BECOME TEST – WISE Mastering

Computer-based Standardized Nursing Tests

Texas State University St. David’s School of Nursing

Acknowledgements

• Liz Fuentes, MS, RN, FNP-CAssistant Clinical Professor, Texas Women’s University

• School of Nursing, Mott Community College, Flint, MI

Table of Contents Mastering

Computer-based Standardized Nursing Tests

Slides• Solid Learning Strategies 4-6• General Test Taking Skills 7-9• How to Read and Interpret a Test Question 10

– Parts of a Question 11-16– Practicing What We Just L earned 17-20– Mathematical Computations 21– Options 22-26– Types of Test Errors 27-33– Eliminating Incorrect Options 34-37– 15 Test Taking Strategies 38-56– References 57

Learning Strategies: Your Guide to Classroom and Test-Taking Success

• With the above workbook that you received at New Student Orientation and

• Learning Strategies Inventories worksheets posted on thewebsite

• Complete Self-Assessment Inventories – One chapter at a time

You must have solid learning strategies to master standardized nursing tests

You are to fine tune and strengthen these learning strategies:

• Getting the most from lectures– Preparing for class– Taking notes

• Everyday learning– Studying– Reading strategies– Tips for remembering facts

• Preparing for – Classroom assessments– Standardized nursing assessments

When studying – what works best for you?

• Don’t change your mode of success– If study groups work for you – continue– If studying alone works – continue– If creating a quiet study space works – continue– If noise keeps you alert – go for it– If changing your study space every couple of hours works - continue

• Assess your attitude toward test-taking– Be positive; it makes a difference– Be steadfast – determined

Checkout this New York Times (9-7-2010) article:Forget What You Know About Good Study Habitshttp://www.nytimes.com/2010/09/07/health/views/07mind.html?_r=1&scp=2&sq=Forget+What+you+know+about+good+study+habits&st=nyt

General Test-taking STRATEGIES

• Avoid changing answers• Be systematic• Work at a steady pace• Stay focused• Breathe• Look for logic

THE TIME OF THE TEST ARRIVES….

• Get sleep• Eat what is kind on your digestive system at a time

that works well for you • Wear comfortable clothing and a watch

– Or try wearing a “Sunday” outfit • Bring a pencil or pen• Goal: Be physically and mentally alert at an intensity

that feels right to you

FORECAST POSITIVE RESULTS• “I am in control of my

attitudes and my attitudes are positive. I can do well on this exam.”

and• I am steadfast –

determined.

Standardized Nursing Tests:How to Read and Interpret a Test Question

Parts of an Assessment Question

• Situation/scenario: Statement giving information about a clinical problem

• Stem: Specifically asks you something

• Options: Choices to answer the stem

The Situation/Scenario

• Sets the stage for the question• Usually describes a client, family member

or significant other with a particular problem or set of problems

• Contains some pertinent information

What is the Question Stem?• Central focus of the item• Presented as a question or incomplete item

– Look for key words such as:• Most correct• Most likely• Do first• Initial• Highest priority

• May require information from the situation in order to answer

Stem Types • True response stem – asks for a true

statement (commonly used)

• False response stem – asks for the incorrect answer (not commonly used)

Options: Choices to answer the stem

• One option is the most correct answer• The other options are called distracters

– May be four options of similar length– May be two short and two long answers– May be similar in length and designed as the correct answer– Must be plausible, but not correct– If an option contains both correct and incorrect information – it is a distracter

Negative Options – not common but you need to be familiar with them• Changes direction of the question• Looks for the WRONG answer

• The correct option answers what the stem of the question is asking you, so make sure to re-read the stem (central focus of a question) after you’ve chosen your answer

Options: Choices to answer the stem

Tips• Separate what the question is telling from what it is

asking– Scenario vs. stem (usually asks for true statement)

• Always identify the client, issue, key words• Eliminate options offering new information• Given: The nurse is always therapeutic and time is

available

Let’s practice what we just learned plus learn a

few strategies

Sample Nursing Test Question

The nurse is preparing a medication for a client and observes the date of expiration occurred two months ago. Which action should the nurse perform?

