Test Taking Skills Successfully Preparing for HESI & NCLEX-RN

1. Test Taking SkillsSuccessfully Preparing for HESI & NCLEX-RN LeeAnn Danner-Wilson

2. Worth your time, paper, and ink to download! • NCLEX Examination Candidate Bulletin • http://www.pearsonvue.com/nclex/ • Will provide you with all the information you need about testing and filling out your paperwork!

3. Taking the NLCEX-RN Testing Center • Plan to arrive 30 minutes early. If you are 30 minutes late you forfeit your appointment. • Will need your Authorization to Test (ATT) Form • 2 forms of ID that are signed and current • Names must match • A digital fingerprint, signature, and photograph will be taken at the test center and accompany the NCLEX results to confirm your identity.

4. Taking the NLCEX-RN • If you leave the room, you will be required to have your fingerprint taken to re-enter • Personal belongings are not allowed in the testing area • Family members or friends are not allowed to wait at the testing center.

5. Testing Center Continued • Once you complete the admission process and a brief orientation, the proctor will escort you to your assigned computer. • Work space • No electronic devices are allowed • No items are allowed in the room • You will be observed at all times (video and audio recordings) • If typing bothers you, request ear plugs • MUST follow directions of the test center staff; can not leave your seat unless authorized by the proctor.

6. Taking the NCLEX-RN • Time • 6 hours which includes: tutorial, two preprogrammed optional breaks (2 hours, 3.5 hours), any unscheduled breaks. • How many questions? • Minimum is 75; of those 75- 60 will be scored and 15 will be unscored • Maximum is 265 • The computer cut me off……. • You are now finished. At this point you will complete a questionnaire about your testing experience. • Pass or Fail • All of the examination questions are categorized by test plan area and level of difficulty.

7. Test Plan Each Examination Question will address: Levels of Cognitive Ability Client needs category Integrated Process

8. Levels of Cognitive Ability • Knowledge • Comprehension • Application • Analysis

9. Client Needs • Categories/Subcategories • Safe, Effective Care Environment • Management of Care • Safety and Infection Control • Health Promotion & Maintenance • Psychosocial Integrity • Physiological Integrity • Basic Care and Comfort • Pharmacological & Parental Therapies • Reduction of Risk Potential • Physiological Adaptation

10. Integrated Processes • Caring • Communication & Documentation • Nursing Process • Teaching/Learning

11. Preparation • Developing a Study Plan • Good Time Management • Calendar • Study Sessions • Quality vs. Quantity • Materials needed • Computer • Questions & Answers • Special Notebook • HESI • Minimum of 100 Questions a day • NCLEX-RN • Minimum of 200 Questions a day

12. Preparing the Night Before • Good nights sleep • Be confident (positive self talk) • Eat Breakfast • Set your alarm early • Be prepared • Avoid conversations • Don’t study the day of!

13. MEMORY DUMP

14. Just a few facts….. • Nursing exams are difficult because the questions ask you to make judgments and apply information-not just recall facts. • No matter how hard you study or how much you can recall, you will not pass unless you can apply your nursing knowledge and make good nursing judgments.

15. First Things First • Setting the Stage • Glass House TheoryAnswer your questions as if the situation were ideal, and you had ALL the resources and time needed. The only client you need to be concerned with is the one in the question • Perfect Medical World

16. Components of a Question • Case Scenario • Stem • Four Answers

17. My New Routine • After reading the Question ask: • What is the question telling me? • What is the question asking me? • Who is the patient in the question? • Are there any key words? • What is the issue?

18. First • What is the question telling me? • What is the question asking me? • Look at the stem!!!!

19. Second • The Client • Who is the focus of the question? • You must identify the client in the question because the answer MUST relate to the client. • The client is NOT always the patient, it sometimes is a family member.

20. Example • A nurse will be going on vacation. To involve the patient in the excitement, what is the best thing the nurse should say ? • A. “Let me tell you about the plans for my vacation.” • B. “Tell me about some of your past vacations.” • C. “I’ll bring the brochures for you to see.” • D. “What do you think about vacations.”

21. Third • Key Words (Circle These) • The important phrases or words in a question • Early • Late • Immediately • Most likely, least likely • Initial • After several days

22. Last • What is the issue in the question? • The specific problem or subject which the question is ASKING • Drug Problem • Toxic Effect Behavior • Disorder Procedure

23. After Reading the Question • Cover up the answers • Read each answer individually • Write out beside why that question • Mark out the ones that are for sure incorrect • Question mark the maybes

24. Pitfalls • Reading into the question • Asking “well what if….”

25. Reading into the Question based on REALITY • A client is admitted to the hospital for an exploratory laparotomy. The client’s daughter says to the nurse, “I wish I could stay with my father, but I need to go home to see how my children are doing. I really hate to leave my father alone at this time.” The best nursing response is:

26. Answers • Your father needs opportunities to be independent. This will help him become self-sufficient.” • “Your father is capable of taking care of himself. Try allowing him more independence.” • “Stress is not good for your father at this time. Perhaps you could call your children.” • “You are feeling concern for both your father and your children. Let me know when you are leaving, and I’ll stay with him.”

