DISCLAIMER: THESE WORKSHEETS ARE FOR EDUCATIONAL PURPOSES ONLY AND DOES NOT GUARANTEE

PASSING TESTS, SPECIALTY EXAMS OR NCLEX. USE AT YOUR OWN DISCRETION.

Defining Test Taking Strategies

ü Strategies are here to help you train your critical thinking and learn how to think outside the books. Most importantly it helps you to
ELIMINATE more effectively.

ü You do not use them for every question, therefore you should utilize then in situations when you are down to the last two or you are
stuck and don’t know what to the topic is.

ü Use them for guidelines or tools to boost your content judgment skills.

Identifying exactly what the question is asking. This will help in the eliminating the incorrect answer choices and is very important for nclex.

Process of Eliminating: if one part of the answer choice is incorrect throw out the whole answer choice.

ABCs—Airway, Breathing, and Circulation: When figuring out how to prioritize your answer choices remember airway majority of the
time is first priority, unless you’re using CPR then it is reversed CAB. This is not a definite strategy for every priority question, but a tool the
guide the nursing process. You must use critical thinking to narrow things down and make a judgment call using the expected outcome for
each patient!

Closed-ended Word vs Opened (Definite): Closed ended words such as “always”, “never”, “every”, “none”, “all”, “only”, often mean a definite
or fixed meaning. Eliminate these answer choices using these keywords deeming them incorrect. Open ended words such as “usually”,

“commonly”, “normally”, “generally”, are possible correct options.

When reading comparable alike or answer choices that have to same outcome if one is wrong the other will be too, therefore eliminate them
both. This can be tricky stay alert for keywords to help determine what the question is asking and what can be eliminated. For example:
putting the patient in high fowlers is the same as Tripod or bedside table position, for a patient that maybe needs to lay flat after a

craniotomy. Those two answer choices would be eliminated.

Maslow's Hierarchy of Needs Theory: The saying goes physiological needs are over psychosocial needs. Physiological needs are the priority!
Then safety, and security, but most importantly ABC’s are answers that if not addressed can kill your patient! If there is not an answer
choice addressing ABCs, then Safety becomes #1 Priority. For example: You may have to question a medication OR pick foods to avoid from a
diet for patient teaching purposes. Both these examples require using safety to answer.

Positive and Negative Questions: When there is a “need for further teaching”-eliminate the “the right thing to do” and look for the answer
choices that is “the wrong thing to do”

“Teachings are effective”- eliminate all wrong responses to find the correct answer choice.

Steps of the Nursing Process: Utilize the nursing process when prioritizing. The nursing process helps to prioritize “immediate” and “initial”
first actions. Assessment is the first

step in the nursing process and is carried out before implementation. The Exception to the statement above is an emergency situation may
need to provide a “priority” intervention.
Watch for Key Words: Look for words and phrases that indicate the topic and a change in the topic. Strategic keywords are place for a
reason. Take your time and think about how the keywords fit, especially pediatric patients, the elderly and maternity population.

The exception to the rule would be priority who do you see first questions, age, gender, don’t matter…Time frame does! Pay attention to the
changing signs and symptoms of the topic. This helps you to eliminate unstable patients that are critical but you’re in between two answers.
Please think about the expected outcome of the critical organs at risk.
Therapeutic Communication Techniques: Answer choices that focus on thoughts, feelings, concerns, anxieties, fears, patients’ family or
significant other. Open ended answer choices bring out the BEST information, unless direst suicide is a threat, and then choose a closed
ended answer choice.


Discussing key words in Depth

1. Best response questions require you to use therapeutic communications using open ended questions unless the patient is suicidal then

use direct close ended questions.

2. Most appropriate = therapeutic actions and validate what’s going on. Look for an answer choice that pulls further information from the
patient using therapeutic responses. Also repeating back what a patient has said. For example: Patient c/o medication noncompliance,

what the most appropriate response? Ask the patient to tell the nurse more about the non-compliance.

3. Most concern = you worry about something that is wrong, looking for a complication in your answer choices. For example: Blood around

IV site and oozing from ears indicates DIC (Disseminated Coagulation) which is a complication of shock.

4. What do you do first or next = indicates priority, pick the answer choice that will give further information “assessment” or an action

that will save the patient's life. For example: If you could do one thing for the unconscious diabetic patient and go home what would it be,
push IV dextrose!

DOWN TO THE LAST TWO?

Process of Eliminating = if one part of the answer choice is incorrect throw out the whole answer choice.

6. Most important means = Look for an answer choice that is time sensitive. Some sort of time frame should be addressed. For example:
Buck’s Traction patients should have freely hanging weights at all times or Diabetics need to take Lispro 15 minutes before meals. Dumping
syndrome s/s occurs 30 minutes after meals. If no time frame is available, then go with the next best and SAFEST answer.

7. Best practice = the nurse uses therapeutic appropriate actions

8. Immediate means look for the answer with the killer medical emergency complication related to the subject/topic. Stable vs unstable can
help you eliminate and narrow down to at least 2 answer choices. Next, Use expected vs. unexpected to determine each outcome to the
patient and which one can save or kill the patient if the nurse doesn’t intervene now.


9. Who do you see first you need to use acute vs chronic, unstable or stable, expected or unexpected actual problem or potential problem.