Sample Nursing Test Question

• Situation/Scenario• Question Stem

The nurse is preparing a medication for a client and observes the date of expiration occurred two months ago. Which action should the nurse perform?

Options to the Nursing Test Question

A. Give the medicationB. Discard the medicationC. Omit the medicationD. Return the medication to the pharmacy Rationale: Laws require all medication to have

an expiration date. Outdated medication should be returned to pharmacy for proper disposal.

Mathematical Computations

• Be mindful of mathematical questions which will be included in an exam:• The nurse is to administer an antibiotic to a child who

weighs 22 lbs. The dosing is 30-50 mg/kg/day.• First you would need to convert lbs to kgs: 2.2lb=1kg so this child

weighs 10 kgs.• Then multiply 10 kg by 40 mg (right in the middle of the

recommended dose) = 400mg/day.• Amoxicillin comes in 125 and 250mg/5cc (1 teaspoon).• Antibiotic dosing should be divided throughout the day. Divide the

total dose per day (400mg) by 3 doses throughout the day = 133mg.• The child can receive 125mg or 5cc three times daily.

Option Position Myths

• No one position is favored; A vs. B vs. C vs. D• When in doubt – select C is a myth that item writers know about…• Don’t look for shapes, letters, sequences, or

patterns in answers

Example: – “I have too many C answers”– There is no pattern to answers

One Last Option Myth

• The longest answer contains the most information but don’t assume the information in the longest answer is correct

Umbrella Option

• Contains other options within it

• Present when there is more than one right answer found

Priority Option• ABC’s

• Airway• Breathing• Circulation• Safety

• Maslow• Patient first• Safe Care

Don’t “Read Into” Options

• Take question at face value

• If it walks like a duck….

Types of Testing Errors

First Error Type

• Misperceiving Information–Words are read incorrectly–Information is overlooked

• See next slide for an example

Read These Options

BIRD IN THE

THE HAND

ONCE IN A

A LIFETIME

PARIS IN THE

THE SPRING

What did you see?

• Did you see “Paris in the Spring”, “Once in a Lifetime” and “Bird in the Hand?”

• Look again at the next slide

Each option has repeated words

BIRD IN THE

THE HAND

ONCE IN A

A LIFETIME

PARIS IN THE

THE SPRING

Second Error Type

• Misprocessing information– Not recognizing a key word

– Example • Dysphagia may be misread as dysplasia

– Focusing on the wrong key word in a distracter

Third Error Type

• Misapplying the response– Results when knowledge cannot be applied

to the question– Graduates have a great deal of knowledge,

but may have difficulty narrowing it to a particular answer

Eliminating IncorrectOptions

Absolutes 101

• Anti-hypertensives always make you dizzy• Patients should never self-medicate

• Doubtless the nurse is correct

• The patient was completely satisfied with treatment

Qualifiers

• The medication is probably the cause of the problem

• Patients usually walk after surgery

• Aspirin is the best medication

• No one ever documents that way

There is no penalty for guessing but you don’t want to “have to” guess too frequently

Test-taking Strategies

• The following are 15 strategies for mastering computer-based standardized nursing tests

• We have included so many because different types test questions require different strategies to answer the question stem correctly

• Your assignment is to practice these strategies to determine which ones work best for you

Strategy 1• Read the client description and question carefully

– Take time to read each word in the situation– Read the question stem – be sure you understand what it

is asking– Form an answer in your mind, then select the option

closest to your answer– The correct answer answers what the stem of the question

is asking you, so make sure to re-read the stem (central focus of a question) after you’ve chosen your answer

