1. T.E.S.T. For Success: Tips for Studying for the NCLEX-RN ® Exam Diane M. Billings, RN, EdD, FAAN

2. T.E.S.T. For Success Take time to prepare Evaluate test-taking skills Study with a focus Tame test anxiety

3. Take Time to Prepare Assess your study needs. Assess your test-taking skills. Assess your computer skills. Assess your language skills. Assess your test-anxiety management skills. Develop a study plan. Practice test-taking—real and simulated. Evaluate your success and modify your plan.

4. Evaluate Test-Taking Skills Can you “dissect” a question? Do you know the six types of “NCLEX-RN style” questions? Do you have a “method” for answering questions? Do you know what to do when you do not know the answer to a question?

5. Anatomy of a Test Question Scenario = A client is admitted to the hospital with cholelithiasis. The nurse is assessing the client’s stools. Stem = Which of the following stool colors should the nurse expect this client to have? Options = 1. Green. 2. Gray. 3. Black. 4. Yellow.

6. Types of Test Questions Multiple choice Multiple response Hot spot Chart/Exhibit Fill-in-the-blank Drag and drop/Ordered response

7. Multiple Choice 1 correct answer, 3 incorrect answers Tests ability to recognize one correct response/action Tests ability to set priorities/determine what to do first

8. Multiple Choice: Example A client is admitted to the hospital with cholelithiasis. The nurse is assessing the client’s stools. Which of the following stool colors should the nurse expect this client to have? 1.Green. 2.Gray. 3.Black. 4.Yellow.

9. Multiple Response More than one response can be correct: “Select all that apply.” Tests ability to differentiate, consider/judge clusters of data

10. A client with 20% second- and third-degree burns is admitted to the burn center. The client weighs 60 kg. The nurse has started an I.V. infusion of lactated Ringer’s solution and has inserted an indwelling catheter. Which of the following is an indication that the client’s cardiac output is satisfactory? Select all that apply. 1.Urinary output is 60 ml/hour. 2.Specific gravity is within normal range. 3.Pain is 7 on a pain scale of 1 to 10. 4.Heart rate is elevated. 5.Blood pressure is dropping. 6.The burn has formed eschar. Multiple Response: Example

11. Fill-in-the-Blank One correct numerical answer Dosage calculation, I.V. drip rates, intake and output

12. Fill-in-the Blank: Example A client has had the following to eat and drink in the last 8 hours: 2 8-oz glasses of water 4 oz gelatin dessert 1 bowl (100 ml) oatmeal with 4 oz milk What is the client’s total 8-hour fluid intake in milliliters? _______________ ml

13. Hot Spot Requires student to identify answer on an illustration Tests ability to locate anatomical structures (physical assessment, placement of tubes, injection sites) Tests ability to interpret waveforms (ECG, fetal monitoring) Tests positioning of equipment (seat belts, crutches)

14. Hot Spot: Example A client has had a mitral valve replacement. Identify the best place to listen to heart sounds on this client.

15. Drag and Drop/Ordered Response Requires student to put answer options in a specified order Tests steps of procedure, setting priorities for nursing actions

16. Drag and Drop/Ordered Response: Example Several children who were involved in a school bus accident have been brought to the emergency department. Place the children in the order in which the nurse should assess them, from first to last. 4. A child with an elbow fracture 2. A child with a sprained wrist 3. A child with a suspected simple fracture 1. A child with abrasions

17. Chart/Exhibit Requires student to interpret data on a chart or table NCSBN charts have “tabs,” for example: Prescriptions; H&P; Labs, Miscellaneous; Imaging; Flow sheets, I&O; Med admin record; Progress notes; Vital signs Tests ability to locate and critically synthesize data

18. Chart/Exhibit: Example A 15-year-old is hospitalized with bacterial meningitis. The physician has ordered aspirin 325 mg every 3 to 4 hours for temp over 99° F. At 5:30 p.m., the client’s mother reports that her child is “burning up.” The nurse reviews the client’s vital signs and medication administration records (shown below).

19. Chart/Exhibit: Example (continued) Which of the following actions should the nurse take first? 1.Notify the physician. 2.Give tepid sponge baths. 3.Institute seizure precautions. 4.Administer another dose of aspirin.

20. Approach to Answering Test Questions Read carefully. “Dissect” the question. Understand what the question is asking (age-related care; set priorities; put steps in order; make a decision; teach a client). “Answer” the question before reading the options. Choose your answer (from those provided). Double check your answer. Submit your answer.

21. Approach to Answering Questions When You Do Not Know the Answer! Read the question again. Determine why you do not know the answer (The disease? The lab test? The drug? The expected outcome? The process?). Determine what you do know. Can you make a reasonable guess? If so, answer the question. Will it take more than 5 minutes to figure this out? If, so move on.

22. Study with a Focus Study to learn, not memorize. Study what you do NOT know. Review your class notes and textbooks. Use practice questions to assess progress. Understand your learning style preference.

23. Learning Style Preferences “Environmental” Preferences: * Dark/light * Alone/group * Noise/quiet “Activity” Preferences: * Visual * Auditory * Kinesthetic

24. Tame Test Anxiety Mental rehearsal Relaxation exercises Deep breathing Smile Distraction Concentration Visualization Others? YOUR Favorites?

25. KEY POINTS Take time to prepare Evaluate test-taking skills Study with a focus Tame test-anxiety

26. Best wishes for T.E.S.T Success Diane Billings, EdD, RN, FAAN