test taking skills 2008

8/8/2019 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

test taking skills 2008

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