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  Introduction: The board exam is a test for entry-level nurses. This means that it does NOT expect you to know everything. So, don’t panic when you encounter questions and you do not have any idea what is  being asked. Use test taking strategies in answering it. After doing an extensive review and you still feel like you don’t know enough, don’t feel bad. It’s natural to be anxious. A little anxiety will actually help you during the board exam as it will keep you alert and focused. Test Taking Strategies: Take time in reading the question, read the question carefully and find out what the question is asking. Keywords are very important. Keywords in the question are usually associated with the option containing the right answer. Be aware of the time, i f you don’t know the answer take a deep breath and proceed to the next question. You need to answer each question for around 1 minute. The remaining time will be spent on taking a break once in a while when you feel tired and shading your correct answers to your answer sheet. I personally recommend a 3 minutes break every 20 minutes of answering questions.  Never, change your answer unless you are absolutely sure with your new answer. (Erasures in answer sheets are not recommended) When answering questions which you have no idea, choose the longest option. It takes more words to make the statement correct and also remember that more words may also make the statement wrong so read them carefully. Always focus on the Patient’s Ability rather than the Patient’s Disability. Interventions must be client/patient centered. In choosing answers, always begin with INDEPENDENT NURSING ACTIONS.  Nursing interventions: Independent are nursing actions that the nurse may perform for the patient without the need of a doctor’s order. Interdependent are nursing actions that collaborates with other members of the health team (Patient, Dietitian, Med-techs, Pharmacist etc.). Dependent are nursing actions that requires a doctors order. Example: The nurse is caring for a patient with a fever. During the morning rounds, the patient complains of headache. The nurse proceeds to check the temperature and finds it to be elevated at 37.9 C, the nurse should: a. Administer paracetamol to relieve headache and fever as ordered  b. Perform a tepid sponge bath c. Document the temperature and call the Physician d. Check CBC for signs of infection In the example above, the independent nursing action is option B. Therefore option B is the correct answer. Choose the option that is totally different from the other choices and stick with it. Example: The nurse is caring for a patient on heparin infusion. During the morning care, the patient complains of sore gums after brushing teeth. The nurse should:  a. Stop the infusion  b. Notify the doctor c. Assess for bleeding d. Administer protamine sulfate In the example above, options A, B, and D are all nursing interventions. Only option C involves nursing assessment. Therefore option C is the correct answer. If you don’t know the right answer, look for the wron g answer and try to eliminate it first. This will narrow down your options. Another Test Taking Strategy is that if the question is asking for a positive answer, choose the answer with positive result and vice versa. Absolute words are usually negative. Choices with “always” “all” “never” “only” are considered negative. Nursing science in not absolute.  If you encounter options that are all correct, look for the umbrella type of option that fits all the other option. Remember that no two option can be correct at the same time. One of my favorites among the Test Taking Strategy is that if you have no clue for any of the option, choose option C. Option C is usually the best or the worst answer that you could come up with. If you are the examiner, you always put more thinking of the option C making it a tricky option. All of the Above option, and you are positively sure that two answers are correct, and one option is doubtful, choose the All of the Above option. Remember that no two option can be correct at the same time. The Coma, Coma and Rule in Test Taking Strategy To use this, first categorize the options with the same answers, then look for the answer that is incorrect. All other option with the incorrect answer are wrong. If the question asks about “What Nursing Action” Always think about the NURSING PROCESS “A.D.O.P.I.E.”   If the question asks about “Patient needs” Always think about the “MASLOW’S HIERARCHY OF NEEDS” and remember that PHYSIOLOGIC NEEDS is priority.   If the question asks you about “Prioritization” Always think about the (ABC) Airway, Breathing, and Circulation. If you cannot find these, choose the option which prioritize SAFETY. In eliminating options, the similar options are automatically wrong options. For example  bradycardia and slow pulse. Since both have the same meaning, automatically eliminate both of these option. No two option can be correct at the same time. Look for opposite options. Example: High Blood Pressure and Low Blood Pressure. These options are the exact opposite. One cannot exhibit both symptom at the same time making one of the option correct.  