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Test Taking Strategies. “Study is nothing else but a possession of the mind.” Thomas Hobbes, 1651. Obtained from Facebook post 4/16/13. Study Modalities. Memory builders Organization of information Writing lists, charts, and tables from notes and texts

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Test taking strategies

Test Taking Strategies

“Study is nothing else but a possession of the mind.”

Thomas Hobbes, 1651

Study modalities
Study Modalities

  • Memory builders

    • Organization of information

      • Writing lists, charts, and tables from notes and texts

        • Classification and grouping of items is highly effective in forming connections and boosting memory (“chunking” of information)

    • Mnemonics

    • Knowledge of optimal study environment/time of day

    • The Pomodoro technique

      • 3 cycles of 20-25 minute studying followed by 5-minute breaks X 2; after 3rd cycle, break for ½ hour

Study modalities1
Study modalities

  • Index cards

  • Study groups

    • Can you explain a concept to someone else?

  • Practice MC QUESTIONS!!!

    • Increases knowledge

    • Increases skill in taking exams

    • Post item analysis is extremely important

Mce post item analysis
MCE Post item analysis

  • Why did I answer that way???

    • DNK! (did not know!)

      • Go back and review concept

    • Misread the stem

      • Easy to miss words, read as something else

    • RUSHED the answer

      • Rushing is theorized to be responsible for most NCE failures


  • Begin early

    Do not cram – studies have shown that retention of information is increased over the long term!

Dietary habits
Dietary Habits

  • Food

    • Fresh fruits and vegetables are recommended to reduce stress

  • Stress-inducing foods

    • Processed or preserved foods

    • Chocolate

    • Eggs

    • Fried foods

    • Junk foods, chips, similar snack foods

    • Artificial sweeteners

    • Pork, red meat

    • White flour products

    • Carbonated soft drinks

    • Spicy foods

Dietary habits1
Dietary Habits

  • Dietary habits/supplements

    • Folic acid, Vitamin E

    • Gingko biloba (efficacy in question)

    • Epicatechin, a flavonol found in tea, grapes, blueberries, and cocoa, enhances memory in mice; the effect increases further when coupled with exercise (Journal of Neuroscience 5/30/07)


  • Attitude

    • Approach exams with a positive, upbeat attitude—”I am well prepared; I’m going to ace this exam!” and other self-fulfilling prophecy-type statements

    • Do you have test taker’s anxiety?

      • Practice relaxation techniques

Relaxation techniques
Relaxation techniques

  • Deep breathing

  • Visualization

  • Mantras

  • Repeating S-T-O-P over and over

  • VISUALIZE yourself sitting at the computer, taking the NCE, and knowing the answers


  • Good sleep is crucial in the days leading up to the exam

    • Do not cram until the wee hours

    • Minimize ETOH and other “mind manipulators” in the days leading up to the exam

  • “You are what you eat”

    • Don’t go to the exam on an empty stomach

    • Don’t “carb load”; balance carbs with protein so that you don’t “crash” mid-exam

Multiple choice exams
Multiple Choice Exams

  • MCEs tend to focus on details which are not typically well retained in short-term memory

    • Repetition and learning small amounts each day allow for a more reliable long-term memory

  • Because MCEs contain many questions, the student needs to be familiar with a much broader range of materials

Mce questions
MCE Questions

  • Usually include a phrase or stem followed by three to five options

    • “Distractors” options which mimic the correct answer and attract attention

    • “Foils” options which contrast with all others making it seem as though it is the correct answer

  • Be sure to take the time to read the stem carefully!

  • Multiple choice exams1
    Multiple Choice Exams

    • Improve your odds of answering by thinking critically

      • Cover the options, read the stem, and attempt to answer; choose the option that most closely matches your original answer

      • Read the stem with each option, treating it as a true-false question; choose the “most true”

    Strategies to answer questions
    Strategies to Answer Questions

    • Immediately eliminate any option(s) that you know to be incorrect

    • Question any option that doesn’t grammatically fit with the stem

      • Look for grammatical clues (i.e. “an” at the end of the stem—correct response begins with a vowel)

    Strategies to answer questions1
    Strategies to Answer Questions

    • Question options that are totally unfamiliar to you

    • Question options that contain negative or absolute words

    Key distractor words
    Key Distractor Words

    • “Absolute” determiners

      • Always

      • Never

      • All

      • None

      • Must

      • Only

        • Responses containing these words are less likely to be correct than those containing conditional or “gray” terms

    Key distractor words1
    Key Distractor Words

    • Conditional or “gray” terms

      • Sometimes, somewhat

      • Some, few

      • Frequently

      • Often, usually

      • Generally

      • Many, majority

      • On the average

      • Probably

    Careful—this option may be correct!

    Key distractor words2
    Key Distractor Words

    • Always read the stem slowly and carefully!