27. Eliminating Incorrect Options • Distracters are incorrect options that are designed to resemble the correct answer. They are intended to DISTRACT you from answering correctly. • Read your answers • Cross out the no’s • Question mark the maybe’s

28. Misreading Test Questions • Incorrectly analyze what is being “asked” • Overlook key words • “Read into” the question • Incorrectly interpret a disorder

29. Helpful Tips • To avoid reading into the question • Restate in your own words • Eliminate options that includes “new” information • Eliminate options that require you to make assumptions

30. Problem • My problem is I get narrowed down to 2 answers and I always pick the wrong one!

31. Guidelines • If you are left with two questions marks and can’t make a decision go with your gut instinct! • Using a selection procedure allows you to make educated guesses. When you narrow to 2, you have a 50% chance of guessing correctly!

32. How to Choose the between the best 2 options? • Use testing strategies • Global Response • Similar Distractors • Similar words or phrases

33. Remember • Testing is like playing a game! When you want to win, you need to strategize. The following are some of your strategies!

34. Global Response • A global response is one that is a general statement and may include the ideas of other options within it. • This option is often the correct answer when 2 or 3 more specific options appear equally correct.

35. Practice Using Global Response • The nurse assigned to care for a child with cerebral palsy should obtain information concerning the child’s abilities, limitations, interests, and habits, because the aim of therapy is to: • Assess the child’s assets and potentialities and capitalize on these in the rehabilitative process, while overlooking limitations. • Reverse abnormal functioning and restore the brain function through rehabilitation. • Provide a therapeutic program that avoids subjecting the child to frustrating experiences that decrease achievement. • Develop an individualized therapeutic program that uses the child’s assets and abilities to achieve success as well as develops the child’s ability to cope with frustration and failure.

36. Answer • 4- This is an APPROPRIATE goal for CP therapy. This is also a global option, since it includes recognizing the child’s assets and helping the child to cope with frustrations and failures due to limitations.

37. Similar Distracters • Always remember there is only 1 correct answer. • If 2 options say the same thing or include the same idea, they can’t be correct. • Answer is the option that is different.

38. Practice using Similar Distracters • A newly diagnosed adult diabetic is demonstrating of the proper technique for insulin injection. The client draws the correct dose of insulin using the proper technique, but when ready to inject the needle, hesitates and says, “I am not sure I can do this.” Which response by the nurse would be best initially?

39. Answers • “I will show you how to inject the needle.” • “I will inject the needle for you this time.” • “You are doing fine so far. Give it a try.” • “Why are you so nervous? Do you need help?”

40. Answer • 3- This is the correct answer because it focuses on the client being encouraged to do the procedure.

41. Similar Words • First use Global Response • Second use Similar Distracters • If still no hope, try similar words, phrases. • If you find a word, feeling, or behavior used in the stem or the case scenario that is repeated in one of the options, that option MAY be the correct answer. • Not the most reliable strategy

42. Using Similar Words • A client has sustained a fracture of the tibia and fibula. In providing nursing care for this client, who has a newly applied long-leg cast, which consideration is vital?

43. Answers • Elevation of the leg in the cast on a pillow will minimize edema. • Healing of a fractured bone requires an extended period of time. • A long period of immobility may lead to atrophy of the muscle. • Analgesics may be needed for pain associated with the fracture.

44. Answer !. When caring for a client with a newly applied cast, it is IMPORTANT to keep the affected extremity above the level of the heart to reduce swelling. Key words are “leg” and “cast”

45. Levels of Cognitive Ability Practice

46. Knowledge Questions • Knowledge questions require you to “recall” or “remember” information. To answer a question you need to commit facts to memory.

47. Knowledge Question • The first step of the procedure for making unoccupied bed is • A. Pulling the curtain • B. Washing your hands • C. Collecting the linen • D. Placing the bottom sheet

48. Answer • B- because you need to know the sequence of steps in the procedure of making an unoccupied bed or the basic principles that your hands must be washed before ALL procedures.

49. Comprehension Questions • Require you to understand information. To answer a comprehension question, you must commit facts to memory as well as translate, interpret, and determine the implications of that information.

50. Comprehension Question • To evaluate the therapeutic effect of a cathartic, the nurse should asses the patient for: • A. Increased urinary output • B. A decrease un anxiety • C. A bowel movement • D. Pain Relief