The question contains several parts:
o the case (sometimes called scenario) - the description of the client and what is happening to him/her
o the stem - the part of the question that asks the question
o the correct responseo distracters - incorrect but feasible choices
Key Words The most important skill for the test taker is the ability to read the question carefully and determine the key elements in each question. Each question has key words. Key words relate to the client; to the problem; and to specific aspects of the problem.
Client Factors such as age, sex, and marital status may be relevant. When a child's age is given it often is very relevant to the answer. Vital signs vary with age. Preoperative teaching methods vary with age. Appropriate toys and diversional activities vary with age. Always pay special attention to the age of a client when it is given. Also consider who is the client for this question. That is, who is the focus of the question. The client may be the identified sick person, or it might be a relative of the identified sick person, or even a staff member.
Problem/Behavior The problem may be a disease, a symptom or a behavior.
Details of the Problemo Is the question asking for nursing actions or client symptoms or family responses?
o Does the question ask about a specific aspect of nursing care assessment, planning, implementation, evaluation?
o Does the question ask details relevant to a specific symptom or behavior the client exhibits?
o Is there additional information about the client or the problem that is important?
Priority Setting
o "What action takes priority?"
o "What should the nurse do first?"
o "What should the nurse do initially?"
o "What is essential for the nurse to do?"
Physiologic needs are first, followed by safety needs, then love and belonging, self-esteem and self-actualization.
The first step of the nursing process is assessment! When the stem of a question asks for the initial nursing action always look to see if there is a relevant assessment answer. The nurse will take an action only when there is enough data to act. Call the physician only when there is not a nursing action that should be taken first. The stem of the question may ask for a nursing action and the correct answer may be to assess.
When the stem of the question asks what is essential for the nurse to do, think safety. Remember many of the test questions are safety questions.
What is the Time Frame? Whenever a specific time frame is indicated in a question it is very important. Pay attention to it. Time related words may be like early or late in relation in symptoms, pre operative or post operative, care on the day of surgery or later postoperative care.
Repeated Words Words from the question are repeated in the answer. Frequently the same word or a synonym will be in both the question and the answer.
Opposites When two answers are opposite such as high blood pressure and low blood pressure or increase the drip rate and stop the IV, or turn on the right side and turn on the left side, the answer is usually one of the two.
Same Answer If two or three answers say the same thing in different words none can be correct. If the answers are too alike, then neither one is correct.
Odd Answer Wins The answer that is different from the others is apt to be the correct answer. It may be the longest or the shortest or simply very different in content or style.
Umbrella Answer / Global Response One answer includes the others. There may be more than one correct answer. One answer is better than all the others because it includes them.
Test Item Check List
Use this handy list to check yourself every time you answer a test question.
Say to yourself, DID I CAREFULLY...
o Read the stem?o Read all of the options?o Read the stem again?
o Look for key words?
o Eliminate obviously incorrect options?
Absolutes
Answers containing universal or absolute words are very apt to be incorrect. Very little in life or nursing is always correct or incorrect. Answers stated in absolute terms should be looked at with great caution.
Deadly (AVOID ANSWERING ANSWERS THAT CONTAINS THE WORDS BELOW)
all
every
total
nothing
always
each
only
any
nobody
never
none
Dangerous
main
chief
avoid
primarily
major
shall
inevitable
eliminate
rarely
impossible
too
Safe
usually
almost
frequently
probably
potentially
may
sometimes
partial
some
might
should
few
essentially
generally
occasionally
nearly
maybe
could
commonly
average
seldom
often
normally
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