      • It is easy to miss the terms:

        • Not

        • Except

          • May see these on the NCE exam but efforts are being made by item writers to gradually eliminate these questions

      • May sometimes be italicized, but not always

    Strategies to answer questions2
    Strategies to AnswerQuestions

    • Trust your knowledge if an answer seems too easy

      • Don’t read into questions

      • Don’t think that the question is a “trick”

      • Do check to make sure that none of the other answers seems better than your initial response

    Strategies to answer difficult questions
    Strategies to Answer Difficult Questions

    • “All of the above”

      • If you know that at least 2 of the options seem correct, all of the above is a strong possibility

        • Don’t fall into the “all of the above” trap, however

      • Beware of the “none of the above” option

        • Frequently the wrong answer

    Strategies to answer difficult questions1
    Strategies to Answer Difficult Questions

    • Number answers

      • If you have absolutely NO idea what the answer is, toss out the high and low and consider the middle numbers

    Strategies to answer difficult questions2
    Strategies to Answer Difficult Questions

    • “Look alike options”

      • One may be correct; if so, choose the one that makes the most sense

        • Eliminate choices that mean basically the same thing, and thus cancel each other out

    Strategies to answer difficult questions3
    Strategies to Answer Difficult Questions

    • If two alternatives seem correct, compare them for differences, then refer to the stem to find your best answer

    Strategies to answer difficult questions4
    Strategies to Answer Difficult Questions

    • Echo options

      • If two options are opposite each other, chances are that one of them is the correct answer

    Strategies to answer difficult questions5
    Strategies to Answer Difficult Questions

    • Favor options that contain qualifiers and adjectives

      • The result is longer, more inclusive items that better fill the role of the answer

        • The longest response is often the correct one

    Strategies to answer difficult questions6
    Strategies to Answer Difficult Questions

    • Look for verbal associations

      • A response that repeats key words that are in the stem is likely to be correct

    If all else fails
    If All Else Fails…

    • Choose response b or c

      • Many item writers subconsciously feel that the correct answer is “hidden” better if it is surrounded by distractors

      • Response “a” is usually least likely to be the correct one

      • Don’t look for patterns – it is a computer adaptive exam!

        • Don’t panic if the last 6 answers were all “b”…


    • Always guess when there is no penalty (you will have to guess to move on!)

      • Do NOT waste > 2 minutes on a question that you do not know the answer to! Answer! Move on!!

    • Use common sense or logic when attempting to select the best possible answer

    • Use hints from previous known questions to answer questions that you don’t know

      ???Should you change an answer before hitting enter???

    Changing answers
    Changing Answers

    • Used to be taboo—i.e. “Go with your first instinct!”

    • Newer thought is to change the answer only if, after further reflection, you have a strong feeling/doubts about your initial response

      • Recent studies show that students who change dubious answers usually improve their test scores

    Multiple choice exams2
    Multiple Choice Exams

    • Remember:

      • The correct answer is guaranteed to be among the possible responses

      • Your first answer is generally correct (unless you are absolutely sure that it is incorrect)

      • You can score points with lucky guesses

      • No amount of skill in test taking will compensate for lack of studying/preparedness!

    Exam day strategies
    Exam Day Strategies

    • Arrive early and take a moment to relax and reduce your anxiety

    • Wear comfortable clothing

    • Think positively

      • It has been demonstrated that when you become emotional—i.e. ”I’ve got to pass this or I can’t work!”, performance ultimately suffers

        • Don’t psych yourself out

    Exam day strategies1
    Exam Day Strategies

    • Anxiety is good (to a point…)

      • Mild anxiety heightens awareness of the task at hand and of the external environment; sharpens senses/concentration

      • Moderate to high anxiety causes the opposite effect; narrowing of the senses, auditory effects (2º hyperventilation)

    The Yerkes-Dodson law


    Exam day strategies2
    Exam Day Strategies

    • Take short breaks during the exam (every 20-25 questions)

      • Budget time wisely

    • Focus and deep breathe

      • Relax

        • These will all help to boost confidence

    • Use of beta blockers?

      • Generally not a good idea unless you know that you are able to tolerate them and they work well for you

    Exam day strategies3
    Exam Day Strategies

    • If you find yourself getting emotional (angry, upset, weepy, etc.)

      • STOP for a short period of time

      • Regain composure/concentration

      • Exercise relaxation techniques

    Exam day strategies4
    Exam Day Strategies

    • Listen for any last minute instructions given by the instructor/test center attendant

    • Read directions carefully

    • Change positions to help you relax

    • Pay attention to passing time

      • Keep a steady pace

    • Do not panic if:

      • you find the test difficult (because you probably will!)

      • question #101 loads! (no, you are NOT failing!!)