– Once a question is answered, it’s done…. Go to the next question

Strategy 2

• The information provided is the only information to use– Avoid adding information to the situation– Don’t assume information that is not there– Don’t refer to personal experience

Strategy 3

• Go with your gut• Go with your intuition • It may be a trigger to your memory if it

sounds familiar• Or perhaps your subconscious is at work

Strategy 4• Identify the step of the nursing process being tested

– If an assessment question is asked, answers should involve collection more data

– You need to become sensitive to words that indicate the phase of the nursing process being tested

Strategy 4: Example continued For example: The nurse completes a client’s vitals and notes the following:• RR: 28 per minute• Temperature: 98.6°F• HR: 90 • BP: 100/70 Which of these results would be concerning to the nurse?

Strategy 4: Options with rationales

A.Temperature: No, it is in normal range

B. Respiratory rate: Yes, the client is tachypneic

C. BP: No, 100/70 could be a normal range for this client

D.HR: No, 90 is within normal range

Strategy 5

• Concentrate on the question at hand

– Each question demands your undivided attention

– Once a question is answered, it’s done…. Forget it!

Strategy 6

• Every question has the same point value

– No question carries more weight on the test than another

– If you don’t know an answer, make an educated guess and move forward

Strategy 7

• Don’t test angry

– Avoid personalizing a question

– Some topics, such as abortion, abuse or rape trigger personal emotions

– Answer according to what you have learned, not according to what you believe

Strategy 8

• Generally, avoid answers containing qualifying words– Always– Never– All– None

• Nothing is always, never, or none

Strategy 9

• Look for answers that are somehow different

– If three options give a specific age, but the fourth option generalizes (i.e. adult), the general option is usually the correct one

Strategy 10• Look for answers that facilitate something such as:

– Client teaching– Assisting the client toward independence– Look for facilitative words:

* Assist * Help* Aid * Reinforce

* Support * Foster

* Encourage * Nurture* Facilitate * Endorse

Strategy 11• Look for relationships between answers:

– Item writers usually write the question first, the right answer next, then the distracters

– Usually the correct answer has a connection with the other options

– Incorrect answers don’t have a relationship with each of the other answers

Strategy 12

• Select the answer that is most inclusive

– If more than one answer looks to be correct, see if one of the answers contains the other

– The more comprehensive an answer is, the more likely it is the correct one

Strategy 13

• When given the option to medicate or use a non-pharmacologic treatment, select the non-pharmacologic treatment

– Alternative methods of treating a problem should be attempted before administering medications

Strategy 14

• For each option note (quickly - in your head) if it’s a true statement (+), a false statement (-) or a not sure (?)

• If there are 2 matching options left, select the more familiar

• If there is 1 matching and 1 not sure, pick the matching one

• GO WITH YOUR GUT

Strategy 15: Practice Practice Practice

• Take practice tests – timed at 2 minutes for each question– Goal: 9 of 10 answers correct

• Take practice tests – timed at 1.5 minutes for each question– Goal: 9 of 10 answers correct

• Take practice tests – timed at 1 minute 15 seconds– Goal: 9 of 10 answers correct

• Take practice tests – timed at 1 minute for each question– Goal: 9 of 10 answers correct

Good resource: http://www.atitesting.com/Solutions/PreNursingSchool/TEAS.aspx for online

Practice Nursing Assessments

Practice Practice Practice

• Using practice tests in a timed environment helps reduce anxiety when it’s time for the real thing

• Practice Practice Practice • We are serious about practicing…

References

• www.mccc.edu/~martinl/…SP10NRS101LectureSession6TestSuccess.pptMott Community CollegeNursing DepartmentFlint, Michigan 48503

• FUENTES, ELIZABETH E., MS, RN, FNP-C, Assistant Clinical ProfessorTexas Woman's UniversityPowerPoint presentation: Test Taking Strategies

• Zerwekh, J. & Claborn, J.C. (2003). Family Nurse Practitioner Certification Review. St. Louis: Saunders.