Test-taking strategies: Nursing student success

Test-taking strategies can help learners choose the correct answers when taking exams. As a nursing student, employing these strategies can help you succeed in both nursing school and on licensure exams. By using effective test-taking strategies, you can also develop clinical judgment by linking theoretical concepts with practical applications that support high-quality patient care.

Okay, so, nursing exams require you to use higher cognitive skills and processes, like applying and analyzing, aimed at testing your critical thinking and clinical judgment. These typically involve the steps that comprise the Clinical Judgment Measurement Model, which includes recognizing cues, analyzing cues, prioritizing hypotheses, generating solutions, taking action, and evaluating outcomes.

To test these cognitive skills and processes, nursing exams use alternate question formats that go beyond traditional multiple choice questions. These include multiple response questions, also called select all that apply questions, where several or all of the listed answers are correct; ordered response questions, where the answer options are arranged in a specified sequence; and highlight or enhanced hot spot questions, where the correct answer is indicated by highlighting specific words or phrases. On top of that, nursing exams often include case studies, which can either present a patient scenario at a single point in time or depict a situation that evolves over time during different phases of care.

Now, in contrast to traditional exams that usually have one correct answer, nursing exams often require students to choose the best option from several plausible ones. The idea behind these types of questions is to mirror real-life clinical decision-making, where multiple solutions are viable, but one solution is optimal based on the scenario.

Alright, let’s explore some test-taking strategies that can help you succeed on nursing exams.

First, before an exam, eating nutritious foods and getting enough sleep can help you stay focused and energized. If you get anxious before or during tests, practice breathing exercises, such as taking slow, deep breaths to boost oxygenation throughout your body, including your brain, so you relax and concentrate. Another way to reduce anxiety is to follow a structured test-taking sequence. For example, start by writing or typing your name; reading the directions; and then checking the exam length to guide your pacing. Next, carefully read each question, and take your time when answering the question.

When answering a question, focus on the subject, clinical setting, the patient’s condition and needs, and what the question is asking you. Pay close attention to strategic words that provide guidance like "best," "first," and "most important." Also remember to avoid reading into the question by making assumptions or considering issues that aren’t presented in the question.

You may also use nursing frameworks, such as the nursing process or Clinical Judgment Measurement Model to help you apply knowledge. For example, when reading a case study question, you’ll assess or recognize cues, such as abnormal vital signs or laboratory values, and then consider how these can impact your clinical decision-making.

Another helpful strategy is to focus on what you know versus what you don’t. In other words, use a process of elimination by ruling out those options that you’re certain are incorrect. This narrows your choices down and helps you to focus on selecting your final answer. If you feel stuck on a question, limit the amount of time you spend on it and come back to it later, if possible. If you still can’t decide on an answer after implementing your test-taking strategies, use your best judgment and go with your gut instinct. Also, once you choose an answer, try to avoid changing it, because more often than not, your first instinct tends to be correct.

Now, some questions require prioritization, where you will rank the patient's needs in order of importance, which can vary depending on factors like the clinical setting and the patient’s condition. For instance, you can classify needs as high, medium, or low, where high priority needs, like hypoxia, involve life-threatening problems that could cause harm or death if left unaddressed; medium priority needs, like discomfort, that aren’t as urgent and can be addressed after the higher problems are addressed; and low priority needs, that include nonurgent problems like educational needs.