Transcript CRUISING THROUGH EXAMS AND DEALING WITH TEST ANXIETY

CRUISING
THROUGH EXAMS
AND
DEALING WITH TEST ANXIETY
Linda Anne Silvestri MSN, RN
Nursing Instructor: Salve Regina University
Author:
Saunders Pyramid to Success for the NCLEX® Exam:
Elsevier Health Sciences
President:
Nursing Reviews, Inc. &
Professional Nursing Seminars, Inc.
PART 1
BEFORE
THE
EXAM
TEST PREPARATION
DON’T MAKE EXAM-TAKING
HARD ON YOURSELF!
PREPARATION IS THE KEY!
HOW TO NAVIGATE
THROUGH
TEST PREPARATION:
SIX TOOLS
TEST PREP TOOL 1
CLASS ATTENDANCE
•Attend all classes
•Actively participate
•Take notes
•Ask questions
•Review
TEST PREP TOOL 2
READ ASSIGNED READINGS
•Read before class
•Take notes
•Make a list of questions
and unclear material
•Ask questions
TEST PREP TOOL 3
REVIEW CLASS NOTES DAILY
Frequent, short study
periods and review
sessions will help you
retain information and
prevent the need to
cram.
TEST PREP TOOL 4
FIND YOUR SPECIAL STUDY
PLACE
It should be comfortable,
quiet, free of distractions,
and suitable for you!
TEST PREP TOOL 5
STUDY GROUPS
Be sure that
study groups are
helpful to you!
TEST PREP TOOL 6
FLASH CARDS
Can include that “difficult to
remember” information
Are convenient, portable, and
can be used to study anywhere
Are helpful for studying alone or
with a group
PART 2
DURING THE EXAM:
TWO TOOLS
TOOL 1
USE BREATHING EXERCISES
Breathe in through
the nose and breathe
out slowly through
the mouth
TOOL 2
IDENTIFY THE INGREDIENTS
OF A
QUESTION
WHY INGREDIENTS OF A
QUESTION ARE IMPORTANT?
HELPS AVOID READING INTO A
QUESTION
INGREDIENTS OF A QUESTION
Include:
 Client or Clinical Event
 Question Query
 Options
CLIENT OR CLINICAL EVENT
 Provides
information
about a client or
event
 Provides the
information you
need in answering
the question
CLIENT OR CLINICAL EVENT
EXAMPLE:
A client’s abdominal dressing becomes
wet while giving a bed bath.

THE CLIENT OR CLINICAL EVENT TELLS
YOU ABOUT THE PROBLEM
QUESTION QUERY
 Usually
comes after the client
or clinical event and asks you
something about it
 Read carefully and identify
exactly what the question is
asking
QUESTION QUERY
A client’s abdominal dressing becomes
wet while giving a bed bath.
QUERY:
The nurse should:

THE QUERY ASKS YOU WHAT THE
NURSE SHOULD DO
OPTIONS

There are four options
in multiple choice
questions

There are more than
four options in a
multiple response
question
EVENT, QUERY, AND OPTIONS
EVENT: A client’s abdominal dressing
becomes wet while giving a bed bath.
QUERY: The nurse should:
OPTIONS:
1. Call the physician
2. Change the dressing
3. Let the dressing air dry
4. Leave the dressing alone
Answer: 2
STRATEGIES
AND
SAILING
THROUGH THE
EXAM:
TWO TOOLS
TOOL 1:
HOW TO
AVOID READING
INTO QUESTIONS
HOW TO AVOID READING INTO
QUESTIONS





Read every word in the client or
clinical event, question query, and
options
Visualize the client or clinical
event and think about what the
nurse should do
Think about what the question is
asking
Look for strategic words
Avoid the “What If?” syndrome
HOW TO AVOID READING INTO
QUESTIONS



Think about the answer
to the question before
reading the options
Use the process of
elimination when reading
the options
Then, reread the event
and query before
selecting the answer
TOOL 2:
ELIMINATING
INCORRECT
OPTIONS
ELIMINATING INCORRECT
OPTIONS



Read every option and eliminate
incorrect options
When you have eliminated 2 options,
reread the client or clinical event and
determine what the question is asking
Then, read the remaining options again
TOP
TEN
TEST-TAKING
STRATEGIES
1. STRATEGIC WORDS
and
PRIORITIZING



Important words or phrases in a
question
Focus your attention to crucial
ideas in the client or clinical
event, query, and in the options
Certain strategic words will
indicate the need to prioritize
1. BE ON THE “LOOKOUT” FOR
STRATEGIC WORDS






Early or Late
Immediately, initial, first
Most Likely or Least
Likely
Most Appropriate
On The Day Of
After Several Days
1. STRATEGIC WORDS
EXAMPLE:
A nurse is monitoring a postoperative client
for signs of infection. Which of the
following is an early sign of infection?
1. A low blood pressure
2. A low respiratory rate
3. An elevated temperature
4. Separation of the incisional
wound edges and a pus-like drainage
Answer: 3
2. USE THE ABC’S
AIRWAY
 BREATHING
 CIRCULATION

2. USE THE ABC’S
EXAMPLE:
A nurse is caring for a client with
pneumonia who suddenly
experiences respiratory difficulty.
The nurse should first:
1. Call the physician
2. Document the client’s problem
3. Check the client’s oxygen level by
pulse oximetry
4. Cover the client with a blanket and
check the client’s temperature
Answer: 3
2. USE THE ABC’S
EXAMPLE:
A nurse is assigned to care for four clients. In
planning client rounds, which client should
the nurse assess first?
1. A client scheduled for a chest x-ray
2. A client requiring daily dressing changes
3. A postoperative client preparing for
discharge
4. A client receiving oxygen via nasal cannula
who had difficulty breathing during the
previous shift
Answer: 4
3. THE SUBJECT OF THE QUESTION





