part of the body should thenurse avoid using soap when patienta patient?
a) Eyes
b) Back
c) Under the breasts
d) Glans of the penis
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You pickIs this positive ornegative?
Range of motion (ROM) exercisesshould NOT be done:
a) F
or comatose patientsb) On limbs that are paralyzed
c) Beyond the point of resistance
d) For patients with chronic joint diseases
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Positive or Negative
What position would becontraindicated for the patient whohas dyspnea:
a) Supine
b) Contour
c) Fowlers
d) Orthopaedic
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One More
An older adult who is dying starts tocry and says, I was alwaysconcerned about myself first and Ihurt so many people during my life.What is the underlying feeling beingexpressed by the patient?
a) Ambivalenceb) Sadness
c) Anger
d) Guilt
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THE OPTIONS
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A, B, C, D and sometimes E
Only one option in a MCQ is correct
The typical number is 4-5 which
reduces the likeli
hood of guessing.
An option can be a sentence, it cancomplete the sentence started withthe stem, it can be an incompletesentence or it can be a single word.
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The Sentence Option
Before performing a procedure, whatshould the nurse do first:
a) Raise the patients bed to ithighestposition
b) Collect the equipment for theprocedure
c) Position the client for the procedured) Explain the procedure to the client
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The complete the sentenceoption.
The primary etiology of obesity is a:
a) Lack of balance in the variety ofnutrients
b) Glandular disorder that preventsweight loss
c) Caloric intake that exceeds metabolic
needsd) Psychologic problem that causes
overeating
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The incomplete sentence option (missingparts of speech subject and verb)
Which intervention is common whencaring for all patients with infections?
a) Donning a mask
b) Wearing a gown
c) Washing the hands
d) Keeping visitors out
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The one word wonder
Which word best describes feelingsassociated with a child in Ericksonsstage of autonomy versus shame anddoubt?
a) Hers
b) Mine
c) Theirs
d) Nobodys
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THE NURSING PROCESS
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Your blueprint for success
Five steps:
1. Assessment
2.
Diagnosis3. Planning
4. Implementation
5. Evaluation
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Test Questions
Are written to test your knowledge ofa specific concept, skill or theory fromthe perspective of the nursingprocess.
The nursing process is your blueprintfor critical thinking!
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ASSESSMENT
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First Step-Assessment
Collecting data
Physical examination, interviewing,
reviewing
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Sample--Assessment
While making rounds, the nurse findsa patient on the floor in the hall.What should be the nurses initialresponse?
a) Inspect the patient for injury
b) Transfer the patient back to bed
c) Move the patient to the closest chair
d) Report the incident to the nursingsupervisor
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DIAGNOSIS
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Second StepAnalysis/Diagnosis
Validate how your data are related
Cluster data
Interpret data Identify the need for additional data
Identify nursing diagnoses
Communicate the diagnoses to others Maslows hierarchy and GordonsFunctional Health Pattersuseful
here.
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Sample--Diagnosis
A patienthad a stroke that resulted in paralysis ofthe right side. When clustering data the nursegrouped the following data together: drooling ofsaliva and slurred speech. Which informationwould be the most significant to include with thisclustered data?
a) Excessive aphasia
b) Difficulty swallowing
c) Inability to perform ADLs
d) Incontinence of urine and stool
Remember your ABCs
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SampleDiagnosisInterpret Data
A patienthas a loss of appetite, hasdifficulty falling asleep, andhas lostinterest in activities of daily living.Which feeling reflects theseadaptations?
a) Anger
b) Denialc) Depression
d) Acceptance
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PLANNING
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Third Step--Planning
Involve the patient
Set goals
Establish outcomes Establish priorities
Plan appropriate interventions
Anticipate patient needs Recognize the need to collaborate
Coordinate care with other disciplines
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Critical words to look for
Achieve, desired, plan,effective, goal, priority,develop, formulate, establish,collaborate, determine.
All of these indicate that yourquestion is a planning question.
You mess up on a planning questionwhen you select options that:
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Dont mess up the plan!
