BECOME TEST – WISE Mastering Computer-based Standardized Nursing Tests

1. BECOME TEST – WISE Mastering Computer-based Standardized Nursing Tests Texas State University St. David’s School of Nursing

2. Acknowledgements • Liz Fuentes, MS, RN, FNP-C Assistant Clinical Professor, Texas Women’s University • School of Nursing, Mott Community College, Flint, MI

3. Table of ContentsMastering 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

4. 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

5. 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

6. 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 Habits http://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

7. General Test-taking STRATEGIES • Avoid changing answers • Be systematic • Work at a steady pace • Stay focused • Breathe • Look for logic

8. 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

9. 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.

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

11. 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

12. 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

13. 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

14. Stem Types • True response stem – asks for a true statement (commonly used) • False response stem – asks for the incorrect answer (not commonly used)

15. 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

16. 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

17. Let’s practice what we just learned plus learn a few strategies

18. 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?

19. 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?

20. Options to the Nursing Test Question A. Give the medication • Discard the medication • Omit the medication • 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.

21. 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.

22. 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

23. One Last Option Myth • The longest answer contains the most information but don’t assume the information in the longest answer is correct

24. Umbrella Option • Contains other options within it • Present when there is more than one right answer found

25. Priority Option • ABC’s • Airway • Breathing • Circulation • Safety • Maslow • Patient first • Safe Care

26. Don’t “Read Into” Options • Take question at face value • If it walks like a duck….

27. Types of Testing Errors

28. First Error Type • Misperceiving Information • Words are read incorrectly • Information is overlooked • See next slide for an example

29. Read These Options PARIS IN THE THE SPRING ONCE IN A A LIFETIME BIRD IN THE THE HAND

30. 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

31. Each option has repeated words PARIS IN THE THE SPRING ONCE INA A LIFETIME BIRD IN THE THE HAND

32. 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

33. 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

34. Eliminating IncorrectOptions

35. 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

36. 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

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

38. 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

39. 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

40. 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

41. 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

42. 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

43. 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?

44. Strategy 4: Options with rationales • Temperature: No, it is in normal range • Respiratory rate: Yes, the client is tachypneic • BP: No, 100/70 could be a normal range for this client • HR: No, 90 is within normal range

45. Strategy 5 • Concentrate on the question at hand • Each question demands your undivided attention • Once a question is answered, it’s done…. Forget it!

46. 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

47. 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

48. Strategy 8 • Generally, avoid answers containing qualifying words • Always • Never • All • None • Nothing is always, never, or none

49. 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

50. 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