A disease, treatment, diagnostic
test
A complication or effect of a
treatment
A specific nursing action
An action of a medication
A side effect, intended effect, or
adverse or toxic effect of a
medication
3. THE SUBJECT OF THE QUESTION
EXAMPLE:
The nurse administers morphine sulfate to a
postoperative client. The nurse monitors for
which intended effect of the medication?
1. Sleepiness
2. Decreased pain
3. Increased alertness
4. Lowered blood pressure
Answer: 2
4. NEGATIVE EVENT QUERIES


Be on the “Lookout” for questions
that contain negative event queries
These questions use strategic words
that ask you to select an option that
is an incorrect item or statement
 Avoid
 Unsafe
 Incorrect
 Least likely
 Lowest priority
 Need for further instructions
4. NEGATIVE EVENT QUERY
EXAMPLE:
The nurse teaches a client with
heart disease about the foods
that are high in cholesterol. The
nurse determines that the client
needs further instructions if the
client states that which food item
is acceptable to consume?
1. Broccoli
2. Cantaloupe
3. Broiled steak
4. Baked chicken
Answer: 3
5. CLOSE-ENDED WORDS
Options that contain close-ended
words are usually incorrect
All
None
Must
Only
Every
Never
Always
5. CLOSE-ENDED WORDS
EXAMPLE:
The family of a client with Parkinson’s disease tells the nurse that
the client is having difficulty adjusting to the disorder and
that they do not know what to do to help. The nurse
suggests which therapeutic measure to assist the client to
cope with the disease?
1.
2.
3.
4.
Plan only a few activities for the client during the day
Assist the client with all activities of daily living (ADLs)
Cluster all activities at the end of the day when the client is
restless and bored
Encourage and praise client efforts to exercise and
perform activities of daily living (ADLs)
Answer: 4
6. COMPARABLE OR ALIKE OPTIONS


Be on the “Lookout” for
comparable or alike options
If two options include a
similar concept or nursing
action, then NEITHER OF
THESE OPTIONS can be the
answer
6. COMPARABLE OR ALIKE
OPTIONS
EXAMPLE:
A client’s abdominal dressing becomes
wet while giving a bed bath. The nurse
should:
1. Call the physician
2. Change the dressing
3. Let the dressing air dry
4. Leave the dressing alone
Answer: 2
7. THE UMBRELLA OPTION
A broad or universal
statement and may
include the ideas of
other options within it
7. THE UMBRELLA OPTION
EXAMPLE:
The nurse teaches a client taking
colestipol hydrochloride (Colestid)
about the need to take which of the
following to counteract unintended
medication effects?
1. Vitamin C
2. Vitamin B
3. B-complex vitamins
4. Fat-soluble vitamins
Answer: 4
8. THE NURSING PROCESS
Assessment
 Analysis
 Planning
 Implementation
 Evaluation

8. THE NURSING PROCESS
ASSESSMENT is the first step
 When you are asked a question
regarding your immediate, initial, or
first nursing action, select the
option that addresses an
assessment action
 If an assessment action is not
addressed in one of the options,
follow the steps of the nursing
process
EXCEPTION: Emergency Situation –
the nurse may need to implement
an action

8. THE NURSING PROCESS
EXAMPLE:
A nurse enters a client’s room and finds
the client slumped down in the chair.
Breathing is shallow and a pulse is
present. Based on this data, the nurse
determines that the priority should be
to:
1. Call the doctor immediately
2. Have the unit clerk call a Code Blue
3. Ask the unit clerk to call the family
immediately
4. Check the blood pressure and level of
consciousness
Answer: 4
9. MASLOW’S HIERARCHY OF NEEDS THEORY




Use MASLOW'S HIERARCHY OF
NEEDS THEORY to prioritize
Physiological needs come FIRST
and select an option that
addresses a physiological need
When a physiological need is not
addressed in the question or
options, think about the hierarchy;
safety needs receive priority next
Remember, address
physiological needs first!
9. MASLOW’S HIERARCHY OF NEEDS
THEORY
EXAMPLE:
The nurse is developing a plan of
care for a client with sickle cell
anemia. Which nursing diagnosis
if stated on the plan of care would
the nurse select as receiving the
highest priority?
1. Anxiety
2. Ineffective coping
3. Deficient fluid volume
4. Disturbed body image
Answer: 3
10. FOCUS ON CLIENT’S FEELINGS




When presented with a communication
question, use of therapeutic
communication techniques in an option
indicates a CORRECT option
Use of nontherapeutic communication
techniques in an option indicates an
INCORRECT option
Always focus on the client's feelings,
concerns, anxieties, and fears FIRST!
If an option reflects the client's feelings,
concerns, anxieties, or fears select that
option as the answer to the question!
10. FOCUS ON CLIENT’S FEELINGS
EXAMPLE:
The nurse is having a conversation with a client who is
upset and is having difficulty verbalizing his
thoughts and feelings. The appropriate nursing
response to the client is which of the following?
1. “Don’t worry so much.”
2. “Everything is going to be all right.”
3. “I can see that you are upset. Let’s talk about
your thoughts and feelings?”
4. “Why are you having so much trouble verbalizing
your thoughts and feelings?”
Answer: 3
PART 3 -- AFTER THE EXAM
AFTER THE EXAM


At the exam review,
determine the
rationale for any
incorrect questions
Continue to review
content from the
exam in preparation
for the final exam
and for the NCLEX®
exam
AFTER THE EXAM

Relax and reward
yourself for doing the
very best!
Thank You and I Wish You Success!