Dont include the patient
Contain inappropriate goals
Misidentify priorities Reflect goals that are unrealistic or
unmeasurable
Fail to include family members orsignificant others
Fail to coordinate and collaboratewith other health team members
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SamplePlanning QuestionID Goals
The nurse is caring for a patient witha new temporary colostomy. Whichwould be a realistic short-term goalfor this patient?a) The patients bowel will function within 2 days
b) The patient will have regular bowel elimination
c) The patient will be at risk for impaired skin integrity
d) The patients skin will remain intact around the stoma
Patient centered, specific (measurable), realistic and
achievable within the time frame.
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SamplePlanning QuestionSet Priorities
A patienthas just returned fromsurgery with an IV and does nothavea gag reflex. Which plannedintervention takes priority:
a) Ensure adequacy of air exchange
b) Observe the dressing for drainage
c) Check for infiltrationd) Monitor vital signs
Remember your ABCs.
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IMPLEMENTATION
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Fourth Step--Implementation
Recognize steps in the process
Implement a procedure or treatment
Identify or respond to life-threatening or adverse
effects Prepare a patient for procedure, treatment,
surgery
Identify or use concepts associated with teaching,motivation, communication.
Recognize the relationship between a procedureand an expected outcome.
Recognize when to document or report patientcare and responses
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Critical words to look for
dependent, independent,interdependent, change, assist,counsel, teach, give,supervise, procedure,treatment, reassess, facilitate,delegate, implement.
All indicate an implementationquestion
You mess up when you select an
option that..
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Dont mess up!
Implements actions outside of your scope of practice
Fails to identify or respond to life-threatening situations
Fails to reassess the patient
Fails to modify interventions based on changing patient
needs Fails to identify that you need additional assistance to
provide safe care
Reflects a lack of knowledge to safely implementinterventions
Fails to document accurately the patients response Delegate inappropriately
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Sample--Implementation
The primary nurse assigns a staffnurse to insert an indwelling urinary(Foley) catheter. What is the firstthing that the staff nurse should do?
a) Explain the procedure to the patient
b) Gather all equipment at the bedside
c) Check the physicians orderd) Washhands thoroughly
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Sample --Implementation
A patienthas an order for a 2-gramsodium diet. What should the nurseteach this patient to avoid?
a) Salt
b) Sugar
c) Liquids
d) Margarine
Teaching = implementation
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Sample--Intervention
What is the underlying rationale forturning a patient every 2 hours?
a) To relieve pressure
b) To assess skin condition
c) To ensure the skin is clean and dry
d) To provide massage to bony
prominences
Implementing safe effective care
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LAST BUT NOT LEAST--EVALUATION
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Evaluation
Identify steps in the evaluation process
Identify actual outcomes as desired or undesired
Identify whether an outcome has been met or not
Identify progress or lack of progress towards anoutcome or a goal
Recognize that the process of evaluation iscontinuous
Recognize that t
he nursing process is dynamic andcyclical.
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Critical Words
expected, met, desired,compared, succeeded, failed,achieved, modified, reassess,ineffective, effective,compliance, noncompliance.
All indicate an evaluation question
You mess up when options areselected that:
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Dont mess up!
Do not thoroughly and accurately reassessthe patient after care is given.
Fail to appropriately cluster new data
(what step is this from?) Fail to determine the significance of new
data
Come to inappropriate or inaccurateconclusions
Fail to modify the plan of care based onchanging patient needs or circumstances.
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Sample --Evaluation
A patient on a bland diet complains abouta poor appetite. What would be the MOSTeffective way to determine whether the
patients nutritional needs have been met?a) Institute a 3-day food intake study
b) Weigh the patient at the end of theweek
c) Request an order for a dietaryassessment
d) Compare a current weight with the
weighthistory
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Sample -- Evaluation
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A FEW HINTS
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Before you answer
Break it down
Rephrase in your own words
Read each option carefully (it maycontain some correct information butnot all.
Identify polarity
Identify key words in the stem thatset a priority (rank)
Identify clues in the stem
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More
Identify patient-centered options
Identify determiners (always, never,)they limit your options
Identify opposites in optionsone willbe the correct answer or you caneliminate both
Look for equally plausible or uniqueoptions
Identify the global option
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More
Identify duplicate facts among theoptions
Identify options that deny patientfeelings, concerns or needs (theseare wrong).
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A few final thoughts
Arrive on time for your tests
Bring the right tools
Understand all of the directions before you
begin
Manage your time wisely
*Avoid reading into the question
Make educated guesses Maintain a positive mental attitude
Check your answers and answer sheet