Testing Success

1. Testing Success Summer 2013

2. Most Common Testing Mistakes • Prepare Superficially • Not preparing for class • Don’t do reading in text • Not part of study group • Cram night before exam • Depend on memorizing • Rely on what you think you know

3. Common Mistakes • Read questions on exam incorrectly • Don’t grasp what question is really asking • Misread due to hurrying • Miss key words in question • Don’t read all possible responses before forming opinion • Select wrong answer by accident • Change answer • Don’t listen to inner voice / instinct

4. 4 Levels of Thinking • Simple to Complex • Knowledge • Comprehension • Application • Analysis

5. Study Techniques to Increase Knowledge • Repeatedly study content • Recite out loud • Flash cards • Write it down • Alphabet cues (3 P’s of diabetes = polyuria, polydipsia, polyphagia) • Acronyms – word formed from first letters of facts • (Caution – change in bowel/bladder habits, a sore that doesn’t heal, unusual bleeding or discharge, thickening or lump, indigestion or difficulty swallowing, obvious change in wart or mole, nagging cough or hoarseness) • Acrostics - phrase, motto, or verse with first letters • Fat Soluable Vitamins = A, D, E, K (All Dieters Eat Kilocalories) • Mnemonics – variation of acrostic, not every word related to content • There are 15 grains of sugar in 1 graham cracker (15 grains = 1 gram)

6. Study Techniques to Increase Comprehension • Explore “whys” and “hows” • Why or how is this information important? • Immobility causes pressure ulcers – why • Soap helps clean the skin – how • Study in small groups • Sharing promotes comprehension • Listen to impressions and opinions of others • Learn new information you may have missed • Reinforce your learning by teaching others

7. Study Techniques to Increase Application • Apply concepts to what you already know • Gravity = force that draws all mass toward the center of the earth • How does this apply to nursing • Hang urinary catheter bag below bladder • Hang IV bag above patient • Raise head of bed for patient with dyspnea • Elevate legs of patient with edema

8. Study Techniques to Increase Analysis • Analysis requires you to critically think • Interpret a variety of data • Recognize commonalities, differences, and relationships • Identify differences • Causes of elevated blood pressure • Many causes, each for different reason • Fluid retention, anxiety, infection • Practice test taking • Review rationales for right and wrong answers • Increase stamina • Control physical and emotional responses • Manage time • Practice test taking techniques

9. Test Taking Techniques • Most items have 4 options for responses • Chance of picking correct answer is 25% • Eliminate 1 distracter and choice of picking correct answer is 33% • Eliminate 2 distracters and have 50/50 chance of picking correct answer • Lets look at increasing your odds

10. Step 1 Break question down into it’s components • Stem • What is the question asking? READ SLOWLY AND CAREFULLY • Paraphrase into your own words before looking at options • Try to answer in your own words before looking at options • Options • Don’t pick one too quickly • It may contain correct information but not answer the question asked in stem • Eliminate obviously incorrect options • Most students can reduce down to 2 possible answers • If you have not idea which one to pick……. THEN WHAT?

11. Step 2 Identify key words in stem that indicate negative polarity • Not, except, never, contraindicated, unacceptable, avoid, least, violate • This question is concerned with what is false • If all options appear correct re-read the stem because you may have missed a key negative word.

12. Step 2 question A patient is receiving a low-sodium diet. What food should the nurse teach the patient to avoid because it is high in sodium? 1. stewed fruit 2. luncheon meats 3. whole grain cereal 4. green leafy vegetables

13. Step 3 Identify key words in stem that set a priority • First, initially, best, priority, safest, most • Requires you to rank all options in order of importance • If having trouble ranking • Eliminate option you think is most wrong then next most wrong, etc. • See next slide for strategies for prioritizing

14. Strategies for Prioritizing • ABC’s (airway, breathing, circulation) • Maslow’s Hierarchy of Needs • Physiological always a priority • Nursing Process (ADPIE) • Assessment must be completed before other steps • Safety of patient is going to be a priority • Rarely is “call the physician” a priority

15. Step 3 question The nurse is assigned to care for a patient who is incontinent of urine and feces. What should the nurse use to best protect this patients skin? 1. incontinence pad 2. talcum powder 3. petroleum jelly 4. lamb skin

16. Step 4 Identify key words/clues in stem that direct attention to content • Takes a broad concept and focuses to a more specific aspect of the concept To meet patients basic physiological needs according to Maslow, what should the nurse do? • 1. Assist patient with meals / fluid intake • 2. Pull curtain when patient is on bedpan • 3. Respond to call light immediately • 4. Raise both side rails on the bed

17. Step 4 Word / phrase in stem significant because similar to or a paraphrase of a word or phrase in correct answer What should the nurse do to help meet the patient’s self-esteem needs? • Encourage patient to perform self care • Ask family to visit more often • Anticipate patient needs • Help patient with bathing

18. Step 4 Clang Association • Word / phrase in stem is identical to word / phrase in correct answer What should the nurse do to meet patients basic physical needs. • Pull curtain when providing care • Answer call bell immediately • Administer physical hygiene • Obtain vital signs

19. Step 5 Identify patient centered options • Explore patient feelings, preferences, afford patient choices, and empower the patient • Use therapeutic communication skills to validate the patient’s feelings, fears, and concerns • The patient is the priority

20. Step 5 question • When assisting a patient who recently had an above the knee amputation to transfer into a chair, the patient starts crying and says, “I am useless with only one leg.” What is the nurses best response? • 1. “Losing a leg can be very difficult” • 2. “You still have use of one good leg” • 3. “A prosthesis will make a big difference” • 4. “You’ll feel better when you can use crutches”

