Nursing TEST TAKING STRATEGY I:
Avoid Reading into the Question
HOW?
Specifically determine what the question is asking
Avoid asking yourself, Well, what if.?
Focus only on the information in the question
1. A client with metastatic cancer is receiving a continuous
intravenous infusion of morphine sulfate to alleviate pain. The
nurse monitors the client for which adverse or toxic effects of the
medication?
a. Dizziness
b. Sedation
c. Skeletal muscle flaccidity
d. Nausea
2. Which of the following does NOT reflect the purpose of
therapeutic bronchoscopy?
a. To examine tissues or collect secretions
b. To remove foreign bodies from the tracheobronchial tree
c. To treat postoperative atelectasis
d. Destroy and excise lesions
Nursing TEST TAKING STRATEGY II:
KNOW THE PARTS OF the Question
The question will consist of:
1. case situation
- information about the client and the information that you
need to consider in answering the question.
2. question stem
- asks something specific about the case situation.
3. optionS - are all of the answers.
Must select one; read every option carefully, and always use
the process of elimination.
Nursing TEST TAKING STRATEGY III:
Find the key words
Key words focus your attention on a specific or critical point
to consider when answering the question.
COMMON KEY WORDS
Early or Late
Best
First
Initial
Immediately
Most likely or least likely
Most appropriate or least appropriate
3. A nurse is caring for a client who just returned from the
recovery room after undergoing abdominal surgery. The
nurse monitors the client for which early sign of
hypovolemic shock?
a. Increase pulse rate
b. Increased depth of respiration
c. Lethargy
d. Decreased deep tendon reflexes
4. Which of the following action would be your highest
priority in taking care of her external shunt?
A. Instruct the client not to exercise the arm with the
shunt
B. Heparinize the shunt daily
C. Avoid taking BP or blood sample from the arm with
shunt
D. Change dressing of the shunt daily
Nursing TEST TAKING STRATEGY IV:
Determine The issue of the question
Issue of the question = Specific Subject Content the
question is asking.
The issue of the question can include the following:
1. Medication or intravenous therapy
2. Side effect of a medication.
3. Adverse or toxic effect of a medication
4. Treatment or procedure
5. Complications of disease , treatment, or procedure.
6. Specific nursing actions
5. Fat emulsion is prescribed for the client receiving total
parenteral nutrition. The nurse is preparing to hang the fat
emulsion and notes the presence of fat globules in the
solution. The most appropriate nursing action is to
a. Shake the solution to dissolve the fat globules
b. Call the physician
c. Return the solution to the pharmacy
d. Place the solution in a bath of warm water until the
globules dissolve
Nursing TEST TAKING STRATEGY V:
true and false response
A. True response questions use key words that ask you to
select an option that is ACCURATE regarding the
information in the question.
B. False response questions use key words that ask you to
select an option that is not accurate regarding the
information in the question. May use the word EXCEPT,
NEED FOR FURTHER
6. A client suspected of having meningitis is being
scheduled for diagnostic tests. The nurse anticipates that
which of the following diagnostic tests will most likely be
prescribed to confirm the diagnosis?
a. Serum electrolytes
b. Electromyography
c. White blood cell count
d. Lumbar puncture
7. A nurse is assessing several clients in a long term health
care facility. Which among the following client is most likely
to develop decubitus ulcers?
a. Malnourished 79 year-old client on bed rest
b. Obese client who uses a wheelchair
c. Incontinent client who has had 3 diarrhea stools
d. 80 year-old ambulatory diabetic client
8. The nurse has explained to a client scheduled for surgery
that he will not be able to eat or drink after midnight. The
client asks whether he can smoke after that time. Which of
the ff responses by the nurse would be most appropriate?
a. Smoking is not allowed because it will make you
more thirsty
b. Ill check with your surgeon
c. You can smoke because it will suppress your
appetite before surgery
d. Smoking is not permitted because it stimulates
stomach secretion
Practice Question: FALSE Response
9. Cortisone (Cortone) is prescribed for a client with adrenal
insufficiency, and the nurse provides instructions to the
client regarding the medication. Which of the following
statements if made by the client would indicate a need for
further instruction?
a. I will eat a good breakfast every day.
b. I will avoid people with colds.
c. I will limit my sodium intake.
d. I will stop the medication when I feel better.
Nursing TEST TAKING STRATEGY vI:
GUIDELINES FOR USE OF ABC & MASLOWS
The ABCs
1. Use the ABCs airway, breathing, and circulation when
selecting answer or determining the order of priority.
2. Remember the order of priority: airway, breathing, and
circulation.
3. Airway is always the first priority.
F. Maslows Hierarchy of needs theory.
1. Use Maslows hierarchy of needs theory as a guide to
prioritize.
2. Physiological needs are the priority; therefore select an option
or determine the order of priority by addressing physiological
needs first.
3. When a physiological need is not addressed in the question or
noted in one of the options, continue to use Maslows hierarchy
of needs theory as a guide and look for the option that addresses
safety.
10. The client with a diagnosis of cancer is receiving
morphine sulphate 10 mg subcutaneously every 3 to 4
hours for pain. When preparing the plan of care for the
client, the nurse includes which priority action?
a. Monitor stools.
b. Monitor the urine output.
c. Encourage the client to cough and deep breath.
d. Encourage fluid intake.
11. The doctor has ordered furosemide (lasix) 80mg IV push
over 5 minutes. The nurse should give priority to the :
a. Assessment of the clients output
b. Assessment of the clients BP
c. Assessment of the clients RR
d. Assessment of the clients neurosigns
12. A nurse is reviewing the plan of care for a pregnant client
with a diagnosis of sickle cell anemia. Which nursing
diagnosis of sickle cell anemia. Which nursing
 diagnosis, if stated on the plan of care, would the nurse
select as receiving the highest priority?
a. Anxiety
b. Ineffective coping
c.Disturbed body image
d.Deficient fluid volume
NURSING TEST TAKING STRATEGY VII:
Steps of the Nursing Process
Remember that ASSESSMENT is the first step in the
nursing process.
When you are asked to select your first and initial nursing