For example, dark red blood from a chest tube is expected, bright red blood is not, nausea and vomiting is expected in a cancer patient,

hypotension is not…these strategies help to eliminate not so obvious patients that may seem critical. Please always think about what is my
expected outcome for this critical patient for every question.

10. What med do you give first pick the lifesaving medication! For example, a pregnant mom with pre-eclampsia should receive Magnesium
before a seizure occurs!

Tackling Select All That Apply

TIP: When applying test taking strategies to SATA...Not all SATA can be broken down with one method. It just depends on what the question is
asking. In order to process of eliminate the WRONG ANSWERS and not leave one behind, or pick an extra one, you must know your content and
pathophysiology. Slow down and ask yourself…

1. TRUE/FALSE-->Do I know this answer choice to not be true? Would I do this as a nurse?

2. PROMOTE/PREVENT---->Does this prevent harm or promote safety or vice versa?

3. EXPECTED /UNEXPECTED -->Is this assessment relevant or is this expected outcome correct for this situation and for this answer choice?

Strategy Practice: Use keywords in the question to help you process of eliminate, and ask yourself does this answer choices I’m choosing make
sense. You must learn to trust your gut for the ones you are unsure of. See Example Below

The nurse is caring for a client diagnosed with an epidural hematoma. Which nursing interventions should the nurse implement? Select All That
Apply

1. Maintain the head of the bed at 60 degrees of elevation. Promotes Intracranial pressure /Eliminate it
2. Administer stool softeners daily. Prevents straining / Keep it
3. Ensure that pulse oximeter reading is higher than 93%. Promotes oxygenation / Keep it
4. Perform deep nasal suction every two hours. Promotes Intracranial pressure /Eliminate it
5. Administer mild sedatives. Prevents agitation / Keep it

LETS BREAK THIS DOWN: “Using promote/prevent”

1. Read each answer choice after reading the question and decide what the answer choice is promoting or preventing.


2. After eliminating the wrong answers you should be left with the remaining correct answer choices.
3. Ask yourself if what you have chosen as correct answers make sense.

Correct Answer is 2, 3, and 5

1. The head of the bed should be elevated no more than 30 degrees to help decrease cerebral edema by gravity.
2. Stool softeners are initiated to prevent the Valsalva maneuver, which increases intra- cranial pressure.
3. Oxygen saturation higher than 93% ensures oxygenation of the brain tissues; decreasing oxygen levels increase
cerebral edema.
4. Noxious stimuli, such as suctioning, increase intracranial pressure and should be avoided.
5. Mild sedatives will reduce the client’s agitation; strong narcotics would not be administered because they decrease
the client’s level of consciousness.


ASSIGNMENTS and DELEGATION

Room Assignments

• Looks for the cleanest patient

• Same infectious diseases can go in the same room together

• Prevent infection (hand hygiene is # 1 priority)

• Promote infection control (remember your precautions)

Float Nurse

• No specialty patients (allergic, anaphylactic reactions…neuro assessments)

• Needs to be oriented to the unit

• Cannot refuse assignments (must refuse in writing)

• Must take patients that are stable with routine care and expected outcomes

• Cannot take a person with Psychosocial/emotional issues (depression, suicidal)

• Chronic Diseases with expected outcomes

LPN

• Stable patients with routine care

• Work is skilled related

• Can assess to collect data for example auscultate abnormal findings “skill related”


• Cannot take new onset, newly admitted, newly diagnosed, initial assessment patients, or patient that require
continues ongoing complicated assessments with judgment calls.

• If the UAP/NAP is listed in the question Lpn cannot do their tasks

• Look for keywords such as administer, recheck, dressing changes, encourage, showing, performing, reviewing skills

RN

• Cannot delegate nursing judgment and initial/new onset characteristics

• Cannot delegate Evaluations, Assessments, or Teaching “EAT”

• Cannot delegate patient with complicated on going assessments

• MUST CONSIDER THE FIVE RIGHTS WHEN DELEGATING A TASK!

UAP/NAP/AP

• Basic skills such as vital signs. Feeding (without dysphagia or aspiration risk)

• ADLS. Finger sticks

• Intake and output. Look for key words such as emptying, recording

• ROM Oral suctioning (noninvasive)

• Bathing retrieving treatments supplies off the unit (blood from blood bank)

TIP: REALIZE THAT NCLEX IS ABOUT LIFE OR DEATH SITUATIONS, GENERAL SAFETY IS #1 PRIORITY REGARDLESS IF

YOU ARE TEACHING SOMEONE OR PERFORMING A TASK. ALWAYS BE SAFE AND MAKE SURE YOUR ASSESSMENTS

MAKE SENSE!


TIP: REMEMBER TO PICK THE BEST ANSWER CHOICE FOR THE SITUATION EVEN IF IT IS NOT WHAT YOU LEARNED IN
NURSING SCHOOL, NCLEX IS ABOUT USING NURSING JUDGMENT IN SITUATIONS THAT AREN’T IDEAL BUT YOU

HAVE EVERYTHING YOU NEED TO COMPLETE YOUR CARE

DISCLAIMER: THESE WORKSHEETS ARE FOR EDUCATIONAL PURPOSES ONLY AND DOES NOT GUARANTEE PASSING

TESTS, SPEICALTY EXAMS OR NCLEX. USE AT YOUR OWN DISCRETION.