Preparing to take a Nursing Exam

TEST TAKING STRATEGIES - Exam questions are based on the cognitive

learning domain (how an individual learns)
PARTS OF A MULTIPLE CHOICE
of BLOOM’S TAXONOMY
C – Case Scenario (description of the patient and what - Questions on nursing exams are based on
is happening) the first five levels of bloom’s revised
taxonomy
S – Stem (that part of the question that’s asks the
question)

D – Distractors (incorrect but feasible choices)

C – Correct answer (the answer to the question)

Example

Case scenario: A patient who is visibly upset says to

the nurse, “I want to talk with the head nurse, no, get
me the supervisor and the director of nursing and the Before Helping a patient receiving furosemide (Lasix)
owner of the hospital. I am mad” The best initial get out of bed, the nurse would:
response for the nurse to make is?
A.) Put slippers on the patient
Stem: The best initial response for the nurse to make B.) Dangle the patient at bedside
is? C.) Take blood pressure while supine
D.) Calculate intake and output
Distractors:
➔ Focus on what is being asked (helping the
A.) Whom do you wish to see first ? patient get out of bed), putting slippers in not
that important, calculating intake and output
B.) Don’t be angry
is irrelevant when it comes to helping a patient
C.) Why do you want to talk to them when I can help get up, taking the blood pressure is important
but not only in supine, the correct answer Is
D.) You seem upset dangle the patient at bedside as it directly
CARDINAL RULES OF TEST TAKING addresses the problem

1.) Read all instructions carefully Which of the following would be the most accurate
2.) Read all test questions carefully in evaluating the effectiveness of furosemide
3.) Answer only what is being asked; do not (Lasix)
read into a question anything beyond what
A.)
Weight
is there
B.)
Degree of shortness of breath
4.) Pace yourself
C.)
Diastolic blood pressure
5.) Make sure you answer all of the questions
D.)
Intake and output
on the exam
➔ 2.2 pounds is equivalent to one liter of fluid
TIME FRAME loss or gained. Weights are the most accurate
in determining the effectiveness of furosemide
- Whenever time is mentioned, it is important ➔ Intake and output is more of an estimate of
- Early vs Late fluid balance. Output may be an indicator of
- Preoperative vs post operative fluid loss, and kidney function, however,
- Surgical day weight is most accurate in determining
amount of fluid loss.
 2.) The functions of the school nurse are as
The nurse is administering furosemide (Lasix) to the
follows:
patient. Which complication is the patient at risk for:
1. School health and nutrition survey
A.) Hypertension (furosemide causes excretion of 2. Putting up a functional school clinic
fluid. Loss of fluid volume would cause 3. Health assessment
decreased blood pressure) 4. Standard vision testing for school children
B.) Arrhythmias (potassium is a major 5. Ear examination is only included
electrolyte that is lost as furosemide 6. Always getting the height and weight
causes fluid to be excreted, low potassium measurement of the pupil
levels can lead to arrythmias) 7. Attendance to emergency cases only
C.) Crackles (furosemide cases liquid to be 8. Prevention on communicable diseases
excreted so crackles would not be present)
D.) Tachypnea (Furosemide causes excess fluid to A.) 1, 2, 3, 4
be excreted. The outcome would be eupnea) B.) 5, 6, 7
C.) 1, 2, 3, 4, 8
Furosemide is potassium wasting, D.) All of the above
ABSOLUTES OPPOSITES
WRONG - Either one of them is right
- Always ➔ A. High blood pressure
- All ➔ B. Low blood pressure
- Never ➔ A. Increase the IV drip rate
- Only ➔ B. Stop the IV
- Every ➔ A. Turn the client on his left side
- Forever ➔ B. Turn the client on his right side

RIGHT SAMPLE QUESTIONS FOR OPPOSITES

- Usually 1.) The nurse understands that a major side effect

- Frequently of morphine sulfate is
- Often A.) Tachypnea
- Seldom B.) Bradypnea
C.) Hypotension
SAMPLE QUESTIONS D.) Constipation
1.) Duterte health agenda for 2016 to 2022 is -opposites (tachypnea and bradypnea)
focus on 3 strategies and one of which is
protect from triple burden of disease, as a -morphine is a cns depressant -> bradypnea
nurse/midwife which life stages will we care ODD MAN WINS
for?
A.) Only pregnant, newborn, infant, child The nurse is caring for an adult client with thyroid
B.) All pregnant, newborn, infant, child including disease. The nurse is observing for thyroid crisis.
senior citizen Which nursing intervention would be most suggestive
C.) Pregnant, infant, child, adolescent, adult of thyroid disease ?
and elderly
A.) Decreased temperature
D.) Always focus on pregnant, newborn, and
B.) Rapid pulse
infant, adolescent, adult, and elderly
C.) Decreased respirations
D.) Decreased energy
 UMBRELLA TERM Assessment first