action, follow the steps of the nursing process to prioritize
when selecting the correct option.
Assessment questions address the process of gathering
subjective and objective data relative to the client,
confirming that data, and communication and documenting
the data.
13. A nurse is teaching a client with coronary artery disease
about dietary measures to follow. During the session, the
client expresses frustration in learning the dietary regimen.
The nurse would initially?
a. Identify the cause of the frustration.
b. Continue with the dietary teaching.
c. Notify the physician.
d. Tell the client that the diet needs to be followed.
REMEMBER THE Assessment Key words:
Ascertain
Assess
Check
Determine
Find out
Identify
Monitor
Observe
Obtain Information
If an option contains the concept of assessment or the
collection of client data, the best choice is to select that
option.
Possible exception to the guidelines: if the question
presents an emergency situation, read carefully; in an
emergency situation, an intervention may be the
priority.
PLANNING
a. Planning questions require prioritizing nursing diagnosis,
determining goals and outcome criteria for goals of care,
developing the plan of care, and communicating and
documenting the plan of care.
b. Regarding nursing diagnoses, remember that actual client
problems rather than potential or at risk client problems will most
likely be the priority.
c. Remember that this is a nursing examination and the answer
to the question most likely involves something that is included in
the nursing care plan, rather than the medical plan.
14. A nurse develops a plan of care for a client with a
cataract. Which nursing diagnosis is the priority?
1. Fear related to lost of eyesight
2. Social isolation related to decrease ability to mobilize in
the community.
3. Disturbed Sensory Perception (visual) related to ocular
lens opacity.
4. Risk for injury related to decrease vision
IMPLEMENTATION
a. Implementation questions address the process of organizing
and managing care, counselling and teaching, providing care to
achieve established goals, supervising and coordinating care,
and communicating and documenting nursing interventions.
b. This examination is about nursing, so focus on the nursing
action rather than on the medical action unless the question is
asking you what prescription (medical order) is anticipated.
c. The only client about whom you need to be concerned is the
client in the question that you are answering; remember that this
client is your only assigned client.
d. Answer the questions as if the situations were textbook and
ideal and the nurse had all the time and resources needed and
readily available at the clients bedside.
When implementing emergency for Mr. Robert, the industrial
nurse at the scene of accident should give priority to:
a. Administering analgesics and applying antibacterial
ointment over the area
b. Wetting the clothing over the involved area with cool
water
c. Assessing the depth and extent of the burn injury
d. Determining exactly how the accident occurred
15. A nurse is caring for a client with angina pectoris who
begins to experience chest pain. The nurse administers
a sublingual nitroglycerin (Nitrostat) tablet sublingually
as prescribed, but the pain is unrelieved. The nurse
should take which of the following actions next?
a. Contact the physician
b. Call the clients family.
c. Administer another nitroglycerin tablet.
d. Reposition the client.
EVALUATION
a. Evaluation questions focus on comparing the actual outcomes
of care with the actual outcomes of care with the expected
outcomes and focus on how the nurse should monitor or make a
judgement concerning a clients response to therapy or to a
nursing action.
b. These questions address evaluating the clients ability to
implement self-care, health care members ability to implement
care, and the process of communicating and documenting
evaluation findings.
c. In an evaluation question, be alert to false response question
because they are used frequently in evaluation-type questions,
and the question may ask for a client statement that indicates
accurate or inaccurate information related to the issue of the
question.
16. A client with multiple sclerosis has been taking
oxybutynin (Ditropan). The nurse determines the degree
of effectiveness of the medication by asking the client
about changes in the following:
a. Extent of muscle spasms
b. Level of fatigue
c. Bowel movements
d. Pattern of urination
NURSING TEST TAKING STRATEGY VIII: Eliminating Similar
Options
A. When answering the question, use the process of
elimination and look for similar options.
B. If any of the options include the same idea, then they
are incorrect and can be eliminated.
C. Remember that there is only one correct option, and
the answer to the question is the option that is different.
17. A nurse is assigned to care for a group of clients. On
review of the clients medical records, the nurse determines
that which client is at risk for excess fluid volume?
a. The client with an ileostomy
b. The client taking diuretics
c.The client who requires gastrointestinal suctioning
d. The client with renal failure
NURSING TEST TAKING STRATEGY IX:
Eliminate Options that contain Absolute Words
A. As you read each option, look for absolute words.
B. Absolute words tend to make an option incorrect, and if
you note an absolute word in an option, eliminate that option.
C. Some of these absolute words include all, always, every,
must, none, never, and only.
18. A nurse is providing safety instructions to the mother of
child with hemophilia and tells the mother to do which of the
following to promote a safe environment for the child?
1. Remove toys with sharp edges from the childs toy box.
2. Allow the child to play with toys only if a parent is present.
3. Place a helmet and elbow pads on the child everyday.
4. Allow the child to play indoors only.
NURSING TEST TAKING STRATEGY X:
Look for the Umbrella Options
A. When answering a question, if you note that more than one
option appears to be correct, look for the umbrella option (also
known as global option or comprehensive option).
B. The umbrella option is one that is general statement and
may contain the ideas of the other options within it.
C. The umbrella option will be the correct answer.
The most important thing to remember in the management 6. Trust your first Instinct
of acute diarrhea is: 7. Think as if you are the kindest person and best nurse in
a.Stop diarrhea the world
b.None of these
c. Prevention and treatment of dehydration 8. PRAY HARD Let God answer the questions for YOU
d. Identify the offending organism