21. Step 5 question • An oriented patient states, “I always forget the questions I want to ask when my heath-care provider visits me.” What is the nurses best response? 1. Offer to stay when health care provider visits 2. Remind patient of health care providers next visit 3. Give patient pen and paper to write questions 4. Suggest family member be present to ask questions

22. Step 6 Identify specific determiners in options • A word/statement that conveys a thought or concept that has no exceptions • Always, never, all, every, none, and only are absolutes • These statements with these words are generally false • There are few absolutes in nursing so examine carefully as there are some • All patients should be treated with respect

23. Step 6 question The nurse is giving a bed bath. How can the nurse best improve the patient’s circulation during the bath? 1. use firm strokes 2. use only hot water 3. keep patient covered 4. apply soap to washcloth

24. Step 6 question A patient states the elastic straps of the oxygen mask feel too tight. How should the nurse respond? 1. explain the mask must always stay firmly in place 2. replace face mask with nasal cannula 3. pad straps with gauze 4. adjust the straps to loosen

25. Step 7 Identify opposites in options • When options are opposites, more often than not, one is the correct answer.

26. Step 7 question A nurse understands that the progress of growth and development in all older adults • Slips backwards • Moves forward • Becomes slower • Remains stagnant

27. Step 7 question A health care provider orders anti-embolism stockings for a patient. When should the nurse apply these stockings? • While patient is still in bed • When patient reports leg pain • When patients feet become edematous • When patient gets out of bed in the morning

28. Step 8 Identify equally plausible or unique options • 2 or more options are similar/comparable, one is no better than the other • So… use “If” “Then” technique • If I perform this intervention in the option then what will be the outcome? • Usually equally plausible options are distracters and can be eliminated • If you find 3 equally plausible options then the 4th option will probably appear unique • Ask yourself “Which of these is different?”

29. Step 8 question What is the main reason passive range of motion exercises are performed? • Increase endurance • Prevent loss of mobility • Strengthen muscle tone • Maximize muscle atrophy

30. Step 8 question What should the nurse do immediately before performing any patient procedure? • Shut the door • Wash hands • Close curtain • Drape patient

31. Step 9 Identify Global Options • Which option is more comprehensive than the others • Usually a broad, general statement whereas the distracters are more specific • Pick out the option that is different

32. Step 9 question The most effective way for the nurse to prevent the spread of infection in the hospital is by: • Administering antibiotics to sick patients • Limiting the spread of microorganisms • Isolating patients who are sick • Keeping all unit doors closed

33. Step 9 question When the nurse is repositioning a patient what is the most important principle of body mechanics? • Elevating the arms on pillows • Maintaining functional alignment • Preventing external rotation of hips • Placing a small pillow under the lumbar curvature

34. Step 10 Identify duplicate facts among the options • When each option contains 2 or more facts • Identify 1 fact as incorrect and can eliminate whole option • Increases your chances of selecting correct answers

35. Step 10 question A health care provider orders a 2-gram sodium diet. Which group of nutrients are most appropriate for this diet? • Fruit, vegetables, bread • Hot dogs, mustard, pickles • Hamburger, onions, ketchup • Luncheon meats, rolls, vegetables

36. Step 11 Identify options that deny patient feelings, concerns, and needs • Avoid Pollyanna syndrome – not everything is ok (nor does it have to be) • Don’t diminish patient concerns, provide false reassurances, or cut off patient communication • Options that imply everything will be alright deny the patients feelings, change the subject, encourage the patient to be cheerful, or transfer nursing responsibility to others are usually distracters and can be eliminated

37. Step 11 question The day before surgery for a hysterectomy a patient says to the nurse, “I am worried that I might die tomorrow.” What is the nurses best response? • “It is really routine surgery” • “The thought of dying can be frightening” • “You need to tell your surgeon about this” • ”Most people who have this surgery survive”

38. Summary • Break down into components • Negative polarity • Priority key words • Key words/clues directing to content • Patient centered options • Specific determiners for no exceptions • Opposite options • Equally plausible or unique options • Global options • Duplicate facts in options • Deny feelings, concerns, or needs

39. Best Nursing Practices Keep Patients Safe Optimizing Every Great Decision Delivered

40. General Test Taking Strategies Follow your regular routine night before test • Go to bed usual time • Sleep deprivation decreases reactions time and cognitive skills • Eat normally • Relax • ………

41. General Test Taking Strategies Arrive Early for exam • Use the rest room • Relax • Meditate • Collect thoughts • Avoid comparing notes with other students • Anxiety is contagious – avoid anxious classmates

42. General Test Taking Strategies Mange your time during the exam • Know how much time you have for each question • Stay on target • Use all the time allotted • Read each item slowly • If bogged down move on and come back to that question

43. General Test Taking Strategies Avoid reading into question • Answer question based on information given / stated in stem • When reading stem underline important words • Don’t add information from your own mind • Don’t make assumptions about information given • Read all options before selecting one • Refer back only to words underline as important in stem • Don’t add information to an option • Option may contain correct information but have nothing to do with what the question is asking

44. General Test Taking Strategies Make educated guesses • Reduce the number of options and guess • Trust your instincts • Do not change your answer

45. General Test Taking Strategies Maintain a positive mental attitude • Too much anxiety interferes with your attention, concentration, and problem solving ability • Feel in control by skipping difficult questions • Enhance relaxation by practicing deep breathing • Tell self “I am prepared to do well” “I studied hard” “I will be successful” • Go to your special place of relaxation

46. General Test Taking Strategies Check your answers and answer sheet • Make sure you clearly marked the answers you meant to select • Did you fill in all questions?