- Look for similar options two or more options - When a question asks about your initial
that could feasibly correct or similar in response or first action, always consider
meaning, then look for an umbrella term or assessment as your starting point unless the
phrase that encompasses the other correct question presents a clear emergency
option - Key tip: when you see questions like “what is
your initial nursing intervention?’ “what is your
PRIORITIZING ANSWERS
first action?” remember: assess before you act
A.) ABC
A patient is experiencing shortness of breath and a
respiratory rate of 30 breaths per minute. What should
the nurse do first?
Which of the following clients should the nurse deal
first? A. Administer oxygen at 2L/min
B. Position the patient in high fowlers
A.) Needs dressing change C. Assess the patient’s lung sounds (although
B.) Needs suctioning (airway) oxygen administration and positioning are
C.) Is in pain important interventions, your first step is
D.) Is incontinent always to assess the patient. Assessing the
A post operative patient who had abdominal surgery is lung sounds will give the nurse critical
tearful and tells the nurse she is too weak and tired to information about the severity of the
take a bath after physical therapy. What is the priority respiratory problem, guiding further
nursing diagnosis at this time? interventions, this aligns with the principle
of assessing being the first step in the
A.) Ineffective coping related to post operative nursing process
state D. Notify the healthcare provider
B.) Acute pain related to tissue trauma secondary
to surgery DIAGNOSIS: IDENTIFYING THE PROBLEM
C.) Delayed surgical recovery related to not - After collecting data, consider the nursing
wanting to be active diagnosis. Test questions may ask you to
D.) Self-care deficit: bathing/hygiene related to prioritize patient problems. Prioritization is
fatigue and weakness often based on Maslow’s Hierarchy of needs
and ABC rile (Airway, breathing, circulation)
- Key tip: When prioritizing, always address the
most critical of life-threatening problem first

A patient is admitted with complaints of shortness

of breath, chest pain, and nausea. Which problem
should the nurse address first?

A.) Nausea
B.) Chest pain
C.) Shortness of breath
D.) Anxiety
 A patient receives a diuretic to treat fluid overload, A preoperative client talks about being afraid of pain
which assessment finding indicates that the because of a previous experience with painful surgery.
intervention was effective What should the nurse do first to help the client cope
with this fear ?
A.) The patient’s blood pressure is reduced
B.) The patient’s heart rate has increased A.) Encourage the client not to be afraid
C.) The patient’s urine output is increased (the B.) Teach the client relaxation techniques
goal of administering diuretic is to reduce fluid C.) Listen to the client’s concerns about pain
retention, which is evidenced by an increase in D.) Inform the client that medication is available
urine output. This is an example of evaluating
HOW TO STUDY MEDICAL SURGICAL NURSING
whether the intervention had the desired
effect, based on objective data
D.) The patient reports reduced thirst

PUTTING IT ALL TOGETHER: TACKLING PRIORITY

QUESTIONS

- Many exam questions will ask “what is the

priority” or “what should you do first” these
type of questions are testing your ability to
think critically using the nursing process

Key tip: Use ADPIE as your guide

Assess first to gather critical data

Diagnose the patient’s most urgent issue

IF DI MO ALAM ANG
Plan by settling a goal that will resolve the problem
HINAHANAP NA CATEGORY
Intervene with the action that addresses the OR CLASS, IRANK MO
priority need
NALANG
Evaluate the effectiveness of the intervention
based on objective data

A client has just returned from the operating room with

a urinary retention (foley) catheter, an IV line and an
oral airway and is still unresponsive. Which nursing
assessment should be made first

A. Check the surgical dressing to ensure that it is

intact
B. Confirm the placement of the oral aiway
C. Observe the foley catheter for drainage
D. Examine the IV site for infiltration

Which is a priority physiological need of a client with a

colostomy?

A.) Disturbance of body image

B.) Inadequate nutrition
C.) Lack of knowledge
D.) Skin breakdown