An important role of the community health nurse in the

prevention and control of Dengue H-Fever includes:
a. Advising the elimination of vectors by keeping water
containers covered
b. Conducting strong health education drives/campaign
directed towards proper garbage disposal
c. Explaining to the individuals, families, groups, and
community the nature of the disease
d. Practicing residual spraying with insecticides

19. A nurse in the emergency room receives a telephone call

from an emergency medical service and is told that
several victims who survived a plane crash and are
suffering from cold exposure will be transported to the
hospital. The initial nursing action of the emergency
room nurse is which of the following?
a. Supply the trauma rooms with bottles of sterile water
and normal saline.
b. Call the laundry apartment and ask the department to
send as many warm blankets as possible to the
emergency room.
c. Call the nursing supervisor to activate the emergency
disaster plan.
d. Call the Intensive Care Unit to request that nurses be
sent to the emergency room.

NURSING TEST TAKING STRATEGY XI: Answering

Pharmacology Questions
A. If you are familiar with the medication, use nursing knowledge
to answer the question.
B. Remember that the question will identify the generic name
and the trade name of the medication.
C. If the question identifies a medical diagnosis, then try to make
a relationship between the medication and the diagnosis; for
example you can determine that cyclophosphamide (Cytoxan) is
an antineoplastic medication if the question refers to a client with
breast cancer who is taking this medication.
D. Try to determine the classification of the medication being
addressed to assist in answering the question; identifying the
classification will assist in determining a medication action and
side effects (diltiazem [Cardizem] is a cardiac medication).
E. Recognize the common side effects associated with each
medication classification and then relate the appropriate nursing
interventions to each side effect; for example, if a side effect is
hypertension, then the associated nursing intervention would be
to monitor the blood pressure.
F. Learn medication that belongs to a classification by
commonalities in their medication names; for example,
medication that are xanthine bronchodilators end with line
(theophylline).
G. Look at the medication name and use medical terminology to
assist in determining the medication action; for example,
Lopressors lowers (lo) the blood pressure (pressor).

I. POINTS TO REMEMBER

MEDICATION RULES
1. Generally, the client should not take an antacid with
medication because the antacid will affect the absorption of the
medication,
2. Enteric-coated and sustained-release tablets should not be
crushed; additionally, capsules should not be opened.
3. The client should never adjust or change a medication dose or
abruptly stop taking a medication.
4. The nurse never adjusts or changes the clients medication
dosage and never discontinues a medication.
5. The client needs to avoid taking any over-the-counter
medications or any other medications such as herbal
preparations unless they are approved for use by the health care
provider.
6. The client needs to avoid alcohol and smoking.
7. Medications are never administered if the order is difficult to
read, is unclear, or identifies a medication dose that is not a
normal one.