    National certification examination nce
    National Certification Examination (NCE)

    • Variable length

    • Computer-Adaptive

      • Based on “item response theory”

    • Multiple choice

      • A stem followed by 4 options

      • No “K-type” questions

      • Minimal to no negative or “except” questions

      • Newer questions such as multiple correct response phased in as of 2009

    The nce cont d
    The NCE cont’d

    • Minimum-100 questions

      • 70 questions from content outline

      • 30 pretest questions

        • Do not count towards score

    • Maximum-170 questions

    • Time limit is still 3 hours

    • Must register for the exam within 3 months of graduation

      • Once application is made, eligibility period is 90 days

    Eligibility policy change 10 07
    Eligibility policy change 10/07

    “Candidates who do not take and pass the NCE within two calendar years of completion of the nurse anesthesia educational program will not be eligible to apply to take the Certification Exam unless they enter and complete another unabridged accredited nurse anesthesia program.” (limit 4 attempts/year)

    Update for the nce
    Update for the NCE

    • New questions released in 2009:

      • Multiple correct response (MCR)

        • The stem is followed by 4-8 responses; test-taker must choose all applicable answers for credit

        • The stem will indicate how many responses are correct

    Multiple correct response mcr
    Multiple Correct Response (MCR)

    Which of the following hormones are secreted by the neurohypophysis? (choose two):

    A) HGH

    B) oxytocin

    C) prolactin

    D) TSH

    E) vasopressin

    F) FSH

    Update for the nce1
    Update for the NCE

    • New questions released in 2009:

      • Computation questions

        • Test-taker will be asked to compute an answer (i.e. calculating SVR based on pt’s vital signs)

        • Rather than having the choice of four answers, the examinee will be asked to enter the computed answer in the space provided

    Computation questions
    Computation Questions

    • Response must be entered in the form of a number (i.e. 1200, not “twelve hundred”

    • Directions will be given as to rounding, decimal places, etc

    • A calculator will be supplied for those questions that may be computationally complex; there will be no use of personal calculators

    Update for the nce2
    Update for the NCE

    • New questions released in 2009:

      • “Drag-&-Drop” questions

        • A clinical scenario will be given and interventions will be listed

        • Tests an examinee’s ability to prioritize

        • May also be utilized in a matching format

        • The examinee will be asked to drag the interventions to the appropriate spot and drop them so that they are in order of requested priority

    Update for the nce3
    Update for the NCE

    • New questions released in 2009:

      • “Hot-Spot” questions

        • The examinee will be asked to identify a feature of a graphic

        • As the mouse is rolled over the graphic, various areas will highlight with an “X”

        • The examinee will choose the correct answer by clicking on the “X” that depicts the requested feature

        • The examinee may change the answer before moving to the next question by clicking on another region (X) in the image

    Update for the nce4
    Update for the NCE

    • New questions released in 2009:

      • Graphics and video

        • Any questions may be visually augmented with the use of graphics and/or video clips as stimuli for the question

      • **Newer format questions intended to test the examinee on clinical acumen/application of knowledge

    Content outline
    Content outline

    Adapted from the 2013 Candidate Handbookhttp://nbcrna.com/certification/SiteAssets/Pages/Program-Administration/20131118%20NCE%20Candidate%20Handbook.pdf:

    Taking the nce
    Taking the NCE

    • Computer skills not needed

    • May have pencil/paper

      • No calculators allowed

    • Space bar, ENTER key, TAB key

    • No tutorial or practice questions

    • Must answer question before proceeding to the next

    • Cannot return to/review previous questions

    Taking the nce1
    Taking the NCE

    • Test centers:

      • Other examinees may be present

      • Attempts by staff to keep noise at a minimum

      • May bring ear plugs

      • May not test privately unless documented disability requires accommodation

      • May take 2-4 weeks to get an appointment at a specific testing center

    Pass fail decision occurs when
    Pass-Fail Decision Occurs When:

    • Candidate clearly demonstrates either competency or incompetence at any point between 100-170 questions

    • 170 questions have been administered

    • Maximum amount of time has been reached

      • Very few candidates time out

    Time frame following program completion until exam
    Time Frame Following Program Completion Until Exam:

    Further analysis of test taker performance on the NCE in relationship to the completion date revealed that the longer the examinee had been out of his/her program, the lower their score on the NCE.

    Pass or fail
    Pass or Fail?

    • Beginning in August 2009, the candidate receives pass/fail status at the end of the examination by the testing center 

    • This is only a preliminary result!

      • All test results must still be validated by the Council on Certification (CCNA)

    • May not sign as a CRNA until verification letter is received from the NBCRNA

    Why is it only a preliminary result
    Why Is It Only a Preliminary Result?

    • Need to assure:

      • Test center security

        • Verifies that the test session occurred under controlled conditions

          • All exams videotaped

          • Irregularities reported; investigation ensues; student’s score is held

      • Verification of validity of results by CCNA

      • Verification of candidate records

    Visit nbcrna website


    • Under “certification” tab, you will find:

      • Candidate handbook

      • FAQs

      • Alternative question formats/tutorials/samples

      • Updated reports

        • Annual report of NCE and SEE performance

          • Pass rates

          • Demographic/satisfaction surveys

          • Monthly certificant lists

    Test taking strategies

    Please contact us at:


    If we can further help you in preparing for the NCE!