In Psychiatric Nursing, verbalization of patient’s feelings is very important. Remember not to reinforce hallucinations and delusions. Acknowledge feelings and present reality. Nursing diagnosis is usually focused on Altered thought process/content. Goals set for patient/client is to have an optimal level of functioning. In a community setting, the Vision Statement have words like disease free and progressive health for Filipinos. The Mission Statement have words like availability, accessibility, and affordability. The Goals Statement have words like promote, reduce, quality and equality of health for men and women. Do practice in answering Nursing Board Exam Questions everyday as this will help you to develop test taking strategies. You need to answer at least 2000 Nursing board exam questions for you to pass the local board exam. Other Test Taking Strategies in Taking the Nursing Board Exam 1. Read Questions Carefully Scores on tests are greatly affected by reading ability. In answering a test item, you should begin by carefully reading the stem and then asking yourself the following questions: ã What is the question really asking?   ã Are there any key words?   ã What information relevant t o answering this question is included in the stem? ã How would I ask this question in my own words?   ã How would I answer this question in my own words?  After you have answered these questions, carefully read the options and then ask yourself the following questions: ã Is there an option that is similar to my answer?   ã Is this option the best, most complete answer to the question?  Deal with the question as it is stated, without reading anything into it, or making assumptions about it. Answer the question asked, not the one you would like to answer. For simple recall items the self-questioning process usually will be completed quickly. For more complex items the self-questioning process may take longer, but it should assist you in clarifying the item and selecting the best response. 2. Identify Key Words Certain key words in the stem, the options, or both should alert you to the need for caution in choosing your answer. Because few things are absolute without exception, avoid selecting answers that include words such as always, never, all, every, only, must, no, except, and none. Answers containing these key word are rarely correct because they  place special limitations and qualifications on potentially correct answers. For example: All of the following are services of the National Kidney Foundation except: 1. Public education programs 2. Research about kidney disease 3. Fund-raising affairs for research activities  4. Identification of potential transplant recipients This stem contains two key words: all and except. They limit the correct answer choice to the one option that does not represent a service of the National Kidney Foundation. When except, not, or a phrase such as all but one of the following appears in the stem, the inappropriate option is the correct answer   —  in this instance, option 4. If the options in an item do not seem to make sense because more than one option is correct, reread the question; you may have missed one of the key words in the stem. Also  be on guard when you see one of the key words in an option; it may limit the context in which such an option would be correct. 3. Pay Attention to Specific Details The well-written multiple-choice question is precisely stated, providing you with only the information needed to make the question or problem clear and specific. Careful reading of details in the stem can provide important clues to the correct option. For example: A male client is told that he will no longer be able to ingest alcohol if he wants to live. To effect a change in his behavior while he is in the hospital, the nurse should attempt to: 1. Help the client set short-term dietary goals 2. Discuss his hopes and dreams for the future 3. Discuss the pathophysiology of the liver with him 4. Withhold approval until he agrees to stop drinking The specific clause to effect a change in his behavior while he is in the hospital is critical. Option 2 is not really related to his alcoholism. Option 3 may be part of educating the alcoholic, but you would not expect a behavioral change observable in the hospital to emerge from this discussion. Option 4 rejects the client as well as his behavior instead of only his behavior. Option 1, the correct answer, could result in an observable behavioral change while the client is hospitalized; for example, he could define ways to achieve short-term goals relating to diet and alcohol while in the hospital. 4. Eliminate Clearly Wrong or Incorrect Answers Eliminate clearly incorrect, inappropriate, and unlikely answers to the question asked in the stem. By systematically eliminating distractors that are unlikely in the context of a given question, you increase the probability of selecting the correct answer. Eliminating obvious distractors also allows you more time to focus on the options that appear to be  potentially sound answers to the question. For example: The four levels of cognitive ability are: 1. Assessing, analyzing, applying, evaluating 2. Knowledge, analysis, assessing, comprehension 3. Knowledge, comprehension, application, analysis 4. Medical-surgical nursing, obstetric nursing, psychiatric nursing Option 1 contains both cognitive levels and nursing behaviors, thus eliminating it from consideration. Option 4 is clearly inappropriate since the choices are all clinical areas. Both options 2 and 3 contain levels of cognitive ability; however, option 2 includes assessing, which is a nursing behavior. Therefore option 3 is correct. By reducing the  plausible options, you reduce the material to consider and increase the probability of selecting the correct option.
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